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DATE: '-I/5/0fp I CITY OF ZEPIIYRHlLLS - BUILDING DEPARTMENT RIGHT-OF-WAY USE PERMIT PERMIT# No cons'ructlon under ground or abon ground o( any (aclllty shall be accomplished on any City Rlgh's o( Way "IChou' "rlUen approv" fro. the City Building Department. Any appllca'lon (or approval o( construction opera'lons on any City owned Rip'. or Way ...... fUrnIsh a deCaUecl dra"lnl.hew.... 'he comple'e scope or the proposed work In 'rlpllcate to the office or the Building Official ror approval prior '0 the commencement or any "ork. A copy or Chb permit Is '0 be kept readily available a' .he .Ite o(.he "ork a' all Clmes. PARCELI.D.N 1~-2(P-.2' -0170- <9Clrx:>OO{OO CITY ROAD '5 i753 ~c..~~er:''''5 W,,-</ ( DATE '-(!slob LOCATION (Legal DescrlpClon): ~ Ie ~"c.l ~'4bol/II;S:D'--' PIS s<.. PG- 12..l.{ Lo~ 10 of... b~1{ 0 PI. {)'-(~. t Lc . o( ZI'(YI'~~ ( Is S.j{p r;.",.ly ~~ r--c.. Permission Is hereby gran.ed'o r;<'!i/l1.G.~ Ls.-..S+ , ror Che construction and maln'enance D,. 've k?<.y +0.- subject '0 the rollowlng condlClons: I. The consfrueClon and maln'enance or such u'lIIty shall not Interfere with 'he property and rip'. or a prior oceupant. 2. All work shall be done In keeping with the standards or 'he City S'reets Department and under the .upenlslon or the City BuDdlnl OfllelaI, "ho will be noClfied a' lea.' one day prior '0 commencement o( construeClon. 3. All ma'erlals and equipment shall be subject '0 inspection by the City Building Official 4. During cons'ructlon all safety regulation. of the Department of TransportaClon .hall be ob.ened and Che City .hall be relieved of aU responsibility from damage of any nature arising from .hls perm I.. Subject '0 'he .ame term. and condition., the permit holder may Cake .ueh .afety m_urel, including placing and dllplay of caution slgnl, a. It may deem neces.ary In conduet of construction and maintenance "ork hereunder. It II the rnponslbWty of the permittee to plaee, maintain, and .upenlse all traflle control and devices. 5. All private and all City properly .hall be restored to It. orlKlnal condition a. far aI practlc"ln the opinion or the City BuIldIng OfIIclaL 6. All underground crossing installations shall be laid a' such depth a. may be specified by the City BuIlding Ofllelal 7. . The sketch covering the details of 'hls InstallaClon shall be made a part of thl. permit. This permit Is granted "Ith the lIDdentandlnl Chat the appllcan' ha. no'lDed all other utility u.ers In .he area covered by the permit and 'akes rull re.ponslblllty for any damage lneurred by prior lnItaOatlona aI . resul' of his opera'lons In order 'ha' they may safe guard 'helr In'eres'" 8. If I. ellpreuly stlpula'ed .ha' thl. permit Is a license for permissive use only and Cha' the placing or facllldes upon public property punuant to Chb permit shall not operate '0 crea'e or '0 vest any property rlgh' In said holder. II. Whenever the Clfy decides '0 further ellplol' the CIt,. Rlgh's of Way, any or all.ald pole., "Ires, pipe., cable., or oCher racWtte. and appurtenanees au.horlzed hereunder, shall be Immedla'ely removed from said Rlgh's of Way, or reset or reloca'ed thereon aI required by the CItY Build.... Ofl1clala' 'he eJIpense of 'he holder of 'hls permit. , 10. The holder shall save and keep the City harmless from any and all damages, claims, or lnJurle. Cha..ay oceur by reuon of the COIIItruetlon, maln'enance, and operallon of said (aclll'y. II. The holder shall comple'e 'he reques.ed work within days or thl. permit .hall b_me nuD and void. In the event the "ork requated Is no' completed upon the elIplratlon date of this permit, the City shall have the right to complete II1Kh "ork and to charae the holder of the permit for aU_" Incurred In completing said work. 12. The holder shall post a cash or surety bond wlfh the Clfy MalUlger In the .um ofS dollan to guarantee perfOI'lllllllee of the oblIptlona herein, and to guarantee maintenance or the right-of-way described herein for a period of one (1) year rollo"lnl completion of the requated ....taDatlon. In the event a surety bond Is posted, the surety bond shall be made payable to .he City and .hall obllga'e the .urety to hold the City harmlet. In the event the holder or 'hls permit should fall to meet any or Its obllgaClons hereunder. The bond shall also indemnify the City ror all court COlt. and realonable .ttomey'. r_ In the event legal action Is required to collect on .ald bond. 13. The permittee shall have a 24 hour emergency contact name and number listed below. SUBMIITED BY: ~"rt)lJ ~~~ q,'(b~ Signature & Title /))iJ "- tA~ Address .s'<t \3 St..Je iJ" 5~ Phone (~LS) tb 2 - D 3 L~ (Permittee) APPROVED BY: CITY OF ZEPHYRHI~ /J Building Official f7 { Ii 17V.L;('-J Date: -{j Uillltle. Supenlsor ~ ~ Dak: ~/'i ~ Public Works Date: 5)6/~l , *r . tJ 1\ t V ..1\)i, . .t)\;;~ () r I.. !i G /' v ~. <j . J yf.. .()tSfG l ' ~~ {-/ ~ ,.~L . \' /j7~ S e/2 /-~ 'J 6{1 I? 1),1 ;5 )t- ~i- City Manager Date: