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DATE: ~/(Io~ . cny OF ZEPIIYRHILLS - BUILDING DEPARTMENT RIGHT-OF-WAY USEPERMlT PERMIT# No constmctlon under ground or abon ground of anJ facility shall be accomplished on any City Rights of Way without written approval from the City Building Department. Any application for approval 01 cOl1stmctlon operations on any City owned Rights of Way shaD fIIrn1.h a detailed draw.... .how.... the complete .cope of the proposed work In triplicate to the office of the Building Official for approval prior to the commencement of any work. A eopy of thb permit I. to be kept readily available at the site of the work at all time.. PARCELI.D.N 1~-1(.,-2' -onO- 0800Dr ol~o CITY ROAD '-{~'-{~ f'q s Ie (2c.",,~ DATE c.-ds(()(p LOCATION (Legal Description): f? C<'j Ie k", GL- ?B >b ?6- ~ ~ 1';- o~ &2. 0 ?~ IlYSI ~ ~d: II'<;,D/"I 2..'-1 Perml..lon I. hereby granted to ~y,..,c fa ~~. for the constnactlon and maintenance 01 'D".. :; J f ~~. of .f. ~ 5; ....S Ie +...- , 'y :'~1~ It: lis. O. I" I ( Cc. 1- .ubJect to the following eondltlon.: I. The constnactlon and maintenance of .uch utility Ihall not Interfere with the property and rights of a prior oeaapant. 2, All work Ih~1I be done In keeping with the standards of the City Streets Department and under the .upervlslon of the City BuDding Official, who will be notlned at least one day prior to commencement 01 constnactlon. J. All materlall and equipment Ihall be lubJect to inspection by the City Building Official 4. During constmctlon all safety regulation. 01 the Department 01 Tranlportatlon Ihall be ob.erved and the City .haD be relieved of aU relpon.lblDty Irom damage 01 any nature arlllng Irom this permit. Subject to the lame term. and condition., the permit holder may take .ueh ..rety measures, Including placing and display 01 caution .Ign., a. It may deem necel.ary In eonduet of con.tnactlon and malntenanee work hereunder. It II the I'elpoIIIlbUlty or the permittee to place, maintain, and .upervlse all traffic control and device.. 5. All private and all City properly .hall be restored to Its original condition al lar as practkalln the opInIon of the City BulIcIIq 0fI'Ic1aL 6. All underground cro'llng installations Ihall be laid at luch depth as may be Ipeclf1ed by the City BuIlding Official 7. . The Iketch covering the details of thlllnstallatlon Ihall be made a part of this permit. This permit II granted with the undentandln. that the applicant has notlned all other utility u.erl In the area covered by the permit and takel filII relpon.lblllty for any damage lneurred by prior ....taUatlons .. a relult of hll operatlonl In order that they may lafe guard their Interelts. 8. It Is expressly stipulated that this permit Is a license lor permissive use only and that the placing of faellltles upon public property punuant to thb permit Ihall not operate to create or to velt any property right In laid holder. 9. Whenever the City decides to further ellplolt the CIfJ RI~ts 01 Way, any or all laid polel, wlrel, pipes, cable., or other faclUtles and appurtenancel authorized hereunder, Ihall be Immediately removed Irom laid Rights 01 Way, or relet or relocated thereon as required by the Clti Build.... Official at the expense 01 the holder of thll permit. 10. The holder .hall save and keep the City harmless Irom any and all damages, claims, or lnJurle. that may oeaar by reason of the COIUtnletlon, maintenance, and operation 01 laid laclllty. II, The holder .hall complete the requested work within days or thll permit Ihall become nuD and void, In the event the work requested II not completed upon the expiration date of thll permit, the City shall have the right to complete .uch work and to charge the holder of the permit ror all_II Incurred In completing .ald work. 12. The holder shall post a cash or surety bond "Ith the City Manager In the lum 01 S dollan to IWlrantee perfOI'llUlllCe 0' the obOptlons herein, and to guarantee maintenance of the rlght~I.way described herein for a period 01 one (I) year following eompletlon of the requested ....tallatlon. In the event a .urety bond I. p08ted, the surety bond .hall be made payable to the City and ,hall obligate the .urety to hold the City harmle.. In the event the holder of thl. permit .hould fall to meet any of 1t8 obllgatlon8 hereunder. The bond shall al80 Indemnify the City for all court co." and reasonable attomey's len In the event legal action 18 required to collect on said bond. 13. The permittee 8hall have a 24 hour emergency contact name and number listed below. Address 7b~IS ('6(~) SUBMITTED BY: I-\CArD IvI r:s- 0",.., a, i lbee /fWu~ ; 5+... w Rd. ~if 7 82- O'2S (Permittee) Signature & Title Phone APPROVED BY: CITY OF ZEPHYRHILLS ~ :":a om"", he ( .:: ~ ) ~ ~~' ~ '1, i~ jb~l j1:xu ;J~/ >~b J~i. _ ! ( L / ( ^"f/Y---' ~fJ~!;u(V". / J A: fLf(" ~ 1, \ r \Q /yV gt v UtOltles Supervisor Date: Public Works Date: City Manager Date: