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CLI 3 (023 3Folk015t CITY OF ZEPHYRHILLS - BUILDING DEPARTMENT DATE: 1201/2010 MIGHT -OF -WAY USE PERMIT PERMIT# 1 1 ()Lt No construction under ground or aboveground of any facility shaft be accomplished on any City Rights of Way without written approval from the City Buttdiag Department. Any application for approval of construction operations on say City owned Rights of Way shotl furnish a detailed drawing showing the complete scope of the proposed work In triplicate to the office (tithe 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 an tinges. PARCEL I.D. N CITY ROAD GREEN SLOPE DR DATE 12101/2010 LOCATION (Legal Description) : ®.: r:, : ', '' . a:, +; ! ! ., Medial Arts Ct. Permission is hereby `ranted to Veriaat of Florida. LLC of 1909 US HWY 301 North. Bldg. D. Tampa. FL 33619 , for the contraction and maintenance of - 1.5" HDPE W/FOC AND HANDHOLES subject to the following conditions: 1. The construction and maintenance of such utility shall not interfere with the property sad rights of a prior occupant. 2. All work shall be done in keeping with the standards of the City Streets Department and under the supervision of the City Building Official, who will be 'welled at lost one day prior to commencement of construction. 3. All materials had equipment shall be subject to inspeetbn by the City Building Official. 4. During construction aft safety regulations of the Department of Transportation shall be observed and the City shall be relieved of 111 responsibility from damage of any nature arising from this permit. Subject to the some terms and conditions, the permit holder may take such safety measures, Winding plating and display of cannon sagas, u It may deem necessary in conduct of construction and maintenance work hereunder. It is the responsibility of the permittee to TTTT 5. All private and all City properly shalt be restored to its original condition as far as practical In the opinion of the City Building Official. 6. All underground crossing installations shall be bid at sub depth as may be specified by the City Bulidtng OffictaL 7. The sketch covering the deb& of obis installation' shall be made a part of this permit. Tbis permit is granted with the understanding that the applicant has notified ag other utility users in the area covered by the pernritand takes hill responsibility for any damage incurred by prior bstaftations as a result of his operations in order that they may safe guard their interests. S. It is expressly stipulated that this permit is a licease for permissive use only had that the placing of facilities upon public property pursuant to this permit shag not operate to ereate or to vest any property right in said holder. 9. Whenever the City decides to farther exploit the City Rights of Way, any or all said poles, wires, pipes, cables, or other faculties and appurtenances authorized hereunder, shall be immediately removed front said Rights of Way, or reset or relocated thereon as required by the City Building Offload 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. 11. The holder shall template the requested work wMthtu days or this permit shall become nun and void. 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 charge 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 et dollars to guarantee performance of the obilpttons herein, and to guarantee maInlenanee of the right- of-way desertbed herein fora period of one (I) year following completion of the requested tustalladon. In the event * surety hood is posted, the surety bond shaft be made payable to the City and shall obligate the surety to hold the City harmless in the event the holder of this perms should fall to meet any of its obligations hereunder. The broad shall also indemnify the City for all court costs and reasonable attorneys fees in the event kgal action Is required to eolleel on said bend. dttee) - ._. i (Pert Signature & Tide (� �i btu V V1_0.w\f * c €r" Address 1909 US HWY 301 North. D. Tema. FL 33619 V APPROVED BY: '3 1 . („ 1 j - 5 Cp CITY OF ZEPHYRHILLS Building Official Dale: A /. A. ' Utilities Supervisor .WOr �!'= 1 o u Dote: ustic Works tderink!_ 'Gfat7 / I�1'• - ''&)C) oAzt) evTS M Date: -� City Manager Date: