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,.__ <br /> 6 - ,,h,. 1)5 cJ ‘ <br /> • ,____/ <br /> , . <br /> PERMIT APPLICATION <br /> —..... <br /> DRIVEWAY ;PERMIT APPLICATION <br /> CONSTRUCTION - WITHIN PUBLIC :RIGHT—OF-WAY <br /> All information must be completely <br /> City_oflephyrhills <br /> 3335 8 Street,Zephyrhills,'FL <br /> Telephone 813.780.0000 Fax 813:780.0005 <br /> ,_",, _, , , ------, ,-....,___ - ---, - ---- ---- - . -u;-:1••■,-74 '''''''''-''''''''' ''' : '"-'''''"'''''''''. 1. , , - ' <br /> -_ <br /> , IL- -- itVROT 4, "--• , - ' . 11 -Jrc - n• ' li'. T.. 4 'MT '',.. . ..'-' .-'' ,... ,. . : <br /> "PRWECT/JOBSITE: 'PROPERTY'OWNER <br /> Address: 4/130 0- ,5+ z-k.'lls Fi ,3s Name: Gay /1 FicLe r ;10 IA <br /> lJnit#: Address: (4143c ( o +L. $t Unit: <br /> Parcel Identification Number: - Laxiaja " State 2t. . j it r kt 11 I- 33.sVa_ <br /> 7- .2 4 - ai -op /G• -de 9(7,- Phone: :P 718-253 Fax: <br /> eV • <br /> CONTRACTOR: <br /> Company: <br /> Name: Lai-Jr elt.cc 5.,...114ve-r OA) <br /> C License #: E-Mall: <br /> - Phone: (gt3 - 71;9- ..5.3(1 tell: Fax: <br /> ARCHITECUENGINEER: . <br /> Name: - Firm Name: <br /> Address: City: State: Zip: <br /> State License #: Phone: Cell: Fax: <br /> Description of Proiect <br /> TYPE OF DRIVEWAY I .1 _ LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRIVEWAY ' 1 WIDTH OF DRIVEWAY (.J) REINFORCED CONCRETE <br /> — 7COMMER . CIAL DRIVEWAY r `ApprOil 1 R.O.W. :XCAVATION ( ) CORRUGATED MATERIAL <br /> PUBLIC ArrFSS DRIVEWAY & DEPTH LINEAR 1-tt r ( ) BOX CULVERT <br /> ( ) OTHER (EXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REOUTRED <br /> ASPHALT V NO <br /> •/" <br /> NEADWALL 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 />