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DATE: 9~tj~()1 '3Lt?- -:s - 7P f ~BlA No construction under ground or above groUDld of any facility shall be Qccomplished on any City Rights of Way w.ithout writte~ approv~ from th~ Ci Buildin De artment. Any application for approvall of construction operatiom on any City owned Rights of Way shall tUrnish a detailed drawmg show~g th:!comPlet: sco;e of the proposed worl{ in triplicate to the office of the Building Official for approval prior to the cOlllmencement of any work. A copy of this permit is to be kept readily available at the site of the wl)rk at all times. .. . /J J / . PARCEL LD. # CITYROAD.Yf ~) (/N;YI~~,J DATE_ 9-/jro7 I , ,+h 51 .. 4!-~ ~(- CITY OF ZEPHYRHILLS - BUlLDING DEPARTMENT RIGHT-OF-WAY USE PERMIT PERMIT# 10{) I LOCATION (Legal Description) : vk~T, , t !<\1.e=' r tJ ~} ~ -r:v- <hJ12 ~ .( U\n "'A:- w~~~~~ S~ TI~ Permission is hereby granted to for the construction and maintenance of of FOe. :pfeil ril-B &.. Co~DUITC::; subject to the following conditions: 1. The construction and maintenance of SUcll utility shall not interfere with the property and rights of a prior occupant. 2. All work shall be done in keeping with thlO standards of the City Streets Department and under the supervision of thc 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 Building Official 4. During construction all safety regulations of the Department of Transportation shall be observed and the City shall be relicved of all responsibility from damage of any nature arising from .his pennit. Subject to the same terms and conditions, 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 hereWlder. It is the responsibility of the permittee to place, maintaIn, and supervise all traffic control and. devices. 5. All private and all City properly shall be Irestored to its original condition as far as practical in the opinion of the City Building Official. 6. All WldergroWld crossing installatiom sluill be laid at such depth as may be specified by the City Building Official 7. The sketch covering the details of this insllallation shall be made a part of this permit. This permit is gr-.mted with the understanding that the applicant has notified all other utility users in the area covered by the pennit and takes full respomibility for any damage incurred by prior installations as a result of his operations in order that they may safe guard their interests. 8. It is expressly stipulated that this permit i.s a liceme for permissive use only and that the placing of facilities upon public property pursuant to this permit shall not operate to create or to vest any propert;r right in said holder. 9. Whenever the City decides to further exp,lolt the City Rights of Way, any or allsald poles, wires, pipes, cables, or other facilities and appurtenances authorized hereunder, shaU be immediately removed from said Rights of Way, or reset or relocated thcreon as required by the City Building Official at the expense of the holder of this permit. 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 of said facility. 'j1" 11. The holder shall complete the requested work within J " days or this permit shall become null and ,'oid. 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 ch~lrge the holder of the 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 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 m,ade payable to the City and shall obligate the surety to hold the City harmless in the event the holder of this pennit should fail to meet any of its obligations hereunder. The bond shall 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 below. SUBMITTED BY: (permittee) VEt<i2-oAl DF fuJfC.iDt) LL-C- . ~ ,~ ~/311D7 Signature & Title j-glYt1rv LilA /T-z.- ;{/: i?/ S? - (? I:-' 6/ "'r:~.At.~ __. ~ Addft" of", " f'4tJ,-" ~ Pi'- f'LTP t7b'f <-.I#ft-Vk,J'c. j ~ ;--;:;-T'" ~ Phone ~/}.- 7yC- / Z J I APPROVED BY: CITY OF ZEPlIYRHILLS Building Official~' Date: .. Utilities Supervisor q" Date: Public Works Date: City Manager Date: