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2. Name
3. Permit Number
5. Address
7. City
8. State
9. Zip Code
11. Phone Number
12. Fax Number
14. Request
    I request that the following requirement(s) of the City of Pinellas Park Driveway Number 1467 be waived:
16. Requirements

    1. Minimum distance from intersection (Section 18-501A)
    2. Maximum width of driveway (Section 18-501B)
    3. Maximum number of driveways (Section 19-501C)
    4. Minimum distance between driveways (Section 18-501D)
    5. Minimum distance from property line (Section 18-501E)
    6. Alignment (Section 18-502)
    7. Measurement (Section 18-503)
    8. Circular Driveways (Section 18-504)
    9. Alternate paving materials (Section 18-511.3(A))
    10. Grass parking (Section 18-1511.3(B))
18. If you requested any requirements waived, describe the unique number you wish in the following fields:
20. Distance from intersection requested
21. Number of driveways requested
22. Distance from property line requested
24. Width of driveway requested
25. Distance between driveways requested
27. Reason for request of waiver / comments:
29. You must supply:
    1. This fully completed form
    2. Plot plan showing street, building, trees, landscaping, driveways, sidewalks, and other pertinent information which influence the location of the driveway
30. Plot Plan
32. Owner / Contractor eSignature
33. Date
    Date
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field