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DATE:3 -\0-01 3bL3 7Prl}oEQ CITY OF ZEPHYRHILLS - BUILDING DEPARTMENT RIGHT-OF-WAY USE PERMIT PERMIT# No construction under ground or above ground of any facility shall be accomplished on any City Rights of Way without written approval from the City BuDding Department. Any application for approval of construction operations on any City owned Rights of Way shall furnish a detalled drawing sho~g the compiete scope of the proposed work in triplicate to the office of the BuDding Official for approval prior to the commencement of any work. A copy of this permit is to be kept readiiy available at the site of the work at all times. l'i, c::' ~ l J...._ PARCEL LD. # CITY ROAD DATE~ 5'3"\'1- QCU(l~ 6\~, - c.-i~ LOCATION(LegalDescription): :\ cJJAJI rEi LA) () TJl.E wEsT 6'-4LL i'i.Vb OlJ 1'Re c.4.s ,) o L b S 1"\ '" V ~ Jot ::III & s., C& T i[ i:: IZ. ~ ~ Ji eJ V l' ~t: #l D ~..fI." Permission is hereby granted to 11 e ~ I '2 ~ ~ f5LOfEL?A- ~~ of F I () R I 1)..\ for the construction and maintenance of _~'/. IJ._~ _ oc. ai t)l~eC flo.u-4L 'oll.E subject to the following conditions: 1. The construction and maintenance of such utility shall not interfere with the property and rights of a prior occupant. 2. All work shall be done In keeping with the standards of the City Streets Department and under the supervision of the City Building Official, who will be notified at least one day prior to commencement of construction. 3. All materials and equipment shall be subject to Inspection by the City BuDding Official 4. During construction all safety regulations of the Department of Transportation shall be observed and the City shall be relieved of all responsibility from damage of any nature arising from this pennit. Subject to the same terms and conditiOlll, the permit holder may take such safety measures, including placing and display of caution signs, as it may deem necessary in conduct of construction and maintenance work hereunder. It is the responsibility of the pennittee to place, maintain, and supervise all traffic control and devices. 5. All private and all City properly shall be restored to its original condition as far as practical In the opinion of the City BuDding Official 6. All underground crossing InstaUations shall be laid at such depth as may be specified by the City BuDdblg Official 7. The sketch covering the details ofthls instaUation shall be made a part of this permit. This permit is granted with the understanding that the applicant has notified all other utility users In the area covered by the pennit and takes full responsibility for any damage blCurred by prior installations as a result of his operations In order that they may lafe guard their Interests. 8. It Is expressly stipulated that this permit Is a license for permissive ule only and that the placing of facilities upon public property pursuant to this permit shall not operate to create or to vest any property right In said holder. 9. Whenever the City decides to further exploit the City Rights of Way, any or alIsald poles, wires, pipes, cables, or other facilities and appurtenances authorized hereunder, shall be immediately removed from said Rights of Way, or reset or relocated thereon as required by the City Building Official at the expense of the holder of this pennit. 10. The holder shall save and keep the City harmless from any and all damages, claims, or Injuries that may occur by reason of the construction, maintenance, and operation ofsaid facility. 11. The holder shall complete the requested work within \'10 days or this permit shall become null and void. In the event the work requested Is not completed upon the expiration date of this permit, the City shall have the right to complete such work and to charge the holder of the pennit for all costs incurred in completing said work. 12. The holder shall post a cash or surety bond with the City Manager In the sum of $ dollars to guarantee performance of the obligations herein, and to guarantee maintenance of the right-of-way described herein for a period of one (1) year following completion of the requested installation. In the event a surety bond Is posted, the surety bond shall be made payable to the City and shall obligate the surety to hoid the City hannlessln the event the holder of this pennit should fail to meet any of its obligations hereunder. The bond shaD also Indemnify the City for all court costs and reasonable attorney's fees in the event legal action is required to collect on said bond. 13. The pennittee shall have a 24 hour emergency contact name and number listed beiow. SUBMlTIED BY: (pennittee) $-1- 4/~J'7 F'T'"o ;z:G -a~"1 9 Signature & Title Address Phone APPROVED BY: CITY OF ZEPmLS BuDding orr:fial' ,.' \,0- Date:~~ ~ ::w....-e . ~ tt -( & 'V I Date: ~:~ S!fiftj