|
:PERMr!"A ICAiION
<br /> I
<br /> aRmwA">YER.ER1ouppL cm., ®R"
<br /> -CONSTRUCT ION"WITHIN.RUBVIC RTGHT GF-WAY
<br /> All infbrmatlon=•be-fllled-In oomplaWy
<br /> Cil y.of.Z�ephyrhiils
<br /> 3335'e Sbeet,2ephyrhift,TL 33542
<br /> i -elephone B13 780.0000 Fax 833MO.0005
<br /> UfaLZWIc� �!!a+f�n=. 'i's+r=`3r t� fi,-;:.f.:•;,�.Y��r,�y"f'iti:^`' `�� L p+ar ! t"=` `'"`3,"i,—NrZx._, ,.
<br /> . '��r ' �� �� t - � ;'�-�.,.-:.'.•:ti't..
<br /> x+' r>• n �;;a�':_t+!x •M"a1' Yx-.;j r�r �4u'_.' ..�;... c.z-``'",',r. .2�-.�; x,�a ,�' '� six�'�:yt�.rs
<br /> .�a,v, �. +'�r�.:'3""r s '� iuCc' �.���.y�•c..nL•.-+w.. „.,-,' �, ,�: ��.�gli.� ,f�:ss.`,,,�, G..
<br /> ? -.;..�k.:iC"'se9�'.t-�..�c' :d�'€,S�;i�... �".+� —'--'S_. -i ai 3r:, �._ t..�:}• ...r. �7}.:`:r=.3.
<br /> .q:r 'r`' 'r'.' :9�Ik�in :'.;L;�r ;= e-•''`,•�-..-.'-i:::':.;;e,::: e•f�-,..'}) 1rn -,,..�•:N f,rr^:... r�rr
<br /> .:i.•;i.e"'r.c::`i ,..L'-��.,:1!':. +rY:�. NWF�,
<br /> PROJECT JOS',SMm. -PROPERTY'OWNER
<br /> Address: ,�"S'SD /B-/h t.e Name: /"j 4rn
<br /> -Unit*: Address:.3 x A»;her o- Unto
<br /> Parcel Identl mUon'Number: C3tv,S"tabe ZI h"ric /) r., . /:: . 9 3 Sa.
<br /> I1-ZCo-2 !-v)r .r-U3 C1ejn—O 'Phone:8'r3-q?mz-SZSvFag,
<br /> CONTRACTOR
<br /> Company: T-tf-t4,s,-c1.11 _ ,,v eiIm*-iVA ,lit c
<br /> Name:-�'c.-1 r�,ts-,r-��-,—/'>•cr t!
<br /> ContraetDr'S Uomm*.,
<br /> -Phone: s?I3 -q?3-525U 'Cell: ;�ix 7�/. /�/q�' Fm
<br /> ARCFiI &/ENGINEER:
<br /> 'Name: firm Name:
<br /> Address: My: . State: zip:
<br /> State Uomnse#• Phone: Cell• Rw. .
<br /> R&SCdMom ofJP1
<br /> LENm oRNEWAY I L►E 'N o
<br /> � WDRIVEWAY FD Z r WID3i'1 of DRIVEWAY ( ),PMNFOR®CONaM7E•
<br /> CC?MMERCtAI.DW WAY R.O.W.. EKCAMUION ( }MRRUGAIM MMERIAL
<br /> ,_,.,,-UBLIC AL1C6S DRNEWAYL„_' ,PEPTH LINEAR FEET ( )BOX CULUBtT
<br /> ( )omim(EXRM)
<br /> JWNSrR MCA MATERIAL • CURB CUT REQUIRED
<br /> ,HALT YES
<br /> �!'MNM iE
<br /> HEADVLMI�REOttMM YES `-no
<br /> NO'i IC,E TO APPL'I N I<: If actual work exceeds scope of this description,additional permits or drawings
<br /> will be required.
<br /> UTILTI'Y SONS REOUIREO: GALL BEFORE YOU DIG:1.80Q.432A770.
<br /> Page I of 3
<br />
|