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. . <br /> PERMIT APPLICATION rl <br /> DRIVEWAY PERMIT :APPLICATION <br /> iCONSTRUCTION WIThIN PUBLIC:RIGHT—OF-WAY <br /> All information nag be completely <br /> City ofZCPhYlltII 5 <br /> -5335 18 th Street, Zephyrhills, - FL33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> • <br /> - - , <br /> IL/ - <br /> "PRO3ECT/.3 OBSITE: rPROPERTY,OINNER <br /> Address: -5 - G../3 / AITE Name: ANIQE Mc <br /> Unit #: Address:Sfot3 t St* Unit: <br /> Parcel Identification Number: Ctty,State, Zip ZE Pacr s.T.s <br /> Phone/3 7 Icot ? Fax: <br /> CONTRACTOR: <br /> • Company: S. S L4,rflCZ€ - Oc Ki <br /> Name: -1c7sii <br /> Contractor's License #: E-Mail: — _ <br /> -Phone: 72-7 sti z.-s - 5 tell: -7 7:7 - c r ("? `eg 2. Fax: <br /> ARCHITECT/ENGINEER: 1(As <br /> Name: Firm Name: <br /> Address: City: State: Zip: <br /> State License #: Phone: Cell: Fax: <br /> Description of Proiect <br /> TY DRIVEWAY 42- LENGTH OF DRIVEWAY • CULVERTS NEEDED <br /> RESIDENTIAL DRIVEWAY /5 - WID11 OF DRIVEWAY ( ) REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.O.W. EXCAVATION ( ) CORRUGATED MATERIAL • <br /> PUBLIC ArrFSS DRIVEWAY- DEPTH LINEAR FEET • ( ) BOX CULVERT <br /> ( ) OTHER (EXPUUN) <br /> CONSTRUCTION MATERIAL CURB CUT REOUIRED <br /> ASPHALT _YES 44__NO <br /> )( <br /> CONCRETE <br /> HEADWALL REOUIRED? __YES <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description, additional permits or drawings <br /> will be required. <br /> UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800A32.4770 <br /> Page 1 of 3 <br /> - - <br />