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PERMITAPPLItATION i - \A <br /> 1 . <br /> DRIVEWAY ipERmrr .APPLICATION <br /> CONSTRU.CEION WITHIN P.UBLIC :R,IGHT-OF-MAY <br /> All information must be completely <br /> City_cifZephyrhills <br /> 3335 8 Street,Zephyrhills, 'FL 33542 <br /> - Telephone R13:780.0000 Fax 813:780.0005 <br /> "PRO3ECP ...10E - <br /> l:idress: 0 -'djfto it/l/ Name: 7 ' r <br /> Unit #: Address: 4)ot AL / ftiOgy, h'Untt: . <br /> Parcel Identification 'Number: City, State, _Zip 74/01.1ii f/ J3s1 2_ <br /> Phone: Fax: <br /> :CONTRACTOR: <br /> Company: C-44 0r 7 ,4 <br /> Name: V6-4.1-r Cu yi r <br /> Conra t r's License*: cm - Cas <br /> 7 E-Mail: <br /> -Phone: f/3) 7/ V 934 g *Cell: Fax: <br /> ARCHITECT/ENGINEER <br /> Name: - Firrn Name: <br /> 'Address: City: State: Zip: <br /> State License #: Phone: Cell: Fax: <br /> Descriation of Project <br /> T)DE OF DRIVEWAY LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> V RESIDENTIAL DRIVEWAY J el WIDTH OF DRIVEWAY ( ) REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY &L,1.LN. EXCAVATION ( ) CORRUGATED MATERIAL <br /> PUBLIC An DRIVEWAY DEPTH LINEAR 1-tt 1 ( ) BOX CULVERT <br /> ( ) OTHER (EXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REOUIRED <br /> ASPHALT YES NO <br /> CONCRETE <br /> HEADWALL REOUIRED? YES X NO <br /> NOTICE TO APPUCANT: If actual work exceeds scope of this description, additional permits or drawings <br /> will be required. <br /> UTILITY LOCATIONS REQUIRED: CALL BEFORE YOU DIG: 1.800A32.4770 <br /> Page 1 of 3 <br />