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yJy, �J <br /> 1 <br /> PERMIT APPLICATION t` <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 813.780.0000 Fax 813.780.0005 <br /> s�abe of aPP� � �—",�( Z— Pr�oc�eped�By; • �`: , , ,� <br /> • cdr•y sMr we� ��#: � <br /> y to Building Departrtient . �o Publk Waks <br /> PRO�ECT �OB SITE: PROPERTY OWNER <br /> Address: 3p�0/ o�l�( Name: /yle�t O?�. /y1d <br /> Unit#: Address: 3IQ 0/ Unit: <br /> Parcel Identification Number: Vi2-a{-�t-/--�e�1-�j- Ci State Zi ,r ,3 � <br /> 4 Phone: Fax: <br /> � �`� ��--� l� �� <br /> CONTRACTOR: <br /> Company: O avu-/' <br /> Name: <br /> Contracto�'s License #: E-Mail: <br /> Phone: Cell: Fax: <br /> ARCHITECT/ENGINEER: <br /> Name: Firm Name• e�yj� � <br /> Address: Gty' State• - Zip• <br /> State lroense #. Phone: Cell: Fax: <br /> D�cri�tion of Project <br /> � LE OF DRNEWAY CULVERTS NEEDED <br /> RESIDEMIAL DRIVEWAY OF DRNEWAY ( )RQNFORCED CONCRET'E <br /> COMMERQAL DRNEWAY B.O.W. FJ(CpVATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LTNEAR FEEf ( )BOX CULVERT <br /> CONSTRUCTION MATE =e� ( )OTHER(DCPU►IN) <br /> ASPHALT CURB CtlT OUIRED <br /> �CONCREfE YES NO <br /> NEADWALL REOUI�D? 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 REO IR D• CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page i of 3 <br />