SUBMITTAL REQUIREMENTS:
Submit two copies of application and backup materials FOR EACH ROAD (one original and one copy) should be submitted to the Lake County Department of Public Works.
Completed applications shall have the following attached (all submittals shall be made a part of this permit):

1. A sketch or construction plans drawn to scale, showing the offset from the centerline of the right-of-way or road to the proposed utility installation, the road right-of-way width and pavement width, the distance from the edge of pavement to the utility, sidewalks, and the location of all other utilities within the area of work.
2. One or more typical cross sections as required to adequately reflect the location of the utility shall be shown. The minimum vertical clearance above or below the pavement or natural ground shall be indicated.
3. Additional information such as the location in relation to the nearest road intersection, bridges, railroad crossing and other physical features shall be indicated on the sketch. Also, a location or vicinity map shall be provided to assist with the general location of the installation and should indicate, at a minimum, the applicable Section, Township and Range.
4. All permit applications must demonstrate that the proposed improvements conform to the right-of-way utilization Requirements included in the Lake County Land Development Regulations.
5. A complete right of way survey may be required for project of significant length & size at the County Engineers discretion.

CONDITIONS:

6. Whenever necessary for the construction, maintenance, operation or alteration of the right-of-way, as determined by the County, any or all of the appurtenances authorized by this permit shall be immediately removed from the right-of-way or relocated, as required by the County, at the expense of the applicant unless reimbursement is specifically authorized.
7. All work, materials and equipment shall meet all County codes and standards and shall be subject to inspection by the County. All right-of-way disturbed by this work shall be restored to its original condition as far as practicable and in accordance to applicable County Codes.
8. The construction and maintenance of this utility shall not interfere with the property and rights of a prior applicant.
9. Where possible, excavation will not be allowed within four (4) feet from the edge, of the pavement. Situations which cannot meet this requirement shall require the approval of the County.
10. The County shall be notified twenty-four (24) hours in advance before starting work. In the interest of public safety all operations shall take place during daylight hours, unless specifically authorized, discontinued by sunset with proper signage maintained during off hours.
11. All traffic detours will be restricted to the limits of right-of-way with necessary flagmen and marking devices. A traffic detour or lane closure shall require specific approval by the County.
12. All utility construction and maintenance shall be preformed with proper shoring, barricades and maintenance of traffic signage in accordance with the Manual of Uniform Traffic Control Devices, with the regulations of Florida Industrial Safety Board, and the Florida Department of Transportation Safety Manual.
13. In the case of noncompliance with the County’s requirements, this permit will be void and the facility will be brought into compliance or removed from the right-of-way at no cost to the County.
14. The County may issue “Stop Work” orders upon any permittee who committing or creating unsafe acts which may create a public hazard or who is not complying with this permit or the applicable codes. The order shall remain in effect until such time as these matters are corrected.
15. The County shall not be responsible for damages to any structure placed within the right-of- way. All structures shall be properly maintained, adequately visible or properly delineated to prevent damage due to normal maintenance of the right-of-way.
16. 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 vest any property right in said holder.
17. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the County’s right, title and interest in the land to be entered upon and used by the holder, and the holder will, at all times, assume all risk of and indemnify, defend, and save harmless the County of Lake from and against any and all loss, damage, cost or expenses arising in any manner on account of the exercise or attempted exercises by said holder o the aforesaid rights and privileges.
18. Open cuts of roads will not be allowed unless specifically authorized by Lake County, call (352) 483-9000 for inspection. Time 8:00 AM 3:30 PM.
19. Pursuant to Section 337.403(1), Florida Statues, any utility placed upon, under, over, or along any public road or publicly owned rail corridor that is found by Lake County to be unreasonably interfering in any way with the convenient, safe, or continuous use, or maintenance, improvement, extension, or expansion, of such public road or publicly owned rail corridor shall, upon 30 days written notice to the utility or its agent by Lake County be removed or relocated by such utility at its own expense.
20. It is agreed that in the event the installation, adjustment or relocation of said utilities are scheduled to be done simultaneously with Lake County construction work, the PERMITTEE will coordinate with Lake County before proceeding and shall cooperate with Lake County’s contractor to arrange the sequence of work so as not to delay the work of Lake County contractor, defend any legal claims of Lake County’s contractor due to delays caused by the PERMITTEE’s failure to comply with the approved schedule, and shall comply with all provisions of the law and Lake County’s current Utility Accommodation Manual. The PERMITTEE shall not be responsible for delay beyond its control.
21. Applicant/Permittee has made no unauthorized changes to this form.
    County use only (Not required)                           
22. For more information, contact:
    Jeff Johnson, Construction Inspection Supervisor
    Department of Public Works
    437 Ardice Avenue
    Eustis, FL 32726
    Phone: (352) 483-9024
    Fax:     (352) 483-9025