HomeMy WebLinkAboutexhibit1BDistrict Six
6/95
DATE:
SECTION N0:
COUNTY:
STATE PROJECT N0. :
APPLICANT:
ADDRESS:
CITY:
TELEPHONE NO.:
Applicant requests P engineering as described
permission
math maintaof in the rid11Department
inof Transportation,
hereinafter called e
Department, to construct, operate,
here: and Nearest Intersect?ion:
ATTACHMENT "B"
STATE OF FLORIDA
DEPARTMENT OF TRANSPORTATION
SPECIAL PERMIT
(if applicable)
PERMIT NO.:
STATE ROAD NO.: T0,
MILEPOST FROM:
RECORD NO.:
orate limits ofa municipality: Yea ( ) No ( )
Is the proposed work within the core Local Government Contact:
Name of municipality:
this application, the location of all existing utilities, both aerial and underground, has
s (as applicable). A letter of
p, Prior to filing PPto the following
of
beenoascertained, a was the accurate locations are shown on the drawing
notification mailed
utilities/municipalities:
It is expressly stipulated that this permit is a license for
permissive shal use t only and athat the ctare construction
ction
3. property pursuant to this permit
within and/or upon public p p _y for the repair,
right in said holder.
4. whenever it is determined by
and/or efficient Department
operati nt alteration,, or relocation of any or all portion
ll
omprovemeh, maintenance,
of said highway and/or transportation highway facility;
transportation tfacility, orm reeetely remove any and or relocate thereonas
installed facilities from said highway
required by the Department at the permittee's expense. permit issuance. The worknshall be
A11 work shall meet Department's Roadwa and Traffic Desi n Standards, S ecifications for Raad and Bridge
5.applicable criteria in effect at the time of p Pauance. Then oshall
br
perfo�diun, and other , This designated engineer
performed under the Inspection super Telephone No.
located at
shall be notified forty-eight l481 hours prior ti o the pre -construction meeting and again launch .a a y
before commencement of work. All material and equ pment shall be subject to inspection by the designated
6. All Department property shall be restored to its original condition as far as practical in keeping with
engineer or his authorized representative.
by the Department.
Department Specifications, and in a manner satisfactory to the Department, within thirty (30) days a the
installation of the permitted work, unless otherwise approvedprofessional
q A drawing covering details of this work shall be
d a part ofrthis
per bear Thissdrawingoashall)include
plan, profile, and crossthsections f Florida.aapprodrawings arepriate, days from the date of
the Per Iteensed in the State t FAs built good faith within days
Yes ( I
6 The ppemiitea shall
va commence actual construction in g
days from the commencement of work
said permit approval shows
shall compete construction d within
from the date of issuance of this permit will be granted.
unless the permittee shows good cause for delay and the Department approves an extension. No extension
beyond one (c) yearthe Department:
9. This construction and maintenance shall not'interfere Instructions 1he property and rights of a prior Penn t ee.
SQ, Special Conditions
the PermitCee, his
It is understood and agreed that the rights and privileges herein set out are granted only to the extent
11. State's right, title, and interest in the land to be entered upon and used by
of the
heirs, assigns, and successors in interest, and the permittee will, at all times, assume all rinkof and
and
indemnify, defend, andoexpense arising in any manner ronaaccounteofethetment exercisemornattempted all
sai, damage, cost, P
said permitteue of the aforesaid rights and privileges. permitted work, all safety regulations of the
12. During construction observedryDepartment acceptance )eof thea P includinggo through the project area in
Department shall be and the holdererto musttake
conduct the ublplacement and proec safety
dccires, that may be necessary
accordance with the Department's current edition of the a and Traffic Desi n Standards. Index Series
Contract No.: BD969
Financial Number: 25266627201
12
600, and the Manual of Uniform Traffic Control Devices.
13. In mite thhia
inn-compiace wth the Departmen's requireenta in effect as of the sopermitlisnvoidiand the work willt be broughtmapproved
compliance a or removed from the right-of-way
permit,
at no cost to the Department.
_ Corporate 5eai
Submitted and Agreed to by: Signature of Permittee
Recommended for approval:
Approved by:
Name and Title (typed)
Title:
Attested
District Permit Engineer or Authorized Representative
Contract No.: BD969
Financial Number: 25266627201
13
Date:
Date: