CITY OF LEBANON – CITY MANAGER’S OFFICE POLE & CONDUIT LICENSE
Upon petition of ______________________________________________________________, it appearing that the public good so requires, it is hereby Ordered that on this ______ day of______________________, 20_____, __________________________________________ be and hereby are granted a license to erect, install and maintain equipment, as described in its/their petition for a license on the public right(s)‐of‐way covered by said petition, with the following conditions: Standard Conditions of Approval: 1. All said equipment, except such wires as are vertically attached to a pole and associated structures, shall be placed in accordance with the National Safety code in effect at the time this license is granted. 2. In accordance with the requirements of RSA 72:23, I(b), the licensee(s) and any other entity now or hereafter using or occupying municipal property pursuant to this license shall be responsible for the payment of, and shall pay, all properly assessed personal and real property taxes no later than the due date of said taxes. Failure to pay duly assessed personal and real property taxes when due shall be cause to terminate this license. 3. The licensee(s) and any other entity now or hereafter using or occupying municipal property pursuant to this license shall be under a continuing duty to report to the City Manager=s Office a description of any alterations, replacements or improvements to the equipment described in its/their petition for this license, whether done by the licensee(s) or any other entity using or occupying property of the licensor pursuant to this license or any other provision of law, within thirty (30) days of the date any such alteration, replacement or improvement is commenced. Equipment Provisions: *SEE ATTACHED PETITION FOR DESCRIPTIONS* 1. All equipment and associated structures allowed pursuant to this license shall be located by reference to the plan titled, ____________________________________________, dated____________________________, which is incorporated by reference into this license. Said equipment and associated structures shall be subject to the following special conditions: _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ City of Lebanon – Pole & Conduit License Page 1 of 2
2. Special conditions relative to reflectors on equipment and associated structures allowed pursuant to this license are: _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ City of Lebanon, New Hampshire By: ____________________________________________ Date: ______________________ City Manager (or Designee) Duly Authorized Received and entered in the records of the City of Lebanon, New Hampshire at Book __________ Page: ___________, or file location_____________________________ Date:______________________________ ATTEST: _________________________________ City Clerk
City of Lebanon – Pole & Conduit License Page 2 of 2
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