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PERMIT APPLICATION- <br /> UTILITIES LOCATE CONFIRMATION NUMBER: 338000700 <br /> PROVIDE.SKETCH IN THIS AREA, IF ADDITI0111AL SPACE.IS REQUIRED,ATTACH TO_THIS. <br /> APPLICATION. <br /> AFFIDAVIT'.A licatlon.ls hereby made to obtaln a pp permit to.do work"and installations as indicated:.I certify that all foregoing. <br /> information is accurate and that all work will comply with.all appliablebbiles:"I understand these:codes shallbke precedence overallapproved construction documents,and Issuance of this permit.is verificadon.that I will notify the preperty owner_of Florida Lien Law- <br /> req:;F.S.713. :' <br /> :The issuance-of this permit does not ensure.campliaiue with deed.restrictions and I.understand that-additional deed , <br /> restrictions may epply to this:property: <br /> Alll:work'shali contply:with the current Florida Building Code,Public Works Design.Manual and FDOT Design <br /> Standards(if applicable). (Public Works Design Manual online Ilnk:yMW d,zephyrhills.Fl:us/publfq_works.asp)_ <br /> APPLICATION IS VOID UNLESS SIGNED:WI111.PROPER.IDENTIFICATION AND.WITNESSED BY A PERMIT <br /> TECHNICIAN OR NOTARY PUBLIC: <br /> NOTE: The.City of Zephyrhills is not"responsible for maintenance or repairs of driveways. Driveways shall not alter <br /> Interfere with existing storimwater treatment and I or conveyance. <br /> PROPERTY OWNERS: .By signing this application:: I.c fy:that I have read and understand the owner/builder disdosure <br /> ___statement: (Please Initial) <br /> 9 U; " . !2 3/2D. <br /> Gre Beebe: <br /> Applicant Print Name A011cant SI drd Date' <br /> fa 3�20 <br /> rmit Technidan Signature ' (or):N Signature'.. Daeb <br /> Applicant-is personally:kgown to me or produced as identification:. . .. . <br /> {type of identification). <br /> -A <br /> Page'2 of 3, I.MALATAK <br /> _ Ll <br /> Ex w80PbMbbrn 2D <br /> i. <br />