The General Use Permit form, as outlined by F.A.C. Rule 14-20.010 under the State of Florida Department of Transportation, outlines a systematic procedure for applicants seeking to initiate any construction or maintenance activities within the purview of the Department’s oversight. Essential for ensuring that such projects adhere to the state's regulations, this document requires comprehensive details from the applicant, including but not limited to the name or entity undertaking the project, contact information, location details encompassing the state road and mile posts affected, and a delineation of the proposed work activities. Notably, the form mandates the attachment of relevant plans or drawings, notification letters for utilities potentially impacted by the work, and specifies the need for applicants to notify designated FDOT engineers prior to the commencement of any activities. Furthermore, it emphasizes the permittee's responsibility for maintaining safety protocols as per the Department’s Design Standards, highlights the necessity for any damages to FDOT property to be rectified at the permittee's expense, and underlines specific conditions pertaining to permit compliance, work commencement, and indemnity clauses. This meticulous requirement set not only aims to facilitate seamless maintenance or construction efforts but equally ensures the safeguarding of public property and the adherence to established safety and operational standards.
| Question | Answer |
|---|---|
| Form Name | General Use Permit Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | florida permit expediting sample contract, general use permit, fdot general use permits, fdot construction forms |
F.A.C. Rule |
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION |
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GENERAL USE PERMIT |
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MAINTENANCE |
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05/08 |
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Page 1 of 2 |
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Date: |
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Permit No.: |
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Name of Applicant or Authorized Agent: |
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Entity (if applicable): |
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(If entity, furnish contact information for responsible representative) |
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Address: |
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Zip Code: |
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City/State: |
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Telephone No.: |
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Email Address: |
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Activity / Project Site |
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County: |
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State Road: |
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Section: |
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From Mile Post: |
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to Mile Post: |
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Construction Proposed or Underway: Yes |
No |
FM Project No.: |
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Name of Municipality if Work is within Limits: |
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Description of Work Activity: |
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General Provisions
1.Attach any pertinent plans or drawings.
2.Attach notification letters sent to any Utilities both aerial and underground that will be potentially impacted.
3.The designated FDOT Engineer shall be notified 48 hours prior to beginning of work.
Contact |
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at ( |
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4.All work, materials and equipment shall be subject to inspection and approval by FDOT. Applicants certification of work at completion is required.
5.The permittee shall be responsible to place and display safety devices and proper maintenance of traffic in accordance with the latest version of the Department’s Design Standards, index series 600, or an alternative plan signed and sealed by a professional Engineer and attached with the permit.
6.All FDOT property shall be restored to its original condition. Any damage to FDOT property as a result of this work shall be repaired and restored in a manner acceptable to the FDOT at the sole expense of the permittee.
MAINTENANCE 05/08 Page 2 of 2
Special Provisions
Conditions
1.In the event the permittee fails to meet any of the requirements of this permit by the FDOT, the permitted activity must cease until brought into compliance. If compliance can not be met, then the permit will be rendered void and said work shall be removed from the right of way at no cost to the FDOT.
2. Work shall commence within |
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days of permit approval. |
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Work shall be completed by |
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(Date) |
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3.The rights and privileges herein set out are granted only to the extent of the State’s right, title and interest in the land to be entered upon and used by the permittee, and the permittee will, at all times, and to the extent permitted by law, assume all risk of and indemnify, defend and save harmless the State of Florida and the FDOT from and against any and all loss, damage, cost or expense arising in any manner on account of the exercise or attempted exercises by said permittee of the aforesaid rights and privileges.
Applicant
I hereby agree to comply with all terms and conditions set forth and described in this permit.
Printed or Typed Name and Title |
Signature |
Date |
FDOT
Approved By:
Print Designated Engineer |
Signature |
Date |
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Title |
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