HomeMy WebLinkAbout04-2827
CITY OF ZEPHYRHILLS
5335-8th Street
(813)780-0020
ELECTRICAL PERMIT
2827
Permit Number: 2827
Permit Type: ELECTRICAL MISC
Class of Work: ELECTRICAL MISC
Proposed Use: NOT APPLICABLE
Contractor: MORTON ELECTRIC
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 3/15/2004
Total Fees: 44.00
Amount Paid: 44.00
Date Paid: 3/15/2004
Work Desc: POWER SUPPLY FOR CATV
Address: 38716 2ND AVE
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: JOHN PANZER
Address: 38716 2ND AVE
ZEPHYRHILLS, FL. 33542
Phone:
ELECTRICAL FEE
44.00 !
!
I ROUGH!LEtTnIC
FINAL ~ ~! 3 rH RL-Lf
-----~---------~---_----'---.-__.__.__._~--~-'""---------~--_._------_.--------
r<.l:~a.Nt;l:'.l!;L:'l'.LU.N l:".l!;.l!;t;: -wl1eh eXEra-tnspece-.ion ~l:rtps-are necessary Que to any C5fie-oIl:11e _____
following reasons, a charge of Thirty-five dollars ($35.00) shall be made for each trip for
each trade:
(a) Wrong address (b) Condemned work resulting from faulty construction (c) Repairs or
corrections not made when inspection called (d) Work not ready for inspection when called
(e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible
The payment of inspection fees shall be made before any further permits will be issued to
the person owning same
'-nwa-rn1'ng1:oowner: YOu~farru-re-EO-recorQa nol:iCe---Of commencement: may --fifsuU-r--n-your--
paying twice for improvements to your property. If you intend to obtain financing, consult
with your lender or an attorney before recording your notice of commencement."
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be
performed in accordance with City Codes and Ordinances.
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CONTRACTOR PERMIT OFF I
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS
5335-th street
(813) 780-0020
ELECTRICAL PERMIT
2827
Permit Number: 2827
Permit Type: ELECTRICAL MISC
Class of Work: ELECTRICAL MISC
Proposed Use: NOT APPLICABLE
Contractor: ATA ELEC. CO.
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 3/15/2004
Total Fees: 44.00
Amount Paid: 44.00
Date Paid: 3/15/2004
Work Desc: POWER SUPPLY FOR CATV
Address: 38716 2ND AVE
ZEPHYRHILLS, FL.
Township: Range:
I Lot(s): Block: Section:
I Book: Page:
I Subdivision: CITY OF ZEPHYRHILLS
I Name: JOHN PANZER
I' Address: 38716 2ND AVE
I ZEPHYRHILLS, FL. 33542
i Phone:
ELECTRICAL FEE
44.00
ROUGH ELECTRIC
FINAL
~._-------_._--.-.__._~-~--
,K~.LN::;l:'~C"l'.LUN 'FEES':-wnenextrcrlfispecUon1:r~psarenet:essary---au-e to any- one oIEne-----
following reasons, a charge of Thirty-five dollars ($35.00) shall be made for each trip for
each trade:
(a) Wrong address (b) Condemned work resulting from faulty construction (c) Repairs or
corrections not made when inspection called (d) Work not ready for inspection when called
(e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible
The payment of inspection fees shall be made before any further permits will be issued to
the person owning same
---Warn1ng---e-o-owner:-your-uJ.l ure-t:b-re~corQanotJ.ce of commencemenElfiayresuIt:Tn your~---
paying twice for improvements to your property. If you intend to obtain financing, consult
with your lender or an attorney before recording your notice of commencement."
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be
performed in accordance with City Codes and Ordinances.
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.. CONTRACTOR
CALL
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PERMIT OFFI
FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
...
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8H St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
3!:2ft5/
/
PHONE CONTACT ~ PERMITTING
OWNER'S NAME
~htl
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fA rJ z- tfd-.
Jnd Ilve.
