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, ,`i, <br /> � � ��i, <br /> PERMIT APPLICATION a <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <br /> All information must be filled-in completely <br /> City of Zephyrhilis <br /> 5335 8"' Street, Zephyrhills, FL 33542 <br /> Telephone 813.7 . 00 ax 813.780.0005 <br /> �Date ofaApai�1 �i �,— — A�oioep�l,�i � . � . >-. . <br /> �r � �nru�e�orih� �,..---"� � . <br /> opy M Butldi�g pe�a�trlent � --'' ,'bt� Publk aMor�ts <br /> PR07ECT 70B SITE: PERTY <br /> Address: � U 7 �-! ..ST Name: � r� �Z p�►1 <br /> Unit #: Address: OSS ()T� Unit: <br /> Parcel Identification Number: Ci State Zi r2 �c� � S <br /> Phone: F's13 3 � S�3o Fax: <br /> CONTRACTOR: <br /> Company: <br /> Name: <br /> Contractor's License #: E-Mail: <br /> Phone: Cell: Fax: <br /> ARCHITECT/ENGINEER: <br /> Name: Firm Name: <br /> Address: City: State: Zip• <br /> State License #: Phone: Cell: Fax: <br /> D�crintion of Proiect <br /> � <br /> TYPE OF DRIVEWAY � LENGTH OF DRNEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRNEWAY Zt� WIDTH OF DRNEWAY <br /> COMMERCIAL DRIVEWAY � ) �INFORCED CONCRETE <br /> R•O•W EXGVATION ( ) CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LiNEAR FEET () BOX CULVERT <br /> ( ) OTHER (IXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REOUIRE_D <br /> ASPHALT YES NO <br /> �CONCRETE <br /> HEADWALL REOUIRED? YES NO <br /> NOTICE TO APP�iG►NT; if actual work exceeds scope of this description, additional permits or drawings <br /> will be required. <br /> �TILTTY LOCATIONS REOUI E� CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />