Okaloosa County BOCC — October 18, 2016 — FY16 FWB Museum final payment — reading text

 ,- RULE 14-43.001, F.A.G. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 575-070-18 RIGHT OF WAY- 08/08 APPLICATION TO PLACE BANNERS ON NON LIMITED ACCESS Page 1of2 RIGHT OF WAY /...----- { ( APPLICANT INFORMATION 1)r -i-~ .}a o..rK ~ lh.1-\fal Ce~"~ Telephone#: (b5DJ 1 '?3.,t] '595 Fax#: lRSD) =&}~.,q£,'7SE-Mail: ~:+1-!-.l...!:&=·+::~~~e=--....L..Y.=-=:..:__.:._i__---l Contact person (This pe~son ~ill serve as th1, cpntact person fo.r all questioni ,ron rning the banner application and placement): (0cu I Le, f\11"\ IVlv..ie.r (\.-\ \,l~W f\i\o,.V\U. eL Address (if different from above): 'SCl.Wle Telephone#: /. --'F=a-x_#_:-"--r-------E--M-a_i_I:-/--,------~---------l Date of Request: LOCATION AND DISPLAY PERIOD This is a request to place 0 pole banners [Z] street banners 0 on the right of way of: Highway name & number: Hw 98, SR 30 Miracle Strip Parkway SE- Big City Location 11.65 From (south or west limits): Florida Place SE To (north or east limits): Per Ave SE Highway name & number: From (south or west limits): ~~~~~~~~~~- To (north or east limits): ~~~~~~~~~~~ Highway name & number: ( r From (south or west limits): To (north or east limits): Highway name & number: From (south or west limits): To (north or east limits): Projected installation date : _............................. .... t)'" L l <........L~-'--'=-~~-+-~--'>J-'"-"'->-f--_._-;-.;;;;.__,.~~~~~~~~~~~~~~~ ~ Banners will be removed on or before (if applicable): ;), Signature of Applica t ii'-"<-""' -< ~f)U,,t, tA) ). or Contact Person: Date: LOCAL GOVERNMENTAL ENTITY APPROVAL Name of Local Governmental Entity: Cit of Fort Walton Beach Name of signing official (please print): Chris Frassetti, CRA Planner ~---=::.!..:.!.=-:.-=.:::==.:..z-=..:....::....:...:......;c=.:...:.:.=.:..~~~~~~~~~~~~~~~~---J Telephone #: 850.833.9604 Fax#: 850.833.9926 E-Mail: cfrassetti Signature of local official: (k i~ Date: CONDITIONS AND STIPULATIONS AGREED TO BY THE APPLICANT 1. Pole banners must be at least 14 Yz feet above the pavement elevation. Street banners must be a minimum of eighteen (18) feet above the pavement elevation. 2. Pole banners will clear the face of the curb (if present) by at least two (2) feet. 3. The applicant (or applicant's designee) will maintain the banners as permitted. 4. The installation of the banners will not require the installation of poles or other support devices on the right of way. 5. The applicant and sponsoring organization will hold the Florida Department of Transportation harmless to the extent allowed by the laws of Florida in all matters concerning the banners and bear all expenses for defense of claims against the Florida Department of Transportation . 6. The applicant is responsible for any damages to public property resulting from the materials or the work of this permit. 7. A sketch of the proposed banners is attached. r 8. View of .traffic control devices is not impeded to those served by the erection of these permitted banners. ( Signature of District Permits Engineer (or designee): Date: - - - ------1  RULE 14-43.001 , F.A.C. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 575-070-18 RIGHT OF WAY - 08/08 APPLICATION TO PLACE BANNERS ON NON LIMITED ACCESS Page 2 of 2 RIGHT OF WAY APPLICATION FOR BANNER AGREEMENT: By signing the reverse of this form, each applicant agrees to the provisions of Section 14-43.001 (5)(d), Florida Administrative Code: 1. To the extent provided by law, the Applicant shall indemnify, defend, and hold harmless the Department and all of its officers, agents, and employees from any claim, loss, damage, cost, charge, or expense arising out of any act, error, omission, or negligent act by the Applicant(s), its agents or employees arising from activities under this permit. 2. When the Department receives a notice of claim for damages that may have been caused by the Applicant in the performance of activities that arise under this permit, the Department will forward the claim to the Applicant. The Applicant and the Department will evaluate the claim and report their findings to each other within 14 working days and will discuss options in defending the claim. The Applicant shall bear all expenses for defense of claims against the Department. REQUIRED ATTACHMENTS: • A sketch or drawing of the banner(s), drawn to scale, including any message, logo, or emblem that will appear on the banner. • A sketch of the specific location(s) of the banner(s), including height, location of supports, proximity to utility poles. • Sketches, photographs, or specific descriptions of the method used to affix the banner to the support structure. • Load rating analysis (or photocopy of previously-submitted analysis) bearing the seal of a professional engineer. I  City of Fort Walton Beach Banner Permit Application Engineering Services Department Name of Event: 0 bSCu.¥ttd ~ T\~e S-t-ml')'l?l . f4: h, b>I Organization Name: 0..b o[ FVv.8 J+e.xl ~ tb.vk 4~ &t-lftuad G~ Period for which permit is desired: From : .JUne..1-lw ,/ "J"1.d1 l-ir To: Ju.1'\£_ i-1~ / :[1,d~ l-1r (Due to state requirements, no banner shall be displayed longer than 30 days in one calendar year. The City will offer no guarantees that banners will be erected for 30 days. The City reserves the right to coordinate the times with other organizations to try to accommodate all events.) f\\a.i1 aQ_, kiUJ Ll ~ ~ 9. L) Actual Date(s) of Event: Location of Event: ~li o~ FW'& lb b~R Rtvk. /; & lbva,l ~t:... (Events being held in the City of Fort Walton Beach will take precedence over events held in other Cities.) Event Coordinator: Name GSCli. l LtjtW\ f\\eN(l(L l HUW\'\f\ /vlCLV\ tLt-)€J£.. Address \ ~Cj MI 'OJ J e &!xe '?ct,.,- kw"'-l( ".) E R- wt\.,t f?V\ ~ Ft- .3a ~{ ~ Fax Please sketch banner including message, lettering, logos and emblems. Please deliver your banner to the Engineering Services Department located east of City Hall at 105 Miracle St rip Parkway, S.W. You may also deliver your banner to our Facilities Maintenance shop at 116 Hollywood Boulevard, S.W. Once your banner is taken down, it may be picked up at the Facilities Maintenance shop. Please remember to pick up your banner after your event. The City does not have the resources to store any banners. I acknowledge that I have read and fully understand the City's Overhead Banner Installation Policy (Page six of this a lication packet). / Date Page Four  CITY: The specific banner location is shown below, including location of supports, proximity to utility poles, photographs or specific description of the method to be used to affix the banner(s) to support structure(s). Show the edge of pavement, curb & right-of-way line. ( r State Road Number: __lQ Minimum Clearance Over Roadway: ...JJ!: Sidewalk: _tt Banner 3' x 40' Type IV Prestress Concrete Poles -------------.. Banner 3' x 40' I r 58" Steel Span Wire~ - APPLICANT: Please sketch banner including message, lettering, logos & emblems. Please deliver your banner to the Engineering Services Department located east of City Hall at 105 Miracle Strip Parkway, S.W.