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I V'" <br /> f <br /> Y a/ <br /> PERMIT APPLICATION „,A_.7 'i - <br /> ''''''1.4 ii . <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 8`” Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 ,, Fax 813.780.0005 <br /> Processed By: r 6 Permit #: <br /> Date of'application: .3-4-09 (gray ar f or staff use only) <br /> ❑Copy to Building Department <br /> opy to Public Works <br /> PROJECT 70B SITE: go <br /> • <br /> Unit #: <br /> Address: VD P - e_ �� � 'P rn � Name: ( - PROPERTY OWNER .� a`��IM?1� <br /> Address: 133SD L2r a is 5e... , ''i ,, : <br /> --- -- ' .' * S -. 2- -7 <br /> Parcel Identification Number: City, State, Zip 170v-P1 / <br /> 0 Zz(,Z I 0O O oo 00 0 / 00 Phone: 813 -oSQ Zug Fax: V3- <br /> CONTRACTOR: <br /> Compan : , r��= 11 L + _ .._.._._ <br /> Name: (`(\ 1-c, .El r. or - .CD �►'� <br /> Contractor's License #: C-2 5C- O3� 3 _ E -Mail: � p - �C_ V 1 <br /> Phone: b . i o Sct - - 58 Cell: 6 3 - 3 2 : 3 - S 2 _ 1 1 T Fax: 3 -- 7 S4-4 7S 9 <br /> ARCHITECT/ENGINEER: r . . n <br /> Name: lL Gra -ram. !-` � jFirm Name: (- e'en <br /> Address: a 58 1- a ew 'DX City: La-1 e t ccrc Sta Zi : <br /> State License #: 3 ? Phone: S ,3 ', (S O&ell: Fax: SQ03 <br /> Description of Proiect <br /> '' ( CU LVERTS NEEDED <br /> TYPE OF DRIVEWAY � T LENGTH OF DRIVEW REINFORCED CONCRETE <br /> RESIDENTIAL DRIVEWAY 17 OF DRIVEWAY ( ) CORROGATED MATERIAL <br /> COMMERCIAL DRIVEWAY R,O.W, EXCAVATION ( ) <br /> PUBLIC ACCESS DRIVEWAY _DEPTH LINEAR FEET ( ) BOX CULVERT <br /> OTHER (EXPLAIN) <br /> CONSTRUCTION MATERIAL, CURB CUT REOUIRED <br /> ASPHALT _ _YES NO <br /> V <br /> HEADWALL. REQUIRED? 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 />