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:PERMIT=APPLICATION = <br /> rD.RIVEWA"Y PERM- i .AP.PLICAT:ION <br /> CONSTRUCTION WITHIN:}P.UBL'IC=RIGHT•O.F=WAY <br /> All information must-be-filled-in completely <br /> (City.of2ephyrhills <br /> -5335-e Street,Zephyrhllls,TL 33542 <br /> Telephone.813.780.0000 Fax 813.780.0005 <br /> g 'i X ,$ .,s. _ `• ,•ss. ^. ' �.s `` "` _. "t{: '•' .., '$ice,: .}' y,�.y• k <br /> �r� •E�7x1 M .r' sS;s' �' ;fit'• . -�"€, " i."_ ;--�a`'�.:<.-S'.:. � x,. <br /> .PRO3EC-T .9 i .PROPERTY'OWNER <br /> Address: Name: Ot'YG� <br /> Unit#: 4 Address: � ,.r Unit: <br /> Parcel Identlflcdtion-Num er: Ci State .Zi r <br /> Q'U o -0 G 7120 - CJ -Phone: ax: <br /> --CONTRACTOR: <br /> Company: ItMnjl . 5*01tylorl <br /> Name: <br /> Contractor's License#: E-Mail: <br /> -Phone: Cell: - Fax: <br /> ARCHITECT/ENGINEER: <br /> Name: LFirm Name: <br /> / )� <br /> Address: City: State: Zip: <br /> State License#: Phone: Cell: Fax: - <br /> Description of Project <br /> TYPE OF DRIVEWAY a�f i� S LENbTH 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 /> CONSTRUCTION MATERIAL CURB CUT REgZRED <br /> ASPHALT YES —NO <br /> •CONCRETE <br /> DWA L REQUIRED? YES fNO <br /> NOTICE TO APPLICANT If actual work exceeds scope of this description,additional permits or drawings <br /> -will be required. <br /> UTILITY LOCAT16NS REQUIRED: CALL BEFORE YOU DIG: 1.800.432.4770, <br /> Page 1 of 3 <br />