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CITY OF ZEPHYRHILLS — BUILDING DEPARTMENT RIGHT -OF -WAY USE PERMIT • DATE: JJ /b- ©i PERMIT #: {'-'`, No construction under ground or above ground of any facility shall be accomplished on any City Rights of Way without written approval from the City Building Department. Any application for approval of construction operations on any City owned Rights of Way shall fumish a detailed drawing showing the complete scope of the proposed work in triplicate to the office 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 the site of the work at all times. _ o i3® PARCEL ID #: /1 "' 6 - / -00/0 - /SR ab CITY ROAD LOCATION (Legal Description): 5230 6 ' / '3, .2 075 Al. - JO Permission is hereby granted to of For the construction and maintenance of: Subject to the following conditions: 1. . . The construction and maintenance of such utility shall not interfere with the pry 2. All work shall be done in keeping with the standards of the City Streets Dept — "r 7( '� 1.�I, 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 4 . % ' 4. During construction all safety regulations of the Department of Transportatior1 isibility from damage of any nature arising from this permit Subject to the same term asures, including placing and display of caution signs, as it may deem necessary in! , 1 is the responsibility of the permittee to ? ? ?? 5. All private and all City property shall be restored to its original condition as fa 6. All underground crossing installations shall be laid at such depth as may be 7. The sketch covering the details of this installation shall be made a part of / That the applicant has notified all other utility users in the area covered by the pe ` prior installations as a result of his operations in order that they may safe guard th 8. It is expressly stipulated that this permit is a license for permissive use only t to this permit shall not operate to create or to vest any property right in said holder. 9. Whenever the City decides to further exploit the City Rights of Way, a f les and appurtenances authorized hereunder, shall be immediately removed from s \ =1 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 damagl. truction, maintenance, and operation of said fadllty. 11. The holder shall complete the requested work within fO days or this pi, ested is not completed upon the expiration date of this permit, the City shall have thl s permit for all costs incurred in completed said work. 12. The holder shall post a cash or surety bond with the City ManaS_.____ _ _ e 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 made payable to the City and shall obligate the surety to hold the City harmless 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 reasonable attorneys fees in the event legal action is required to collect on said bond. SUBMITTED BY: (PERMITTEE) 413AG. dam r t rites Signature & Title ca- Address Q805 .S, / t /!a• Al 4/ L-V ' 2WV C• REVIEWED BY: CITY OF ZEPHYRHILLS Utilities Supervisor Date Public Works Date.