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<br />, <br />PER APPUCATION <br /> <br />UTILmES LOCATE CONFIRMATION NUMBER: <br /> <br />PRO IDE SKETCH IN THIS AREA, IF ADDITIONAL SPACE IS REQUIRED, ATTACH TO THIS <br />APP CATION. <br /> <br />~ <br /> <br />~ <br /> <br /> <br />: Application is hereby made to obtain a pennit to do work and installations as indicated. I certify that all foregoing <br />is accurate and that all work will comply with all applicable axles. I understand 'these axles shall take precedence over all <br />. n documents, and issuance of this pennit is verification that I will notify the property owner of Ronda Uen Law <br /> <br />Liance of this permit does not ensure compliance with deed restrictions and I understand that additional deed <br />resbictions may apply to this property. <br /> <br />shall comply with the current Florida Building Code, Public Works DesIgn Manual and FDOT DesIgn <br />ndal'ds (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 treatment and I or conveyance. <br /> <br />By signing this application: I c that I hay ead and understand the owner/builder disclosure <br />(please initial) <br /> <br /> <br />Date <br /> <br />1~07) <br /> <br />(or) Notary Signature <br />Applicant i~ ( ) personally known to me or produced <br /> <br />Date <br /> <br />I 1'2-'2--/07 <br /> <br />(type of identification) <br /> <br />as identification. <br /> <br />Page 2 of 3 <br />