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.;': '�tl <br /> . <br /> . <br /> PERMIT APPLICATION <br /> h <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 /> Dabe of applicadon: �7�( P�ooe�sed By: � �ermik#: Q '?f <br /> (9�Y area tor sfaR use ) '�`"','' <br /> ❑Copy to Building Departrnent to Public Waics <br /> PRO�ECT/70B SITE: PROPERTY OWNER <br /> Address: �-"ti c)._ - Name: - � <br /> Unit#: Address: ` �� �� Unit: � <br /> Parcel Identification Number: Ci State Zi � � ' � <br /> �-2. � > >�% - , � �_.. � Phone: '�-��'- �L�.{ "' Fax: �� �L.L- - <br /> CONTRACTOR: <br /> Com n C - ��` �:(� �` C� � <br /> Name: <br /> Contractor's License #: � � �, - � q E-Mail: � ,^ ' � <br /> Phone:�t?�°�-?-►-1�3 Cell: Fax: �l2-•,��- �C�41 <br /> ARCHITECT/ENGINEER: <br /> �- _ <br /> Name: �� � Firrn Name: �``;' � <br /> Address:�_"' - , Ci � State: Zi <br /> State License #: r Phone.��, ��- Cell: Fax:�'? -�{`�;� -� "� <br /> Descriution of Proiect <br /> P D V ;�LENGTH OF DRNEWAY CULVERTS NEEDED <br /> RESIDEM�WL DRIVEWAY ���` �WIDTH Of DRIVEWAY ( )REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.O.W. EXCAVATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEP'TH LINEAR FEET ( )BOX CULVERT <br /> ( )OTHER(IXPLAIN) <br /> cnNSTRUCTION MATERIAL CURB CUT REOUIRED <br /> SPHALT YES NO <br /> CONCREfE <br /> HEADWALL REOUIRED? YES NO <br /> NOTICE TO APPLICANT: if actual work exceeds scope of this description,additionat permits or drawings <br /> will be required. <br /> 11TILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />