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C Mt <br /> PERMIT APPLICATION <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <br /> All information must be filled-in completely <br /> City of Zephyrhilis <br /> 5335 8t'Street,Zephyrhills, FL 33542 <br /> Telephone.811780.0000 Fax 813.780.0005 <br /> u'g< rda,r`..^--•�'::c�cx �i:.�..„�,:u„ �i_;:s,3;.,:.� -- K:.4. _- - -::a::zXt "-y7! -*r r -.:. sanc?;� 'k. <br /> "'�` Permit#• '�' <br /> .-� _ � � ';a.� '- � H•��� {gray�� tGrstaff"us�'.«EY),�'s'�' -�s 3h. _ w �u <br /> PROJECT .IOB SITE: PROPERTY O NER <br /> Unit#: Address: Unit: <br /> Parcel Identification Number: city,State zip 3 <br /> Phone: J0 12 jEe&aax: <br /> CONTRACTOR: <br /> company: — V tZn <br /> -Name: <br /> Contractor's License.#: <br /> Phone: Cell: F <br /> ARCHITECT/ENGINEERc _ <br /> Name: . Firm Name: <br /> Address: City: State: Zip: <br /> State License#: Phone: :Cell: Fax: <br /> Destfttion of Protect <br /> TYPE O DRIVEWAY 3 LENGTH OF DRIVEWAY CULVERTS NEEDED' <br /> ' _ ESIDENTIALDRIVEWAYWIDTH OF DRIVEWAY ( )REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R:O EXCAVATION { }CORRUGATED MATERIAL . <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEET ( )BOX CULVERT <br /> ( )OTHER(EXPLAIN) , <br /> CONSjw CTION MATERIAL CURB CUT REQYjRE_D— <br /> ,ASt HALT YES _eENO <br /> CONCRETE <br /> HEADWALL REQUIRED? YES NO <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description,additional permits or drawings <br /> wilt be required. <br /> UTILITY-LOCATIONS REQUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />