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PERMIT APPLICATION <br /> DRIVEWAY PERMIT APPLICATION <br /> =CONSTRUCTION -WITHIN PUBLIC RIGHT-OF-WAY <br /> All information must be -in completely <br /> City. of:ZephyrhiIIs <br /> 5335 8 Street,Zephyrhills, :FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> Y new ^%z'.-sa� raaw. <br /> i�r �� I� ��' 13i� { :e� 5� s z,; 1 � .. �, Y -S s `rz- ��t�" ;� ��� <br /> ..�...�.: x:, ` r k o lth h blykr k�l� J : r u. � c r, J€{. <br /> e .l�G�''" =°1� u � H t &r .;ti � . . _ e_ — <br /> PROIECT JOB`SITE: PROPERTY' OWN ER <br /> Address: d o w Dr/1e Name: CA T 1 ' i/r <br /> Unit #: Address: 6Of6/_ �� � f J � / : 33SYa- <br /> Parcel Identification Number: City, State, Zip Z <br /> Phone: Fax: <br /> CONTRACTOR: <br /> Company: G- 4-&19p - tilm RCf <br /> Name: 7 64.t.r eyr <br /> Contra is Li ense #: L K- C d 51513 E -Mail: <br /> Phone : /3) 7/y 93 Si Cell: Fax: <br /> ARCHITECT /ENGINEER: <br /> Name: Firm Name: <br /> Address: City: State: Zip: <br /> State License #: Phone: Cell: Fax: <br /> Description of Project <br /> TY,PE / <br /> OF DRIVEWAY g LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRIVEWAY d- WIDTH OF DRIVEWAY ( ) REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.O.W. EXCAVATION ( ) CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEET ( ) OTHER LVERT <br /> CONSTRUCTION MATERIAL CURB CUT REOUIRED <br /> ASPHALT YES NO <br /> CONCRETE <br /> HEADWALL REQUIRED? YES X 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 I. of3 <br />