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11-11458
Zephyrhills
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Building Department
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Permits
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2011
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11-11458
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Last modified
10/19/2011 1:28:24 PM
Creation date
10/19/2011 1:28:23 PM
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Building Department
Company Name
CITY OF ZEPHYRHILLS
Building Department - Doc Type
Permit
Permit #
11-11458
Building Department - Name
CITY OF ZEPHYRHILLS
Address
5055 AIRPORT RD
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• <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 Zephyrhills <br /> 5335 8"' Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> A <br /> Oliwto-000 ;4„ <br /> PROJECT/30B SIT PROPERTY OWNER <br /> Address: - o ,5 ft: ,rP?r t �t Name: C°J' 5 ns <br /> Unit #: Address: Unit: <br /> Parcel Identification Number: City, State, Zip <br /> Phone: Fax: <br /> CONTRACTOR: <br /> : <br /> Com an ,, (!�9 ,70 I I1 C <br /> Name: y c �Q (.O & <br /> Contractor's License #: C C /5 B6-46, E -Mail: <br /> Phone: Cell: Pp - 477q Fax: <br /> ARCHITECT /ENGINEER: <br /> Name: Firm Name: <br /> Address: City: State: Zip: <br /> State License #: Phone: CeII: Fax: <br /> Description of Proiect <br /> TYPE OF DRIVEWAY 7 ( LENGTH OF DRIVEWAY CULVERTS NEEDED <br /> ___,RESIDENTIAL DRIVEWAY / a WIDTH OF DRIVEWAY ( ) REINFORCED CONCRETE <br /> ✓ COMMERCIAL DRIVEWAY R.O W. EXCAVATION ( ) CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY (p DEPTH LINEAR FEET ( ) BOX CULVERT <br /> ( ) OTHER (EXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT OUIg,Fb <br /> ASPHALT YES / ENO <br /> /CONCRETE <br /> HEADWALL REOUIRED? 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 />
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