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DATE: E-~-01 CITY OF ZEPHYRHILLS - BUILDING DEPARTMENT RIGHT-OF-WAY USE PERMIT PERMIT# 3(P:;<3- 7Fp/JOAE No construction under ground or above ground of any facillty shan be accomplished on any City Rights of Way without written approval from the City Building Department. Any application for approval of construction operations on any City owned Rights of Way shall furnish a detailed drawing showing the complete scope of the proposed worl( in triplicate to the office of the Building Official for approval prior to the commencement of any work. A copy of this permit is to be kept readily available at the lite of the work at an timel. PARCEL LD. # CITY ROAD DATE /';~r-~ 1. The construction and maintenance of IUch utility lhan not interfere with the property and rightl of a prIor occupant. 2. An work lhan be done in keeping with the standards of the City Streeta Department and under the lupcrviaion of the City Building Official, who will be notified at leaat one day prior to commencement of comtruction. 3. An materlala and equipment shan be lubject to inspection by the City Building Official 4. During comtruction aillafety regulationl of the Department ofTranlportation shan be observed and the City shall be relieved of an responsibility from damage of any nature arising from this pennit. Subject to the lame terms and conditions, the permit holder may take luch safety melllures, including placing and display of caution signs, as it may deem necessary in conduct of comtruction and maintenance work hereunder. It is the respomibillty of the pennittee to place, maintain, and supervise an traffic control and devices. 5. All private and all City properly shall be restored to ita original condition III far III practical in the opinion of the City Building Official 6. An underground crossing installations shall be laid at such depth III may be spedfied by the City Building Official 7. The sketch covering the details of this installation shan be made a part of this permit. This permit is granted with the understanding that the applicant bu notified all other utility users in the area covered by the pennit and takes full responsibility for any damage hu:urred by prior installations III a result ofhil operations in order that they may safe guard their intereds. 8. It ia exprelsly ltipulated that this permit is a liceme for permislive we only and that the placing of facllitiel upon publlc property pursuant to this permit shall not operate to create or to vest any property right in laid holder. 9. Whenever the City decides to further exploit the City Rights of Way, any or all laid polel, wires, pipel, cables, or other facilitiel and appurtenances authorized hereunder, lhan be immediately removed from laid Rights of Way, or reset or relocated thereon III required by the City Building Official at the expense of the holder of this permit. 10. The holder shall save and keep the City harmless from any and all damagel, Clalml, or injuries that may occur by relllon of the comtruction, maintenance, and operation of said facility. 11. The holder shan complete the requested work within days or this permit shall become nuil and void. In the event the work requested is not completed upon the expiration date of this permit, the City shan have the right to complete such work and to charge the holder of the pcrmit for all costs incurred in completing laid work. 12. The holder lhan pOlt a cash or lurety bond with the City Manager in the IUID of S dollars to guarantee performance of the obligations herein, and to guarantee maintenance of the right-of-way delcribed herein for a period of one (1) year fonowing completion of tbe requested installation. In the event a surety bond is posted, the surety bond shall be made payable to the City and shall obligate the lurety to hold the City harmless in the event the holder of this permit should fail to meet any of its obligatioDl hereunder. The bond shan alao indeDlllilJ' the City for an court costs and relllonable attorney's fees in the event legal action is required to conect on said bond. 13. The pennittee shall have a 24 hour emergency contact name and number listed below. SUBMITTED BY: (P'nn1"') VE~L ~~ ~// d,;..o,o1 Signature & Title ,.~. ~r )jE~fJ ~~,,-Ih.K).5f ~/d-1"1 F7'T';:J Address "f?~I'J~~M7I!/ ~ FI. TP&I/S~ 7711'1'{P'tF'- 35~/9 Phone :1?J?-- 7'/C-/~::? J . APPROVED BY: CITY OF ZEP Public Works Date: City Manager Date: