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� �, <br /> � , <br />� i <br /> � <br /> a <br /> PERMIT APPLICATION ' �q <br /> ��. <br /> DRIVEWAY ERM�IT APPLICATION <br /> CONSTRUCTION W THIN PUBLIC RIGHT-OF-WAY <br /> All informati n must be filled-in completely <br /> Ci of Zephyrhills <br /> 5335 8"'S reet,,Zephyrhills, FL 33542 <br /> Telephone 813 780.0000 Fax 813.780.0005 <br /> Da# �o�a li'cat'ron: Y%gZ= ,`; . , - ,, : �. _..�., .- {� . , ��.,;<..� ,. :., £ . <br /> !� - PP ., �- ( �Proce'ss . By';.: ,% +J °ti-r3. . �P.erna�t.�: . :.s <br /> �. :.. ,. . :- �,` . ` - - � . _ , <br /> . � yray:area�for,staff usE'anly) , '' . :- �- '� <br /> '� Q�oP`l:Eo;9uslcling'Deparhne�$ �Z��n� : :�� - ` - ' ,�Gop,y'taF?}�tilic-Works.,�. ' " ;-`� <br /> PR07 T/70B S PROPER OWNER <br /> Address: I Narrie: ` � <br /> Unit#: ' �Address: , (,►'j Unit: <br />� Parcel Identification Number: �Ci St te Zi <br /> - � �Phone: ( U Fax: �- <br /> CONTRACTOR: <br /> Com an � <br /> Name: � <br /> Contra or's Lic n e #: ` � � E-Mail: , 5 lQ� <br /> Phone: - Cell: � Fax: � - <br /> � <br /> ARCHITECT/ENGINEER: ' <br /> Name: Firm ame: � � {� <br /> Address: .Ci State: Zi <br /> State License #: Phon "; II: Fax: <br /> , <br /> � <br /> De cri tion of Pro'ect <br /> � <br /> TYPE OF DRIVEWAY �LE GTH OF DRNEWAY CULVERTS NEEDED <br /> RESIDENTIAL DRIVEWAY WI H OF DRNEWAY ( )REINFORCED CONCRETE <br /> COMMERCIAL DRNEWAY R.O.W. , EXCAVATION ( )CORRUGATED MATERIAL <br /> PUBLIC ACCESS DRIVEWAY DE H � LINEAR FEET ( )BOX CULVERT <br /> I ( )OTHER(EXPLAIN) <br /> CONSTRUCTION MATERIAL CURB T RE UIRED <br /> ASPHALT Y • NO <br /> �CONCREfE <br /> HEADWALL REOUIRED? YES �C NO , <br /> NOTICE TO APPLICANT: If actual work excee s scop I of this description,additional permits or drawings <br /> will be required. <br /> UTILITY LOCATIONS RE UIR D: , CALL BEFORE YOU DIG: 1.800.432.4770 <br /> Page 1 of 3 <br /> � <br /> , i <br /> � <br />