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r ERMIT APPLICATION <br /> DRIVEI WAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC.RIGHT-OF-WAY <br /> All information 1ga be filled-in Completely <br /> City of Zephyrhills <br /> 5335 a Street,Zephyrhills, FL 33542- <br /> f Telephone 813.780.0000 Fax 813.780.0005 <br /> .:r., <br /> Date of application ,' �, *P�aress�ed��.ty„�• � .x Perrnit# � ,�=-. ��. �°,:�:"��c��a <br /> '�1Co�y,to ilclmgDep (#meet' 1; CIGQP 14 Publ► Y}torlss ,a <br /> PRO3ECT/3013 SITE: P OPERTY OWNER <br /> Addressi -517 Z h S '= e. Name: �f . n tre n-►�.�{� . <br /> Unit.#: Address'312 r,�",/ea.J Unit: <br /> Parcel Identification Number: - CiN,State Zip D7 de Gi FL 2 - <br /> Z fe_=2-1- d p'l d =P 21 O o 0 V7 0 Phone2/_?�,9�7g�2:,S o FcW- <br /> CONTRACTOK: <br /> Company: Add <br /> .Namur' ei <br /> Contractor's License #: C 'L E-Mail: J, oj,7 <br /> Phone: Cell: 13 72.4o.S- Fax: <br /> ARCHITECT/ENGINEER: <br /> Name: Firm Name: <br /> Address: City: Stater Zip: <br /> State License #: Phone: Cell:- Fax: <br /> Description of ProiecE <br /> TTY-PE&F DRIVEWAY LENGTH OF DRIVEWAY CULVERTg NEEDED <br /> je! RESIDENTIAL DRIVEWAY 7 _WIDTH OF DRIVEWAY ( )REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY. 1t.04 f'. EXCAVATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEEL ( }BOX CULVERT <br /> CONSTRUCTION MATERIAL CURB CUT RE_�c U11 ECG ( )OTHER(EXPLAIN) - <br /> SPHALT YES ti� NO <br /> CONCRETE /^ <br /> HEADWALL REQUIRED? YES y NO <br /> I• <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this descrip#i�n,additional permits or drawing's <br /> h will1 be required. <br /> UTILITY LOCATIONS REQUIRED CALL BEFORE YOU DIG: 16800.432.4770 <br /> Page 1 of S <br /> t <br />