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<br />G? I,
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<br />CITY OF ZEPIIYRIULLS - BUILDING DEPARTMENT
<br />JUGllT-OF-WAY USE PERMIT
<br />
<br />PERMITN
<br />
<br />DATE:
<br />
<br />. No condruetlon under grounll or abon IIll'Ound or an}' fRelllly ,"all be lI<<ompll.hed on lUI" CII" RighI. of W.y ....lIhout ....rltten .pproval from the
<br />Clly Dulldlnlll D..partment, Any appll..atlon f..r IIppr..VltI ..r con.tru",lon ..peratlon. "" any Clly o....ned Rlgh" or Way.haD turnl.h . det.lled dra....lnl.howlnl
<br />the compl..te ,c"pe or I.... propo.ed work In 'rlplleate t.. the ornce or Ihe Dulldlnlll Ornclal for appro,,",1 prior to lhe commencement or any work. A copy or thl.
<br />permll .. to be kepi readily available at the .lIe or Ihe ....ork lit all lime..
<br />
<br />PARCEL I.D. N
<br />
<br />1'1~1~-11_ 0(70- 00000 -OflfO CITYROAD s~g()7.,
<br />
<br />LOCATION (Legal De.crlpllon):
<br />
<br />k~/.p fCA.}~,^ S'~h c/.'v,'S,'OA
<br />Pj - FJ"t~
<br />Lo-l- I
<br />or (, 't.<{o P(;. 04;;1
<br />TAC.
<br />
<br />FRc..+l, I!r .' ^ S
<br />l..Jo.t
<br />
<br />DATE s/~01()r,.
<br />
<br />Permission Is herel,y granled to
<br />for the construction Md malntemmee 0
<br />
<br />
<br />Z~f1 L.y i~;Llr
<br />
<br />subject '0 the following eondlllons:
<br />
<br />l. The eon.lrucllon and InalntemUlce or luch uflllly ,"all nollnlerrere wllh Ihe property lUId rlgh.. of a prior occupant.
<br />
<br />2. All ....ork ."~II bc done In kceplng wllh Ihe Ifamhuds of IIle Clly Streels Deparhbent and under Ihe lu,ervlslon of Ihe Clly Building Omclal, "ho
<br />,"'Ill be notlned allead one day prior to eommeneement of con.trucllon.
<br />
<br />J. All malerlal. and ellulpment shall be .ubJeet to In.peetlon by Ihe Clly Bulldlnl Omclal
<br />
<br />4. Durl"g con.tmetlon 1111 sAfety re~laflon. of the Department of Trllnsportllllon Ihall be observed and the City Ihall be relieved of all
<br />rc.ponllblllly from damage of any nature arl.lng from thl. permll. Subject 10 .he lame 'erm. and eondlllon., Ihe permit holder may take lueh larefy meuurel,
<br />Including placing ami cUsplay ..f eallflon .Ign., al II may deem necenary In conduct of construction and malntenllnce work hercunder. It h the felpon.lblllCy or
<br />the permlffee '0 place, mal,,'aln, and .upervl.e all traffic conlrol and device..
<br />
<br />5. All prlvAle and 1111 Clly properly .hAII be re.tored 10 lis originAl condition liS fAr as practical In the opinion or .he Clly Building Official
<br />
<br />6. All underground crolllng In.,htllatlo... .hall be lAid at such deplh a. mAY be .peclned by the City Building Official
<br />
<br />~. ' The .ketch coverlnR Ihe detail. of Ihl. In.lallal"III .hAII be made a part of 'hls pennlf. This permit Is Rranted wllh 'he unden'lUIdlng .h.t the
<br />al'pllcanl ha. no'lned all other u'lIIty ulen In 'he llrea conred by .he permU and takel full re'ronllblllty for any damage IMurred by prior In.tallatlonl al .
<br />re.ul' of his operAtions In order 'hA' 'hey nlay .afe goud 'helr Interes...
<br />
<br />8. III. npre..ly 'lIpula'ed Iha' Ihl. permU I. IIl1ee...e for perml.dve u.e only IInd thll' the placing of fadlltles upon public property punuant '0 Chi.
<br />permll Ihall nol opemle to erellte or to vesl any property rlghl In Inld holder.
<br />
<br />9. Whenenr Ihe City decide. to furlher C1lllloU Ihe CU)' RighI. of WilY, any or all laid poles, wire., plpel, cllblel, or olher fllellUlel and
<br />appurtenAncel aulhorlzed hereunder, .halllle Immedlalely removed from laid Rlpl. or Wa)', or re.et or reloca.ed 'hereon.1 required by the cui Bulldln,
<br />Official lit Ihe ellpense of Ihe holder of Ihls permll.
<br />
<br />10. The hohler shall .al'e and keep (he Clly hamde.. frlllll IIny IInd all damllge., claim I, or lnJurlel that may occur by realon or the comtruetlon,
<br />mA'lnlellAnce, IUId operaflo" of .ald faclllly.
<br />
<br />II. The holder IhAII complete the reque8led work wllhl.. days or thl. pennU Ihllll become nuU IIIId void. In the event the work requeltecl
<br />I. not completed upon Ihe n"lratlcn1 da'e of 'hls permit, the Clly shall have Ihe rlgh' to comple'e .uch work and to chllrge .he holder of the permit for aU COlta
<br />Incurred In complellng laid lvork.
<br />
<br />12. T"e holder shllll "ost a calh or .urety bond Trllh file Clly ManARer In 'he IU ors O..~ . ran'ee performlUlee orebe obllpflom
<br />herein, IInd ... ~AnUllee malntenRnce or the rlfthf-of-"'.y de.erlbed herein f..r II period 0 yellr followlnl comple' "" 0 the requelled !nllall.don. In the
<br />event.. ."rety bond I. "",'ell, Ihe .uret" b.....1 .hllll be mllde "lIyable I.. the Clly IInd .hall oblllllll.e y hRrmle.. In the event the holder of
<br />Ihl. I,ermlt .h.."ltl rail I.. lIIeet any or I.. ..bIlIllRII..n. hereunller. The "..nd .hall RI... Indemnlf" the CIty for all eourt cost. IInd reas..nable IIffomey'. fee. In the
<br />evenlleglllllcfl.." I. required t.. e..lleet on SAid b..nd.
<br />
<br />13. The l'erllllUee .hall have a14 hour emergency conlad nAme and number 1I..ed below,
<br />
<br />SUDMrnED BY:
<br />(P.~I"~, gY'"'(fJi-Qn S ~ ~(.
<br />Signature & Tille ~ U
<br />Addre.. 3" <. 4 , 1 S t-. ~ lJ . ~ <-{
<br />Phone C~(1)7 bl. ~ O'tLr;-
<br />
<br />APPROVED BY:
<br />CITY OF ZEPBYRlI
<br />
<br />
<br />1.
<br />
<br />Dulldlng Official
<br />Dale:
<br />
<br />Utllllle. Supervisor
<br />Dale:
<br />
<br />City MlII1ager
<br />Dille:
<br />
<br />? ~( VI.{ O<?'~ e
<br />(p' I ~ 0(",
<br />
<br />'~-Iz-<Ii1 ofr~
<br />
<br />Public Work.
<br />Date:
<br />
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