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_N/j <br /> 1-10i <br /> - <br /> PERMIT APPLICATION - _ `�-----� <br /> DRIVEWAY PERMIT APPLICATION: . -- <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF=MONY_"�"���������-�--�' <br /> All information must be filled-in completely <br /> City of Zephyrhills <br /> 5335 a Street, Zephyrhills, FL 33542 <br /> Telephone 813.786.0000 Fax 813,780.0005 <br /> 906 <br /> _ ._�W_ <br /> ce. P., !{ <br /> PRO3ECT JOB SITE: P OPERTY OWNER <br /> Address, 5-6/0 /8-1h Sit-Pef Name: ,1ve_J &1e4f.S <br /> Unit#: Address:3/325 e_/eA. g Unit: <br /> Parcel Identification Number: City, State-Zi _a. e Gi-t Ft- 33 5 2 <br /> it-2(P ?-1-0010.Z1 a s - ax-1 o Phone;, <br /> CONTRACTOR: <br /> Company: 8 u-"e,,- •e/ l•�yc�IM�r��/ jn c <br /> Name:le_-i OtA tHcr� J <br /> Contractor's License #: C R C 13.3 2-41g5 E-Mail`. e %n ve J�r�l.� s @ Qr•-�ai/ c�, <br /> Phone: 8 i3-'q7 3-5 ZS 6 Cell:jp 3-2,/S-JY 9S Fax: <br /> ARCHITECT/ENGINEER: <br /> Name: Firm Name: <br /> Address: City: State: Zip: <br /> State License #: Phone: Cell: Fax: <br /> Description of Project <br /> TYPE OF DRIVEWAY LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRIVEWAY WIDTH OF DRIVEWAY { )REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.O.W. EXCAVATION O CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEET { )BOX CULVERT <br /> { )OTHER{E)(PLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REQUIRED <br /> ASPHALT YES NO <br /> CONCRETE <br /> HEADWALL REQUIRED? YES NO <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description,additional permits or drawings <br /> will be irequired. <br /> UTILITY LOCATIONS REQUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />