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� <br /> PERMIT APPL'ICATION �r • � `'x �j <br /> �� �J <br /> DRIVEWAY:PERMIT APPLICATIO <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 /> �t,�et'�f�p}�Ibc�Dtt:: - _ ' . rProoe�ie�d ::�;:...-..___. �,..�,:.-....-r-- '�Fe�aiit�#:= , . <br /> , � ��{/ r��.., ..: <br /> _� . �:_. ��� . '�I'.., .".' ': .�::Fr�'s�: .. t ,. _: , - ±- <br /> , . . _ .. ._ • i(�(3yt�lD'1b1=f�f�l�z'� ,. '; �:. .1 :., _. _,�. :._- _. <br /> ' � .� � "�Gt1}�'W`Br��►g'i�►Y'l�tiietit: - .• . ;, ' ' - �•QiCppy:te3�.R�ijtili�;lMar�; � . <br /> PR07ECT .70B`SITE: PROPERTY OWNER <br /> Address: Name: ;-,. ,. <br /> Unit#: Address: .�7 � <br /> Parcel Identification Number: Ci State Zi 'Z� — <br /> Phone: F x: <br /> CONT CTOR: <br /> Com o <br /> Name• �� � <br /> Con r s Li nse#: ' E-Mail: <br /> Phone� � Ceil: - Fax: -7 <br /> ARCHITECT/ENGINEER: , <br /> Name: Firm Name: <br /> Address: City: State: Zip• <br /> State License#: Phone: Cell: Fax: <br /> Descriu�ion of Proiect <br /> TYPE OF DRIVEWAY ,�_LENGTH OF DRNEWAY CULVERTS NEEDED <br /> ✓�ESIDENTIAL DRIVEWAY �'�WIDTH OF DRNEWAY ( )REINFORCED CONCRETE <br /> CAMMERQAL DRIVEWAY r�.o.w• EXCAVATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEEf ( )BOX CULVERT <br /> CONSTRUCTION MATERIAL CURB CUT OUI ED O OTHER(DCPLATN) <br /> ASPHALT YES �NO <br /> �NCRETE <br /> HEADWALL REOUIRED? YES ./� <br /> NOTICE TO APPLICANT: If actual work exaeeds scope of this description, additional permii�s or drawings <br /> will be required. <br /> UTILITY LOCATIONS REOUI D: CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br />