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CITY OF ZEPHYRHILLS-BUILDING DEPARTMENT <br /> RIGHT-OF-WAY USE PERMIT <br /> DATE: PERMIT* <br /> No construction under ground or above ground of any facility shall be accomplished on any City Rights of Way without written approval from the City Building <br /> Department. Any application for approval of construction operations on any City owned Rights of Way shall furnish a detailed drawing showing the complete <br /> scope of the proposed work in triplicate to the office of the Building Official for approval prior to the commencement of any work. A copy of this permit is to be kept <br /> readily available at site of the work at all times. <br /> PARCEL ID#: O d��rt(e'a I - �O —�qct 00 0©D.. CITY.ROAD: Nt IA, Ave,. <br /> LOCATION (Legal Description): <br /> Permission is hereby granted to PIA01�r chaky&'X of 6-10C41&SZ <br /> For the construction.and maintenance of. ' <br /> Vol.,. <br /> Subject to Yhe following onditions: <br /> 1. The construction and maintenance of.such utility shall not interfere.with the property and rights of a prior occupant.- <br /> 2. All work shall be done in keeping with the standards of the City Streets Department and under the supervision of the City Building Official,who will <br /> be notified at leasfone day prior to commencementOf:construction, <br /> 3. All materials and equipment shall be subject to Inspection by the City Building Official. <br /> 4. During construction all safety.regitlatfons-of-the:Department of Transportation shall:be observed and the.city shall be relieved of all responsibility <br /> from damage of any nature arising from this permit. Subject to the same terms and conditions,the permit holder may:take such safety measures, <br /> including placing and display of caution signs,as it may deem•necessary in conduct of contraction and maintenance work hereunder. It is the <br /> responsibility of the pemtittee to???? <br /> 5. All private and all City property shall be restored to its original condition as far as practical1ri-the opinion ofthe City Building Official. <br /> 6. All underground crossing installations shall be laid at such depth as may be specified by the City Building Official. <br /> 7. The sketch covering the details of this installation shall be made a part ofthis permit. This permit is granted with the understanding that the applicant <br /> has noted all other utility users in the area.covered by the. and takes full responsibility for any damage incurred'by prior installations as a <br /> result of his operations in order"that they may safe guard their interests. <br /> a. It is expressly stipulated that this permit is a license for permissive use only and that the placing of facilities upon public property pursuant to'this <br /> permit shall not operate to create or to vest any property dghfin said holder. <br /> 9. Whenever the City decides to further exploit the.City Rights ofWay,any or all said poles,wires,pipes,cables,or other facilities and appurtenances <br /> authorized hereunder;shall be immediately removed from said Rights of Way,or reset or relocated thereon as required by the City Building Official <br /> at the expense of the holder of this permit <br /> 10. The holder shall save and keep the City harmless from any and all damages,claims;or injuries that may occur by reason of the construction, <br /> maintenance,and operation of said facility, <br /> 11. The holder shall complete the requested work within days or this permit shall become null and void. In the event the work requested is not <br /> completed upon the expiration.date of this permit,the City shall have the right to complete such work and to charge the holder of the permit for all <br /> costs incurred in completed said work. <br /> 12. The holder shall post a cash or surety,bond with the City Managevin the sum of$ dollars to guarantee'performance of the obligations <br /> herein, and to guarantee maintenance of the right-of-way described herein fora periodl'of one(1)year following completion of the requested <br /> installation. In the event a surety bond is posted,the surety bond shall be made payable to the City and shall obligate the surety,to hold the City <br /> harmless in the event the holder of this permit should fail to meet any of its obligations hereunder. The bond shall also indemnify the City for all <br /> court costs and reasonable attorneys fees Kthe event legal action is required to coltect on said bond. <br /> SUBMITTED BY: <br /> (PERMITTEE) <br /> z. <br /> Signature&Title <br /> Address <br /> APPROVED BY: <br /> CITY OF ZEPHYRHILLS <br /> Utilities Supervisor <br /> !r <br /> Public Works Date l2 `�205 AlD OPFNCd�3'_/� -�1sp0 sfCL biSTU�PgEQ �t2 �S <br /> Building Dept Date <br /> City Manager �cDate <br /> rpf CuJtS�Co� s cif tn� 1i ���%. OYIS '�� ,PI��V� ���0.5 eWIGlI l <br /> ��ij ,c� <br />