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PERMIT'APPLICATIOM ''«4�{�ff`' <br /> . <br /> � <br /> DRIVEWAY PERN{I7 qppLICATION <br /> C�NSTRUCTIpN WITHIN PUBLIC RIGHT-OF-{�ypY <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 /> Dat�ee of aPP�k�stiom -'7-t 3 <br /> �o� ' �'�1/ Pecinit if�: <br /> ❑ t+o Buildi p��rn wq�r) - ��-O U <br /> PR07ECT 706 SITE: m�c waks <br /> Address: �,,/ Z.. �� PROPERTY QyyNER <br /> Unit#: " � Name: � � - �� <br /> Parcel Identification Number: Address: - ' ' � 1--�-- <br /> �_�/�;- Ci State Zi --' Unit: <br /> 2.l- lY'�d,.�� ,� ,�.r. '--L - <br /> ` Phone�.3 �� ' <br /> 3_ Fax: ��2� , `�� <br /> CONTRA�pR: <br /> Com n ,- <br /> Name: �� � '� <br /> � � ` - �,. <br /> Contractor's Lic se #: � � , � <br /> Phone: �? --�L�1 _ E-Mail: � , <br /> Ceil: � " ~�` ' � .L�.�Y� <br /> ARCHITECT/ENGI Fax: ,-C_ �� " <br /> NEER: <br /> � <br /> Name: <br /> Address: L�� � Firm Name: , <br /> State Lice � �� � "�� <br /> nse #: c� ' State: <br /> Phone:' �` CeN• � Zi <br /> Fax: _ �� <br /> �QI1 of Proiar+ <br /> RESIDENTIAL DRNEWAY P.��'LENGTH OF DRNEWAY <br /> COMMERCIAL DRIVEWAY ��DTH OF DRNEyyAY CUL{/�Qn y��;�:. <br /> PUBLIC ACCESS DRIVEWqy �s O REINFORCED CONCRETE <br /> DEPTH IINEA�� ( )CORRUGATED MATERIAL <br /> � )BOX CULVERT <br /> �A SPHALT � S�.B�CUT EO IREn ( )OTHER(p�p�N��_ <br /> 25_CONCRETE YES NO <br /> ��_WALL En��*or-- _�YES <br /> NO <br /> �0 C T APp rrenrr: if actual woNc exce���p�of this description,addit' <br /> will be required. <br /> ional permits or drawings <br /> UT�LTIY�g�aTreMc e�... � C,�L� �EFORE YOU DIG: 1.80Q.432,47fp <br /> Page Y of 3 <br />