Laserfiche WebLink
<br />PERMIT APPLICATION <br /> <br /> <br />~~~ /;; ~Ldl <br />r -,;11) -D4. ($5J <br />I ;/f01/v./ '-Pe\)'Yl'~ _ <br /> <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 8th Street, Zephyrhills, FL 33542 <br />Telephone 813.780.0000 Fax 813.780.0005 <br /> <br />Date of application: Processed By: <br />(gfllY area for staff use only) <br /> <br />OCopy to Building Department <br /> <br />Permit #: <br />OCopy to Public Works <br /> <br />Address: ';fJ;.j <br />Unit #: <br />Parcel Identification Number: <br /> <br /> <br />CONTRACTOR: <br /> <br />5510 <br />55 OCt <br />5~\3 <br />55\5 <br />551<0 <br />56\i-\ <br /> <br /> <br />E-Mail: <br />Fax: <br /> <br /> <br />ARCHITECT /ENGINEER: <br /> <br />,rJA <br /> <br />Firm Name: <br />City: <br />Phone: <br /> <br />State: <br />Cell: <br /> <br />Zip: <br />Fax: <br /> <br />Name: <br />Address: <br />State License #: <br /> <br />TYP OF DRIVEWAY <br />RESIDENTIAL DRIVEWAY <br />_COMMEROAL DRIVEWAY <br />_PUBLIC ACCESS DRIVEWAY <br /> <br />DescriDtion of Proiect <br /> <br />~ LENGTli OF DRIVEWAY <br />~WIDTH OF DRIVEWAY <br />R.Q.W; EXCAVATION <br />~DEPTH _LINEAR FEET <br /> <br />CONSTRUCTION MATERIAL <br />_ASPHALT <br />-::X-CONCRETE <br /> <br />HEADWALL REQUIRED? _YES -t-NO <br /> <br />CURB CUT REQUIRED <br />_YES -+-NO <br /> <br />CULVERTS NEEDED <br />( ) REINFORCED CONCRETE <br />( ) CORRUGATED MATERIAL <br />( ) BOX CULVERT <br />( ) OTHER (EXPLAIN) <br /> <br />NOTICE TO APPLICANT: If actual work exceeds scope of this description, additional permits, or drawings <br />will be required. <br /> <br />UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> <br />Page 1. of 3 <br />