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<br />I I <br /> <br />.PERMIT PPLICAnON <br /> <br />UTILITIES LOCATE CONFIRMATION NUMBER: <br /> <br />PROVID SKETCH IN THIS AREA, IF ADDITIONAL SPACE IS REQUIRED, ATTACH TO THIS <br />APPLlC TION. <br /> <br />~~. <br /> <br /> <br />AFADAVIT: <br />information . <br />approved <br />req., F,S. 713 <br /> <br />The Issua ce 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 work II comply with the allTeI1t florida Building Code, Public Works Design Manual and FDOT DesIgn <br />Sta dards (If applicable). (PUblic Works Design Manual online link: www.d.zephyrhills.f1.uS/public_works.asp) <br /> <br />. APPlICA ON IS VOID UNLESS SIGNED WITH PROPER IDENTIFICATION AND WITNESSED BY A PERMIT <br />TECHNICIAN OR NOTARY PUBUC. <br /> <br /> <br />plication is hereby made to obtain a permit to do work and installations as indicated. I certify that all foregoing <br />accurate and that all work will comply with aU applicable codes, I uilderstandthese codes shall take precedence over all <br />documents, and issuance of this permit is verification that I will notify the property owner of Rorida Uen Law <br /> <br /> <br />NOTE: The CIty of Zephyrhllls Is not responsible for maintenance or repairs of driveways. Driveways shall not alter I <br />interfere with existing stormwater treabnent and I or conveyance. <br /> <br />By signing this application' .ertify tha read and understand the owner/builder disclosure <br />(please initial) <br /> <br />Iv'" <br /> <br />an Signature <br /> <br /> <br />IJI~ )~ <br /> <br />Date <br /> <br />(or) Notary Signature <br /> <br />Date <br /> <br />I /2z/07 <br /> <br />Applicant is ( personally known to me or produced <br /> <br />(type of identification) <br /> <br />as identification. <br /> <br />Page 2 of 3 <br />