2. APPLICANT*
3. DATE*
5. DESCRIPTION OF WORK*
7. LOCATION OF WORK*
9. OTHER SPECIFIC CONDITIONS
11. COMPANY*
12. SUMBITTED BY*
14. ADDRESS*
15. TITLE*
17. PHONE #*
19. UPLOAD PLANS
22. Note: If requested by the Ford County Administrative Services Department, the applicant shall furnish detailed plans of the work, which shall show the work location, construction details, and the materials to be used. This permit will be subject to the following terms and conditions: 1. All work shall be done in strict accordance with the plans approved by the Administrative Services Department. The Administrative Services Department must approve plan changes in advance. 2. Upon completion of all work authorized by the permit, the applicant shall submit to the County "as built" plans accurately depicting the location and depth of any facilities installed within County Right-of-Way. 3. As condition of the issuance of this permit, it is agreed that the applicant shall furnish all labor, equipment, and materials required, to do the work solely at its cost; that the applicant has and will maintain suffficient insurance, as required by Federal and State Laws, to protect the general public and Ford County in the event of damage to others as a result of the under-taking of this work; and that the applicant will hold Ford County harmless against any and all claims arising because of this work. 4. All public right-of way will be restored to a condition equal to or better than that, which existed prior to construction. Care will be taken not to destroy survey monuments. 5. All facilities installed under this permit shall be protected or monumented in accordance with applicable Federal or State laws. 6. Any violations of the above terms and conditions shall immediately cause this permit to become null and void.
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