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<br />DATE: 8-11-,\'1
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<br />CITY (W ZF.I'IIYIUlIU,S - UlJlUJlNG DEI'ARTMENT
<br />IUGUT-Olf_W A Y USE I'ERMI'I'
<br />
<br />PERMI1'I#
<br />
<br />9~g
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<br />Nu ClllllIl'lldllln under Ilruulld or .ho,'e Ilnluml of .n~' f.clIlI" ....11 he .ccum..II,"ed on .ny City RI..... or Way "IChou' "riUen appro"" rro.. .he
<br />ell, BulldlnllDcltnr'menl. Any ....plle.Uon for "ltltru".1 of clln. h'Ud Ion o..er.'lon. on .n, Clt, o"ned RI..... or W.,....U ftlmI.. . ..Called....."... ..."...
<br />.... comltle'e leulte uf .... Itropo.ed "ork In .rlltllc.'e '0 'he office of 'he BulldlnR Offiel..1 ror "PI' roYal prior '0 Ibe COIIIIDleaeemen' 0' IlII1 "ork. A c:epyo,..... ,
<br />..ermlll. '0 be kepI readily .vall.b1e .. lhe .I'e of I"e work ... ..II 11m c..
<br />
<br />PARCEL I.D. "
<br />
<br />Sl8 l' ').(, ~ ~'l,..
<br />
<br />CITY ROAn
<br />
<br />AI~.:nMe: AV6
<br />
<br />DATE $ - 11-'1,\
<br />
<br />LOCATION (LellIlIDe.crlltUun) : ,
<br />eAsr 0;: ~1<.1t' ~I\J6 LAfJ~
<br />
<br />~ N~T~(!)r Au~.nms fJrVb"
<br />
<br />Perm I.. Ion I. hcnhy Ill'"nled 10
<br />for I"e eon.llnlcUun "nd m..ln'en.nce of
<br />
<br />of
<br />
<br />.ubJed 10 I"e rollo11'lnll cundl.lunl:
<br />
<br />1. The cun.h'UcUon ..nd m.ln.e......ee of .uch uUllly .....11 no' III'erfere wllh 'he proper'y and ri..... or a prior oceupant.
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<br />2. All '''ul'k ."~II be dOlle In keeltl"ll ",lib '''e ......d.rd. of 'be Clly S'ree', Depu.nlen' and under'he .upe"blon or'he CUy BulJdIn. Omclal, "bo
<br />11'11I be no'lDed ..Ie.... one d..y Itrlor.o eonnneneeme..' oLeun"lnIdlon.
<br />"
<br />3. Allm,,'erl..11 .nd equlltme... Ih"lIlte lubJed '0 bL...edlon Ity 'he Clly Building Officl.L
<br />
<br />." ~
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<br />4. During condl'llellon all late.y rellula'lon. or 'he Depu'men' or Trllnspor'aUon .h.U be ob.e"e. and the CI'1.ha11 be relieve. or.u
<br />re'ltun.lblll.y rn.... dllllllllle or .ny nll'ure arlsblll rrum .hls permlC. Subject .0 .be .Iune .erm. and eond........ .he perml' holder ..a,. lake .ucIa ..relf mcuure't
<br />IlIdudlnll pblelnllllnd dl.plllY or e.ullon .Ign.. .. I. m.y deem nCffI..ry In con.ud or con.trudlon and .......enance w.rk hereunder. II II the mpOlllIbWIy .r
<br />.he permlUee to plllCe, mllln'.ln. .nd .upen'lse .11 'l'1IIffie eontrol .nd devlee..
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<br />5. All ..rh'".e and all Clly properly .bllll he n,'ored '0 II. original condlUon .. r.r.. p...eelealln the .plnlon or the City BuU..... omclaL
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<br />6. All ulldulll'ound ero..lnl ......III1Uun. ....11 he 1.ld .. .uc" dcp.h a. mllY be '1leelOed by Che City Bulldln. ornelaL
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<br />7. The .kdeh eonrlng 'be de'"I1. or 'hls bl'lall.Uon ....11 be mllde . pu. or .hl. permit. Thl. permit II ,l'llIIfe. wlCh .he un..n......... .... the
<br />...pllc.nt has no.med .11 o'her u'III'y user. In 'he .re. covered by 'he perml' and 'ake. rull re,poRllblllty for ...,....p lneurrecl .y prior ....taIIa.1oiu .. a
<br />re.ull orhl. o..nllllon.ln urdn that 'he,' m.y s.re gUlUd .helr In'cre..s.
