1. Before beginning work in the highway right-of-way, it is the responsibility of the permit holder to contract other utilities which may be located in the area of the proposed work.
  2. Pipe lines conveying gas (natural or artificial), oil, gasoline, motor fuel or other flammable substances under and across primary roads shall be installed in accordance with rules of the Iowa State Commerce Commission and American Standard Transmission and Distribution Piping System requirements.
  3. Non-compliance with any of terms of Dubuque County policy, permit or agreement, may be considered cause for shut-down of utility construction operations or withholding of any relocation reimbursement until compliance is assured, or revocation of the permit. The cost of any work caused to be performed by the County in removal of non-complying construction will be assessed against the permit holder.
  4. A copy of the approved permit shall be available on the job site at all times for examination by Dubuque County officials.
  5. This permit may not be transferred or assigned by the applicant. If the utility equipment which is installed under this permit is sold, leased, or otherwise transferred, the applicant shall require the purchaser, lessee or transferee to obtain a new permit in its own name prior to the effective date of the sale, lease or transfer. Otherwise, rights acquired under this permit shall terminate and the applicant may be required, upon the County's demand, to immediately remove all utility equipment from the right-of-way and to restore the roadway to its existing condition at its own expense.
  6. A new permit is required any time there is a change in the class of transmittant, an increase in the maximum design pressure shown on the permit or any other physical change in the utility facility.
  7. The authority granted by this permit is limited to Dubuque County's own limited easement on said highway right of way. It does not intend to remove or supersede any independent right the servient landowner may retain pursuant to Keokuk Junction Railway Co. v. IES Industries Inc. 618 N.W.2d 352 (Iowa 2000).
  8. This permit is subject to any laws now in effect or any laws which may be hereafter enacted.
  9. This application is subject to revocation by the Board of Supervisors at any time, when in the judgment of the Board it is necessary for the improvement or maintenance of the highway or for other reasonable cause.

improvement or maintenance of the highway or for other reasonable cause.

NAME OF CONTRACTOR:___

PERSON TO CONTACT: ___ CONTRACTOR PHONE NO.: ___

NAME OF APPLICANT: ___ APPLICANT PHONE NO.: ___

TITLE: EMAIL:

AFFIDAVIT OF APPLICANT'S SIGNATURE

I, ___ the ___ for ___

Name of individual

Official title Name of company

do solemnly swear I have read the foregoing application and all statements and data contained herein are true and correct.

___

Signature

Recommended for Approval by the County Engineer's Department OR Chair of the Board:

_____

DATE: ___

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NAME OF CONTRACTOR
PERSON TO CONTACT
CONTRACTOR PHONE NO
NAME OF APPLICANT
APPLICANT PHONE NO
TITLE
EMAIL
the
for