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<br />DA TE: <br /> <br />CI'IY OF ZEPlfYRIULLS - BUILDING DEPARTMENT <br />RIGHT-OF-WAY USEPERMlT <br /> <br />PERMJT## <br /> <br />No eon.truetlon under arolU1d or .hon ground of any f.elllty .hall he .eeompll.hed on any City Rlpt. of W.ywlChout written .pprovallrom .... <br />City Building Department. Any .pplle.tlon for approval of con.trudlon oper.tlon. on .ny City awned Rlpt. .fW.y....1I IUmIsh. detailed draw.......wtna <br />the eomplete .eope of the propo.ed work In trlplle.te '0 .he alike of the Bulldlnl Olllelal far .pprov.1 prior to the ftIIImeneement ., any w.rk. A CO".,... <br />perml' I. to be kept re.dlly .v.llable .t the .lte of the work .t .11 time.. <br /> <br />PARCEL I.D." <br /> <br />CITY ROAD <br /> <br />DATE <br /> <br />LOCATION (Legal De.erlptlon) : . ..\-'v\llx f . <br /> <br />~1t~~l(&-ap~~~~.~f~ (1J:t~~~, :tl~~JQ~~~'Px>l~ I, <br /> <br />Perml..lon I. herehy Innted to <br />for the con.truetlon and m.lntenanee of <br /> <br />of <br /> <br />.ubjHt to the followln. condition.: <br /> <br />1. The eonstruetlon .nd m.lntenanee of .ueh utility .hall not Interfere with the property and ......t. .f. prior _pant. <br /> <br />2. Allwork .h~1I be done In keeplnlwlth the .tand.rd. of the City Street. Dep.rtment and under the .upel'\'lslon of the City BuUdInI 0....1, w. <br />will be notlOed .t Ie..t one d.y prior to eommeneement of eon.truetlon. <br /> <br />3. All m.terlal. and equipment .hall be .ubJeet to bupeetlon by the City Bulldln. OIlleIaL <br /> <br />4. Durlnl con.truetlon .1I..fety repl.tlon. of the Dep.rtment of Tran.port.tlon .hall be ob.el'\'ed and the City .haD be relined .,.U <br />re.pon.lblllty lrom d.ma.e 01 any nature .rI.1n1 from thl. permit. SubJeet to the ..me term. and condition., the permit holder may take .ueh .arelJ m_um, <br />lneludlnll plaeln. and dl.pl.y 01 e.utlon .Ign., ..It m.y deem neee...ry In eonduet 01 eonstruetlon and maintenance work hereuader. It II the m.....UIIJ or <br />the permittee to plaee, maintain, .nd .upel'\'lse all trallle control and device.. <br /> <br />s. All private and .11 City properly .h.1I be re.tored to It. orllln.1 eondltlon .. f.r.. praetlealln the opinion .1 the CIIJ BuIhIIaa 0fI1c:1aL <br /> <br />6. All underaround ero..InIIn.t.lI.tlon. .hilll be 1.ld .t .ueh depth.. m.y be .peelOed by the City Bulldlnl 01lk1aL <br /> <br />7. The .ke'eh eoverlng .he detail. of .hl.ln.tallatlon .hall be made. p.rt of thl. permit. Thl. permit Is lranted with the undentandlnl that the <br />.pplleant has notll1ed .11 other utility u.en In the .re. eovered by the permit and take. lUll ftlIpon.lblllty lor any damapJneurred .y prior ............ .. a <br />rault .f hi. operation. In order that they m.y ..fe p.rd their Intere.t.. <br /> <br />8. It Is ellprellly .tlpul.ted that thl. permit I. . lleen.e for permllllve u.e only and that the plaelnl or rulllt," upon pu.1Ie property panUMt to ..... <br />permit ....11 not operate to ere.te or to nit any property right In ..Id holder. <br /> <br />9. Whenever the City deeldes to IUrther nplolt the City RI..... of Way, any or .1I.ald po,", wlm, plpel, e..,", or ofher lulUtle. and <br />.ppurtenanees authorized hereunder, .h.1I be Immedl.tely removed from laid Rlpt. or W.y,.r met or reloeated then... --.ulred .y the Cltj Bddlna <br />Olllel.lat the npense 01 the holder 01 this permit. <br /> <br />. 10. The holder .hall.ave and keep the City harm Ie.. from any and all d.ma.., elalm., .r injuries that IDaY oecur .y ..-.- .,.... --fnIctIoa, <br />maintenance, and operation of ..Id fulllty. <br /> <br />II. The holder .h.1I eomplete the reque.ted work within day. or thl. permit .haD bec:ome naB and void. .. the event the w.rk req..... <br />Is not eompleted upon the nplratlen d.te of this permit, the City .h.1I have the rlpt t. eomplete .ueh w.rk and to ellarp .... helder ., the penn" 'or aU _lI <br />Incurred .. ftIIIpletln..aId work. <br /> <br />12. The holder .h.1I p..t a ea.h or .urety bond with the City MansKer In the .um of S dollan t. parantee perf.1'IIUUIee ., the o.Up...... <br />herein, and to guarantee malntenanee of the rlaht-of.way de.erl,," herein lor a perlotl of one (I) year followln, ftlllpletlon ., the ....... ...taIa...... In .... <br />even. a IUrety bond I. pOlted, the .urety bond .hallhe made payahle to the CIf, anti .hall.hUgate the IUrety to hoW the CIIJ hanaleu Ia the ri_t the hoIder.r <br />.hls permit .houId fa" to meet any of It. ohllKAtlon. hereunder. The ....d .hall all. indemniFy the City 'or all nurt _.. .. ......... .tto..,'.. Ia .... <br />event legal utlon Is required to eolled ... .ald ....d. <br /> <br />13. The permittee .hall have a 14 hour emergeney contad name .nd number lI.ted below. <br /> <br />(Permittee) <br /> <br />) SUBMIITED BY: <br />J) 0/7'1 If T CL I/VAJ <br /> <br />APPROVED BY: <br />CITY OF ZEPHYRHILLS <br /> <br />Slpature &: Title I <br />Addre.. .J 0 I 2- '2. 1{611 J1 ~ L 11 . LAJt?S Joel, <br />Phone 9? '3 - Y/2 0 - / '3"3 ~, - & Lf'? <br /> <br />Bulldln, Olllelal <br />Date: <br /> <br />Utlll.le. Supel'\'lsor <br />Date: <br /> <br />Pu.11e W.rks <br />Date: <br /> <br />, I <br /> <br />City MansKer <br />D.te: <br />