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CITY OF ZEPIIYRFiILLS-BUILDING DEPART�IEh"T � DATE: �I23��C71''�j RIGHTAF-WAY USE PERMIT PF,RMIT# No rnnstruction under ground or above�round ot any faciflty ahall be accomplis6ed on any Ciq�Ri�hts af W ay without wrtlten appro��al from t6e City Suilding Deputment My appiieation for approvai of comtruetion operalionc on any City awned Rights of Way shall furnish a dMailed drew[eg showtng the complMe seope oi tAe proposed work in triptleate to the offiee of the Building Officisl for approval prior to Ne ammcncement of any wnrk.A rnpy of ffiu permit is M be kept resdily ovailrble a[ipe ske of[he work at all Hmcs. P��RC�LI.n.# CI'IYROAD �t2� �0 DATE I.00A770N(l.egat Dcacription): - vr��zY eo� .�wt v�GN�i'�Ry RcaaD � �'rr( F�r� �AO Permisxion is hercby granted to ��Z��" of T��/r'T. fnr tbe conxtructioe and maintenance of- Q� � • R3Ct UTt�ES �Ib ACCOwWDA-TE _�s� a� 'ito A�3!R� 20/� _subjeM ro the follo�rin�eonditiunx: 1. 7'he construction and mairttenance of such�tiliry shali not interfere with tAe propertp snd rights of a prior occupant. 2. Aii work chail be done In keeping wSd��he standards of the City StreMS Departmmt and under Ne supen•ision of the City Buildinq Otficial,who w�ilt be notified at least one day�prior m eammeneement of cons[ruction. J. All materials and equipment shall be subjett m inspection by the CiN BuileGng O�cfal. 4. During construc[ion all Fatety regulations of[he Departmeot of Transportntion�liall be observed and the City shali tce relieved of ail rctpunsGbitity from damage of any naturc arising from this permit SubJcet to the same[crms and wnditions,tbe permit holder may take suc6 satety measures,including placing snd display ot cauNon signs,as it msy deem necessary in conduet of constructiort and maintenantt work hereimder.It is tbe res{ansibilfty of t6e permittee ta???? 5, UI private and ail Cih properly sha13 be resfored lo Itc original condi[Mn as far as practicai in the opinion of t6e City Auilding Otfieial. 6. AIt undergrnund crossing instxllationa shall be laid at such depth as may be specified Ay Me CiN BuitdinR Official. 7. The sketch coverirtg t6e details of thix in.ctallation shall be made a part of this permit This permit is granted�vit6 the understanding thnt the applicant hae notified aU other utility vsen in the area wvered by the permit and takes full responsiDiliry for any damage incunrd by priur installations as a result of his operetions in order that they mey safe guard thelr intererts. 8. It is expressly stipulated that this permit is a license far permissive use onfy and tha[the placing of facitities upon publie property pursuant to this permit shall not operate ro creatt or to vest any property right in said bolder. 9. Wdene��er the Ciq�detides to fuKher ezploit the Cit}'Rights of Way,any or ail said poics,wires,pipey cables,or other facil{tiw and eppurtenanccx authoriud hereundeq ahall be immctliately removcd from said Ri{;hts of R'ay,or�aet or relocated thereon as required by the City Building Offieial af the expensc of the riolder of this permik. ]0.The holder cha11 save and keep the City hwrmless trom any and atl damages,claims,or injurics[hat ms��oca[r 67•reason nf the mnstruction, malntenance,and operstion of said facility. 1 t.7'he halder shall mmplete the requcsfed work within �+O days or this permit shall bernme null and void Tn the tvent the work requested is not completed upon the expiratiun date of this permit,[he Ciq•shall bave thc right ta complete xuc6 e�ork and to charge the holder ot thc permit for ait rnsts incurred in complcGng said work. 12. �he dolder s6a11 post a caah or aurcty bond wH6 the Ciry Mansger m the sum of S dollars to gaerantet performance oP the obligations hcrein,snd to guarantee maintenance ot thr right-af-way descdbed 6erein fur a period of one(1)year fotlowing completion of the requeated instaUation.In the event a surety bond is posted,Ihe wrety bond shall be made p4yabic to Me City and s6all obliyyte Me xurety W hold the Ciry harmiess in [he event the holder of this permil shoWd fail to meet any of ita obligations hertu�der.Thc bond shaU nlso indemn3fy the City for all court rns[x and rcasonaAle attorneys fees in ffie event Iegai ac[ion is required ro rollcet on said bond. I � Sl,'BMITTED BY: (Pc�mlttcel _. �S �N��P!� Signature&1'ide �E�i'�b� ✓��^�Y�'�— _ Address �qr^I UCl �� •i 1�'��•�Tfi +7�....Y.Tf��—d ��,�a . t� t�� '�-.->� �o�� .-. v��-,.,a�� I� �s�i 2 - `'I �,�-�C� � nerxoven ut• CffY OF ZEPIIYRHI[.LS L Duil ' (NTic __ Dale: Utilities Super'visor � Datc• Public W'vr ,�,p �j Date: `�lY'C.1)�7 City an Dale: L