Laserfiche WebLink
�-L� <br /> - -; <br /> Li � t „�•;• ,i;, <br /> : < <br /> PERMIT�1PPLICATION � ''�`". ' <br /> h. <br /> DRIVEWAY PERM�T APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <br /> Ali 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 /> Date of appl :� ,.{� Prooessed,BY� � + PaRnit#: �- � <br /> bo 8uildi (a+r aro�tor sMr we ) <br /> l� to Puwic WarlcS <br /> PR07ECT 70B SITE: PROPERTY OWN�R <br /> Address: Q �#- Name: j o � <br /> Unit#: L,;-� S- , � Address: `'► rt-. Unit: <br /> Parcel Identification Number: Ci State Zi `Z� ` �'L <br /> Phone: Fax: <br /> CONTRACTOR: <br /> Com n : U� Rf5 �F <br /> Name: � ,- . ; <br /> ntractor's License#: �-) � E-Mail: � ��S _� o� <br /> Phone: �' - d v3 Cell: - <br /> � - <br /> � <br /> � ARCHITE ENGINEER: <br /> c� <br />� Name: Firm Name: <br />? Address: <br /> .� CitY' State• Zip. <br /> ,m State �cense #. Phone: Ceil: Fax: <br /> V <br /> � <br />� �a�on of Proi <br /> �E OF DRNEWAY `1 LENGTH OF DRNEWAY CULVERTS NEEDED <br /> RESIDEMIAL DRNEWAY �WIDTH OF DRNEWAY ( )REINFORCED CONCRETE <br /> COMMERCIAL DRIVEWAY R.O.W. EXGVATION ( )CORRUGATED MATERIAL <br /> PU LIC ACCESS DRIVEWAY �r DEPTH LINEAR FEET ( )BOX CULVERT <br /> �(��U.4� ACcP.�J TL 2 <br /> CONSTR U�CTION MATE r �cji�y ( )�ER(�PWN) <br /> YES NO �� <br /> �CONCRETE Z,F p�� � <br /> HEADWALL REOUI ED? YES NO <br /> NOTICE TO APPLIC/II�T: If actual work exceeds scope of this description,sdditional permits or drawings <br /> will be requir�ed. <br /> �1TILTTY LOCATION&REn��ro� • CALL BEFORE YOU DIG: i.800.43Z.4f70 <br /> Page i of 3 <br />