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<br />8. It I. ell..re..ly .lIltula'ed .h.. .hl, I.nml. I. . license ror ..em....lve u.e 0111,. .nd .h.. the plaelna of raellltle. upon pubUe property punUlllll to .....
<br />permll .hall..n' upera'e '0 erea'e or to n.. ...y property rlKflt In ..Id holder.
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<br />9. Whenenr 'he CI.y decide. .0 fur.her UI,loU .he Clly Rlgh.. or Way, any or lill..ld pole., wi...., 1'...., cab.... or other r.elWle'lII1.
<br />appurtenanee. au.borlzed hereunder. .h.1I be Immedlll.ely remond rlVm .lIld Rill". of W.y. or re.e'or reloeate.lbereoa.. require. by the Clti Ball.....
<br />Ornel.1 .. .he ClIpen.e or .he hulder or .hb perm I..
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<br />10. The holder .h"ll,"", and kerp 'be CI.y harmless rrum any IInd 1111 d.mllge., el.lm., or lnJurle. .... may oeeur by reuon or the COIII'ructloDt
<br />main.ellllnce. ...d ol,er..lon uf .ald raelllly.
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<br />II. T"e hulder .h.11 complde '''e l'ClJue..ed work ",1I"ln 10 dllY' or 'hls permlt.haD 1Icco... auU 11I1" "old. In .he e"CII' the ".rk req....ted
<br />I. no' eomltle'ed upon 'he 11I1'lr.llon Ila'e or .hl. perm I', 'he Clly .hall hll"e Clle rlgh. .0 eomple'e .ueh work and ......e the bolder.r the perml' for all_II
<br />b1curnd In eompldb.. said work.
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<br />12. The holdcr ...,,111'0'. . ellsb or .u.'e'y bond nl'" 'be Clly Manllgn In 'he .um ors ..lIan .. guarantee pertol1lll1llCe or the oblla.......
<br />hcreln. .nd '0 guarllnlee IOlIln.cnanee or Ihe rlllh.-or.",.y described herein rur . perlo. or one (I) ye.r followlnl eoIDplellon .r the req.....ecI....lallallon. In ....
<br />even. a .ure.y bond I. polled, .he .ure.y bIHld .hall be m.de p.y.ble .0 .he Clly .nd .hall obllg..e the .ure.". ..... the Clay ...rm....1n the nad the boI.er.r
<br />.hl. Iterml. .hould fall 'u med IIny or II. obllg..Ion. hereunder. TIle bond .hllll.l,o Indemnlry.he CIt,. r.r .11 c:eurt _II.... rea....." a...me,.'. fill In ....
<br />even. leaallldlon I. required .0 coiled on ..Id bond. I
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<br />13. The l,ermlUee '''"11 have . 24 hour emergeney eon'"d nanle .n. number 1I,'ed belo".
<br />
<br />(PerlOlI'u)
<br />
<br />SUBMn"I'ED BY:
<br />-
<br />GTt::'
<br />~~~
<br />
<br />e.L-JYYIG S~
<br />
<br />M \ k litlfL
<br />FLLIl... :::to,4i U:J..lJ I 1=LA 33ec:> 1
<br />
<br />Slpa'ure & Tille
<br />
<br />A.dre.. (2..0
<br />
<br />P"olle~4-I- ~BB-S357
<br />
<br />APPROVED BY:
<br />CITY OF ZEPIIYRIIILl.s
<br />.......OfDd..~.,. '~, ,..-
<br />Da.e: ~ 0
<br />U.IIIC1e. Supenl.ur ;;i ,? ~~~"----'"
<br />Dale: ~/ ~~J'
<br />
<br />~:~~~e wurk.t;ff[r~
<br />
<br />
<br />Clly ManllRcr
<br />U.'el
<br />
<br />THE UTILITY DEPARTMENT SHALL
<br />BE NOTIFIED 24 MOORS 'N
<br />ADVANCE Of STARTING WORK
<br />(813) 782.. 1/11
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