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{/ ~r/r{l t louse. PHONE
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7~7- 73~- 7a~y
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK ;? DC' SUBDIVISION
PARCEL ID # II-)'b- J}.- (}()/O - dIXIOO- ft'
(ORTAIN FROM PROPF.RTY TAX NOTIC-E\
WORK P'ROPSED: (JNEW CONSTRUCTION (J ADDITION (JALTERATION (JREPAIR cvfNSTALL
(J SIGN (J MOVE (J DEMOLISH
PROPOSED USE: (J SGL FAMILY DWELLING (JMULTI-FAMILY (J# OF UNITS (J MOBILE HOME
(J COMMERCIAL (J INDUSTRIAL (J SWIMMING POOL (JOTHER
o RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
C /JTV
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
(J BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
lO ELECTRICAL
fbn
AMP SERVICE
~ FLORIDA POWER
(J W.R.E.C.
(J PLUMBING
~MECHANICAL $
(J GAS (J ROOFING (J SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
(J OTHER
TYPE OF CONSTRUCTION: (J BLOCK
(J FRAME
(J STEEL
(J OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA(J YES (J NO
CQ~QTO:aii,$EC;:TI()N
BUILDER
COMPANY
SIGNATURE STATE CERT OR REGIST #
* * * * ** *;d;:.*Xe :*i1T~ * * * * * * ** *. * * * *)* ~: * **:: * ~**.** **~~,
ELECTRICIAN// '/~ COMPANY / fJ !-ti'C7 rICo
SIGNATURE ' /7/'v1 ~ STATE CERT OR REGIST # 5';;;('4"5
******************************************************************
PLUMBEll
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*****************************************************************
OTHER I
COMPANY
SIGNATURE
STATE CERT OR REG 1ST #
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" wJ:iich
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be licensed in accordance with state and local regulations. If the contractor is not
licensed as required by law, both the owner and contractor may be cited for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to what
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-780-0020.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs as the contractor, you are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wishes
you to sign as contractor that may be an indica~ion that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to commencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will
be done in compliance with all applicable laws regulating construction, zoning, and land
development.
Appli~ation is hereby made to obtain a permit to do work and installation as indicated. I
certify that no work or installation has commenced prior to issuance of a permit and that
all work will be performed to meet standards of all laws regulating construction, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A, etc.", it is
understood that a drainage plan addressing a "compensating volume" will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance.
A permit issued shall be construed to be a license to proceed with the work and not as
authority to violate, cancel, alter, or set aside any provisions of the technical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, construction, or violations of any code. Every permit
issued shall become invalid unless the work authorized by such permit is commenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for 'a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,50 ALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
, 2CL-
(name of person acknowledged)
Dwho is personally known to me, or
Dwho has produced
(type
and wrioD did D did not
of identification)
take an oath.
Signature of person taking acknowledgement
Name typed, printed or stamped
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _day of
by
acknowledged
, 20
(name of person acknowledged)
[1ho is personally known to me, or
Dwho has produced
(type of identification)
and who Ddid DUd not take an oath
Signature of person taking acknowledgment
Name typed, printed or stamped
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.PASC6. COUNTY DEVELOPMENT REVIEW
WEST pAsco GOVT. CENTER S-230
7530 LITTLE ROAD
NEW PORT RICHEY, FL 34654
(727) 847-8142
(352) 521-5144
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PA~CO CQUNTY
- USE PERMIT -
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RIGHT-Of-WAY USE PERMIH .' /
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MSunshine-One CallM
(800) 432-4770
- 48 hours prior to excavation -
GENERAL INSTRUCTIONS
No construction, under ground or above ground, bf any facility, shall be accomplished on any County Rights of Way without written approval 'from
. the County. Any application tor approval of construction operations on any County owned Rights of Way shall furnish a detailed drawing showing the
complete scope of the proposed work in quadruplicate to the County for review and approval prior to the commencement of any work. It copy of this
permit must,be kept readily avaUable at the alte of the work at all times. \:
Sec. No, T lit R County Road,?"":"'" "'//____ Date /0,'$/ D.3
Permit For I' i>t':' /JU'f:.l./1kjV,,- _~____ ~~-~
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(Project Name)
LOCA nON (Legal Description)
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(Address of Permittee)
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Permisalon is hereby granted to ".t"~/"J.I//~ ,.Ili:.,,/5J.. /V;'/)vl--K.k:.:..$.
(Name of Permittee)
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for the construction and maintenance of
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(Descriplil;ln of Work)
subject to the following conditions:
1, The construction and maintenance of such utility shall not interfere with the property and rights of a prior occupant.
2. All work shall be done in keeping with the standards of Pasco County and at the satisfaction of Pasco County, who will be notified at least
one day prior to commencement of construction,
3, All malerials and equipment shall be subject to Inspection by Pasco County,
',' 1- Durinq construction all safety regulations of the Florida Department of Transportation shall be observed; and Pasco County shall be relieved,
of all responsibility from damage of any nature arising from this permit. Subject to the same terms and conditions, the permit holder may take such
safety measures, Including placing and display of caution signs. as it may deem necessary in conduct of construction and maintenance work hereunder.
5" All private and all Pasco County property shall be restored to its original condition as tar as praclical, in the Clplnion of Pasco County.
6. All unCllerground crOSsing installations shall be laid at such depth as may be specified by Pasco County, unless Cltherwise authorized. Inatalla-
tlQn of utili.... under County rGllda ahall be by JKldng and boring only.
7. The sketch (four cople.) covering the details of this installation shall be made a part of their permit. This permit is granted with the understanding
that the applicant has noUned all other utility users 10 the area covered by the permit and takes full respollsiblllty fO/any damage incurred by prior
installations. a result of his operations. He also takes full responsibility lor notifying any and all utility or underground users of his proposed operations
in order thaI 'hey may safeguard their interests.
8,'11 is e!tpressly stipulated that this permit is a license for permissive use only and that the placing of facilities upon public propertypursuanl
to this permit shall not operate to create or to vest any property right in said holder. "
9, Whenever Pasco County decides to lurther exploit the County Rights of Way. any or all 01 said poles, wires. pipes, cables or other facilities
and a~purtenances authorized hereunder, shall be immediately removed from said Rights of Way, or reset or relocated thereon as required by Pasco
Counly at t~ expen.. of the holder 01 this permit,
10, The holder shallaave and keep Pasco County harmless from any and all damages. claims, or injuries Ihat may Q(;cur by reason of the construc-
lion, malntellllllCe and operation of said facility, '
............~"-....,
". The holder shall complete the requested work Withl{t'3Oi6ii;;LUlQ...Wl~r this permit shall become null ~ 'Iold. In the event the ~k' re.
quested is nat completed upon the expiration date of this perm'it';'"'PbCtt'CouniY shall have the right to complete such work and to charge the holder
of the permit for all costs Incurred in completing said work.
.. 12. )rhe permittee shall post a cash or surety performance gueren,ee with lhe County Clerk. Based on a cost estimate prepared by the permittee's
\ ~nglneer and IIpproved by the County. The amount of the guarantee Is to be an amount equal to 125% of the cost to construclthe permitted improvements.
)lilhe event. surety bond ~ posted, the seid liurety bond shall be made payable to Pasco County and shall obligate the auretyto hold the County
('harmlesa In the event the holder of this permit should fall to meet any of its obligations, hereunder, The bond shall also indemnify P88CO County for
all court cost. and re880nable ettorneys fees in the event legal action is required to collect or said bond.
i 13. The permittee shall post a cash or surety maintenance guarantee with the County Cler.k based on a cost estimate prepared by the permittee's
I engineer and eppt'oved by the County. The amoung of the guarantee is to be an amount equal to 15% of the ~ost to construct the permlItecllmprovements,
\In the event.. surety bond is posted it shall meet all the criteria stated in No. 12 above.) i, . ,"'" ''/..2 7-' I
, 14, SPECIAL CONmTIONS /~:; r'.i -/77;':' /')' i('i" l:(r<"/.""It,Ii"i..~; (/ < :1'./ ,...,;- /IJ,);e. 11./-+..\ tN )~ ~:Ii",i
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APPAOVE~ av.i ~,: 0;~ ~t%'~;; ,., L ,
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Utilities ServiF.'es~' " -.J ! ,., .
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SUBMITTED BY r '\ ., "- ."---,
Signature
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Print Nam. and Title
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" Public Works!:
Guarantee E~timate Review: ,
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Developmenl Review Approved: (/ ~;..,
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MaIling Addr.ss (Street. Ci.y, Stal.)
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BRIGHT HOUSE NETWORKS
GENERAL RIGHT OF WAY PERMIT
EXHIBIT" A "
Bright house Networks daily activities that do not require a specific right of way utilization permit
when working within the boundaries of Pasco County right of way
New Customer Service
1. Installation of service drops from serving location.
2. Installation of new aerial distribution cable from existing poles.
3. Installation of a second. aerial distribution cable from existing poles.
4. Extension of existing aerial distribution cable from existing poles.
5, Installation of anew bwied distribution cable that does not cross or begin in the pavcemcnt.
6, Extension of an existing buried distribution cable that does not cross or begin in the pavement.
7. Installation of two way four inch conduit system that does not cross or begin in the pavement.
8. Extension of a two way four inch conduit systam that does not cross or begin in the pavement.
9. Installation of a new pole line.
10. Extension of ~ting pole ~ providing it does not encroach into an lU'ldergr01.U1d utility area.
11. Adding of new equiptment to existing cable.
12, Pulling in new underground feeder cables in an existing permitted manhole and conduit system,
13. Digging of a splice hole to splice a new cable or changing equiptment.
14. Digging of 8 splice hole for cable acceptance testing for quality.
15. Digging of a splice hole to change the size of a cable leg for new service.
~.a1n~anee of imtina CATV Facilities
1. Replacement of existing service drops.
2. Replacemcntl repair of an existing aerial cable providing other aerial utility service still exist.
3. Replacement of existing poles providing other aerial utility service still exist.
4. Rep1acemclntJ repair of existing equiptment.
5. ReplfWeJ:l1ent/ repair of an existing underground feeder cable in an existing permitted manhole
and conduit s}1ltcm.
6. Pumping water out of a manhole to maintain underground cables in conduit system.
7. Digging of splice holes to locate and repair damaged cables.
8. Digging of a splice hole to change the size of the cable,
9. Diging of a splice hole to add a side leg off feeder cable.
10. Digging of a hole to repair broken conduits.
11. Dissing of a splice hole for cable acceptance testing for quality,
12. Diging of a splice hole to repair damaged cable.
l). Digging of 8 hole to verify the location of buried facilities.
14. Removal of facilities no longer needed for service.
1$. Tree trimming to clear aeri,al facilities.
16. Adjust aerial facilities to accommodate other users of pole line and! or to meet National Elcctri
Safety Code.
BRIGHT HOUSE NETWORKS
GENERAL RIGHT OF WAY PERMIT
EXlDBIT .. B ..
A GENERAL RIGH OF WAY PERMIT (GRP) - is given for certain routine repetitive work not requiring
a specific permit defined on Exhibit" A " that is 5 feet or greater from back of curb (BOC) or edge of
pavement (EP).
No roadway will be open cut or directional drilled with this pennit.
.'-
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Upon completion of work the Pasco County Inspector shall be notified for a final inspection of the
project.
Best Management PractiCes (BMP) will be observed at all times.
Notify Sunahi:neStat:e One Call of Florida at 1-800..432-4770 not less than 48 hours or more than
5 days prior to construction,and all other requirements of Florida Statute 556 will be observed at
all times.
MAINTENANCE OF TRAFFIC
· All activities in accordance with this agreement will require confonnance to the "Matwal of
Traffic Control and Safe Practices for Street and Highway ConstIUcion. Maintenance and
Utility Operations." (Chapter 316, Florida Statues)
· Pedestrian. bicycle and handicap traffic must be safely maintained and must DOt be redirected
into the roadway or into ditches. Use of sidewalks may not be impaired or closed for greater
that 60 minutes. When a sidewalk is to be removed means of rerouting pedeatr:ians, bWyalists
and handicapped people must be constructed prior to sidewalk removal per Florida
Department of Transportation (FDOT), Manual on Uniform Traffic Control Revises MUTCD
and American Disabilities Act (ADA),
· No street shall be closed without the prior written peIInission of Pasco County Ins.pector. At
least 2 normal working days (Monday thru Friday) advance notice is required. All
maintenance oftraffio plans are to be sulmitted to the Pasco County Inspector for approval
prior to conunencement ofcoostruction. Appropriate worl< zone safety is to be fi)Dowed at all
times.
· All construction activities shall include traffic control through the work zone in accordance
with FOOT" Roadway and Traffic Design Standards" Indexes 600 Series titled " Traffic
Control Through Work Zones."
Where it is diacovered that a site specific permit will be required, i.e., during excavation existing facilities
become less that .5 feet from BOCIEP.
1) The Construction Supervisor will notify the Bright house N etwoIks Engineer that a project
Cannot be completed 1Ulderthe GRP.
EXHIBIT" B " c:onUnued
2) The Bright hoU6e Networks Engineer will noti.tY the Pasco County Inspector of the situation
and schedule a field meeting. (Every effort will be made to arrange the field meeting within
a time frame that will not require the Construction Crew to leave the site and reshedu1e the
work.)
3) The Bright house Networks Engineer will be responsible fur notification all appropriate
personnel of the time and location of the field meeting.
4) A mutual understanding of the scope of work required to complete the project will be achieved
at the field meeting.
5) At the Pasco Comty Inspector's discretion, a verbal approval of the work may be issued
allowing work to resume.
..
6) The Bright houae Networks Engineer shall apply for a sUe specific Permit inclusive of all
details as agreed upon at the field meeting. (If a Verbal ~proval was granted, the &ite specific
shall be submitted as an" After -the-Fact" application.)
7) Upon completion of the work, the Pasco Comty Inspector shall be notified for a Ilnal
inspection of the project.
---lUGIIT OF WAY RESTORATION
· All disturbed areas in the right of way will be sodded wUess otheIWise directed by Pasco
County Inspector, Sod must be maintained until it roots, a minimum water of2 weeks.
· Vegetation, other than sod, will be restored to its pre-construcion condition.
· Prior to disturbing sprinkler systems, plants and mailboxes that may be disturbed during
construction, notifY property owners, Replace those items that are damaged by pennittee.
· The permittee shall be responsible for handling all complaints regarding the construction
project.
f)ATF;:
CITY OF ZF:rIfYRHlLLS - ROfLIHNG HF.PARTMF',NT
R1GJfJ-O_F.:JYA '\::.JLSJ!;.2_t.RMU:
PERMIT#
Nil rllll,hlll'flnn nn,IPf lllmm,I fll Jlhove Ill'lInll.1 IIf n"~' fJldll!:l' ~hnll he nrrllnlJ1ll~he,I nn II"~' CltJ' R1llhh of WR~' wlthoul "tltleh I1I11'ro\nl rl"'" Ihe
CltJ'. BulldlnR nl'I'l1ttnteut, An~'l1l'rllrntlon for "1'1'1'0,,"1 nf Nlh~h11('tlo" "(I",tnllonq on nny ell)' IIwned Rlfilhh of WRJ' ,hnll filmt,h" oIelnll...1 th'nwlnll qhowIllll
the "'''"pll'te 'co(le of the I'rn(lo'l'd \1'orl< In trll'llrnle 10 Ihe offiee IIf I"e Rnlldlnll Officlnl ft,r nI'I'I'o'AI ptlot 10 Ih", eO"'lIll'nl'eltlenl IIf nllJ' wnrl<. ^ eop~' of Ihl"
(lermlt I, hi he 1(l'pl rendlly n\'nllJlble At the ,ltp IIf Ihe lVorl( nl nil time,.
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..-.--..-....--.....-----. -, ....~---..-....-. . .. ~--"-""- ....~_w..._.____.~__._.__ ___._ _____ _...h___'___H__'_ ..________~._____.__ ____._____._. .______._____~____.__________._.____.. _______._______
-'- '---'-"-. ..--,-------.-.-.------.. ..-. '__ ____.___n_________.__._._._..___._.___.___~______._______'_~~._
Prtml"I,," I~ hrtl"'V I!;t'".ll'll 10 __'__________,_______,____ _____,___of __~_'________________________________.___________.__.____~
fOI' the C'on~lrul'llon'Jln" 1I1"lnte;'~~~;'I~' ----~-
"--~-~-_.__._._--~_._--_._--------. . ..._~~--._._--------_._----_.------.__.._--------_._~..-~.-
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---~~..-..--- --- ..---~..- ----....----.-.-.,..-..-.-~- --------.----.--.-.----.-----_..._ _W. ._._ ___ __. __.__'.._____________.___
I, The eon~h'lIeflo" nllll mlll"tl'n""ee of ."eh 1I11l11~' _hnll 1101 Inlnfl'l'p with Ihe pt"pl'tl~' And t'I!!:h" of n I'tlot oel'np"n!.
l. A II ,,',,1'1, -hllll hI' dOll.. 111"I'''I'lllR wlfh Ihl' _1"."IAt<I~ of Ihe City ~treet, Bel"ulnl..,,1 AIIII IInlll't Ih..ml'..I"II~'nll nf th.. CIt~'Rlllldlnll Offldlll, who
"'Ill he lIoiln.-,1 nl II'MI "n~ ,III,' flrlol' 10 1:'0mllWJI('p",,,"t of I:'OIl-tl'llrUon.
