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.� � 4146499 � 'r• CTTY OF ZEPHYRHILLS-BUILDING DEPARTMENT DATE: RIGHT-OF-WAY USE PERMIT PERMIT# No constructiou under ground or above ground of any facitity shall be accomplished on any City Rights o[Way without written approval from t6e City Building Department.Any application for approval otconstrucfion operations on any City owned Rights of Way shall furnish a defailed drawing showing t6e complete scope of the proposed work in triplicate to the office o[the Buildiug O�cial for approval prior to the commencement of any work A I � copy of t6is permit is to be kept readily available at the site of the work at al!times. ' � PARCELI.D.# �4-26-21-001 0-01 3 0 0-001 0 CTTYROAD 4th street � II DATE �i I i � LOCATION(Legal DescripHou): I - One Bore across 4th street at 4928 4th street AND PLACE ON HANDHOLE OVER FXISTING DUCT � Permissionisherebygrantedto FRONTIER FL ot 120 E LIME STREET, LAKELAND, FL 33801 ra��he�o�sno�hooeoama��eoeo�eor- ONE 2"HDPE DUCT W/FIBER AND ONE OVER AN EXISTING CONDUIT � , _subject to the following conditious: , 1. The construction and maintenaoce 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 o[t6e City Streets Deparhnent and under the supervisiou of the City Buildiog Oflicial,who will he noNfied at least one day prior to commencement of construcfion. 3. All materials and equipment shall be subject to inspection by t6e City Buildiug OmciaL 4. During construction all safety regulations of the Department of Transportallon shall be observed and the City shall be relieved of all responsibility from damage of any nature arising from this permit.Subjec[to the same terms and conditioos,t6e permit holder may take such safety measures,including placing aod display of caufion signs,as it may deem necessary in conduct of construction and mainteuance work hereunder.It is the responsibility of the permittee to???? 5. All private aud all City properly s6a11 6e restored to its origival condition as far as pracHcal in the opinion of the City Building Official. 6. All uudergrouod crossing installations shall be laid at such depth as may be specified by the City Buildiog O[ficial. 7. The sketch coveriog the details of this iustallafiou shall be made a part of this pemut This permit is granted with the understandiog that the applican[has notified all other ufility users in the area covered by the permit and takes full responsibility for any damage incurred by prior installafions as a result o[his operations iu order that they may safe guard their interests. 8. It is ezpressly stipulated that this permit is a license for permissive use only and that fhe placing of facilities upon public property pursuant to this permit shall not operate to create or to vesf any properly right in said 6older. 9. Whenever the City decides to furiher exploit the City Rights of Way,any or all said poles,wires,pipes,ca6les,or other facilities aod appurtenaoces authorized hereundeq shall be immediately removed from said Rights of Way,or reset or relocated thereon as required by the City Building Otficial at the expense of the holder of this permit. 10.The holder shall save and keep the City harmless Gom any and all damages,claims,or injuries that may occur by reason of the conshuction, maintenance,and operation o[said facility. 11.The holder shall complete t6e requested work within 60 days or this permit shall become null and void.In the event the work requested is not completed upon the expiration date of this permit,the City shall have the right to complete such work and to charge the holder of 16e permi[ for all costs incurred in completiog said work 12.The holder shall pos[a cash or surety bond with the City Manager in the sum of S dollars to guarantee perfarmance otthe obligations herein,aud to guarantee maintenance of the righhof-way descri6ed herein for a period of ooe(1)year followiog complefion of the requested instaltatioa In the event a surety bond is posted,the surety bond shall be made payable to the City and shall obGgate the surety to hold the City harmless in � t6e event the holder of this permit should fail to meet any of its obligations hereundec The bond s6a11 also iodemnify t6e City for all court costs and reasonable attorneys fees in the event legal action is required to collect on said bond SUBMITTED BY: (Permittee) 1-20✓lt1�C� `OWI wl.�vV�C��OVl.S Signature&Title`V��.�/�-✓�� C.WG � Address /2-o E .��+� ,5'T�'7' /�![L/a� �l �3$o I �6�� - �80.-2�y � APPROVED BY: CTTY OF ZEPHYRHILLS Buildiog ORcial Date: UtiliNes Supervisor Date: Public Works , Date: City Manager Date: I i -- -