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<br />PERMIT APPLICATION <br /> <br /> <br /> <br />DRIVEWAY PERMIT APPLICATION <br />CONSTRUCTION WITHIN PUBLIC RIGHT-Of-WAY <br />All information ~ 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 /> <br /> <br />PROPERTY OWNER <br /> <br />Address: <br />Unit #: "3 <br />Parcel lden' cation Number: <br />04 1fl 11 OOW>- hCD?> Q <br /> <br />1050 <br /> <br />. CONTRACTOR: <br /> <br />Compan~~=~ <br />Name: ..~~ (~ (~, <br />Contractor's Ucense #: CBc125~ ;)"''€Ju~ E-Mail: ~:~e~~~rdh~s.can <br />Phone: 813-88S-7744x248 Cell: Fax: 8 _ _ <br /> <br />ARCHITECT IENGINEER: <br /> <br />Name: <br />Address: 1 fl1 Or:; N, Fl or; (fa 2hT~ <br />State Ucense #:' #60987/#56877 <br /> <br /> <br />~ption of Prqjec::t . <br /> <br />6G- '-:;;~ENGTH OF DRIVEWAY <br />1l{J' WIDTH OF DRIVEWAY <br />&Q.W. EXCAVATION <br />~DEPTH _liNEAR FEET <br /> <br />CURB CUT REOUIRm <br />_YES _NO <br /> <br />CULVERTS NEEDED <br />( ) REINFORCED CONCRETE <br />( ) CORRUGATED MATERIAL <br />( ) BOX CULVERT <br />( ) OTHER (EXPlAIN) <br /> <br />TYPE OF DRlVEW4Y <br />--X-.RE5iDENTIAL DRIVEWAY <br />_COMMEROAl DfUVEWAY <br />_PUBLIC ACCESS DRIVEWAY <br /> <br />CONSTRUCTION MATERIAL <br />---..ASPHAlT <br />~CClNCRETE <br /> <br />HEADW4LL REQUIRED? _YES _NO <br /> <br />NonCE TO APPLICANT: If actual work exceeds scope of this description, additional permits or drawings <br />will be required. <br /> <br />UTILITY LOCATIONS REQUIRED: CALL BEFORE YOU DIG: 1,800.432.4770 <br /> <br />Page 1 of 3 <br />