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<br />/16;'3 -7i'~{)(L <br /> <br />DATE: ~...I').,() 7 <br /> <br />CITY OF ZEPHYRHILLS - BUILDING DEP ARTl\'lENT <br />RIGHT-OF-WAY USE PERMIT <br /> <br />. 1 (j) -z., <br />PERMIT# & D <br /> <br />No constJuction under grolDld or above grolDld of any facility sball be accomplished on any City Rights of Way without written approval from the <br />City Building Department. Any applkatlon for approval ofconstJuction operations on any City 01Vl\ed lUj&hts of Way sball furnish a detailed drawing showing <br />the complete 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 <br />permit is to be kept readily available at the site of the work at aD times. <br /> <br />PARCEL LD. # <br /> <br /> <br />CITY ROAD <br /> <br />DATE <br /> <br />"~ AC AN-i <br /> <br />.........." "'nby......... ...JI-~ <br />for the construction and maintenance of .e <br /> <br />subject to the foDowing conditions: <br /> <br />.f Z=I; ~ <br />/,:J..! )I bp& ~- rI I c:;,- <br /> <br />()pr;~ ~ 6k- <br /> <br />1. The construction and maintenance of such utility sball not Interfere with the property and righh of a prior occupant. <br /> <br />2. All work shall be done In keeping with the standard. of the City Streets Department and Ul1.der the supervision of the City Building OffIcial, who <br />will be notified at least one day prior to commencement of constructiolL <br /> <br />3. Ail materials and equipment .hall be subject to Inspection by the City Building OfficiaL <br /> <br />4. During constJuction all .afety regulations of the Department of Transportation shaD be obs'~rv~d and the City shall be relieved of all <br />responsibility from damage of any nature arising from this pennit. Subject to the same terms and conditi,ms, the permit holder may take such safety measures, <br />Including placing and display of caution signs, as It may deem necessary In conduct of construction and mllintenance work hereunder. It is the responsibUity oC <br />the permittee to place, maintain, and supervise all traffic control and devices. <br /> <br />5. All private and ,all City properly .hall be restored to it. originai condition as far au prac:ticalin the opinion of the City Building OffIcial <br /> <br />6. AlIlDldergrolDld crossing lnstallationssball be laid at such depth au may be specifled by th~ City Building Official <br /> <br />7. The sketch covering the details of this Installation shall be made a part of this permit. Thisllennlt is granted with the understanding that the <br />applicant has notified all other utility users in the area covered by the permit and takes full responsibility Cor any damage lneurred by prior Installations as a <br />result of his operations in order that they may safe guard their interests. <br /> <br />8. It is expressly stipulated that this permit is a license for permissive use only and that the pll.cing oCfacllities upon public property pursuant to this <br />permit shall not operate to create or to vest any property right In said holder. <br /> <br />9. Whenever the City decides to further exploit the City Rights of Way, any or all said poles, "fires, pipes, cables, or other facilities and <br />appurtenances authorized herelDlder, sball be Immediately removed from said Rights of Way, or reset or relocated thereon au required by the City Building <br />Official at the expense of the holder of this permit. <br /> <br />10. The holder shall save and keep the City harmless from any and all damages, claims, or injuries that may occur by reason oC the constJuction, <br />maintenance, and operation of said facility. <br /> <br />11. The holder shall complete the requested work within jl) days or thi. permit shall become nuil and void. In the event the work requested <br />Is not completed upon the expiration date of this permit, the City shall have the right to complete such wOl'k and to charge the holder oC the pennit for all costs <br />incurred in completing said work. <br /> <br />12. The holder shall post a cash (lr surety bond with the City Manager In the sum of S _ dollars to guarantee performance of the obligations <br />herein, and to guarantee maintenance of the right-of-way described herein for a period of ODe (1) year foU.~wing completion of the requested InstallatiolL In the <br />event a surety bond is posted, the surety bond shall be made payable to the City and shall obllgate the sunty to hold the City harmlellin the event the holder of <br />this permit should fall to meet any of its obligations hereunder. The bond shall also Indemnity the City fol' all court costs and reasonable attorney's fees In the <br />event legal action is requlred to collect on said bond. <br /> <br />13. The permittee shnll have a 24 hour emergency contact name and number listed below. <br /> <br />(permittee) <br /> <br /> <br />Lt4 <br />-~...o'7 A~r <br />':J- ~4 rL 83#9 <br /> <br />Address <br /> <br />Phone 8J3~ 7y.O"/~:3J <br /> <br />APPROVED BY: <br />CITY OF ZEPHYRHILLS <br /> <br />Building Official <br />Date: <br /> <br /> <br />City Manager <br />Date: <br />