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�� 3'13-�Z� c��S3� <br /> ' ��T�cct.� C1a�^'t� ��rtlf-D��t� <br /> .., <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 Zephyrhilis <br /> 5335 8"' Street, Zephyrhills, FL 33542 <br /> Telephone 813.780.0000 Fax 813.780.0005 <br /> �be��Ppli��ip�t �- �1 Z ° .,� <br /> � �'��:.... <br /> �� ��- • � ; :,: <br /> #o�1`r�, - . , ��i�tt�iY+t�las. <br /> PR07ECT �OB SITE: PROPERTY OWNER <br /> ,4ddress: 9 T� ?',e�tT Name: /Y1 c ,¢�L ����c <br /> Unit#: Address• oS3 � �ST, Unit: <br /> Parcel Identification Number: Ci State Zi 7r r�G �� Ls F� 33S <br /> - - OD/ -C�/DDo- DGy/D Phone:� 0- no- 9 Fax: �3- 7�0� 3aS <br /> C`fll �,�CJ <br /> CONTRACTOR: <br /> Com n : i p rrJS'T,eucTio <br /> Name: �' FF' 1��Xp <br /> Contractor's License #: E-Mail: <br /> _Phone: / -�30 (o Cell: Fax• <br /> ARCHITECT/ENGINEER: <br /> Name: /�� Firm Name• <br /> Address: City• State• Zip• <br /> State �cense #. Phone: Cell: Fax: <br /> pescriution of Proiect <br /> TYPE OF DRIVEWAY �/� ,LENGTH OF DRNEWAY <br /> RESIDENTIAL DRNEWAY �!WIDTH OF DRIVEWAY )REINFORCED CONCREfE <br /> COMMERCIAL DRIVEWAY R.O.W. EXCAVATION (�)CORRUGATED MATERIAL <br /> �PUBLiC ACCESS DRNEWAY DEPTH LINEAR FEEf ( )BOX CULVERT <br /> �ONSTRUCTION MATE ie� ( )OTHER(IXPLAIN) <br /> ASPHALT YES NO <br /> �CONCREfE <br /> FIEADWALL REOUIRED? YES �NO <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description,additional permits or drawings <br /> will be required. <br /> �JTILITY LOC!►TIONS REOUIRED• CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />