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:PERMI1rAPP13CA170N � <br /> I RrVEWAYPIERMIT.AP PLICA'�ON <br /> CONSTRUCU. ON WITHIN.PUBLIC RIGHT OF-WAY . <br /> fail lnfarmatioh must-be=filled-1n completely <br /> City.ofZephyrhiNs <br /> a335:8�`Street,�ephy�lils,'F133542 <br /> Telephone B13.780.0000 Fax 813 780.0005 <br /> . - :.T ;;f,:?,i?i`,..'- ri';�r_'=�;- �y;.;�• x.�....>:. :r;tr:-'-�•.�i: -;i:.��<�;,,3�:_w,c�-�—g:�_,...:,..��.,s��r�: _ ,.;L:�,rS�;�•. -_.. . �•. . ... _ <br /> It}$�7L'O • }$RilSL2EI;. emu: ;h.. t,'; xl $�$ a F.src�3EEtt+Yts' 3�.:1cif17_ :_^..zz,,.?.";; <br /> •yr•vS=.. PP.-.-z, .j 3.-x`r';::"-=8: <br /> '{z zr ''.i-'cy`«. L� ,i�,.§Y: • i";,=�'ai;;.LL: - .is i=''.. -,i:• r%;i;r; ..� <br /> � �78LDQ��: -.,'..., <br /> d•-4°.�`•" gad" _ ..J. .,: <br /> �� •:,` s C[1`x yyBcfiifdi .�'r�'7,.,r.,.. - - - - Caw=,4 ";�-yC`a torn il�+�ot�' c �-,-:;;;�.:= <br /> �:::�.i:;::�. �Y�7 -�9�Pa{�IQ17t�.... _r... ,`�..c• .t:Lt � �� -}�1� ''a:;_d.•y2.`',: - z <br /> :PRf3�E:CF 9CB;ylC 'PROPERTY OVDIER <br /> Address: Name: -rhiS-T(e-dc.-A-jju MriJ7s !,C <br /> -Unit*: Address: =Q Goa c,&J ,-,v-f }}LtUirit <br /> Parcel Identifiration*Number: Ci Stbte Ta• zc F�rs'�'�lu <br /> o l'�a Phone:?6;.-.L;sg- f r,r'ci Fax <br /> -CONMC.TOR: <br /> Company: 'C.bby _inn: --t-toC. <br /> Name: f ;=1:> ; <br /> Contractor's License#: .r>cG 4 772-�5 E-Mail; <br /> -Phone: r?J�ri,-o525 Cell:' Fax: <br /> ARCMEc&JENGINEE1R: <br /> Name' Firm Marne• <br /> Address: City State` Zip: <br /> State Ucense#: Phone:. Cell: Fax: ' <br /> De_scri[Lbon of Project <br /> TYPE OF®MEWAY y� LENG H Or DRIVEWAY CULVERI`S'HEEDED <br /> / RESIDENTIAL DRIVEWAY ' t r WIDTH OF DRN6WAY { )REIMRCED CONDE <br /> COMMERCIAL DRIVEWAY ifT C W, EXCAVATION ( )CORRUGATED MA1'EMAL <br /> PUBLIC ACCESS DRIVEWAY �/ Dff" LINEAR FEET ( )BOX CULVE-P'T <br /> ( }OTHER(WLAIN) <br /> COMS8'RUCTION mATERrAL. . CURB CUT REQUIRED , <br /> ,ASPMALT YES NO <br /> �_ CONCRETE <br /> ,H-E&D—WALL REOUM YES —L/ NO <br /> NOTICE T•O APPLTC#INT; If actual Work exceeds scope of this description,additional permits or drawings <br /> well be requlired., <br /> UTTLTrt LOCATjdNS RE40UIRED: CALL BEFORE YOU DIG:1.80DA32.4770 <br /> Page I, of 3 <br />