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<br />, I <br /> <br />PERMIT APPLICATION <br /> <br />UTILmES LOCATE CONFIRMATION NUMBER: <br /> <br />PROVI E SKETCH IN THIS AREA, IF ADDITIONAL SPACE IS REQUIRED, ATTACH TO THIS <br />APPLIC TION. <br /> <br />~ <br /> <br /> <br /> <br />AFFIDAVIT: Application is hereby made to obtain a permit to do work and installations as indicated. I certify that all foregoing <br />information' accurate and that all work will comply with all applicable codes, I understand' these cocIes shall take precedence over all <br />approved co struction documents, and issuance of this permit is verification that I will notify the property owner of Florida Uen Law <br />req., F.S. 71 . <br /> <br />The issu nce of this permit does not ensure compliance with deed restrictions and I understand that additional deed <br />restrictions may apply to this property. <br /> <br />all comply with the current Florida Building Code, Public Works Design Manual and FDOT Design <br />ndards (if applicable). (Public Works Design Manual online link: www.d.zephyrhills.f1.us/public_works.asp) <br /> <br />TION IS VOID UNLESS SIGNED WITH PROPER IDENTIFICATION AND WITNESSED BY A PERMIT <br />TECHNICIAN OR NOTARY PUBUC. <br /> <br />City of Zephyrhills is not responsible for maintenance or repairs of driveways. Driveways shall not alter I <br />Interfere with existing stonnwater treabnent and I or conveyance. <br /> <br />By signing this application: I certify that I h e read an understand the owner/builder disclosure <br /> <br />~"';n"") ~/00 <br /> <br />(or) Notary Signature <br />Applicant is ( ) personally known to me or produced <br /> <br />0<- <br /> <br />(type of identification) <br /> <br />as identification, <br /> <br />Page 2 of 3 <br />