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CITY OF ZEPHYR HILLS BUILDING DEPARTMENT RIGHT-OF-WAY USE PERMiI' DATE: 5 -7. O PERMIT W- No construction underground or above ground of any facility shall be accomplished.on any City Rights of Way without written approval from,the City Building Department. Any application for approval of construction.opera6ons on any City owned.Rights,.1 Way shah furnish a detailed drawing sfiowing the complete scope:of the proposed work in triplicate to the office of the Building Ofticial:for approvaf prior to the commencement of any work. A copy of this permit i'slo be kept readily available at the site of the work at all times. PARCEL ID#: I�- U'�, 'CO.Ir? -3 �Ioq - DGtUU PITY ROAD ara� 5�szz� LOCATION (Legal Description): Permission is hereby granted to . ��1 e� fc. of � yTfl rfi fJ��t#'. For the construction and imaitntenance of:, . t 3 { * � ciy T. . ( �.C�f✓ tghA� . b:Ci Q : 5t }:: 01�Oho � A lbx s,>. \" �t?itG Mt6i f { C3tL. CtlQ 5. S_ubject to the following conditions: 1. The construction and maintenance of.such utility shall,not interfere fvith.the property and rights of a prior occupant. .. 2. All work shaft be done in-keeping with,the'standards of the City Streets Department and underthe supen sIion of the City Building Official,who will be notified at least one-day prior to commencement of construction: 3. All materials,and equipment'shall be subject to Inspection by,the Clty Building Official., 4.. During construction all safety regulations-of the Department of Transportation shall be observed and the City:snail 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. It is the - responsibility of the permittee to???? 6. All private and all City property 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 si,ch depth as may be speGfietl,by the.City Building Of f cial:- 7. - The sketch covering the details.of this Installation shall be made a pail of this permit. Thispermit'is granted with the.understanding that the applicant has notified all other utility usemlh the area covered by the permit and takes full responsibility for any damage Incurred by prior installations as a result of his operations.in order that.they.may safe guard their interests. 8. .fit is ezpresalp stipulated that this permit is a license.for permissive use;only and that the placing of facilities upon public property pursuant to this permit-shall.not operateao create or to vest any property right in said`holder. 9. Whenever the City decides to further exploit the City.Rlghts of Way,any or all said poles,wires;.pipes;cables,or other facilities and appurtenances authorized hereunder;shall be.imrmediately removed from said Rights of Way,or resat or reloca#ed thereon:as required by the,City Building Official :. at the expense.of_the holder of this permit. 10. The holder,shall save and keep the City harmlessfrcim any and all damages,claims, or injuries that may occur by reason of the,construction, r0aintenance,and operation of said facility., , 11: Tire holder shah complete the requested work within. days.or,this permit shall become null and void. In the event.the work requested is not completed upon the 4xpiritibri;date of this permit,the City shall have the right fo complete such work and to charge the holder of the permit for all costs incurred in completed said Mork: . 12. The holder shall post a,casfi or surety bond with the City Manager in the aim of$, dollars to guarantee performance of the obligations . herein, and:to_guarantee maintenance of the rdght-pf;way;dew.i.bed herein for a period of one.(1) year..following completion of the requested. installation. In the event a surety is posted,the surety bond shall-be-made payable to the.City and shall obligate the surety to hold the.City harmless In tine event the holder of this:permit should fait to.meet any of its obligations hereunder.:The bond shall also Indeinnify-the City for ati . court costs.and reasonable attorneys fees In the event legal action is required to collect on said bond. SU$MITTED BY. (PERIUIITTEE). Signature&Tithe j r Address 514 APPROVED AY: CITY t?F ZEP.HYRHI;LLS Utilities Supervisor Date z �� Public Works. Date.l2Mets"C2t "tea QPIE,Qc ?tf "f St�D PCLLDIS'7~r�2gt� !� Building Dept Date City Manager Date . p %-V'j°P15 �'r h D-l`� `�C c`t t lz),IS. � C IG c�(� P i e-C",