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c�/ � r � � /� I �v '/ ��- "' ' CITY OF ZEPHYRHILLS - BUILDINC DEPARTMENT Ck'�t`'`� �� DATE: -� RIGHT-OF-WAY USE PERMIT PERMIT# � I No construction unJer �r��und or abovc �round uf any �ACillh' SIl'AII bl' Accomplishcd on an�� Cih� Rights of �V;�y ��-ithout writtcn HpprovHl 1'rom the City Buildin�! DepartmenL Any applicAtion for Approval of co�struction operations on any City owned Ri�;hts of'��'N� shHll furnish a detailed drH�ving sl�owing the cumpletc scopr of the proposed work in [riplicate to the ofticr of the BuildinK Official for approvAl priur tu thc commencemcnt of �n� �+-ork. A copy ot'this permit ia ro Ae kept readih� ��ilable xt the site of the work A[ all times. PARCEL I.D. # CITI R04D � "- /�{J�V (� D,1TE LOCA'1'lON (Legal Uescription) Pcrmission is hercby grnntcd to ,� /�.�k}'�'t(/(�Sv �() of �a 7�� J R"S � W�.b�� C.CId}�G( �. for the ��1 �d mAint y•n�ncc ol' C � H �� (� � �� (�J f 1Ll�C 13 0►U' rca SS I� L.� � 1�t/C7t/t/[.�' .'� - r _subject to Ihe follo�.in�! conditiuns: I l�he cunstructiun ;�nd tnaintcn:�ncc u(such utilit� sl�all no1 intcrfcrc with thc pruperh :ind rikhts uf a prior uccup;u�[. :. rUl ��urk sh�ill be dune in kecpin�! �rrth the standards o( thc ( ity Streets Ucp�rtment and undcr the supervi.ion of the ( ih 13uildin� Official, who �� ill bc nolilicd �� Ic:ist unc d:�r priur [u cummcnccmcnt nf cunstructian. 3. �II m;iteriAls :�nd eyuipment shall be sub,jece �u inspecriun by thc ( ih Buildin}! 017icial. �. During construction :�II sal'et�� rc�,ulations of the llepartment o1'Transportation shall be obsrrved :�nd thc ( itv shall he relieveJ of all responsibility 1'rom dama}�e ol'any nature Arisin�; I'rum this permiL Sub,ject ro the sAmc terms nnd conditiuns, the permit holder may [akr such safrty measures, IIICIII(�111(; �I}��jp� NII(J (IISFIIAV uf cau[ion signs, ns it may deem necessary in conduct of cunstruc[ion and m:�intenance work hereunder. It is thc responsibility of [he permitlee to O9•'• i. All pri� n[e and nll Cih� properh� shHll be restored tu its originnl cundition AS �:If A5 �1fAChCHI in the upinian of [he City I3uildinK 017icial. 6. All undcr�;ruund crossin�, inst�llations sh�ll be laid at such dcpth :�s mAy bc spccilicd by [hc City Buildin� Officinl. 7. "l�he sketch cuvrrin}; Uic details of this ins[allatiun shAll be made a pxrt uf this permit. �1'his permi[ is gr�nted with [he understAnding that the applicant has no[itied all other utility uscrs in the areA cuvered b�� the permit and takes full responsibilit�� 'or xny dHma�;e incurred hy prior installations as A result of his oprralions in ordcr thnt thcl' mA� safe guard their interests. k. It is espressly stipulAted Ihat this permi[ is a licensc I'ur permissive use unly and that thc placing of f�cilitics upon public property pursuant tn this permit shall nut uperatc to cre�tc or to vest any prnperty right in said holdrr. '). �ti'henerer the City decides to further exploit Ihr City Ri�hts of Wn�•, :�ny or all snid poles, wires, piprs, c:�bles, or c>Iher fACili[ies and appurtenAnces authorizeJ hereunder, sh�ll be immedi�tcly removed from said Rights of Wa�, or reset or reloc�tcd thereon :is reyuired bY the Ci[y Buildin{; 017iciAl at the e�pense of [hc holder of this permit. 10 "f'he holder shall sAVC anJ keep the City hArmless from any And All damages, clxims, or injuries that mn� occur by reason of thc construction, maintenHncc, and oprr:�tion of s;�id G�cility I 1. 'nc� hoWer shall campletc the reyucsted work within Jays or this permit shall became null �nd �-uid, In the event the work rcyues[ed is not completed upon the expirAtiun da�e of this permit, the City shall hxvr the ri�ht ro complete such work and to charge the hoWer of thc permi[ (or all custs incurrcd in complctin�; said wurk. 12. The hulder shall post a cash or surety bond with the Cih� MAnager,in the sum of S Jollars to �;uarantee perfurmance of the obligHtions herein, and to �;u�rantee maincenance of the right-o1=�vHy described herein 1'or'a period of one (I ) yeHr following complction of the requested installHtion. In the event a surety bond is posted, the surety bond shall be mAde payable to the City And shall obligAte the sureh� tu huld thr City harmless in the event the huldcr of this permit should 1'ail to meet any of its obligHtiuns hereunJer The bond shall also indemnit'y the Citr fur All court costs and reasonablr attorncys fees in the cvenl IcgHl :�ction is required ro cotlect on sniJ bond. � v�"' (� S1�13NI1TTEUl31': � nl�l� � �^ � �� (Permittec) 4 '� !\ ! � �-i� ( �� 7 �� Si�naturc ac 'I�i[le � ✓ � Q.t/Sj /�� 1 V 5 /� / / ��Jress .3 �✓ c..3 ...5� .J�y �Q CS/e /� ( � ( � 0. Q � I�� 2 Z �: � �f�..� �