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3 Cn23 3��r�}l-b C_.133 ' CITY OF ZEeHYRfIILLS-BUILDINGDEPARTMENT � n „ �j(' ' DAT�: RIGATAF-WAY USE PERMIT PERMIT#��U10 No constructlon�mda ground or above cramd of�ny facility shall be a¢omplishcd on ury Qty Rlghb of Wry Mthout writtrn appronl from Ihe Qty Building Deparhnent.Airy appllatlon for approval o(constractlon operatlons on my Qtr omKd RIghU of Way shall Nrdsh�deta0ed dr�wloQ showing the mmpkfe scope of the propmed worl�ln trlplicate tn ihe adllce of the Bulldin�O1I1cld for�pprovd prlor fn f6e rnmmencemmt of any work.A copy of this permit Is to be kept readRy�vailable ft[he ilte of fhe work at all tlmes. n ---/ PARCEL LD.# CITY ROAD / T V�'� � ( �C� � DATE � LOCATION(Ixgal Desa�lpflon): O 1 V �V �-' �r ��' y�� -�("D L �a �I G. , ' o i � � Pamission Is haeby granted W �� • f �q� u_� D ��33 tor the construction and malntenance o - \ ��T�l _A� !i � r -��_T t a�n/' � �/ rr�/► 1 /t ) /�,X,3[ �V1GlWS�.Q�- _subjed to the followf co tl s: � � �i� 1. The mnstruclton and msintenance of such utllity shalt not interfere with tt�e property md rlghts of a prior occupanL 2. All wark shall be done in keeping Mth the standards of iLe Clty Streets Depariment and under the supervi�lon of the City Buildf ng OflSdal,who wlll be notlfled at least one day prior to mmmencement o[rnnstructlon. 3. AD ma[erlals and equipment sdull be subJed to inspecfion by the G�ly Building Ofticial. 4. During constructlon all safety reguleUons of the Department of Transportatlon shall be observed fnd fhe City shall be rdleved of all responsibitlty from damage of any nature arl�ng hom this permiL Subject to the same terms and condltlons,fhe pa�Wt holder mry take mch ffie[y measures,L�cludtr�g pladng and display of wution signs,es tt may deem necesssry in condad of constroction and mainteronce work hereuader It Is the responsibUity of LAe permikee W???? S. All private and all pty property shall be restored W Its orlginal condltlon as tar as practical in t6e opinlon ot the City Bullding O(ticlil. 6. All underground aos�ng Installatlons shall be lald at such deptt�as may be speclRed by the City Bullding Oftkisl. ' �hr skrtdi rorerine thr drfafls nf thiz inNallatlon diall be made a part of Ihis permiL Thie permi�ie arantrcl wifh the nnderslendin¢tliat fLe �� =dl � .�i �� ' s � ,,.,,.�.,,i,�. ,p,,..�,.. .. .,�....�„ _ ,,. .. � ,. .. ,. ,.�„ 8. It ts eapressly stlpulate�Ihat fLis permll Is a Hcense for permisslve use only and W at Eae placing of facIDUes upon publlc property pursuant to thls perWt shall not operate W aeate or W vest any property right In sald holder. 9. Wha�ever the dty decides to furBier eaploit the City Rlghts of Way,atry or all ssid poles,wires,pipes,cable5,or ofher facllitla and appurtenances autt�orized hereunder,shall be Immedlafely removed from sald Rlghts of Way,or reset or relocated thereon as required by the Clty Bullding Ofticisl at ihe eapense of fhe holder of this permit 10. The holder shall save and keep tl�e City harmiess(rom any and all damages,claims,or injuries tLat may occur by rea.nn at the consVuctlon, mulntenance,and operation o[said tacilily 11. The holder 5ha11 complete the requested work within��days or this permit shall become nu0 and wid.In the event the work requested Is not completed npon the eapUatlan dafe of Ihis permit,tLe City shall have the right fa complete sud�work and to charge the holder of N�e permll for aIl costs incurred In wmpleting safd work. 12. The holder shall post a cash or surety bond witf�the(9ty Mana�;er 1n the sum of$ dollars to guarantce performanct of lhe obllgaflons herefn,and to guarantee maiMenance of the righto4way desa�ibed hereln for a perlod of one(1)yeur tollowL�g completlon ot fhe requested in�allatlon.In the event a surety bond Is posted,the�rety bond shall be made payable W the Cily and shall oblieete the surety W hold fLe Clty harmleu In the event the holder ot this pamlt should tafl W meet any ot 1b obllgatbns hereunder.ihe bond shall also Indemnlfy the Clty for all court costs and reasonable attorneys fees in the event legal actlon Is requlred to wliect on said bond. SUBMITTED BY: cr�m►cr�) Pi�1 �0 f� 2 �, � (\ Si�ature&TI ` Cv�'�"/�� ,Q"t l�/� / Aaa�eu (—74�=�ZM ,,r__,�v� v / ��.c�v�,�c� �L� 33t�[� APPROVED BY: CITY OF ZFPHYRI-IILLS Suflding Ofticial Date: Utilitles Supervlsor "w Date: �p A I PubllcWorks /2 n/W �PEM G�JT�' Date: qly Msnager Date: