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. : CTTY OF ZEPIIYRHILLS-BUILDING DEPARTMENT �� DATE: S'S'��J RIGHT-OF-WAY USE PERMTT PERMIT# No construction under ground or ebove ground of any facility shall be accomplished an any City Rights of Way without written approval from the City Building DepartmenG Any application for approval of construction operations on any City owned Rights of Way shall furnish e detailed drawing showing the complete scope of the proposed work in triplicate to the olTice of the Building OtTicial for approval prior to the commencement of aoy work A copy of this permit is to be kept readily evailable at the site of the work at all tim�. � PARCELI.D.# �I�?��I•oo ro-/53po^�% �0 CITYROAD ?7"/� 6vTREEj' DATE LOCATION(Legal Description): �� 1�S� L CSl'S l Tkl R l9 (3 L.l� l S3 �R - 802 �4 '7�9 Permission is hereby granted to�ARR YL FoS�� or p cJ K� �µ�R�Y ��ot��Dr} ��c. forWeconstructionandmaintenanceof�/��Y ��E ��E�� SEE kr7flcHE.D �1�T: _subject to the following conditions: 1. The construction and maintenance of such utility shall not interfere with the praperly and rights of a prior occupant. 2. All work shall be dooe in keeping with the stendards of the City Streets Department nnd under the supervision of t6e City Huilding OlTicial,who will be ootified at least one day prior to commencement of construction. 3. All materials and equipment s6a11 be subject to inspection by the City Huilding OlTicial. 4. During construMion all safety reguletions of the Department of Transportation shall be observed and the City shell be relieved of alt responsibility from damege of any nature arising from this permiL Subject to the same terms and conditions,the permit holder may take such sefety measures,including placing aod 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???? 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 ORcial. 6. All undergrouod crossing installations shall6e laid at such depth as may be specified by l6e City Building ORcial. 7. T6e sketch covering the details of this installation sha116e made a part of thie permit This permit is granted with t6e understanding t6flt the applicant 6as natified all other utility users in the area covered by the permit and takes full responsibility for any demage incurred by prior installations as a r�ult of his operations in order that they may snfe guard their inter�ts. 8. It is ezpressly stipuleted t6at this permit is e license for permissive use only and that the placing of facilities upon public property pursuant to this permit shall not operate to create or to vest any property right in said holder. 9. Whenever the Cily decides to further eiploit t6e Cily Rights of Way,any or all said poles,wires,pipes,cables,or other facilities end appurtenances euthorized hereunder,shall be immediately removed from seid Rights of Way,or reset or relocated thereon as required by the City Building Officisl at the eapense of the holder of this permit 10.The holder shall save and keep the City harmless Gom any and all dameges,claims,or injuries that may occur by reason of the construclion, maintenance,and operntioo of seid facility. 11.The holder shall complete the requested work within �5 days or this permit shall become null and void.In the event lhe work requested is not completed upon the expiration dute of this permit,the City shall have the right to complete such work nnd to charge the 6older of the permit for all costs incurred in completing said work 12.The halder shall post a cesh or surety bond with the Cily Menager in the sum of$ dollars to guarantee performance of the obligetions herein,and to guerantee maintenance of the right-of-way described herein for a period of one(1)year following completion of t6e requested installation.In the event a surety bond is posted,the surety bond shall be mede paye6le to the City end shall obligate the surety to hold the City harmless in the event the holder of lhis permit should fail to meet eny of its obligations hereunder.The bond shall also indemnify the City for all court costs and reasoneble attorneys fees in the event legal action is required to collect on said bond. SUBNIITTED BY: (Permittee) �R� �.— � Signature&Title Address_�L8"�J� E�[—J"V`L/� �1.+��' C.z/ �17��. �l� - �� n�l�� (?—�l�?^ ��'�o APPROVED BY: CITY OF ZEPFIYRIIILLS Building OClicial Date• ' Utilities Supervisor Date: Pu61ic Works Date• [`Gw Mw�noP.