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OATE: 3- ~ - lY2.... 3Co2.3 3POorwp CITY 01' 1,ErIlYIlIIJU.s - UlllI,UlNG UEltAltTMEN'(' IUGIl'l'-Olt-W A Y USE ItERMlT PEKMITN 1069 No ~on.lrudlon undu Ilround or lI"on Ilntund of IIn,. fll~IIII)' .hllll be II~Nm...llahed on IIny Clly Rlpl. orw.y "Ilhouf "rlffen IIpproYlI1 rro.. f'" ell.)' Dulldlnll Depllrlmenl. Any IIpplkllllon for IIppntYlI1 of ~on.frudlon opullllon. on IIny elly o"ned Rlchll of W.'....II naml.h . delaDed d"'''lnll'''''lnl Ihe ~omplele leope of Ihe pntpond "ork In Irlpll~lIfe 10 lhe offi~e of Ihe Dulldlnll Officllll for IIpproYlI1 prior 10 lhe eomm_ment of .ny "ork. A eop, 0' f.... pumlll. fo be kepi relldlly 1I'"III1I1"le .llhe .lte 0' Ihe "ork IIf 1111 lime.. PARCEL I.D. II CITYROAIJ G~~~rt. DATE 3-'1-6 2. LOCA'rJON(LePIDe'Crlp~I..~ N ~ - B\\J~rl_ 3 12, Sf D ~~~'';~~~.tJS'~!&~~or~~ Kf~e~6~~"''''- ~~ Puml..lonl.huehnrllnledto Vl.~1 ~e.~~' O~W~ ~",~f t~ ~~~ ~lK.30I\.l l~l~gD' forlheNn.lru~t1anllndmlllntenllnceof __ i_d: ___p ~--__oO___ _1_ .ubJect to .he rollo"lnll rondltlonll I. The ronatcuellon IInd m.lnt_ce 0' .ueh utlllty....n not hllerrere "lth .he property and rlallt. 0'. prior OCCUpllllt. 2. All "ork .h~11 be "one In keepln. "II" I"e .I.ndllrd. or .he City Slree" Dep.rllhent 11M under .he .upenl.1on ., lhe City BuDdlnl orne"l. "ho ".111 be notlOed .t lell.t one d.y prior to eommeneemen. of ron.hu~non. .,..... J. All m.'erl.l. and equlpnlen' .....11 be .ubJed '0 In.'pecllon hy 'he City Dulldln" OrnelaL \ ... During condructlon .11 .afe'y repla'lon. of Ihe Depu'men' of "'r.n.por'.lIon .hllll be ob.ened IIIId .he CI.y .hall b. rell.nd or .11 relponllblllly fntm d.m.lle or IIny nllfure arl.ln. from .hl. pennlt. Subject '0 the .lIme 'enn. and CflIIdlllon.. the permit holder ..ay ..ke .ach ..retr ..euure.. IncludlnR plllrlnR IInd dl.plllY of caution .Ip.. II' It mllY deem nree...,)' In conduct of conl'ructlon and malntenanc:e "ork hereunder. It h the rnpon.lbW'1or Ihe permltlee 10 pl.ce. mlllnl.ln. .nd .upenlle .1I1M1ffic conlroland device.. S. All prlYII.e .nd .11 CI.y properly ....n he rellored 10 II. orlllnlll condlllon .. f.r .. practical In .he .pln.... .r the CI', BulldlnlOrnelaL 6, All unduRround ~ro..InIIn.IIIIIAllon~ .hllll be IlIld .t .u~.. depl" .. mil)' be '1ledned by .he City BulldlnlOrnelaL 7. The .ke.eh conrlnllhe det.ll. .r thl. In.I.III1.lon .11.11 lie m.de II pArt of 'hi. pennlf. Thl. permit .. lranted "lIh the Wldontandlnl that .... Applk.nt h.. nollned 1111 o.her a.lllty u.en In the .re. ~oYered by.he permit IInd '.ke. 'ull re.pon.lblllty tor IIIIY d...llle Incurred by prior Imt.....t..... III . re.ult of hi. opnAllon. In order thll' .hey mlly..te IUllnt .helr Intere.... II. It I. upre..ly .tlpalllled .hll' .hl. pennlt I. . Ilcen.e tor pennlllln a.e 0111)' ...d Ihll' .he plllclnl or tllcllltle. upon public prop.rty pununt to ahll pennl. ....11 not opente '0 crule or t. n.1 any property rlllht In ..Id hold.r. ,. WheneYer Ihe Clly deeldel '0 fUrther eI,lolt lhe Clly HIIlhI. of W.y. .ny or lill ..Id pole.. "Irea. pipet. ab.... or .ther r.cIUtle. and Appurten.nre. lIu'horb.ed hereunder. .hall b. Immedllltely remond rrom .lIld RIIlhI. of W.Y. or re.ef .r reloc.ted fhe.-.. required by'he Clti Build..... Officllll .. lhe elpenae .f lhe holder .r .hll pennlt. " 10. The holder .hllll.lIye and keep 'I.. City h.nnle.. rrom .nYllnd .11 dllmllle.. cl.lm.. or lnJurlet t.... ...yoccur.y re..on or the COIUtructlon. mllln.enAnce. IlRd opn..lon 0' ..Id f.clllly. II. 1'1.. holdn .hllll complete the reque..ed "ork "Ilhln 9/J dllY' or .hl. pennlt ....IIIteco... nuD and YOld. In .he eYen' lhe ".rk reque..ed I. not comple.ed upon tI.. uplr.lIon d.le 0' thl. penn I.. Ihe City ....11 hllve .he rlllh' to complete .uch "ork and .. _.... .he holder .f the permit r.r all COlt. Incurred In comple"nll ..Id "ork. 12. Tile holder .11.11110.' . cII.h or .urely bond "II.. II.. CII, MllhIIger In 'he aUln oU dollan t. KUIlrantee perf.11IIIIIICe .fthe ............ herein, .nd 10 ~.r.nlee mAlnlenllnce .r'he rllh....r."a, de.nlhed herein for a period of one (I) ye.r follo"lnl cemplellon or lhe reque.fetlln.~1Ion. In ... nent · .urely bonell. polled. .h. .urely hond ....11 he mllde p.Yllble to .he ClI,lInd .h.1I ollllple lhe .ure'y '0 hold the City harmle.. In .he nett' .he holde' .r .hl~ permit .hould filII 10 meet .ny of It. obll...Ion. hereunder. The bond .....11111.0 Indemnlfylhe City for.n court COlt. and re..onable ....rney.. reel In the nent lelllllllctlon I. required .0 collect on .lIld bond. ., . .., 13. 1'1.. l.erllllUee .hllll".,"e . 14 hour emergency conlact nllme IInd nunlber 1IIIed belo". SUOMI'I"I'ED OY: (....."'~) ~~ Slpa.ure&T1tle' - /Aco('p~stxs~N &~~ Addre.. \20~_ LlW"t\.ta S-\. fL.U<'30.(Y' L~ke1~d, FL '338DI Phone ~~"6 - (p ~ ~ ...l1o \ 0 APPROVED BY: CITY OF ZEPIIYRIIILl.8 BUIIdInIOffiClal~ ');;r~J~~ D.tel 1ft - - . ummel Supenl.or ~~ . ~ /e- . ~_ D.'el .3 - <::> t..... Clt, M.n.ler O..el Publk Work. O.'e: