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• <br /> • <br /> PERMIT APPLICATION <br /> DRIVEWAY.PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT -OF -WAY <br /> All information must be filled -in completely <br /> City of Zephyrhlis <br /> 535 8 Street, Zephyrhlils, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> PROJECT/39B SI C ROPERTY OWNER <br /> Address: 1� - 1) 9 .14 - 61/4_ dC ( ( Name: wised Pones <br /> Unit #: Address:5439 Beaumont center Blvd #1050 <br /> Parcel Identification Number City, State, Zip Timm. FL 33634 <br /> 04 OO(0 - 00 u ) - Phone: 813- 885_7744 Fax: 813- 885 -2433 <br /> CONTRACTOR: <br /> • <br /> Company: W <br /> Name. — F'11ot'YIB.S - er C. .r' . . <br /> Contractor's Ucense #: CBC1.2 It) E -MaII: maavagecawixr7 *r1>rw� . am <br /> Phone: R11- RRS-7744x 74R Cell: Fax: R11 -RR5-2433 <br /> ARCHITECT /ENGINEER: <br /> Name: Byron R Anderson /Tam Millefirm Name: Structural Engineering and Inspections Inc. <br /> Address: 1 is 05 N F1 rn Ave OW: Tampa State: Fr• 'Zip: 33549 <br /> State License #:. #609R7/#5 Phone:R13 -R49 -5769 Cell: Fax: 813 -849 -5770 <br /> TYPE OP DRIVEWAY LENGTH OF DRIVEWAY CULVER7s NEEDSn • <br /> Y RESIDErrrIAL DRIVEWAY Up MOTH OF DRIVEWAY ( ) REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY jimew, MicAMIER () CORRUGATED MATHUAL <br /> PUBLIC ACCESS DRIVEWAY (P DEPTH LINEAR FEET ( ) BOX CULVERT <br /> ( ) OTHER (EXPLAIN) <br /> ASPHALT YES NO <br /> _CONCRETE <br /> HEADWALL P[ IITRED7 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 REQUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />