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<br /> P.ERMIT'APP.L7CATION _ ��`
<br /> zDRIVEWA�f:PERM�IT AP.Pl���►;�ON
<br /> r�QNS�RUC�ON 1N�'t�ITN:P.UB�IC�RIGtflf OE=WAY
<br /> All information:ID,�be-filled-in compietely
<br /> - ;City-of:Zephyrhills
<br /> -5335:8�'Street,Zephyrhills,:FL"33542
<br /> 7elephone.8.13.780.0000 Fax 813.780.0005
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<br /> "PRO�ECT .JOB�ITE: `PROPERTY'OWNER
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<br /> Address ''i '�� ,t;� ,^�. w,,�.-. Name: � y ,.�- ..-.,�,,, ��, .- � .
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<br /> Unit#: Address: 1 o s a �=�-/ Unit: _ �
<br /> Parcel Identification Number: �3 _ � �� - ;, t t_ r•� a�` � Ci .State Zi �.� y.; ,��!, � �: ;. ;' ,� ;�Si
<br /> �, .� �.�,r,.�« , • Phone: ?,�� �/t'r 9 Fax:
<br /> :CONTRACTOR:.
<br /> Corr�panY' ^ �', �r � a.� �� ,�,:;� ;
<br /> Name• sk�� ,�� �t1 � _�.� '�.� ��,�°��`_>
<br /> Contractor`s License#• %���� F` -�-- �r�� t��= ? � '�' F-Mail:
<br /> -Phone��S;� �'��� :�_. ��.fE�r� Cell: �o >�� r� � Fax:
<br /> ARCHITECT/ENGINEER: �
<br /> �Name: ' Firm Name:
<br /> Address: CitY: State: Zip:
<br /> State License#: Phone: Cell: Fax:
<br /> Descriotion of Proiect
<br /> �
<br /> TYPE OF DRIVEWAY 2-S LENGTH OF DRNEWAY CU T
<br /> RESIDENTIAL DRNEWAY 3�_WIDTH OF DRIVEWAY ( ) NFORC CONCREfE
<br /> �_COMMERQAL DRIVEWAY R•O•W. EXCAVATION O CO U D MATERIAL
<br /> PUBLIC ACCESS DRNEWAY DEPrH LINEAR FEEf O BOX LVERT
<br /> ( ) R LAIN)
<br /> CONSTRUCTION MATERIAL CURB CUT REOU�,�
<br /> ASPHALT YES ,-r``. NO
<br /> �CONCRETE
<br /> HEADWALL REOUIRED? YES .,:�NO
<br /> NOTICE TO APPI:ICANT: If actual work exceeds scope of this description, additional permits or drawings
<br /> wilt be required.
<br /> UTILITY LOCATIONtS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770
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