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.� <br /> ;`r ' <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 0 Fax 813.780.0005 <br /> �� ��� ��� � � � . �� �_� � <br /> :. . �� - - :,, � �. _ =� ��„� � <br /> �. � <br /> PR07ECT 70B SITE: PROPERTY OWNER <br /> Address: Name: <br /> Unit #: o Address:3R7�a q o Unit: Lo� a <br /> Parcel Identification Number: Ci State Zi �,,,tt <br /> - � Phone: Fax: <br /> CONTRACTOR: <br /> Com n : �+-N�o � <br /> Name: � � <br /> Contractor's License #: 5�� 8 a- E-Mail: . CoM <br /> Phone: $t3-�8 -I(� Cell: Fax: - S'- 5' �' <br /> ARCHITEGT/ENGINEER: <br /> Name: Firm Name: <br /> Address: City: State: Zip: <br /> State License #: Phone: Cell: Fax: <br /> Descriotion of Proiect <br /> TY 3�'� LENGTH OF DRNEWAY CULVERTS NEEDED <br /> RESIDEM'IAL DRNEWAY �WIDTH OF DRNEWAY () REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.O.W. EXCAVATION () CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRNEWAY DEPTH LINEAR FEET () BOX CULVERT <br /> ( ) OTHER (IXPLAIN) <br /> CONSTRUCTION MATERIAL CURB CUT REOUIRED <br /> _�SPHALT YES NO <br /> _�CONCREfE <br /> HEADWALL REOUIRED? YES NO <br /> NOTICE T�.APPLICANT: If actual work exceeds scope of this description, additional permits o� drawings <br /> will be required. <br /> UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page i of 3 <br />