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PERMIT APPLICATION <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <br /> All information must be filled-in completely <br /> City of Zephyrhills <br /> 5335 8th Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> _Date of applicatign: Processed By Permit#: <br /> (gray area for staff use onty) <br /> I]Copy to Building Department I]Copy to;Public Works <br /> PROJECT/JOB SITE: PROPERTY OWNER <br /> Address:SCO$ S Name: 1Z J- $r,-\ Inc. <br /> Unit#: Address:QkZIZ- I-e I rren"DC Unit: <br /> Parcel Identification Number:'- - _ 66- City, State Zip <br /> Phone: Fax: <br /> dy-k a-fin, cbm <br /> CONTRACTOR: <br /> Company: 1 K 46I+n r"(-. <br /> Name: -\)C;\1'�d &ICA9 <br /> Contractor's License #:cla"g qpci�2- <br /> Phone: `Z,(3-;jq-3z9g Cell: Fax: <br /> ARCHITECT/ENGINEER: <br /> Name:-TW jp;,(fr, Firm Name: <br /> Address:9(m1,cwnr� r�� x1� .si lust City:S�rqT'�v;ll� State: Zip: <br /> State License# Phonegp� -(v Iq• ,z2 Cell: Fax: <br /> Description of Project <br /> TYPE OF DRIVEWAY LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> _�,ARESIDENTIAL 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 /> (CONSTRUCTION MATERIAL CURB CUT REOUIRED )OTHER(EXPLAIN) <br /> �15PHALT 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 />