Laserfiche WebLink
<br />l2CC'E)~J e G .-0' <br />ba<K-~ ,~ <br />?-r-j <br /> <br />PERMIT APPUCATION <br /> <br />.' "t <br />................ '. .... <br />, '. <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 />CONTRACTOR: <br /> <br />Company: (2.y;>\4^ 0 S'l"',d..\-:g,... ok Flor:JfA. <br />Name: 14.."..,') IA ~1' l b.ecl <br />Contractor's Ucense #: L~ ( .. (2.50 q I i.f <br />Phone:7R 2 - 092..,.... Cell: -'/'-f" ,,> if (0 <br /> <br />E-Mail: i-\~;U.€Q@?fy.....-;...~...~.f I' (J d.' ':"''1, (cJ/t"I <br />Fax: 7$U; - (,..., '7 .r <br /> <br />ARCHrnCT /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 DRNEWAY <br />-K-COMMERCIAL DR:NEWAY <br />__PUBUC ACCESS DR:NEWAY <br /> <br />_ LENGTH OF DRI'lf)NAY <br />_WIDTH OF DRIVEWAY <br />R.O.W. EXCAVAnON <br />_DEPTH _UNEAR FEET <br /> <br />CULVERTS NEEDED <br />( ) REINFORCED CONCRETE <br />( ) CORRUGATED MATERIAL <br />( ) BOX CULVERT <br />( ) OTHER (EXPLAIN) <br /> <br />CONSTRUcnON MATERIAL CURB CUT REQUIRED <br />~:...ASPHALT _YES X-NO <br />..);:._CONCRETE <br /> <br />HEADWALL REOUIRED? _YES ,LNO <br /> <br />NonCE TO APPUCANT: If actual work exceeds scope of this desaiption, additional permits or drawings <br />will be required. <br /> <br />UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> <br />Pagel of 3 <br />