The purpose of this blog post is to provide a general overview of the use permit form, which is required for any event or activity that takes place on County property. This form must be completed and submitted to the County for approval at least thirty (30) days prior to the event or activity. The information in this post will help you understand what is required when completing and submitting the use permit form. For more specific information, please contact the County Clerk's office. Thank you!
| 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 |
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FDOT
Approved By:
Print Designated Engineer |
Signature |
Date |
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Title |
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