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f.,. <br /> PERMIT APPLIGTION <br /> DRIVEWAY PERMIT APPLICATION <br /> CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY <br /> All information mu be filled-in completely <br /> C"ity of Zephyfiills <br /> 5335 8'"Street, Z�hyrhilis, FL 33542 <br /> Tele�one 813.780.0000 Fax 813.780.0005 <br /> , P��' r <br /> � � , <br /> D�l�of � - " '�bt7�'�a�Eilldrs�F,reaiN� a <br /> p�Pl,��9� ��C�pq�to 1�MI� <br /> PRO�ECT 70B SITE: PROPERTY OWNER <br /> Address: _. rc_ Name: ��:`•�S �if � �� FvNr�. <br /> Unit#: � I C 2 �r T- Address: %• 'S �J �D .9�t�Jnit: <br /> Parcel Identification Number: C' State Zi /,A-,��M7� 3.�' ' <br /> i�- - c�-aU -oG��a w,«,e: � - 3 - Fax: ��-�y-3s�� <br /> CONTRACTOR: <br /> Company c�l�' /IJr�T�� �i`J'1ES <br /> Name: �/r % "G�i/�i� <br /> Contractor'sLicense#: C,�G/�-� �G';� E-MaiL• r.r/��Li,`�i'yi.S ��'��?�`�N:a,.�t�d�:vt,,,-f/� <br /> Phone• ��7- d 43-d7�G Cell• 7�7-a�1�-a7�� Fax: ��7-�E 9- 3SY7 <br /> ARCHIfECT/ENGINEER: <br /> Name: Firm Name: <br /> Address' Gty: State: Zip: <br /> State License #: Phone: Cell: Fax: <br /> Descriution of Proiect <br /> � <br /> aa LENGTH pF pRNEWpY d1L1lERT5 NEEDED <br /> RESIDENTL4L DRIVEWAY a v, WIDTH OF DRIVEWAY ( )REINFORCED CONCREfE <br /> COMMERCIAL DRIVEWAY R.O.W. DCGVATION ( )GORRUGATED MATERIAL <br /> PUBLIC AQCESS DRIVEWAY �"OEPTH �LiNEAR(�Ef ( )80X CULVfRT <br /> ( )OTHER(EXPLAIN) <br /> c�srrtucrioN Mu�tun� �''�' <br /> L�LT YES NO <br /> XppNCRErE <br /> YES �WO <br /> NOTICE TO APPLICANT: if actual woric exceeds soope of this description,additional permits or drawings <br /> will be required. <br /> UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800A32.4770 <br /> Page 1 of 3 <br />