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; { ' � 4146499 i; - CITY OF ZEPHYRHIY.,LS-BUILDING DEPARTMENT �' DA'TE: RIGHT-flT-WAY USE PERMIT PERMIT# F _ i. ' No construction under ground or above ground of any facility sLa1Z be accomptished on any City Rights of Way witLout written approval from the i!� City; uilding Department.Aay application for approval of constructian operations on auy City owned Rights of Way shall furnish a detailed drawing ! showzng the complete scope of the proposed work in triplicate to the office of the$uiiding Q�cial for approvaI priar ta the commencement of any work.A � copy af this permit is ta be kept readity availab2e at the site of the work at aii times. PARCEL T.D.# 14-26-21-0010-01300-0010 CITY ROAD 4th street ` i DA'TE � LOCI TION(Legal Description): ' - One Bore across 4th street at 4928 4th street AND PLACE ON HANDH4�E �VER t. — ,, Permssionisherebygrantedto FRONTIER FL of 12Q E L.lME STREET, LAKELAND, FL 3380'! ;; tortil eo�truet►onanamaintenan��ot- ONE 2"HDPE DUCT W/ F(BER AND ONE OVER AN EXISTING CONDUIT ` I '' _subj et ta the follawing eonditions: 1. The construction and maintenanee of such uNlity shall not interfere with the property and rights of a prior occupant. ' 2. All work shall be done in keeping with the standards of the City Streets Departmeut and under the sapervision of the City Building Official,who ` will bIC notified at least one day prior to commencement of constructioa � � 3. All materials and equipmept shall be subject to inspection by the City Building Official. ' i A. Dnring canstruction alI safefy regularions of the Departmenf of Transportatian shaEI be o6served and the City shall be retieved of all `� respoi sibility from damage of any nature arising from this permit.Subject to the same terms and conditions,the permit holder may take such safety � meas i res,including placing and display af cau$on signs,as it may deem necessary in conduct of eonstructioa and mainteuance work hereunder. It is the respo si6ility of fhe permiftee ta???? � 5. All private and all City properly shall be restored to its original condition as far as practical in the opinion of the City Building Official. ' 6. All underground crossing installations shall be laid at such depth as may be specified by the City Building Official. ; i. 7. The sketch cavering the details af this installation s6all be made a part of this permit.This permit is granted with the understanding that the applic nt has notified all other utility users in t6e area covered by the permit and takes full responsibility for any damage incurred by prior installatipns as a result� f his operations in order that they may safe guard their interests. � S. It is expressly stipulated that this permit is a license for permissive use only and that the placing of faciliNes apon public property pursuant to ' this pe mit shall not operate to create or to vest any property right in said holder. ' 9. Whenever the City decides to further exploit the City Rights of Way,any or all said poles,wires,pipes,cables,or other facilities and ' appur eaances authorized hereunder,shall be immediately rempved from said Rights oi Way,or reset or relocated thereon as required by the City Building I Officia at the expense af the holder of this permit. � � 10. The holder shall save aad keep the City harmless from any and all damages,claims,or injurias that raay occur by reason of the construction, mainte ance,and operation of said facility. • 11. The hoMder shall complete the requested work within �� days or t6is permit shall become null and void.In the event the work �� reques ed is uat campleted upou the expiration date of this permit,the City shall 6ave the right to complete such work and ta charge the holder of the permit �� for atl�I osts incurred in completing said work. � 12. The haTder shalt post a cash or surety bond with the City Manager in tfie sum of$ dallars ta guarantee performance of the i, obligat ons herein,and to guarantee maiatenaace of the right-of-way described herein for a period of one(1)year fallowing completion of the requested ', installa�Hon.In the event a surety bond is posted,t6e surety boud sLall be made payable to the City and shall obligate the surety to hald the City harmless in ; the eve t the holder of this gerrait should fail ta meet any of ifs obiigatious hereunder.The bond shal]also indemaify the City for all court costs and z ireason�ble attarneys fees in the event legal action is required to cqllect on said bond. � I SUBMTTTED BY: � ( (Permittee) ��✓�t1��f ti—U i^'1 vYl.�� 1 O i�i-� � � � � /� �J ��G � � Signature&Title"`i""[LT/�'✓ �f'�""� � Address ��—O � ,2/f'�� ,5'�lLL�`"�'�' f�'i�Gt.l�f+Cf ,�! �J�$�� i ' � �St�3 -- �O�S�. — '�pc��{ � fi ; ; t � APPROVED BY: y I ' , CTTY OF ZEPFII'RHILI.S 4 ' � � Buildin 4�ciai Date: I � Utiliticsl upervisor � Date: I� � //�y �� f PubtielVorks �� !� R1 �tJ�� !�F,�{�� '�,,,�I�j��I✓tl9tsG1 ��'� � i Date: � , City Ma�ager ; Date: I , 13 I