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r i <br /> PERMIT APPLICATION G„ <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLI_ C RIGHT-OF-WAY Ott-) <br /> All information must be filled-in completely <br /> City of Zephyrhills <br /> 5335 0 Street, Zephyrhift FL 33542 <br /> Telephone 813.780.009-0 ' Fax 813.780.0005 <br /> flue ofa icatibn:� c _ �.,�.; =•> Prac d B, � :c, =` �; P rmit;#e �"„,,.;;.k � ���� ,_ <br /> �.�- t •.l �' "� L9ray` for ff,u " nJY} _ •.. -` �; ` <br /> 'r�.. .�- �. .��..� <br /> PROJECT 30B SITE: PROPERTY OWNER <br /> -Address:' —3 D Z . 026 O. 8 Name: a ` 7 if <br /> Unit#: Address:-,t4 j <br /> Parcel Identification Number: . L714 City,-State,Zip <br /> 7 . <br /> Phone: . F x: <br /> CONTRACTOR: <br /> Com an : -t M G cyou k Y\ <br /> . .Name: HfAAMh nLc�"- j <br /> Contractor's.License#: -Mail: JAM <br /> Phone: ell: l Fax., <br /> ARCHITECT.JENGINEER. <br /> Name: Firm Name: <br /> Address: City: State: Zip <br /> State.Litense#: Phone: Cell: Fax: <br /> Description.of Proiect <br /> TYPE- DRIVEWAY �J LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRIVEWAY WIDTH OF DRIVEWAY ( ')REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R,O.W. EXCAVATION CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR'FEET ( )BOX CULVERT - <br /> ( )OTHER(EXPLAIN) <br /> cokgEsucr M-ATERIAL . CURB CUT REQUIRED-- <br /> ASPHALT YES. <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 REOUIRED: CALL BEFORE YOU DIG: 1.$00.432.4710. <br /> Page 1 of 3 <br />