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I • �y <br /> r <br /> :PEP'16ff APPlICA7TON <br /> . ............ <br /> DRIVEWAY P.ERM,:T.AP.PL,CA'RQN <br /> sCONSTR-UCTION ITHIN-PUBLIC RIGHT—OF-WAY, <br /> Ali Information must be-filled-In completely <br /> SCity.of-Zephyrhills <br /> -5335 St'.Street,Zephyrhills,.A 33542 <br /> 'Telephone.813 780:0000 Fax 813.780.0005 <br /> 'PR03ECT J0BjSITE: ---PROPERTY'O ER <br /> Address: 2 Z77 Name: <br /> Unit#.: Address: 9 iv A r Unit: <br /> Parcel Identification-Number: Ci State z - t a b 3 5/ <br /> Phone: 74�1 ,Z/a Fax: <br /> :CONTRACTOR: <br /> Company: <br /> Name: <br /> Contractor's License#: E-Mail: <br /> _Phone: Cell: Fax: <br /> ARCHITECT/ENGINEER: <br /> -Name: Firm Name: <br /> Address: City: State: Zip: <br /> State License#: Phone: Cell: Fax: <br /> Description of Proll <br /> OF DRIVEWAY `1`i� a <br /> T�' LENGTH OF-DRIVEWAY CUlV,ERTS NEEDED - <br /> RESIDENTIAL DRIVEWAY WIDTH OF DRIVEWAY ( )REINFORCED CONCRETE. <br /> COMMERCIAL DRIVEWAY R.O.W. 01CAMATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH, __ IINEAR FEET ( }BOX CULVERT <br /> OTH - <br /> CONSTRUCTION MATERIAL CURB CUT REQUIRED ( ) ER(EXPLAIN) <br /> ,ASPHALT YES . NO <br /> 4/ CONCRETE <br /> HEADWA!!RE IRED? YES NO <br /> .NOTICE TO APPLICANT:.If actual work exceeds scope of this description,additional permits or drawings <br /> -will be required. <br /> UTILITY LOCAT16NS REQUIRED: CALL BEFORE YOU DIG: 1.800.432.4770. <br /> Page 1 of 3 <br />