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p f u ,,,, <br /> 4-1 3 5 '; <br /> z <br /> pERmrrAPPL7CATION -_ <br /> OR.TVEW PERMIT :APPLICkTION <br /> CONSTRUCTION "wri:HTN ',PUBLIC :RIGHT—OF <br /> All information mug be completely <br /> - City.oflephyrhills <br /> 3335 8 Street,Zephyrhills, 'FL 33542 <br /> Telephone .813.780.00 Fax 813:780.0005 <br /> dy.. <br /> PROJECT JOB : - -PROPE'_;. OWNER <br /> Address: Name: " <br /> Unit #: Address: 3 ESel Unit: <br /> Parcel Identification "Number: II- ISO -2E- t0( /q(oco-111 OCty, State, _Zip .‘ <br /> 2--reL rt..1 <br /> Phone: ' Fax: <br /> .CONTRACTOR: <br /> Company: 1S kfTi-cs <br /> Name: &erre_ (Ai `41Sd <br /> Contractor's License #: oscial E-Mall: <br /> -Phone: 3 8E- oS IV ceiv.W.- 9) ct Fax: <br /> ARCHITECC/ENGINEER: <br /> - Name: - Hrrn Name: <br /> Address: City: State: <br /> State License #: Phone: Cell: Fax: <br /> Description of ProieCt <br /> TYPE OF DRIVEWAY la LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRIVEWAY CI WIDTH OF DRIVEWAY ( ) REINFORCED CONCRETE <br /> X COMMERCIAL DRIVEWAY R.O.W. p-XCAVATION ( ) CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY 44'DEPTH LINEAR Ftti ( ) BOX CULVERT <br /> ( ) OTHER (E(PLAIN) <br /> • - qo <br /> CONSTRUCTION MATERIAL 4111 . • _ • <br /> ASPHALT - NO <br /> - N - CONCRETE <br /> HEADWALL REOUIRED? YES 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: 1.800.432.4770 <br /> Page 1 of 3 <br />