Laserfiche WebLink
PERM T APPLICATION <br /> UTILITIES LOCATE CONFIRMATION NUMBER: , <br /> PROVIDE SKETCH IN THIS AREA, IF AI[ DITIONAL SPACE IS REQUIRED, ATTACH TO THIS <br /> APPLICATION. . <br /> W�� <br /> I� <br /> 41 <br /> r I/e� �8��'�✓-�� try <br /> V . - <br /> Y EDG11- <br /> E P4 . <br /> OM <br /> 19 <br /> AFFIDAVIT: Application is hereby made to obtain a permit to do work and installations as Indicated.,I certify that all foregoing <br /> information is accurate and that all work will comply with all applicable codes, I understand these codes shall take precederice over all <br /> approved constructiowdocuments,.and issuance of this permit is verification that I will notify the property owner of Florida Uen Law <br /> req.,F:S.713: <br /> The Issuance of this permit does not erisure cornpliance with deed restrictions and I understand that additional deed: <br /> restrictions may apply to this Property. <br /> A11-w- o' rit.shell comply with the.current Floelft Building Code,Public Work Design Manuai:and FDOT®ea14". <br /> SWndnrds(if apPlicable): (Public Works Design Manual online link:www.ci.zeptiyrhilis.fl.us/public_works.asp) <br /> APPLICATION IS VOID UNLESS SIGNED WITH PROPER IDENTIFICATION AND WITNESSED BY A PERMIT <br /> TECHNICIAN-OR NOTARY PUBLIC. <br /> NQTE, The City of Zephyrhilis Is not responsible for maintinance or repairs of driveways. DrivewaYs shall not alter/ <br /> hiterfere-with existing storrnwater.treatment and j or conveyance.. <br /> PROPERTY OWNERS: By signing this application: I certify that I have read and understand the owner/builder disclosure <br /> statement. (please initial) <br /> Applicant Print Name Applicant Signature Date . <br /> .Permit Technician Signature (or)Notary Signature Date <br /> Applicant is( )personally known to,me or produced as identification. <br /> (type of Identification) <br /> Page 2 of 3 <br />