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<br />OATE: 03- IS'-DO
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<br />CITY OF ZE'>IIYIUIJU,S - UlJIU'lNG UE'>ARTMENT
<br />JUGUT-OJr-WAY USE J>ERMlT
<br />
<br />PERMJTN 9$-rM
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<br />No ~lIllwlrucllon under Rround or IIbon Rn,untl of .n,' fllcllll" wbllll be IIccolnpl/8hed on IIny Clly Rlplw of W.y ""houl "rlllen .pproval from lhe
<br />Clly OulldlnR Depnrlmenl. Any IIppllcllllon for "l'pmv"1 of con'''"cllon operllllon. IIn IIny Clly o"ned Rlllhl. of W.y....,llUmlwh . detailed dl1l"In......"1n1
<br />Ihe complele w~ope of Ihe propo.ed "ork In Irlpllcllle 10 Ihe office of Ihe OulldlnR Officllll for ..pprov..1 prior to lhe ~mmen~ment of .ny "ork. A ~py of tbb
<br />perm II I. to be kepI rudlly ""lIl1l1ble lit the .lIe of Ihe work lit ..II lime..
<br />
<br />PARCEL I.U.II
<br />
<br />CITY ROA"
<br />
<br />ItUE C!.-
<br />
<br />DATE
<br />
<br />Perml..aon I. hneby RflUlled 10
<br />for Ihe conwlncllon IInd mlllnlenllnce of
<br />
<br />
<br />E4sT
<br />
<br />ON
<br />
<br />liVE ~
<br />
<br />l,.IJlTj:-I Jf j)1<<ChON~1
<br />
<br />L/III\6
<br />
<br />STI'Z-GlZ\ L ItkG LMD ~.
<br />I
<br />
<br />.ubJect 10 Ihe folloft'11I1l condlllon.:
<br />
<br />2. All "'urk .h~1I be done In kee"lnll ",lIh Ille .'lIndardw of Ihe Clly Slreeb Depul",enlllnd under the .upervlJJlon of the Clly Bulldln, Omelal, "ho
<br />,,'11I be nollned .t lellsl one dlly prior 10 commencement of ~un"ncllon.
<br />
<br />I. The conwlructlon IInd m.lnlenlUlce of auch uUllly .hllll nulllllerfere wllh the property IInd rllIll. of. prior occupant.
<br />
<br />3. Allmlllerllllw .nd equlpnlent .1,1111 be .ubJect to InwpecUon by the Clly BUilding Officl.L
<br />
<br />.~. ......
<br />
<br />... lJurlng condrucllon .11 warety rellullltlon. of '''e lJepulmenl of Trlln.porlllUon .hllll be ob.erved and Ihe Clly ....11 be relieved of.1I
<br />rewpon"bllll,. from dlllllllge of IIny nllture arising from thl. permll. Subject to t"e .lIme term. and condlllon., the permit holder may Cake .um .afety measure.,
<br />'''''..... ,,,,,~. .n' ..,I.,.r ~.".. ...... .. " ...,...... ........,.,. "".... ., ....,........ ... .....,....... _> .......n. "0... ..........". "
<br />Ihe permlUee 10 plllce, mlllntllln, and lupenlse all I rllffic controlllnd dnlte..
<br />
<br />6. All underRl'ound cm'.lng In.tIlIlIlUon. whllll be IlIld lit .uc.. deplh II. nlllY be 'I'eelned by the Clly Bulldlnl OmelaL
<br />
<br />~. All prh...le IInd .11 Clly properly .111111 be redo red to II. orlglnlll condlllon III fu aw prllctlc.11n the opinion of the City Bulldln, Omelal.
<br />
<br />7. The .ketch co\'erlnR Ihe delllll. of Ihls In,'.lll1l1on .11.11 lIe mil de II p..,' of Ihll permit. Thl. permit I. ,ranted "'Ih the under.Candln, that the
<br />IIppllcanl h.w noUned ..II olher ullllly Ulen In Ihe arell ~overed by Ihe I'ermllllnd IlIke. full re.pon.lblllty for any d.m.Ce Incurred by prior ....t....tlo... III a
<br />re.ult of hi. operllllon. In order thllt they mllY .are pud Ihelr Interewb.
