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Item 4D - Encroachment AgreementINSTRUCTIONS FOR COMPLETING AN ENCROACHMENT AND JOINT USE AGREEMENT OF A PUBLIC EASEMENT All forms shall be signed in ink only by a property owner, legal partner or corporate officer. An authorized agent of the landowner must submit a Power of Attorney. PLEASE SUBMIT ALL OF THE FOLLOWING REQUIRED DOCUMENTS: 1. One copy of the Application with an original signature. 2. One copy of the Easement Joint Use Agreement with an original signature, signed and notarized. Do not submit copies of signatures and notary acknowledgments. 3. One copy of EXHIBIT NO. 1 that contains the precise metes and bounds description of the part of the easement to be used. This information is best provided by a registered land surveyor. Note that the City staff is not authorized to prepare this information. Do not place drawings or plats on this exhibit. 4. One copy of EXHIBIT NO. 2 which shows in graphic form the nature of the encroachment with dimensions. Please limit the area of usage of the easement to only that needed to accommodate your needs. Plans or drawings may be reduced, provided the final document is legible. City staff will make final decision on legibility. 5. The Public Works Department may require an additional EXHIBIT NO. 2A which may include a detailed drawing or cross sectional drawings of decks, signs, retaining walls, fences, driveways, piers, footings, etc. to fully evaluate the extent of the encroachment 6. One copy of EXHIBIT NO. 3 with original signatures, signed by all agencies listed regardless of whether they have utility equipment in the easement. This will need to be done before submitting to the City of Southlake. 7. After this agreement is filled out, you will need to return it to Public Works Department and pay: • The Public Easement Encroachment Permit Fee of $155. 8. This agreement will be circulated through the Public Works, Planning and Development and Building Inspection Departments within the City of Southlake. Please allow approximately seven to ten working days to complete the circulation process. 9. This agreement's final review and approval rests with the Director of Public Works. 10. After approval by the Director of Public Works, a copy of the signed agreement is forwarded to the Building Permit Department for retention in any pending permit files, a copy is retained in the Public Works Department and a copy is sent to the applicant for their records. Submit these documents to: City of Southlake Department of Public Works 1400 Main Street, Suite 320 Southlake, TX 76092 0900-New N Drive\ADMINISTRATION-PW DEPT\Fonns\AgreementsUoint Use and Encroachment Agreement - Public Easement-2022 Update.docx APPLICATION FOR ENCROACHMENT AND JOINT USE AGREEMENT OF A PUBLIC DRAINAGE AND / OR UTILITY EASEMENT ,o I1- Date of Submittal To the City of Southlake: The undersigned hereby makes application to allow an encroachment and joint use of a portion of the public drainage and / or utility easement situated on or abutting property located at 805 Victoria Lane, Southlake, TX 76092 and described by metes and bounds in Exhibit No. 1 of the attached agreement. The reason for the encroachment and use of the easement is as follows: Residential Fence crossing perpendicular to drainage easement t arris a Prte�er Signature of Property Owner 805 Victoria Lane Address Southlake TX 76092 City State Zip 214.801.0679 Telephone Fax Number 107 Easement Joint Use Agreement THE STATE OF TEXAS COUNTY OF Be it known, that the City of Southlake, herein after referred to as "City," and its franchised Utility Companies, herein referred to as "Utilities," do consent and agree to permit the following Mark E. Harris , herein after referred to as "Applicant," to use an easement, situated on or abutting LOT 12-R BLOCK A-R , OF Huntwick Estates IN THE CITY OF SOUTHLAKE, TEXAS, as described on the attached Exhibit No. 1, depicted graphically on the attached EXHIBIT No. 2 and consented to by the public utility companies as listed on the attached EXHIBIT No. 3, to be used for the purposes of a fence crossing and being subject to the following conditions: That the Applicant, his successors or assigns shall maintain in good condition all of the easement area and the improvements situated thereon; and, that City and Utilities shall not become responsible for such maintenance at any time in the future. That the Applicant shall and does hereby agree to indemnify and hold harmless the City and the Utilities from any and all damages, loss or liability of any kind whatsoever by reason of injury to property or third person occasioned by its use of the easement or act of omission, neglect or wrong doing of Applicant, his officers, agents, employees, invitees or other persons, with regard to the improvements and maintenance of such improvements; and the Applicant shall, at his own cost and expense, defend and protect City and Utilities against any and all such claims and demands. That the Applicant shall arrange for all activities and improvements in the easements to be discontinued and / or removed within thirty (30) days of written notification, at the discretion of City, for: (1) Lack of maintenance to the easement; (2) Failure to provide access to the City or its designees; or (3) Compliance with a City Council directive that use of the easement by the Applicant be discontinued and the cost associated with the discontinuing of such activities, and the removal of such improvements, as well as property adjacent to the easement necessitated by such discontinuation of the easement, shall be borne by the Applicant. IV. That the Applicant, his successors or assigns shall not seek compensation from City or Utilities for loss of the value of the improvements made hereunder when such improvements are required to be removed by Applicant. 0A00-New N Drive\ADMINISTRATION-PW DEP7Torms\AgreementsUoint Use and Encroachment Agreement - Public Easement-2022 Update.docx V. This agreement shall be filed of record in the Deed Records of Tarrant County, Texas, and shall bind all future owners of this lot and shall for all purposes be considered a covenant running with the land. IN TESTIMONY WHEREOF, Applicant executes this Easement Agreement on this �/ n day of Sr.Pi, 20. Mark rris Printed y ame By: U//� By: Applicant's Signature NOTE: Complete the attached acknowledgements. City of Southlake Mayor Note: Only complete the appropriate acknowledgements THE STATE OF TEXAS COUNTY OFTARRANT Corporate Acknowledgment BEFORE ME, the undersigned authority, A Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument and acknowledged to me that same was the act of said , a corporation, and that he executed same for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this the day of , 20 My Commission Expires: THE STATE OF TEXAS § COUNTY OF FARRAf�4 PAWK § Notary Public in and for the State of Texas Individual Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally �r appeared "ifKK E. 71ri 14? , known to me to be the person whose name is subscribed to the foregoing instrument and acknowledged to me that he executed same for the purposes and consideration therein expressed. GIVEN UNDER MY H this the �� day of c$ 20. e`Js .r 11ANA NNOUN8INAVONG Notary lD Nt 1882863 ] My Commission Expires 'ems "aa F' February6,2027 Notary Public in a d for the State of Texas My Commission Expires: �/� 2•Da THE STATE OF TEXAS COUNTY OFTARRANT City of Southlake Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument and acknowledged to me that same was the act of said , a municipal corporation, and that he executed same for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OFFFICE this the day of 20_ Notary Public in and for the State of Texas My Commission Expires: EXHIBIT NO. 1 Being that portion of that certain public utility easement / drainage easement situated in Huntwick Estates BlockA-R, Lot 12-R Addition/Survey to the City of Southlake, Tarrant County, Texas, and being more particularly described by metes and bounds as follows: EXHIBIT NO. 2 The following is a drawing depicting the area or portion of the easement and property described in Exhibit No. 1, that is subject to the encroachment and joint use agreement in this application showing the nature of the encroachment and use with dimensions. This drawing shall include unorth arno*.|e��doncrp�ono/the subject poopedyand o�oiningprupu��a. PDX ` EXHIBIT NO. 2A The following is a detail and / or cross section drawing of the improvement(s) in the utility easement / drainage easement to be subject to the encroachment and joint use agreement in this application. EXHIBIT NO. 3 The undersigned public utility companies, using or entitled to use, under the terms and provisions of our respective franchise with the City of Southlake, do hereby consent to the encroachment and joint use of the described portion of such drainage and 1 or utility easement requested in this Application for encroachment and joint use of a public drainage and utility easement. Oncor Electric Delivery Company By: NIA (Please Print) Title: (Please Print) Signature: Verizon Telephone Company By. N/A (Please Print) Title: (Please Print) Signature: Charter Communications, Inc. By: NIA (Please Print) Title: (Please Print) Signature: Atmos Ener By: NIA (Please Print) Title: (Please Print) Signature: AT&T 1 Southwestern Bell Telephone Compan By: NIA (Please Print) Title: (Please Print) Signature Tri-County Electric Compan By: NIA (Please Print) Title: (Please Print) Signature: City of Southlake By: (Please Print) Title: Signature: (Please Print) SERVICE PROVIDER CONTACTS FOR EASEMENTS IN SOUTHLAKE Oncor Electric Delivery Budd Rodgers, Distribution ROW Agent 109 Crestwood Lane Springtown, TX 76082 Office: (817) 443-3434 Mobile: (432) 234-9052 Email: buddy.rodgers@oncor.com AT&T/Southwestern Bell Eric Williams Manager Engineering Design 1460 Round Table Drive, Room 1000 Dallas, TX 75247 Office: (214) 745-2964 Fax: (214) 745-8230 Charter Communications, INC Marla Collier, Charter Coordinator Office: (817) 298-3615 Email: Marla.Collier@charter.com Tri-County Electric Cooperative, Inc. Lauren Baccus, Development Coor. 4900 Keller -Hicks Road Fort Worth, TX 76244 Office: (817) 752-8226 Fax: (817) 431-9680 Verizon Telephone Joe Garza Superintendent — Network Engineer Office: (972) 252-0770 Cell: (325) 245-5102 Email: joe.garza@ftr.com Atmos Energy (Gas) Greg Zylka, Project Manager 2000 Reliance Pkwy Bedford, TX 76021 Office: (817) 685-1257 (ext. 1313) Fax: (817) 359-1338 Email: gregory.zylka@atmosenergy.com