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agin ■ Tiro <br /> j#0 <br /> 4 ; <br /> • <br /> - v-8 <br /> PERMITAPPLICATION P79,_ <br /> DRIVEWAY :PERMIT :AP,PLICATION <br /> CONSTRUCTION NM.HIN PUBLIC :RIGHT-OF-WAY <br /> All • information ingg be completely <br /> .City.ofZephyrhills <br /> 3335 g Street,Zephyrhills, 33542 <br /> 'Telephone 813:780.0000 Fax 813780.0005 <br /> • • 7 <br /> -PRWECT/JOBSITE: .PROPERTrOWNER <br /> Address: L H 30 0 r5+ z-k1J f 5lig_ Name: C_Nlui A 1-tar r <br /> Unit #: Address: Lig 30 10 Unit: <br /> Parcel Identification Number: - State 2i• k rk / <br /> Phone: :r 78 .2 5 Fax: <br /> Di • <br /> CONTRACTOR: <br /> Com.an : <br /> Name: La.,...)reitcr . OA) <br /> Contractor's License #: E-Mail: <br /> -Phone: (3\ 7S9- gs -Cell: Fax: <br /> ARCHITECT/ENGINEER: <br /> Name: Firm Name: <br /> Address: City: State: Zip: <br /> State License #: Phone: Cell: Fax: <br /> Description of Proiect <br /> in . <br /> TYPE OF DRIVEWAY , LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRIVEWAY , WIDTH OF DRIVEWAY (4) REINFORCED CONCRETE <br /> —7-COMMEItIAL DRIVEWAY le-ApprOn EXCAVATION ( ) CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY t .91 1 I DEPTH LINEAR FEET ( ) BOX CULVERT <br /> • ( ) OTHER (EXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REQUIRED <br /> ASPHALT _YES +/ NO <br /> •/ <br /> HEADWALL REOUIRED? YES N/ NO <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description, additional permits or drawings <br /> will be required. <br /> UTILITY LOCATIONS REQUIRED: CALL BEFORE YOU DIG :1.800.432A770 <br /> Page 1 of 3 <br /> • <br />