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PERMIT APPLICATION <br /> 4 •\ <br /> ;DRIVEWAY e:PERMIT.A1P,PLICATION <br /> (CONSTRUCUON WITHIN PUBLIC :RIG HT—OF-"WAY <br /> All information mug be completely <br /> City ofZephyrhills <br /> 3335 8 Street,Zephyrhills, FL <br /> Telephone 813780.0000 Fax 811780.0005 <br /> "PRO3ECTOOB SITE: 'PROPERTY' OWN ER <br /> Address: 5t../3 /Am .-r-¢..ez-c• Name: Ma CLISKER_ <br /> Unit#: Address:SCcd.3 (FeAk Sr Unit: <br /> Parcel Identification Number: Ctty,State, Zip .7-Epikcititu-L.C. C-":1- 335 <br /> Phone:103 7 1Sot? Fax: <br /> •CONTRACTOR: <br /> • Com. an : C- _ _ <br /> Name: -.1 <br /> Contracbr's License -#: E-Mail: • _ <br /> -Phone: 72 Z-S7E., - Ce11:7-s- - 7- c r t -*F.:221 Fax: c-oK <br /> ARCHITECT/ ENGINEER: 1 ...tA . • <br /> Name: - Firm Name: <br /> Address: City: State: Zip: <br /> State License #: • Phone: Cell: Fax: <br /> • Description of ProieCt • <br /> TYPERF DRIVEWAY 4 Z LENGTH OF DRIVEWAY • CULVERTS NEEDED <br /> KRFSIDENTIAL DRIVEWAY /5 WIDTH OF DRIVEWAY ( ) REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.O.W. pCCAVATION ( ) CORRUGATED MATERIAL <br /> PUBLIC ArrFSS DRIVEWAY DEPTH LINEAR htt I ( ) BOX CULVERT <br /> ( ) OTHER (EXPLAIN) <br /> CONSTRUCT/ON MATERIAL CURB CIJT REQUIRED <br /> PHALT _YES 4e <br /> . <br /> JIEADWALL REQUIRED? YES Y . NO <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: 1.801:IA31.4770 <br /> Page 1 of 3 <br />