<br />
<br />fl. It I. expre..ly .Upulllted thllt Ihl. I,ermltlw · IIcen.e for permlwwlve u.e onl)' .nd Ihllt the pl.eln, of f.ellltle. upon public property punuanl to thll
<br />permll .h.1I not operllle to crellle or to ,"e.' ....y property right In wllld holder.
<br />
<br />It. Whenever t"e Clly decide. 10 furlller ul,lolllhe Clly Rlghlw of Way, IIn,. or Jill .ald pole., "'re., pip", e.ble., or olher f.eIUtle. and
<br />.ppurtenllnce. lIulhorlzed hereunder, .hall be Immedllllely removed from wllld Rlg"'. of Way, or re.et or reloc.ted thereon.. required by the City Build....
<br />Offidlll.""e ellpenwe of Ihe "older of thl. perm II.
<br />
<br />. 10. The holcler .hall .lIve and keep IIIe Clly harmleww from IIny IInd 1111 dllmllRe., elalmw, or Injurle. t"'t m.y oeeur by re..on of the tonItruetlon,
<br />m..lnlenllnce, ....d ol,erallon of ..Id faclllly.
<br />
<br />II. The holder .h.1I complele the requealed ",ork "'lIhln dllYw or Ihls permlt.h.1I become nuD and void. In Ihe event the "ork requelled
<br />I. not compleled upon the nplrallon d.te of Ihl. permit, Ihe Clly .h..1I hllVe the right to complete ,uch "ork and to e......e the holder of the permit for all eoll.
<br />Incurred In ~omplellng .ald "ork.
<br />
<br />12. T"e "older '''"11 1'0.1 a cIIsh or .urely bond wllh Ihe City Mllnager In '''e .Uln of $ dOIl.n to RWIrantee performaaee of the obU..II0111
<br />"ereln, IInd to guU..nlee mlllntenllnce of lhe rlllht-of.,,"y descrlhed "ereln for a period of one (I) ye.r follo"ln. completion of the reque..ecI.........1Ion. ......
<br />even I · .urety bond I. po. led, Ihe wurely bond wh.1I be mllde paYllble to Ihe City IInd .hllll ol,lIgllte the .uretylo hold the City harmle..1n the evenl the holder of
<br />Ihl. I'ermlt .hould filII 10 lIIed IIny of Ilw obllgaUonw hereunder. T"e I,ond w....lll1lwo Indemnify Ihe Clly for.1I court coli. and re..onable .1I0mey'. feet In the
<br />event legllllldlon I. required to eolled on .lIld bond. "
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<br />13. The l,ermlUee .hllll h.,.., II 24 IlOur emergeney conlact nllme IInd number IIded below.
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<br />Public Workw
<br />D.le:
<br />
<br />
<br />SUOMnTED OV:
<br />(Perml"ee) ~ IE PtDYL.( D 4
<br />
<br />Slp.ture Ie Title 7JIi~,~ A(!ee~/b~~uv _
<br />Addre.. 120 C. Lt/-vtE 5r,c....t. 7. r LA-iY?LIhv lb. Fl.-OLloyt 3 '38V J
<br />
<br />Pllolle 8b ~ - b (J?- go') "7
<br />
<br />Building Officlll
<br />D.'e:
<br />
<br />H /I Ll--
<br />p'f. 6 IV
<br />1'"1-{ If) f- t/ n tz!'
<br />T / /vII {).,/ )xy
<br />-rlf~ ~ f)lfr/~D 6 rlll-'
<br />I~( p~ Dr ~/)ql
<br />fI j) tJ f1 19 J
<br />/;J v tf- . " / ~ . ,
<br />
<br />Clly Man"Rer
<br />Dalel
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<br />..
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