Utility Easement Agreement Template printable pdf download

Utility Easement Agreement Template

UTILITY EASEMENT AGREEMENT

Date: ______________________

Owner Name Printed: ___________________________

Please note:

A separate form is needed for each utility company listed below. Please fax. mail or Email to that

company. Permits will not be accepted until all approved agreements have been returned from each

Utility Company and turned in together with permit application.

To whom it may concern:

I propose to apply for a Greenacres City Permit to erect a ________________________________, in the

Utility easement on my property at _______________________________________, the legal being Lot

_____ Block _____, Subdivision ______________________________. (Brief description of dimensions

and location from property lines etc.) ______________________________________________________

In the event that you have no objection to this project, will you please complete this from and return to me

at: __________________________________________________________________________________

_____________________________________________________________________________________

I understand that your company will not be responsible in any way for repairs to, or replacement of, any

portion of this ________________________________, and that any removal or replacement of this

construction necessary for your use of this easement will be done at my expense.

Owner’s Signature ________________________________

(FOR UTILITY COMPANY USE ONLY)

Utility Company: ______________________________________________________________________

We agree to the proposed construction under the circumstances described above.

By: _______________________________

Title: _____________________________

Date: ______________________________

8/2016

Utility Easement Agreement Template