.1, A" 1111111" IA'~ """ <'fl'.Ilp"'ml ,h'l11 he qul',lr('/ III lll~pedlon h~' Ihl' Clf.r Rulhlh'l!; OffidAI,
i, U'lIlng po",ttlll:'t!,," All 'nfI:'I~' '1'~1"nflo", of Ihl' U"""l'h",,"1 of Tl'nll'(lo,'In'""I ~11A1I h.. oh~"I'''PlIAnd Ihe (It ,I' ,hnll hI' 1'1'111''''11 of nil
I'I"l'on~I"lIl1y fl'O," IIAml1!!" of nll.r nAlntp ..tl~I"R fro", fhlq l'l'tmlt, S',h,ll'ct 10 the q"mp IN'lll~ nlld I:'olldlllon" Ihe l'''t",1t lIoldl't 11111~' 1I1I(e "Ieh ,,,fetJ l1Ien,qute~,
Inchllllnll pll1clllllAnll I""I"n,l' of enufloll .Ig.." A' II mOJ' "..em IIPP!'q'AI',V 'n eondllel of eOIl_ltllet/on 111111 mnlnll'"Allel' wOI'l, he!'l'lIIlIln, If I, the rp'l'on,Ihllll," of
Ihe I'Hmllt..e I" I'll1el', IIlnlnlnln, All" '''(IN,'he nil trnffll' eonll'ol nl111 de,'II'I",
5, ^ III"'" fltl' lllld nil CII~' I'I'''pp'''y _Imll hI' I'P~IOI'"'' 10 lh orlll"I,,1 e'mdltlott n~ fflr Aq J1rAI:'t1cAlln the "plnloll of tI... CIIJ Rl.II'"n!! Omclnl.
(" AIII1""l'll!rOlm" l'fo_~llIg Imlnllntl"", ~hnl1 hI' lold III ~"..h 'Ie(llh ,,~ mA~ "I' ~"eell1l',1 h" fhl' C11~' Rulldln!! Omdnl.
7, Th.. ,l!efl'h c",""rlng nIl' ,Iplnll. of fl." h"'nllllflo'l,.h,," hl' InA.le" I'AI'I of Ihl, "p!'lull. Thl, !'I'\'!II" I~ lltll"tpl' n-llh thp u"dpfOl""'llng Ih,,' Ihe
n""lIrAnl hn~ nolln",l All olhpr utlllt" mHO I" Ih.. A"l'n ('0' Nell h~' Ih.. pl'tmlt nllll tAI(p, f'III reqJ1on,lhllltJ for Jl"," dAmnl!;e Inl'Ilrted hJ' ptlnt '"qtnllntlo", ,,~ A
I'e,ult nf h'~ oIH"'I1t1on. III onln Ihnl n,p~' mA~' ,n(1' Run..., Ihdl' '"lere,to,
R, It I, "'pl'r~.,.\, qt!ltIIlAled "1,,1 Ihl. ""1'11111 I. " IIeeml' flit, l,n"I"''''" me onl,l' nn.I tlml Ihe ,,11Idlllol of f"elllll",. "(I"" puhlle ptopp..ty I'urqunllt I" Ihl,
Ill'I'llIlI "hl111 "'" 0'11'1'01.. to neAtI' or to .eql n".I' ptOl'plt,r "llhl III ".1.1 holllpr,
9, Wh('llell't thp CII~' .11'"ld..s to fllllhel' "'I,Il.1t fh.. ('ll~' ~IRh" of WIlJ', fln~' or All 'n"ll'olr~, "'re., 1,lpl'~, eRhl..., or other f"r"We.. nnd
"1'I""'ell""ee, Authnl'l~"fl hl'l'I"III<I"I', ~h,,1l h<, IlIulI<'lllnl...~, I'l'mol'e" ftoll1 .",,, R1llhh of WA~', 01' rp"cl 01' nloenl"ll Ihl'/'eo" ,,~ te'ln"'l'fl h~' Ihe City Bulldln.-
Offidnl '" fill' e'llell,e of Ih.. hohlel' of Ihh permit,
1 fl, The ho"'l'I' '''AII 011\ e AI"I I,eq. the CU." hAI'III'e.. f....'" AllY nlld All IlnIl1Alll',~. elAlm,~, 01' Inlutlp. thlll m,,:v ""enr h)' r"'''~on of Ihp eo",tnlello".
11Inlnll'nnllee, "",I nfll'mllon of .nld fAdll!,\.
II, Thr hohll'r ,hnll eoml'l..le Ihl' rp'l"eRle.llVOI'" '\'lIhlll.._ __ ,_ ,I,,~', 01' Ihl_ 1'''1'1..11 ~hn" herom.. null "",1 'oil!. III thl' e\'l'nl the "'otk teq,.e,t..II
I. not ('n"'(lll'ie" "p"" Ihl' ...,.Irnllon _'RIp "I' fl,l~ ,,"nil It. Ihe CII:v "111.11 hnl.. Ih.. rlllhl In enml'l",11' .,...h n-or-l( Anfl In dlAl'ge Ihe h"leI!'r of Ihe permit 1'0" "II ro~h
In""I"'rd In ell'"I.kll"R .nl" \\'otk
12. The hnhle,' ,hAII J1nd n eA~h 01' ,uret:v' ho"d with Ihe ('II~' Mon"!!:..t III Ihe ."m nf $~__m _,____ ,lolI"r,~ 10 f1-IIAI'Ollle.. "l'l'forntl1l1el' "f th", ohl!~"tfo",
hel'rln, nrlll 10 gllnl'nnle.. "IA'"tpllAnee "f Ihe I'I~hl-l.f-wlI,\' dc,erlhNI line III fill' 1\ (letlnd of 0111' (I) ~'''Jlr foll"wln~ <'ntnrlefloll of Ihe reqlle,led In~t""lItlon, fn Ih'!
<"'ent A~!lI'<,I~' h"I"II. 11f)~I..d. Ihp ~"rely 1","" 'hAll h.. mAlle I'n:VAhle 10 fI,1' C1f,v nlld ,hAII "hIlRAII' Ihp ~utely In III'''' Ih.. Clt~. hlltmle~o In Ihe <,"ent th.. hol,l..r of
Ihl, petlllll ~llIm'" fnll to meel An~' nf Ih obll!tnllou~ heteUllllel', The hOlld ,hAII n1so Indl''''lll~v Ih.. ('lt~' fOl' All (,(lI111 e".I. And I'l'Mnnnhlp IlffOl""J", fp", In Ihe
pnllllel!All1l'llflII I. l'equll'l'll 10 eoll{'d fin ,nl<l hnnd.
13. Thl' l'I'r-rllltlee ,shnll hll,e " 21 hOllt eml'l'l!l'ue~' I'olltn<'l "nllle nil" I""nbPl" 1I,led hI' low,
SIJR!\IITTli:Il IW~
/PetmWl'el.. ----B4(L-C--M?.L:~_t::::.~_ ____~____.______
Slllnolnre Ii< Tltle___ '____~'..____._..,'__.. ___.._______ _,..__,_,__~__,~,________, '.'.___,.._
^ 1M te.,,_,
.-..~---.,-.._---.-.___.____n__.... _______~__.._._____ ...._..___~.. ______ ___.~.._ ______._._,,_.
Phon..
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.zAephyrhill= Slelg
Dept_
~
.-
VVhom. ev-er-
F_ KItty
--
1-800-679-8004
---- .,
~ 8'13-780-00.20
- 4/1512004
Cl Urs--t
-
RELEASES
cc::.
X For ...............
CJ .......... ~_... Cl PI--..- --...,.
=-~
- c-n......_. THESE VV1LL Al..L 6E A RELEASE ON BRIGHT HOUSE CABLE FOR POVVER
SUPPL Y"'S FOR: CA. T'V _ .AU ~n the right or '\Nay
6002 PARKHILL TERRAcE DR PERMIT#2886
38716 Z"" AVe
PenTlit 1#2827'
38217 S.R. 54 VV....i Perrnrt#2946
38349 C_R. 54 E3st Pennit#2947
38635 South Ave
F'errnit#2828
650.4 Huntington Or
F'ermitn;:2Q02
6038 Noami Ave
7425 G~ope Dr
5840 1- St
5913121:1151
Perrni1#2903
PetT"T1jt1Jl':2904
P-ermit#29Q5
6638 Dairy Rd
5709 6'" St
Perrn;t#2906
Pel"T'Tlit#2927
Perrn.t#:2:926
38451 6-- Ave
Permi1#2944
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J 8 ,'II SUP. 'J N (8' 3
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