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, . ��� � �- i�-�i <br /> a`.k% 1�J - <br /> PERMIT APPLICATION " � F (�-- j �jp Q /ti' <br /> L <br /> (� , <br /> `:' <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <br /> All information m i be filled-in completely <br /> City of Zephyrhilis <br /> 5335 8"' Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> �abeof ��" —� � ���►�.," ! , ���4 <br /> cv�r � <br /> ��PY to Bt�ildi'i�g �nerit �i't.�,Pi71�C Wbr�Cs <br /> PR07ECT 70B S E: PROPERTY OWNER <br /> Address: t --"l ' � Name: r�/ <br /> Unit #: Address• nit: <br /> Parcel Identification Number: Ci State Zi �— ,��✓�'`/%Z <br /> Phone � � ax: <br /> .� <br /> CONTRACTOR: <br /> Company: <br /> Name: <br /> Contractor's License #: E-Mail: <br /> Phone: Cell: Fax: <br /> ARCMITECT/ENGINEER: <br /> Name: Firm Name: <br /> Address: City: State: Zip: <br /> State License #: Phone: Cell: Fax: <br /> Descriotion of Proiect <br /> TY �� LENGTH OF DRNEWAY I, �� CULVERTS NEEDED <br /> ESIDEMIAL DRNEWAY �� WIDTH OF DRIVEWAY �� () REINFORCED CONCREfE <br /> COMMERCIAL DRIVEWAY R•O•W EXCAVATION () CORRUGATED MATERIAL <br /> PUBLiC ACCESS DRIVEWAY DEPTH LTNEAR FEEf O BOX CULVERT <br /> ( ) OTHER (IXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REOUIRED <br /> ASPHALT YES NO <br /> �CONCREfE <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 REQUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page i of 3 <br />