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:PERMIT-APP.LICAT1OiV ' <br /> DRIVEWAI( PERM.IT:AP,PL.ICATION <br /> CONSTRUCTION WITHIN:PUBLIC=RIGHT--O.F=WAY <br /> All Information-mu be-filled-in completely <br /> :City.of2ephyrhilis <br /> '5335:e Street,Zephyrhiils,-F.L 33542 <br /> 7elephone.813.780.0000 Fax 813.780.0005 <br /> . ):• cry ..,u.-f.:.w.a?S:'Ki: �-�.ari %.1�.�.-.s::zF. 'w5a�:µ -- - - <+e:tin..�� -,:ri:'r.- --uJ�"� r ::.- ' <br /> [��� loce6on i�:...a.a>t,�..'-i.�s:,�$`.w ?_h aGl`�LOSGY{p.���'i..zv%.1�_..ef �' .s+1-+.:�:.` ',t-��Eilnd :'�`C _ _d •:53,; -"".cis_.yr-7."::':.x, <br /> t-',--�`—;i,rY,�-�r.':s; ;r3J� .,r;�r."-;,�e�:.. �a~a. s• �'=aA�._• -e1":.�..,x...:cv;�ay .:v-�%�n ,1;:..,:- _.��e t�'S .itc;.C; <br /> :?L'°z�::s::- "ir..a.; �'.:. �`'3''w....u.�e�" �:�-s�.:�i°=�S _}�,�-F.:�s�28�0[ :(1111�.. �r,n'e�d ;��r"s��k•.a.-`r.-.;; ^'�..;�'�,...,�ita .es... _i•.z'.t�-..4.$)rc:.i'i'` - <br /> 1 Y: t * "�. .��:_ &:.: .r..`�:a K'a Y.. _v s...i�;... - -.�,� T,r��t F s>,...sS�u _- - .;:•:�,•, �a.w ,r_.� -1".,. <br /> i Y.e.`"�'zs- ."[: '.�,y. .-` ;",c)a ';4. 5.`'�•.,^=. .� � � .�'...s<s.�a '�s-� <br /> VR03ECT -70B{SITE: -PROPERTY'OWNER <br /> Address: 3 Qt1i Name: 6119 1vr i 9 C/4N.0 <br /> Unit#: Address: 6'06 3 57- Unit: <br /> Parcel Identification Number: State -zip Z,'g 0 �1�5 F4 <br /> Q®!0 -/ 0 0-06y 0 'Phone: 02-0-5-6 I Fax: <br /> s - <br /> i <br /> ',CONTRACTOR: <br /> Company: A'GMMINtvw u'e'(iiR ,tf 664I - m joao2 ; <br /> Name: r v <br /> Contractor's License 11 D If It / E-Mail: <br /> Phone: a I 5a 7 Q 1,9 W 'Cell: Fax: <br /> ARCHITECT/ENGINEER: <br /> Name: Firm Name: <br /> Address: City:! State: Zip: <br /> State License#: Phone: Cell: Fax, <br /> Description of Proiect <br /> s <br /> TYPE OF DRIVEWAY 5 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 /> CONSTRUCTION MATERIAL CURB CUT REQUIRED ( )OTHER(EXPLAIN) <br /> ASPHALT 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 />