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<br />CITY 01" ZEI'IIYIUIIU.s - UlIIl.UlNG DEI'ARTMEN'I'
<br />JUGUT-Ol'-W A Y USE l'ERMl'l'
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<br />PERMl'l'N
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<br />71((
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<br />DATE: 1- 2./- 0 g
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<br />No con"flIcllon under ~round or .ho\'e ~rc,un.I..r .ny r.cllll). ....11 he .ccolnpll.hed on .ny Clly RI..... .rWay wi....... wl'lllen .pp...".......... lhe
<br />Clly Dulldlnll Depnrlmenl. Any.pplk.Uon ror .I'pro".1 or con.lflIcU"n "pu.Uon. nn .ny Clly owned RI&I'" .rw.y...... n.mlah. ....IIe. draw", ....19...
<br />Ihe complele .cope or lhe propo.ed ".rk In Irlplle.le 10 Ihe ornce or Ihe B..lldlnll Officl,,1 ror .ppro"al prior Co lhe commenc:emen. or IlII1 work. A copy or thb .
<br />permU Ia 10 he kepI re.dlly .\"Allable a'lhe .lIe or I"e work .1 "lIlll11e..
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<br />PARCEL 1.0. "
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<br />CITV ROAn IY)EDICf-)L tI,t:\.() I-N
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<br />DATE 1)21 /lI)cff
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<br />LOCATION (LeI,,1 De.cl'lpCIon) I
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<br />2. All work ."~II be done In keel,lnR "1IIal"e ""ndard. or Ihe Clly Slreel. Dep.,"'aen' .nd under.he .upenlalon or'he Clll BuDdlnl Olllclal. who
<br />"III be nomled .. Ie,," one dal prior 10 eommencemen' or "on"flIcllon.
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<br />I. The con.lflIeUon IInd maln'enanee or .uch ullllly ....11 no' Inlerrere "lIh Ihe proper'lMd l'I&la', ar a prior oc:c:upan'.
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<br />3. All na.'el'llll. and equlpnaen' .hAII be lubJect 'a Impeellon bl 'he Clll D..II~lnA Omc:laL
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<br />\ of. D..rlng .0n"flIctlon all..re'l "'AlIlallom or 'ho Dep.rlmm' or'I'ran.por'.l\on ....11 bo ob.onod .... tho CII1IW... ...1In.. 0' aU
<br />....pon.,blll'l rram damaAo or anl naturo .rl.lng rram .hla pennll, Subject '0 .he 'Ame 'ennl and condl......, .he penal. hohler "., lake lucIa ..,.I1.....u....,
<br />IncludlnR pla"InK and dl.pl"l or .a..Uon lip.. a. II 01.' deem neeea.ary In \'Onduct ar cona'flIcllon and maln'enance work hereunder. It h the rnp-abWtr 0'
<br />'he ptrmlUee '0 plllce, malnlaln. and ...penl.e all'nm. conlrol "nd device..
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<br />S, All prl"nle and all Clll properly ....11 be rellored '0 II. orlllnal condlUon "' r"r.. practical In tho opln'" or tho CIIJ JlqUd", Ollldal.
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<br />6, All undultround e......lnl......III.llon. Ihilll "e IlIld .. lueh depUI a. mny be '1,<<lOed bl the CIIJ BulIcI.... Omc:laL
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<br />7. . The .kefch coverlnK Ihe de""1a .r .hl. 11I.."II"Uon .b.1I be m"de " par' ar .hl. pennlt. Thll permll 1a'l'llIlled "Ith .ho WldenlaDdln. tha.1he
<br />.p,llean' ha. noUned.1I other ullllll...e... In the area cntre. by the permll "nd I"k.. rull re.pan.lblllty ror IlII1 da..le InCurred ., prior ............. .. a
<br />relull anll. opernUon. In order 'hat 'hey m.,..re pud 'helr Inlere.'" "
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<br />.....
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<br />8, It I. upre..ly IlIpula'ed 'h"llhl. permit I. . lleen.e ror perml..ln u.e 0111). IInd tha'lho ,lacln. or raclllll.. upon publle praper'l pu...lIIlft". ....
<br />pennll ....11 nat aper.te to .~"ee or '0 n.. anl Prupertl rlpt In ..Id holder.
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<br />11. W"enner Ihe Clly decide. '0 n.rl"er elplolt U.o ClCl Rlpl. or WilY. .ny or Iill..ld pole.. wi..... pi,.., C!...... or .Iher radO.... and
<br />.ppurtenllnee. A..'horized hereunder, .hall bolmmedllleely ~mo\'C" rrom ."Id RIRlII. or W.y, or re.e' or ...Ioc.eed the........ ...qulred b,.... Clti DuD.....
<br />Orncllll .llhe upen.o or the holder or thl. pennll.
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<br />. IU. The holder .h"II..\'O nndkeep Ihe City h.rmle.. rrom nny "nd "II dllmllge.. claim.. or InJurlc. ,,,,,,,., oecur by ........ or.... COIU'ructlon,
<br />malntenllnce, nnd aperallon at ..Id r.clllly.
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<br />II. The holder .h.1I eomple'e Ihe ~qu"'ed work nllhln 10 d"y. or ...1. pennlt .haU become...O and ~old. In I'" neat Ihe work I'Cque.ted
<br />I. no' eompleled upon d.. C.lI,lnllon d.le or Ihl. permit. Ibe CIC,.hall hllVe the rlghl '0 complete lueh work and .. dlal'l. Ibe holder 0' the penalt r.r all_It
<br />lncur...d.1n compleelng .ald "orlc.
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<br />12, The holder .halll,o.1 Il .".h or aurely bond "lCh ehe CIC, MIlMger In ehe a..m or S dol....... pIll'lllllee perr.1'IIIIlDCe or the oldla.CIou
<br />herein. .nd '0 gUAfllnle~ m"ln'enllllCe ar lhe rIRla'-or-".y duerlhed I..reln ror. period or one (1) year roUowln1 comp"llon o,.be ........Ied ............... In 11M
<br />ovenl · ,urely bond I. po. led. the ,u"'ly bond ah.1I be made p.y,,"le to II.. CI.y and .hall abllp'e .he ,u""l'. hoW Ihe Clll hannle.. In"" "eDC 'ho holde.. or
<br />Ihl. pennlt ahoulll r.II'o nlecl "nl or IC. abll~.IIon. he~under, The 1I0nd ah"IIAI.o indemnity Ihe Clll ror .11 court \'0", ...d "'Monable aUomel'. 'ee. In the
<br />evenlleAlI1 .cllon I. required 'a collect on ."Id bond. t'I I
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<br />13, The pernllU.e .h,,1I han " 24 ho..r emergency conlnd n"nle "lid number lI.ted below.
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<br />SUBMn-J"ED BVI
<br />(P".'uu, ~ aL&;cl9
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<br />Slp.'ure&''''11e D. ~~ / E"rg;tc€Q.r
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<br />Addre.. /20 6:.. Llmt;;: ST. . LAJ<,..6UWO I FlA. 33&v/
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<br />Pholle
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<br />APPROVED BV:
<br />CITY OF ZEPUYRIIIL1.8
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<br />~kIlnl Ornclal
<br />f"e:
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<br />UlllllltI Supcnl.or
<br />D.le:
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<br />Public Wark.
<br />Da'el
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<br />
<br />~~nn"Aer
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<br />..
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<br />:f~~:;'~~';f. 7,~.
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