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<br />I I <br /> <br />- -!O"' () <br />~ ! :.J.-'1 <br /> <br />.. PERMITI~PPlICATION <br /> <br /> <br /> <br />~DRIVEWAY iPERMErAPPLlCAIION <br />'CONSTRtlCllON 'WrrHIN .PUBLlC ~RIGH'T~OF";WAY <br />All information~ be'filled-in completely <br />tl . " J' If <br />(City.of~Z~phyrhills ~ LDc>r\:::. \ ssoeO' <br />'53358ttl Street,:Zephyrhills, R 33542 <br />"Telephone .8.13.780.0000 Fax 813.780.0005 <br /> <br />Address: <br />Unit#: <br />Parcel I entlfication Number: <br /> <br />'CON+CTOR: <br /> <br />Comoan": 7-/..-... A go I.. ~- <br />Name: <br />Contrad or's License #: <br />Phone: Cell: <br /> <br />ARCH~CT IENGINEER: <br /> <br />Name: i <br />Addres : <br />State Li ense #: <br /> <br />. <br /> <br />E-Mail: <br />Fax: <br /> <br />Firm Name: <br />CI : <br />Phone: <br /> <br />State: <br />Cell: <br /> <br />Zi: <br />Fax: <br /> <br />DescriDtion of Proiect <br /> <br />11111.. tI . <br />~LENGTH OF DRIVEWAY <br />1.?~7/IWIDTH OF DRIVEWAY <br />R~W. EXCAVATION <br />(9" DEPTH _UNEAR FEET <br /> <br />CURB CUT REOUIRED <br />_YES ----END <br /> <br />CULVERTS NEEDED <br />( ) REINFORCED CONCRETE <br />( ) CORRUGATED MATERIAL <br />( ) BOX OJLVERT <br />( ) OTHER (EXPLAIN) <br /> <br /> <br />., _YES _NO <br /> <br />T APPUCANT: If actual work exceeds scope of this description, additional permits or drawings <br />equired. <br /> <br />UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> <br />Page 1 of 3 <br /> <br />-.".-- -.. <br />!--_.~ <br />