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<br />3"23
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<br />-SPoJ40 tjuJ
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<br />cny Olr ZEltll V It III L1,S - IllllU)lNG DEltAR'l'MEN'l'
<br />IUGII'I'-Olt.W A Y USE ItERMI'l'
<br />
<br />PERMI1'##
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<br />DATE: Z,. 20 - 0 L,
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<br />No eon,'ruellon under .~ound or .hon .round or...,. r.elllly .h.III,e lleeolnpll.hed on .ny City RI..... orway wlthou' ,..ritt.. app..."" ....... ....
<br /><:lIy Bulldln. Depar'men', AnYllpplle.11on ror .I'pnvIII.r _"nIe''''' .per.'lon. on .ny Cltyo,.....d R....I. or Way "'''l\am''' a ........ .ra,..... ...,......
<br />.he comple'e .eepe .r .he propo.ed ,..ork In 'rlplle.le .. .h. ornee .r lhe Bulhlln. orne.... ror IIpprov.1 prior '0 the "".._men' or IID1 w.rk. A _"or..... ,
<br />permll .. '0 he kept re.dlly .vllllable .. .he .I'e or 'he ,..ork II' 1111 tlmel.
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<br />PARCEL I.D./I
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<br />tL --
<br />CITV ROAI) J 2.. .$teEel
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<br />DATE 2-2D'Cffo
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<br />LOCATION (Le..1 De.ertpllon), I2..TL
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<br />STeal G... H!JI... 5c-lvJo /
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<br />~^-I {,J~ST
<br />
<br />S,,)r:;-
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<br />Perm...lon I. he.....y ar....'.d '0 v.~ (l. 11 "'.-.;>
<br />ror the e.....rudlon ...d maln'_e .r _ lJ ~ \ t::.. D
<br />
<br />r""CMN<:
<br />
<br />or ~t'l.IDA
<br />r 0. ll. e:
<br />
<br />.ubJeet '0 'he rollo"lnl eondl......,
<br />1. The eon"nIe'lon ....d m.In'enance or .uch uUllly .h.1I no' k.lerrere wllh .he proper'l anti ........ or. prior _put.
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<br />2, All work .h~1I "e done In keeplna willa .he .Iud.rd. or Ihe CIl)' Slree" Deparllhen' IIIId under.... .upenlllon or.... Clll BuIhI.... Olllclal, who
<br />will be noelned .. leul one d.y prior '0 eommeneemen' or COlll'rueU....
<br />
<br />......
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<br />3. All m.lert.1I ud e.ulpmenl ....11 be lubJed 10 bupecllon ..)' lhe CIl)' Dull~lnl OIl'k:IaL
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<br />... Durlna conslruellon .11..re.)' replaUol1l 0' .he Depar'men' 0' Tnn.port.lIon .h.1I ... o..ened and .... Ch'....... .. nUn" .f aU
<br />re'pol1ll.III'l 'rom d.m..e ., a., nature .rI.1q 'nm thll permit. SubJec. ...he '.me 'erm. IIIId contIh_. .... pel'lllll hoI.... .ay c.. .... ....e., ....un.,
<br />loeludln. plaeln. .nd dltpla)'.r cau'lon ..... .. I. m., deem -...ry In _due' 0' eOI1l'ruellon IIIId .alntenance w.rk hereund.r. It II die ......1b0l., of
<br />.h. pe.'mlllee '0 pl.ee. m.InI.1n, .nd .upen"e .11 'nll'k: eonlrollllld device.,
<br />
<br />S.AII prlv,,'e .nd .11 City properl)'.hall be re'lored '0 It. orllln.1 eondlllon .. r.r.. pndlcalln .... .p........r.... CI., BuIIdIaa OOIdaL
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<br />6. All under.round e.....InI.....lllll1llon. .h.lllte 1,,101 II' .ue" dep'" II' n.1I1 be 111~lned by .... CI., Bulld.... OmclaL
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<br />7, ' The .kelch eenrlna .he del.ll. .r Ihl. 111I1.11a11on .1...11 be m.de . p.rC or .hl. permit. Thl. pemalt II ann'" ,..Ith .... WIden.......'.... the
<br />...,lIc.... h.. nollned .11 o'her uIW.)' u.en In the .re. eovered bylhe permit ud '.kea rull relpon.lbID'l ror 1Ih1.....'.lnCur.... .y prior ............ .. .
<br />re.ult on.l. oper"lIon. In .rder .ha. 'hey m.y ..r. IW'nI 'helr Inlere..., "
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<br />8. It I. ellprellly ,'Ipul.'ed Ih.. Ihl. perml' .. . IIeen.e ror pem....lve u.e 0..1)' a..d .h.. the placln,.rracUl.Ie. ..pon public proper., punllllDl .. ....
<br />perml' .1...11 no' openle '0 eRIIle .r 10 n.1 u)' property rip' In ..Id holeler.
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<br />9, Whenever '''e City decide. '0 l'ur'her ellplol' .1.. City Rlpl. .r W.y, .ny or liD ..Id pole.. wi..... P..... eab.....r .....r racJWlea...
<br />.ppurCelUlneel .ulhorlze. hereunder. ......... Immedla'ely remove. rrom .11101 Rlp'l or W.Y. or re....r re..... thentlll.. ft1u1.... .y" Chi 1IuIhI....
<br />Omel,,1 .. lhe expe.... o'.he holder 0' thll permll,
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<br />" lU. The holder .hall..v. ud keep lhe Clly h.rmlel' rrom .nyand .11 dll_lIlel. el.lml. or lnJurIe. ..... ..y_r .,........ .r.... .....ructlon,
<br />m.In'elUlnee,lIIId .penllon oh.ld r.elllly. . ,
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<br />11. The holder .hall_plele the reque.led work wllhln q 0 dllY' or 1..1. perml' .haD ...._IIuII... ".w. Ia.... Iveat.... w.rIe ft1.....d
<br />I. no' compleleol upon d.. explrallon d.le or .hl. perm I.. lhe CII)' ....11 have Ihe rip' '0 eomple" .uch ,...rk.... .. ..... the ......r .f the ........,... aU co."
<br />Ineurred In eomple'ln. ..Id work.
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<br />12, "he holder .h.1I PO" . c..h or .urd)' bond wllh .he Clly M....ger In 'he lum on dollan .. pal'lUlleo perl.l'IIIaIIee.r.... obUa.1IoaI
<br />hereIn, .nd '0 p.ran'eli m.ln'enanee ., lhe rlp....r.,...,. de.erlbed herein ror. period ., one (1) )'ear followlnl co.plellon of.... ncpIIIW............ In....
<br />evenl · .ure.y bond I. polled, lhe .urel)' bond .hall b. m.de p.y.ble '0 lhe CIt)' .nd .h.1I oltllp'e the .ure', .. boW die Ch'........ ... .... ..... .... bolder 0'
<br />.hl. perml' .llOuld r.1I '0 n.ec. .n, 0' II. .bIIA.llon. hereunder. TI.. hond .hall...o Indemnl'l .he City ror .U court ..... .... reaonable ......,.. rOIl In ....
<br />evenlle..1 .ellon I. required 10 eollec:' on ..Id bond. Ii I
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<br />13. The permlClee ....III.."e . 14 hour emer.eoey eon'.d n.n.e IInd number 1I,'ed belo,...
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<br />SUBMI'I"rED BY,
<br />(Permlllce) V.tttrZ.ON \-l.bIC-I~""
<br />SIIIUI'ure &: TI.1e -m-"",- ~
<br />
<br />Addre..
<br />
<br />.5 J'f2.e1?I
<br />it,"3 - er,fL - 1> 2-t.f5
<br />
<br />,2-0 E. LIWI!?
<br />
<br />11-1 c...
<br />~sP !EitJG,~/~7e..
<br />
<br />LakLLa....,/> . fi.t;n.. ,t>,4. 33eo I
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<br />,
<br />
<br />Plaolle
<br />
<br />APPROVED BVI
<br />CITV OF ZEPIIVRIIl
<br />
<br />BuUdlnlOmela1
<br />O.'el
<br />
<br />Clly M.....er
<br />D.'e.
<br />
<br />
<br />\
<br />
<br />U.UIlIe. Supenl.ur
<br />Da..:
<br />
<br />Public: Worka
<br />D.'e,
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<br />..
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<br />'~~:r-. (.,~r,~
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