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<br />PERMIT APPUCATION <br /> <br />......'..............'; <br /> <br />'.' . ." <br /> <br />. . <br /> <br />~eCfi~d~d-<- <br />t3 .<o-.C( <br /> <br /> <br />DRIVEWAY PERMIT APPLICATlON <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 />; Datitof.'iappli' <br /> <br />"~c. ':-..: Y;- ::<.~,>>":':. -, <br />'....,',..c._:,.... . <br /> <br />CONTRACTOR: <br /> <br />Company: Ry.....G.oI'l 4} J J:: ( or; J. Il.. <br />Name: 1-\4.1'" 0 \& I <br />Contractor's Ucense : L~(.. - 12 S- 0<7 I <br />Phone: 782 ~ 051,) Cell: ...." I.( ~ "5" '7 Co <br /> <br /> <br /> <br />_a.-. ~;'I f J- r I..l :':;.1 . ~,., <br /> <br />ARCHrrECT /ENGINEER: <br /> <br />Name: <br />Address: <br />State Ucense #: <br /> <br />Rrm Name: <br />City: <br />Phone: <br /> <br />State: <br />Cell: <br /> <br />Zip: <br />Fax: <br /> <br />DescriDtion of Proiect <br /> <br />TYPE OF DRIVEWAY <br />_RESIDENTIAL DRIVEWAY <br />~COMMERCJAL DP.'NWAY <br />__PUBUC ACCESS DRIVEWAY <br /> <br />_ LENGTH OF DRNEWAY <br />_WIDTH OF DRIVEWAY <br />~ EXCAVAnON <br />_DEPTH _UNEAR FEET <br /> <br />CULVERTS NEEDED <br />( ) REINFORCED CONCRETE <br />( ) CORRUGATED MATERIAL <br />( ) BOX OJLVERT <br />( ) OTHER (EXPLAIN) <br /> <br />CONSTRUCTION MATERIAL CURB CUT REOUIRED <br />~ASPHALT _YES ~NO <br />..lL..CONCRETE <br /> <br />HEADWALL REOUIRED? _YES LNO <br /> <br />NOTICE TO APPUCANT: If actual work exceeds scope afthis description, additional permits or drawings <br />will be required. <br /> <br />UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> <br />Page 1 of 3 <br />