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• 1 ' <br /> PERMIT APPLICATION ;-n�• T In <br /> ' Fpl <br /> •5 <br /> .y Z <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC-RIGHT-OF-WAY <br /> All information must be filled-in completely <br /> City of Zephyrhilis <br /> 5335 8t'Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> PROJECT/JOB SITE: PROPERTY OWNER <br /> Address: Qrlo �in/7� 'rw� Zt,�G �isrtc6 Name: P & Wo,-4on �n <br /> Unit#: ..3/ " 'v Address: 1 *? d • '7-r Unit: <br /> Parcel Identification Number: City, State Zip <br /> 3✓-ZSGl-O/�O-p /{o -03/a + - Phone: <br /> ' �C��l-""1-G�,u ��J C�J`�"�' �G.:..�T7c� �y,+�'�� 1•'��,,�CJ f"`1 �l�.. �i C�'/�"? ' <br /> CONTRACTOR: <br /> Company:_ <br /> Name: 0) i—e- <br /> Contractor`sLicense #: C_ CC3, E-Mail: Cc,,y� <br /> Phone: Y 13. Cell: Fax: <br /> ARCHITECT/ENGINEER: <br /> Name: A tom- i2e -5- ,1-1%, Firm Name: <br /> Address: State: FL__ Zip: <br /> State License #: Phone: Fax: <br /> Description of Project <br /> DRIVEWAY LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> TM ,,,,,,,,RESIDENTIAL DRIVEWAY WIDTH OF DRIVEWAY ( }REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.O.W. EXCAVATION O 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: 1.800.452.4770 <br /> Page 1 of 3 <br />