CITY OF ZEPHYRHILLS - BUILDING DEPARTMENT
RIGHT-OF-WAY USE PERMIT 

DATE: _________________________                                                                PERMIT # ______________________________

     No construction under ground or above ground of any facility shall 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 shall furnish 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 permit is to be kept readily available at the site of the work at all times.

PARCEL I.D. #                                                                                        CITY ROAD                                                                         

DATE                      

LOCATION (Legal Description) :

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Permission is hereby granted to                                                                                                                            of                             

for the construction and maintenance of: 

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subject to the following conditions:

1. The construction and maintenance of such utility shall not interfere with the property and 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 notified at least one day prior to commencement of construction.

3. All materials and equipment shall be subject to inspection by the City Building Official.

4. During construction all safety regulations of the Department of Transportation shall be observed and the City shall be              relieved of all responsibility from damage of any nature arising from this permit. Subject to the same terms and                        conditions, the permit holder may take such safety measures, including placing and display of caution signs,                            as it may deem necessary in conduct of construction and maintenance work hereunder. It is the                                                   responsibility of the permittee to ????

5. All private and all City properly shall 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 laid at such depth as may be specified by the City Building Official.

7. The sketch covering the details of this installation shall be made a part of this permit. This permit is granted with the                understanding that the applicant has notified all other utility users in the area covered by the permit and takes                          full responsibility for any damage incurred by prior installations as a result of his operations in order that                                  they may safe guard their interests.

8. It is expressly stipulated that this permit is a license for permissive use only and that the placing of facilities upon                    public property pursuant to this permit shall not operate to create or to vest any property right in said holder.

9. Whenever the City decides to further exploit the City Rights of Way, any or all said poles, wires, pipes, cables, or other             facilities and appurtenances authorized hereunder, shall be immediately removed from said Rights of Way, or                             reset or relocated thereon as required by the City Building Official 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 complete the requested work within                  days or this permit shall 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 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 of $               dollars to                             guarantee performance of the obligations herein, and to guarantee maintenance of the right-of-way described                            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 permit should fail to meet any of its                                                                obligations hereunder. The bond shall also indemnify the City for all court costs and                                                                      reasonable attorneys fees in the event legal action is required to collect on said bond.

SUBMITTED BY:

(Permittee)                                                                                                              

Signature & Title                                                                                                      

Address                                                                                                                    

APPROVED BY: 
CITY OF ZEPHYRHILLS

Building Official                                                                                                      
Date:______________________________

Utilities Supervisor                                                                                                 
Date:______________________________

Public Works                                                                                                          
Date:______________________________

City Manager                                                                                                        
Date:______________________________