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II -----aa��;�—i�—�----� +-�—�" C1TY-OF�ZEPHYRHILL-S�=�BUILDING�DEPARTtVIENT �` .:`++� ' °� � RIGHT-OF-WAY USE PERMIT DATE' ( ii S" °��1� PERMIT#: t� � d 0 � No construction,under ground or above ground of any iacility shall be accomplished on any City Rights of Way without w►itten approval from the City Building Departenent. Any application for approval of construction operations on any City owned Rights df Way shall fumish a detailed drawing showing the complete scope of the proposed work in triplicate to the office of the Building Official for approval prior to the commencement of any woric. A copy of this perrnit is to be tept readily awa�lable at the site of the work at all times. pARCEL ID��: .�1- 26 �ai�O�`e-o�7�a-��5 CITY ROAD '�� 5�� - ;, . . _OCATION.(�,Legal Description): s��,� �� U�1 � �� .��e�l l�r�� ��r�^1 � � ��5 ClS P� � �� S'� �o�►� �S � �o�, '�� 8`g TT�°�t ��3 p�C� . �ermission is hereby granted to of =or the construction and maintenance of: ��6� lu=�f�- �i��i2{1�� - i� � �P�tl ��v'��.i4�C� �'� - .. � �ubject to the foilowing conditions: � 1. The construction and maintenance of such utility shall not interfere with the property and rights of a prior occupant- 2. All wark shall be done in keeping with�the standards of the C(ty Streets Department and under the supervision of the City Building Offiaal,who will be notffied at least one day prior to cortimencement of conshvction. - 3. All materials and equfpment shall be subject to inspection by the City Building Official. 4. D�uring construction all safety regutations of the Departrnent of Transportation shall be observed and the City 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 m�y fake such safety measures, ir�cluding plaang and display of caution signs,as it may deem necessary in conduct of construction and maintenance work hereunder. It is the responsibility of the permittee to 7??? 5. All private and ali City properiy shall be restored to its original condition as far as pra�tical in the opinion of the City Building OFficial. 6. �I underground crossing installations shall be laid at such depth as may be sperJfied by the City Building Officiai. 7. T�e sketch covering the details of this instailation shall be rnade a part of this permft Thls pertnft is granted with the understanding that the a�plicant has notified all other u811ty users in the area covered by the permit and takes full.responsibility for any damage incurred by prior ir�stallations as a result of his operations in order that they may safe guard their interests. 8. It�lis expressly stipulated that this permit is a license for permissive use only and that the placing of faalities upon public properiy purs�nt to this p�ermit shall not operate to create or to vest any property right in safd holder. 9. Whenever the City decides to further exploit the City Rights of Way, any or all said poles, wires, pipes, pbles, or other fadlities and abpurtenances authorized hereunder,shall be immediatety removed from safd Rights of Way, or reset or relocated thereon as required by the � City Bullding Official at the expense of the holder of this permit 10. T�e holder shall save and keep the City hartnless from any a�d all damages, claims,or injuries that may occur by reason of the construdlon, rt�iain�nance,and operation of said fadltiy. 11. The holdershali complete the requested work within days or this permit shall bewme null and void. In the event the work requested is n�ot compieted upon the expirafon date of this permit;the Ciiy shall have the right to complete such work and to charge the holder of the petmit fo�r all costs incurred in completed sald woric. 12. l'�e holder shall.post a cash or surety'bond with the City Manager in the sum of$ dollars to guarantee perfortnance of the o�bligatlons herein, and to guarantee maintenance of the right-of-way described herein for a period of one (1)year following completion of the requested installation. In the event a surety bond is posted,the surety bond shall be made payable to the City and shall obligate the surety bo hold the City harmless in the event the holder of this permit should fail to meet any of ifs obligations hereunder. The bbnd shall also indemnffy ttie City for all court costs and reasonable attomeys fees in the event legal action is required to collect on said bond. SUBMITT'ED BY: (PERMITTEE) �/-�� v��tP.�/f�,/JL C t�lS��lJ �' Signature 8�Title F/,-� �� d �eI�JP.2d.✓�d�f��' Y�f-1� �1��. 1�- 6-�L� � )� � Address_�o2�D ��.��c.�rS CN_. �7�P�c n�a-Ni?�. �'$6 9�� "�-- ' <�— � APPROVED BY: CITY OF ZEPFLYRHI . - _ �' ' �y , �.�- uilding O(fiaal !, - � Date V .- Y-�. r � i _.._.___ 'tilities Supervis�or . Date "� �� , ublic Va/orks i Date`�_[_. V(.- �.C�c d�I� �N Sl�� C�� _�_ �Mana er �', . -� Date....';. t� ' .�' 9 " fiy-��, �� i _ . _ . _ _ . - -- �-�- �