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E <br /> PERMIT APPLICATION - � <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <br /> All information must be filled-incompletely <br /> City of Zephyrhills <br /> 53358. Street, Zpphyrhills, FL 33542 <br /> Telephone 813.78 nQ.0000 Fax,813,780.0005 <br /> ss:cr�r^�r-P/nA`MW+r ,=z• Permitp;#�Pr ocessed r q_ <br /> rr <br /> xs <br /> PRO3ECT/30B SITE: PROPERTY OWNER <br /> Address:%M*7 50 C t Name: <br /> unit# . 2, A Address: r Unit: <br /> Parcel Identification Number: City,State Zi afz �. <br /> Phone: ax: <br /> CONTRACTOR:. <br /> ,Company: w6e� <br /> Name: a, <br /> Contractor's License #: Mail: ck-\cI. l C <br /> Phone: celf.A k 21 Lj�; 67qqt2 fax: <br /> ARCHITECT/ENGINEER <br /> Name: Firm Name: <br /> Address: City: State: Zip: <br /> State License.#: .. Phone: Cell: Fax: <br /> Description of Proiect <br /> TYPE OF DRIVEWAY � LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> _LLRESIDENTiAL DRIVEWAY DTH OF DRIVEWAY ( )REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.O.W. EXCAVATION_ ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEET ( )BOX CULVERT <br /> C )OTHER(EXPLAIN) <br /> CONST CTION MATERIAL CURB CUT REOUISM <br /> L-IKSPHALT. 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 required. <br /> UTILITY LOCATIONS REQUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />