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<br />Rf2j:~W B ~c., .f) 7 <br /> <br />/" <br /> <br />PERMIT APPUCATION <br /> <br />. <br />. <br /><, , <br /> <br />..'......................... .' <.,.1." <br />". . <br /> <br />DRIVEWAY PERMIT APPLICATION <br />CONSTRUCTION WITHIN PUBLIC RIGHT-Of-WAY <br />All information must 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 />Address: V'~ L". <br />Unit#: <br />Parcel Identification Number: <br />0').- ~-2\-o2 0-00000- 00"'0 <br /> <br />LLG <br /> <br />CONTRACTOR: <br /> <br />Company: Q.Y"'" 0..'" F( t:J/': do. <br />Name: Co. <br />Contractor's Ucense : CS C-l 2-S- 0 if, '-( <br />Phone: 81J -,82.-0925" Cell: tll$ -71"(- "S"'1f1 <br /> <br /> <br />E-Mail: o.,:,~ le <fi) l!..y""o.A Coi,5~/'u d: i.M , ~i'" <br />Fax: f?1J - 788"' C. 17:r <br /> <br />ARCHITECT/ENGINEER: <br /> <br />Name: <br />Address: <br />State Ucense #: <br /> <br />Arm Name: <br />Oty: <br />Phone: <br /> <br />State: <br />Cell: <br /> <br />Zip: <br />Fax: <br /> <br />DescriDtion of Proiect <br /> <br />CONSTRUCTION MATERIAL <br />~ASPHALT <br />-X....CONCRrn <br /> <br />_ LENGTH OF DRIVEWAY <br />_WIDTH OF DRIVEWAY <br />&Q:W" EXCAVAnON <br />_DEPTH _UNEAR FEET <br /> <br />CURB CUT REOUlRED <br />_YES ~NO <br /> <br />CULVERTS NEEDED <br />( ) REINFORCED CONCRETE <br />( ) CORRUGATED MATERIAL <br />( ) BOX CULVERT <br />( ) OTHER (EXPLAIN) <br /> <br />TYPE OF DRIVEWAY <br />RESIDENTIAL DRIVEWAY <br />X COMMERCIAL DRIVEWAY <br />_PUBUC ACCESS DRIVEWAY <br /> <br />HEADWALL REOUIRED? _YES LNO <br /> <br />NOTICE TO APPUCANT: If actual work exceeds scope of this desaiption, additional pennits or drawings <br />will be required. <br /> <br />UTIUTY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> <br />Page 1 of 3 <br />