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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 813.780.0000 Fax 813.780.0005 <br /> .a4 a - r`., ,�r��a�.a�'-,x y. ..T: ¢�. .s.. . <br /> p''�# `'.x'.`'�• r6s+� ., .. ,. � <br /> °�.'� 3', r4; � :�'� r .� -i', ����a"fi-'`���`�a° _ <br /> �e - ' '�;��:�.;•;,;m g�f l��a. « <br /> PR07ECT �OB SITE: PROPERTY OWNER <br /> Address: 51'cb h �- Name: i � <br /> ,/ Unit#: Address: 580 /$�h nit: � <br /> Parcel Identification Number: Ci State Zi 3 S�{Z <br /> Phone: rd�3-313- og Fax: b ,� <br /> -.�_=�.�.-..�.---.__ '� <br /> CONTRACTOR: <br /> Company: <br /> Name: <br /> Contractor's License #: E-Mail: <br /> Phone: Cell: Fax: <br /> ARCHITEGT/ENGINEER: <br /> Name: Firm Name: <br /> Address: City: State• Zip: <br /> State License #: Phone: Cell: Fax: <br /> Descriution of Proiect <br /> Jr��LENGTH OF DRNEWAY CULVERTS NEEDED <br /> � RESIDENTIAL DRNEWAY LWIDTH OF DRIVEWAY ( )REINFORCED CONCRETE <br /> COMMERCIAL DRNEWAY R•O•W EXCAVATION O CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPT LINEAR FEET ( )BOX CULVERT <br /> CONSTRUCTION MATERIAL `CURB CU�RE,OUIRED � )�ER(IXPLAIN) <br /> ASPHALT YES NO <br /> �-CONCRETE <br /> HEADWALL REOUIRED? YES NO �!VS $r!.I� W q I IC �/'�rv� (�-��,�,� Qrp,�� �,J� 1�� <br /> 5,1c1c o� �1-F�e hc�-e 3x 4 50 � <br /> NOTICE TO APPLICANT: If actual work exceeds scope of this description,additional permits or drawings <br /> will be required. <br /> UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />