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DATE:~Olo CllY OF ZEPHYRHILLS - BUILDING DEPARTMENT RIGHT-OF-WAY USE PERMIT PERMIT# No Instruction under ground or abou ground of any facility shall be accomplished on any City Rights of Way without wrlUen approval from the City Building epartment. Any application for approval of construction operations on any City owned Rights of Way shall fUrnish a detailed draw.... ....w.... the complete s ope of the proposed work In triplicate to the ollke of the Building Omclal for approval prior to the commencement of any work. A copy of thb permit I. to be kept readily available at the .Ite of the work at all times. PARCELI.D. H-,){g .,),,\ -60(0 ~{)'Z-50() -0150 CITYROAD \("1-t1'15+ DATE I LOCATION ( egal Description): Permission Is reby granted to 9o..-\Y-\ CI" ((')o.c:o:,e.. \ \ 0- for the constru tlon and maintenance of of ,'Y'Io..V'se \ \0. (\'-^,",",""\,,ur~ \ (f"YJ subjed to the t: 1I0wlng conditions: 1. ~he condructlon and maintenance of such utility shall not Interfere with the property and right. of a prior oeeupant. 2. il work sh~1I be done In keeping with the standards of the City Streets Department and under the .upervlslon of the City BuIlding Ot1leIaI, who will be notlDed t least one day prior to commencement of construction. . 3. II materials and equipment .hall be subject to Inspection by the City Building OflklaL 4. urlng construction all safety regulations of the Department of Transportallon .hall be ob.erved and the City .haIl be reUeved of aU respon.lblllty f m damage of any nature arising from this permit. SubJed to the .ame terms and conditions, the permit holder may take luch lafety meaurel, including plac g and display of caution Slgnl, as It may deem neeellary In conduet of construction and maintenance work hereunder. It II the I'elponIlbUlty of the permittee t place, maintain, and lupervlse all tramc control and devices. henever the City decldel to further exploit the City Rights of Way, any or all laid polel, wlrel, pipe., cable., or other facUltle1 and appurtenances uthorlzed hereunder, shall be Immediately removed from laid Rights of Way, or reset or relocated thereon.. l"efIulred by the CItY B.lld.... Oflklal at the e pense of the holder of this permit. II private and all City properly shall be restored to Its original condition as far.. practlealln the opinion of the City BuIId1nl Ot1le1aL II underground cronlng installations shall be laid at such depth as may be speclOed by the City BuIlding Otl1c1aL 7. . sketch covering the details of thlllnstallatlon shall be made a part of this permit. This permit II granted with the undentandlng that the appllc s n tlf1ed all other utility ulen In the area covered by the permit and takel full relponllblllty for any damaae lneurred by prior ....tallatlatu u . result of his op tlonsln order that they may safe guard their Interests. Is exprellly stipulated Ihal this permit Is a license for permissive use only and that the placing of facllltlel upon public property punuant to "II operale to create or to vest any property rlghlln said holder. he holder shall save and kecp lhe City harmless from any and all damages, claims, or Injuries that may oeeur by reuon of the COIUtruction, d operallon of said facility. O( to mo:s .\="i""OY'" Lcvo\- ',\1""5 (?('c-\--, U"\r\ . he holder Ihall complete Ihe requested work within \ ~ 0 days or Ihls permit .hall become nuD and void. In the event the work requelted Is not C'Omplele upon the expiration date of this permit, the Clly shall have the right to complete such work and to charae the holder of the permit for aU _tl Incurred In com Ietlng .ald work. he holder shall post a cash or surety bond "lIh the Clly Manager In the sum on -dollan to guarantee performance of the obllptiona herein, and to arantee maintenance of the right-of-way described herein for a period of one (1) year following completion orthe req1lelted ....tallatlon. In the event It surety b d Is posted, the surety bond shall be made payable to lhe Clly and shall obligate the .urety to hold the City harmle.. In the event the holder of Ihls permit sho d fall to meet any of lis obligations hereunder. The bond shall also Indemnify the City for all court cost. and reuonable attorneY'1 fen In the event legal adl II required to collect on laid bond. 13. he permittee shall have a 24 hour emergency ctlntact name and number listed below. SUBMITTED BY: ~ ::~:=~T.k ~td::a..O-:;Ei~~'\\~ .../ Address 30/4/ ~iR, S 4- /Phone (61 3) 91:3 ._/t'/(} C(Fr,stv-u c':. \- \ '^"' APPROVED B CITY OF ZEP YRHlLLS /tJ/ESLE'1 CIIAPE.L-.I=L, ~3543 -AS2/ / C/lrJt,/- (V'/'~ ? 27- 93)/ Building omel. Dale: Utilities Supervl or Date: Pul>>1Ic Works Date: City M_ler Date: