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DATE:A~lbl 3U~3 - TPF AIJEP No construction under ground or above ground of any facility ~haIl be accompJUhed 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 ~haIl fumlsh 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 i~ to be kept readily available at the site of the work at all times. CITY OF ZEPHYRHILLS - BUll.DING DEPARTMENT RIGHT-OF-WAY USE PERMIT PERMIT# DATE~7 PARCEL LD. # CITY ROAD LOCATION (Legal Description) : //-J-h ./lV- ~.J-h :5,,), ~ / -S+- :5~ J 5,J-h A-~ J 2./ + h //-10 J3-/-h AV; J- Permission is hereby granted to V E~ for the construction and maintenance of 'It ~ubject to the following conditions: J '/1./11 J-//JPE :)1 :;~tJR.:J!}.40/;~ /'~LJn~ / Cfor-p 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 Wlder the ~upcrvision of the City Building Official, who wili be notified at leut one day prior to commencement of construction. 3. AU materials and equipment shall be subject to inspection by the City Building Official 4. During construction all safety regulations of the Department of Transportation shall be observed and the City shall be relieved of aU responsibility from damage of any nature arising from this permit. Subject to the same terms and conditions, the penoit holder may take such safety measures, including placing and display of caution signs, as it may deem necessary in conduct of COlllltruction and maintenance work hereunder. It is the respollllibllity of the permittee to piace, maintain, and supervise all traffic control and devices. 5. All private and ail City properly shall be restored to its original condition aa far aa praeticalin the opinion of the City Building Official 6. AU WldergroWld crossing instaUations shall be laid at such depth aa may be specified by the City Buildhlg Official 7. The sketch covering the details of this installation shall be made a part of this permit. This permit is granted with the Wlderstanding that the applicant has notified all other utility users in the area covered by the permit and takes full rCllponsibility for any damage hu:urred by prior installations us a result of his ollerations in order that they may safe guard their interests. 8. It Is expressly stipulated that this permit is a license for permissive uae omy 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 allsald 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 permit. 10. The bolder shall sllve and keep the City harmless from any and all damages, claims, or lnJurlea that may occur by reaaon of the construction, maintenance, and operation of said facility. 11. The bolder shall complete the requested work within \1;;0 days or this permit Bhall become null and void. In the event the work requested is not completed upon the expiration date of this permit, the ClIy shall have the right to complete such work and to charge the holder of thc permit 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 S doUan 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 Burety to hold the City harmless in the event the holder of this permit should fail to meet any of its obligations hereWlder. The bond shall also Indemnify the City for all court costs and reasonable attorney's fees In tbe event legaIaetion is required to collect on said bond. 13. The permittee shall have a 24 hour emergency contact name and number JUted below. SUBMITrED BY: Public Works Date: (permittee) V~~~rn& LL-L -.... &TO"" -7 m f'--t()-o7 JJFJ- jJ 5/>u:Ih<,P~ f};ylH) P7r fJ Address '2?&,Oo Ad mtJ [Jr. FL-TPtYt!/s;;) -r;;m~4.J FL 5s/.s7L 9 Phone -&/ ~ - 7LJo-/:23/ City Manager Date: