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16) The rights granted herein may not be assigned by Permittee. <br />17) Notification of approval/denial of this request will be issued by return of this form, <br />upon signed authorization by the Board of Public Works. <br />IN WITNESS WHEREOF, this Agreement was executed on the date first written above.. <br />Date: <br />Permittee Signature: <br />Name: <br />Title: <br />BOARD OF PUBLIC <br />�WORKS <br />Gary A. Gilot, President n <br />Elizabeth A. Maradik, Member <br />Joseph R. Molnar, Member <br />BOARD OF PUBLIC WORKS APPROVAL <br />Therese J. Dorau, Member <br />Jordan V. Gathers, Member <br />ATTEST: <br />�-'inda GPT�rtix <br />Linda M. Martin, Clerk <br />Updated 05/2017 3 <br />