Laserfiche WebLink
PERMIT APPLICATION <br /> DRIVEWAY PERMIT ,APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY : <br /> All information must be filled-in completely <br /> City of Zephyrhills <br /> 5335 8t'Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> off <br /> ON AFe�J}MPL ME <br /> PROJECT/JOB SITE: PROPERTY OWNER <br /> Address:. Name: <br /> Unit#: OZ 33 64v Address: 1�Coo 0'7--,-).< Unit: . <br /> Parcel Identification Number: City, State Zip <br /> Phone: __Jv7jS YFax: <br /> CONTRACTOR: <br /> Com an .z . 4-0 r c <br /> Name: "a C>O .L3 C_-9,c. <br /> Contractor's License #: C C_02 0 E-Mail: � ty .)t � ar-`�Qn' Ccr�». . <br /> Phone: 1T 3 S y 1-3Y Y-7 Cell: Fax: <br /> ARCHITECT/ENGINEER: <br /> Name: A ►`� � c�l-i Firm Name: <br /> Address: ' '"1 ��r* �t Grw�k CitY:� n� , State: t=C _ zip: <br /> State License #: Phone: 1 -:2G;C ell: Fax: <br /> Description of Project <br /> RIVEWAY LENGTH OF DRIVEWAY' CULVERTS NEEDED <br /> _jP 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 /> --ASPHALT YES NO <br /> jw<C'ONCRETE <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 />