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<br />PERMIT APPLICATION <br /> <br /> <br />.5~~ t; XL~ <br />r-~ tJ -D4.($~j <br />I ;I/Oi'''''-'' :Yeryn'r\- _ <br /> <br />5510 <br />550<:1 <br />5~\3 <br />56\5 <br />55\(0 <br />56\1-\ <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: <br />DCopyto Building Department <br /> <br />Processed By: <br />(gray area for staff use only) <br /> <br />Permit #: <br />DCopy to Public Works <br /> <br />Address: t;S'/ <br />Unit #: <br />Parcel Identification Number: <br /> <br /> <br />CONTRACTOR: <br /> <br /> <br />E-Mail: <br />Fax: <br /> <br /> <br />ARCHITECT I ENGINEER: <br /> <br />rJ~ <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 />~ LENGTH OF DRIVEWAY <br />~WIDTH OF DRIVEWAY <br />R.O.W. EXCAVATION <br />~DEPTH _LINEAR FEET <br /> <br />CONSTRUCTION MATERIAL <br />__ASPHALT <br />+CONCRETE <br /> <br />HEADWALL REOUIRED? _YES <br /> <br />CURB CUT REOUIRED <br />_YES -j-NO <br /> <br />CULVERTS NEEDED <br />( ) REINFORCED CONCRETE <br />( ) CORRUGATED MATERIAL <br />( ) BOX CULVERT <br />( ) OTHER (EXPLAIN) <br /> <br />$.-NO <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 />