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• <br /> : PERMIT-APPLICATION <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN :PUBLIC :RIGHT OF =WAY <br /> All information t be- fIlled_:n completely <br /> ;City ofZephyrhills <br /> 5335 8t 'Street,2ephyrhills, -FL 33542 <br /> Telephone 8 13.780.0000 Fax 8 13.780.0005 <br /> ' s <br /> rv� <br /> K - <br /> • U <br /> PROJECT _ �.. L h i <br /> 7OBtSITE: PROPERTY OWNER <br /> Address: <br /> Unit #: <br /> Parcel Identification Number: Address:37 /o (404,A/01- Unit: <br /> — 0Oi bC� —dO0 C StateZi• r-. - . <br /> t) Phone: 9/3 - 3 .55 -// -5 Fax: <br /> CONTRACTOR: <br /> Com. - : jn : if) — , „ /T <br /> Name: , L <br /> Contractor's License*: <br /> -Phone: /3 — ,3 / - _5" Cell: "41e . 1Fax: <br /> Fax: <br /> ARCHITECT /ENGINEER: <br /> Name: I ; ". 4 - Firm Name: <br /> Address: CI <br /> State: Zi • <br /> State License #: <br /> Phone: Cell: <br /> Fax: <br /> union of Proi <br /> RESIDENTIAL DRIVEWAY 5f � ' LENGTH OF DRIVEWAY x,44 V <br /> ' COMMERCIAL DRIVEWAY Z>�WIDTH OF DRIVEWAY NEED D <br /> PUBLIC ACCESS DRIVEWAY'•' �EXCAVA ON ( ) REINFORCED CONCRETE <br /> [2_DEPTH ?6 LINEAR FEET ( ) BO )BOX CULVERT <br /> MATERIAL <br /> CONSTRLr_??nN ( CLVERT <br /> ASPHALT y SUt� BUT En11TQRM1 ( ) OTHER (EXPLAIN) <br /> CONCRETE �� 4,49 I A�J1S Y� NO <br /> HEADWA 'Q ntrIRFQz YES ZNO <br /> NOTICE TO APP If actual work exceeds scope of this descri <br /> will be required, ption, additional permits or drawings <br /> UTILITY LOCATIONS R UIRED CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />