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PERMIT APPLICATION <br /> DRIVEWAY PERMIT'APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-CAP-WAY <br /> All information us be filled-in completely <br /> City of Zephyrhills' <br /> 5395,8�'Street,Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> Date,gfapplYcafidn: Prooesseii 8y` . ... PemiYt;#: . <br /> ' TgtO,arm tar st�S sue onN}" - <br /> Citbpy tOOB Idin :De arfriieiit,_ <br /> . <br /> 9 P (]Copy3o'P1j*.Works " <br /> PROJECT 30B SITE: PROPERTY OWNER <br /> Address: Gtr Name: o�t>y '�o�✓ <br /> Unit:#: Address: . 0. " Unit: <br /> Parcel Identification Number: City,State,Z e y7r3 FG: i35`f z <br /> Phone / a2,?YJ Fax: <br /> CONTRACTOR: <br /> Company: <br /> Name. <br /> Contractor's'License#: E-Mail: <br /> Phone: Cell: Fax: <br /> ARCHrf ECT/ENGIMlEER: <br /> Name: Firm Name: <br /> Address: City: state: Zlp: <br /> State License#: Phone: Cell: Fax:: <br /> Description of Project <br /> TYPE OF DRIVEWAY . /3VO-LENGTH OF,DRIVEWAY CULVERTS NEEDED <br /> LRESIDEM7A,L DRIVEWAY =ffWIDTH OF DRIVEWAY ( )REINFCikCED CONCRETE <br /> -COMMERCIAL DRIVEWAY F3 O.W. EXCAVATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEET ( )BOX CULVERT <br /> _ fl3t1STRUGTION MATERIAL CURB CUT REQUIRED ( }DER(EXPLAIN) <br /> C <br /> ____ASPHALT YES NO <br /> -JeCfCONCRETE <br /> HEADWALL REQUIRED? YES NO <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description,additional permits.or drawings: <br /> Will be required. <br /> UTILITY LOCATIONS REQUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br /> iI , <br />