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. 3~Z3'-'lPrACJt='6 CITY OF ZEPHYRHlLLS - BUILDING DEPARTMENT RIGHT-OF-WAY USE PERMIT PERMIT# tR 8 3q DATE: No construction under ground or above ground of any facility shall be accomplished on any City Rigbts of Way wilhout written approval from the City Building Department. Any, application for approval of construction operatiolU on any City owned Rights of Way shall fumJsh a detalled drawing showing the complete scope of the proposed worie in triplicate to the ofI"ICe 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 tbe site of the work at all times,.. .. _ L /, r 1, PARCELLD,# ClTYROADJIA.e/aa'j -5ccg~LoW DATE~ 1. The cOlUtruction and maintenance of sum utility shall not interfere witb 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 supcrvbion of the City Building Official, who will be notified..t ieWlt one day prior to commencement of cOlUtruction. 3, AU materials and equipment shall be subject to inspection by the City Building Official 4. During construction all safety regulatiolU of the Department of Transportation shall be observed and the City sball be relieved of all responsibility from damage of any nature arbing from this permit. Subject to the same terms and conditions, the permit holder may take such safety measures, including placing and dbplay of caution signs, as it may deem necessary in conduct of cOlUtruction and maintenance work hereunder, It b the nspolUibllity of tbe permittee to place, maintain, and supervbe all traffic control and devices. 5, ~ll prIvate and all City properly shall be restored to its original condition as far IIll practical in the opinion of the City Building Official. 6. AU WldergroWld crossing installatiolU shall be laid at such depth as may be specified by the City Building OfficiaL 7. The sketch covering the detailS of this installation shall be made a part of this permit. This permit b gr.mted with the understanding that the applicant has notified all other utility users in the area covered by the permit and takes full responsibility for any dlllDJtge incurred by prior installations as a result of his operatiolU in order tbat they may safe guard their interests. 8. It is expressly stipulated that this permit b a licelUe for permbsive use oniy and that the placing of facillities 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 expioit the City Rights of Way, any or allsald poles, wires, pipes, cabies, or other facilities and appurtenances authorized hereunder, shall be immediately removed from said Rights of Way, or reset or relocated thereon Wl required by the City Building Official at the expelUe of the holder of this permit. 10. The bolder shall save and keep the City harmless from any and all damages, claims, or injuries that may occur by rellllon of tbe construction, maintenance, and operation of said facility. 11. The holder shall complete the requested work within J 2...0 days or this permit shall become null and void. In the event the work requested b not comlJleted upon the expiration date of this permit, the City shall have the right to complete such work and to marge the holder of the permit for all costs incurred in compieting said work. 12, TIle holder shall post a CllSh or surety bond with the City Manager in'the sum of $ dollars to guarantee performance of the obligations berein, 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, tbe surety bond shall be made payable to the City and shall obligate the surety to hold the City barmiess in the event the holder of this permit should fail to meet any of its obligations hereunder. The bond shall also indemnify the City for all court costs and rellllonable attorney's fees hi the event lega.1action b required to collect on said bond. 13. The permittee shall have a 24 hour emergency contact name and number listed below. APPROVED BY: CITY OF ZEPHYRHlLLS B~\.5~~b:r /(-J{ Date: r -/ 0-) SUBMITTED BY: 21Itc.." (permittee) /I,{:!.,fCi(;:CA/ or:: rLoe/ZJ,7A ~ (\:;?,t/'. Signature & Title ~R,V4A./ LAA/r.c: AlE.If'? .::re: ,ee-G/Q4' I ~ C(,;..JTJ7) Addres~a::J 4flA/Ho ~ R.rPLJ(z,5~ mll1f7A ;:L~ '3.%19 Phone /-.$/B-74cv -/:G .31 Utilities Supervisor Date: J~p/ ~ Public Works Date: City Manager Date: " ,