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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 completety <br /> City of Zephyrhills <br /> 5335 8"' Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> �ArYMii'h/)Y�1 ���, � � � ' � $ t Mk ' _ _ <br /> ,,� � �� <br /> � <br /> PR07ECT )OB SITE• PROPERTY OWNER <br /> Address: ! 5 v � i' � Name: Y"� � N v � � n-- <br /> Unit #: Address: � �F rl" Unit: <br /> Parcel Identification Number: — 2 -� �, "� nu � d Ci State Zi Z�f/N/t (� 4�-i- R' ts' L 3 g �. z. <br /> 0 0-- �� b�o Phone: �'� �' �? Fax: � 3- 6 D'I — <br /> lA�...2L_1.!-osio�I 6eu- �l1G'�L. � � S—�`fS�d <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 /> DesCrio n,of Proiect <br /> ('� <br /> T�1 PE�OF DRIVEWAY ��• L NGTH OF DRNEWAY <br /> RESIDEM'IAL DRNEWAY WIDTH OF DRI�VEVUAY () REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY � EXCAVATION <br /> PUBLIC ACCESS DRIVEWAY �prH 1 � LINEAR FEEf () BO U VER D MATERIAL <br /> CONSTRUCTION MAT ore� () OT ER (IXPLAIN) <br /> CU�OUIRED � <br /> � ALT ES NO <br /> NCRETE <br /> 11EeDWALL R�OIlI D� YES �NO <br /> NOTICE TO APP ?ceNT If actual work exceeds scope of this description, additional permits or drawings <br /> will be required. <br /> UTILITY LOCA ONS REOLTRFn• CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />