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" �� - -- ' -- --- --J- --��C1TY�OF ZEPHYRHILLS- BUILDING DEPARTMENT RIGHT-OF-WAY USE PERMIT DATE: � � � t� � z�' � � PERM(T#: No constructlon under ground or above ground of any facility shail 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 shail 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 pertnit is to be kept readfly available at the site of the work at all times. PARCEL ID#: � i �- ��C„ -20 -�'f��i C� rU.--'��-c� --�''-t`�'ITY ROAD i Z``` ��' LOCATION (Legal Description): t} hC�' C_ � Z fi� ��' �N �?��/i i�"� , � � � �'� � � � L( 2 Permission is hereby granted to of For the construction and maintenance of: Subject to the following conditions: 1. The construction and maiMenance of such u�lity shail not intertere with the property and rights of a prior occupant. 2. All work shali be done in keeping with the standards of the City Streets Departrnent and under the supervision of the Cfty Building Official,who will be notlfied at least one day prior to commencemeM of construdion. 3. All materials and equipment shail be subject to inspection by the Ci1y Building Official. 4. During construction all safety regulations of the Department of Transportation shall be observed and the City shall be relieved of all responsibilily from damage of any nature arising from this permit Subject to the same terms and conditlons,the pertnit holder may take such safety measures, inGuding plaang and display of caution signs,as it may deem necessary in conduct of construction and maintenance work hereunder. It is the responsibilily of the permittee to???? 5. All private and all City property shali be restored to its original condition as far as practical in the opinion of the City Bullding Official. 6. All underground crossing instaliations shall be laid at such depth as may be specified by the Gty Building Official. 7. The sketch covering the details of this instaliation shall be made a part of this permit This permit is granted wRh the understanding that the applicant has notified all other utllity users in the area covered by the permft and takes full responsibfiity for any damage incurred by prior installations as a result of his operations in ortier that they may safe guard their interests. 8. tt is expressly stipulated that this pertnit is a license for permissive use only and that the piaang of faalities upon public property pursuant to this pertnit shall not operate to create or to vest arry properiy right in said holder. 9. Whenever the City decides to further expioit the City Rights of Way, any or all said poles, wires, pipes, pbles, or other facilities and appurtenances authorized hereunder, shall be immediatety removed from said Rights of Way, or reset or relocated thereon as required by the Gty Building OFficial at the expense of the holder of this perm�. 10. The holder shall save and keep tt�e City harmless from any and ail damages, claims, or injuries that may occur by reason of the construction, maintenance,and operation of said fadlity. 11. The holder shali complete the requested work within days or this pertnit shail become null 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 pertnit for all costs incurred in completed said work. 12. The holder shall post a psh or surety bond wfth the City Manager in the sum of$ dollars to guarantee perfortnance of the obligabons herein, and to guarantee maintenance of the right-of-way desc,�ibed 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 pertnit should fail to meet any of its obligations hereunder. The bond shall also indemniiy the City for all court costs and reasonable.attomeys fees in the event legal action is required to collect on said bond. SUBMITTED BY: //(�-, r, C./ (PERMIITEE) ��>"-C� t��t�.�� ` "�I�/ / � �'f�`" � ' � �� Signature&Title r z-� ! (�c��,:� !,� Address (S�-' � Z �`�` �'�` 2.P�v�h,�C � 5 �i ��S`�'� APPROVED BY: �E �', c{ � ND'��, CITY OF ZEPHYRHILLS Building Official Date Utilities Supenrisor Date Pubiic Works Date ZL�B l 2 City Manager Date �