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DATE: CITY OF ZEPHYRHILLS - BUILDING DEPARTMENT RIGHT-OF-WAY USE PERMIT PERMIT# No construction under ground or abon ground of an)' facility shall be accomplished on any City Rights of Way without written appronl from the City Building Department. Any application for approv'al of construction operations on any City o'l'lned Rights of Way shall furnish a detailed drawing showing the complete scope of the proposed work In triplicate to the ornce of the Building Ornclal for approval prior to the commencement of any work. A copy' of this permit Is to be kept readily available at the site of the work at all times. PARCEL 1.0. # ~4~:2.5r .2/...(jO(O '"100300 -C1 000 CITY ROAD GfLUA/\ 5/'0 {k- ck. DATE LOCATION (Legal Description): Permission Is hereby granted to for the construction and maintenance of of subject to the following conditions: 1. The construction and maintenance of such utility shall not Interfere with the property and rights of a prior occupant. 2. A II work sball be done In keeping wltJi the standards of the City Streets Department and under the supervision of the City Building Official, who will be hotltled at least one day prior to commencement of construction. 3. All materials and equipment shall be subject to inspection by the City Building Ornclal. 4. During construction all safety regulations of the Department of Transportation shall be obsen'ed ami the City shall be rellend 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 ma)' deem necessary In conduct of construction and maintenance work hereunder. It Is the responsibility of the permittee to place, maintain, and supervise all traffic control and dev'lces. 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 Official. 6. All undergl'Ound crossing Installations shall be laid at such depth as ma)' be sllecitled by the City Building Official. 7. The sketch conrlng the details of this installation shall be made a part of this permit. Thh permit Is granted with the understanding that the appllcaht has notified all other utility users In the area covered by the permit and takes full responsibility for any damage Incurred by prior InstaUatlons as a result of his operations In order that they may safe guard their Interests. 8. It Is npressly 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 operate to create or to vest any property right In said holder. 9. Whenever the City decides to further exploit the City ~ights of Way, any or all said poles, wires, pipes, cables, or other facilities and appurtehances authorized hereunder, shall be Immediately' removed from said Rights of Way', or reset or relocated thereon as required by' the City Building Official at the expense of the holder of this permit. 10. The holder shall san and keep the City harmless from any and all damages, claims, or Injuries that may occur by reason of the construction, maintenance, and operation of said facility. 11. The holder shall complete the requested work within days or this permit shall become null and void. In the ennt the work requested Is not completed upon the expiration date of this permit, the City shall have the right to complete such work and to charge the holder of thc permit for all costs Incurred In completing said work. 12. The holder shall post a cash or surety bond with the City, Manager In the sum of$ dollars to guarantee performance of the obligations herein, and to guarantee maintenance of the right-of-way described herein for a period of one (1) year following completion of the requested 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, harmless In the ennt the holder of this permit should fall to meet any of Its obligations hereunder. The bond shall also indemnify the City' for all court costs and reasonable attorney's fees In the event lelalactlon Is required to collect on said bond. 13. The permittee shall have a 24 hour emergency contact name and number listed below. SUBMITTED BY: (permittee) ~JA1 /t~ ~ Signature & Title Address Phone APPROVED BY: CITY OF ZEPHYRHILLS Hulldlnrc Official Date: Utilities Supervisor .....::(' ~ ;;~W.'b~~~p City Manager Date: