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Verizon-PT 981015 Permit to Construct Access Driveway Facilities Forrn 1058 (Rev.12-98) on Highway Right of Way Previous versions are obsolete. To: City of Coppell Hwy. 121 Permit No. P.O. Box 478 Control Section Coppell, TX 75019 gg 1700 Pacific Ave., Suite 3800 The Texas Department of Transportation,hereinafter called the State,hereby authorizes Dallas, TX 75201-4619 hereinafter called the Grantee, to (re) construct an access driveway on the highway right of way abutting highway no. 121 in Dallas County,located 125' i S.W. of Coppell Road Subject to the following: 1. The Grantee is responsible for all costs associated with the construction of this access driveway. 2. Design of facilities shall be as follows and/or as shown on sketch: 1 - 24' Driveway All construction and materials shall be subject to inspection and approved by the State. 3. Maintenance of facilities constructed hereunder shall be the responsibility of the Grantee,and the State reserves the right to require any changes, maintenance, or repairs as may be necessary to provide protection of life or property on or adjacent to the highway. Changes in design will be made only with approval of the State. 4. The Grantee shall hold harmless the State and its duly appointed agents and employees against any action for personal injury or property damage sustained by reason of the exercise of this permit. 5. Except for regulatory and guide signs at county roads and city streets,the Grantee shall not erect any sign on or extending over any portion of the highway right of way,and vehicle service fixtures such as service pumps,vendor stands,or tanks shall be located at least 3.6 meters (12 feet) from the right-of-way line to ensure that any vehicle services from these fixtures will be off the highway. 6. This permit will become null and void if the above-referenced driveway facilities are not constructed within six(6)months from the issuance date of this permit. 7. The Grantee will contact the State's representative telephone ( ) at least twenty-four(24) hours prior to beginning the work authorized by this permit. Texas Department of Transportation Date of issuance District Engineer The undersigned hereby agrees to comply with the terms and conditions set forth in this permit for constru '• of an access driveway on the highway right-of-way. , Signed: property o r or owner's representative) /1 Date: