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PERMIT APPLICATION <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OE-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 /> �L "F ..k_"^ w „a-'• !v*,•. _ _ -4- '.�T - - <br /> cc�� y C., " -�'�c, m <br /> Wt?, -r E . _ - i <br /> _ _ ,,}u ti L, <br /> 'Y'wZ' M 1if ��l�i• 1.-.Jtu:N fri rAp �i' t����,I,NI .�i n'"+z''-F. 1t+r.ul{t?II�.e _ e. v_-_si�tN r 3#. _ Y IA, r�T! -•bum {fiF1�1ai:_ �h <br /> PROJECT/JOB SITE: PROPERTY OWNER <br /> Address: 7/6 64q zrvi, Name: P Wo,44ge-, _:Z .c <br /> Unit#: Zo-r ,// /s_ Address: i 6c)p`T-e 1� .a�, Unit: <br /> Parcel Identification Number: City, State Zi <br /> 3Z S-Z/ -D040-o/Qoa-olio Phone: " ,/5G Fax: <br /> CONTRACTOR: <br /> Company: Q r4.0 <br /> Name: i-D v c,P 61 -L3 ape_ <br /> Contractor's License #: G C 03 E-Mail: L)r)f. orJdn Ccrrh <br /> Phone: 1�' S`/`/-3 j Cell: 'Fax: <br /> ARCHITECT/ENGINEER: <br /> Name: A'& 12e- Firm Name: <br /> Address: �"y �'/'� :�.,��� L�.��City:j G State: �L Zip: <br /> State License #: Phone: Fax: <br /> Description of Project <br /> TYPE PftDRIVEWAY 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 /> ( )OTHER(EXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REQUIRED <br /> PHALT 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 I of 3 <br />