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Letter of Permission for Installation of Internet Services

This authorizes NETworx Broadband, Inc to install Fiber Optic Internet services at the following location:

Property Owner Name:

Phone:

I, give permission for NETworx Broadband, Inc to install services at the property listed above. This installation could include, but is not limited to, the following:

Drilling an entry hole in building

Tacking wire on the outside of the building

Mounting a Fiber Optic box on the side of the building

Attaching service drop to the building

Attaching ground wire to the side of the building

Digging a trench across the property from the building to the pedestal located in the “right-of-way”

All of the above will be done in agreement with the owner of the property.

Please note: We will work to ensure that your property is returned to as close to normal condition as we can after the work is complete.

If you have any questions, please call NETworx Broadband, Inc at (844)759-6381 or email at sales@networxbroadband.com.

Please answer the following questions to help us ensure a safe and most efficient completion of your installation. Keep in mind we will be hiring Gopher State One Call to mark all underground utilities however any additional info you may provide will help.

Do you have an underground sprinkler system anywhere on your property?
Yes

No

If YES, **ACTION REQUIRED**, when you see flags in your yard (e.g. Gopher State marking your public utilities), please ensure you mark your sprinkler heads and if possible the waterlines with at least flags and/or paint. Mark your entire yard all the way to the backside of your home. You can locate your sprinkler heads by turning on your system. If your system has been blown out for the season, contact your sprinkler service provider to provide sprinkler heads and possibly waterline locations.

2. Do you have an underground dog fence?

Yes

If YES, **ACTION REQUIRED**, when you see flags in your yard (e.g. Gopher State marking your public utilities), please ensure you mark your underground fence with at least flags and/or paint. Mark your entire yard all the way the to backside of your home.

3. Are you aware of any other pipes, wires or any other obstruction that may be in the path of our fiber installation?

If YES, **ACTION REQUIRED**, when you see flags in your yard (e.g. Gopher State marking your public utilities), please ensure you mark any other pipes, wires or any other obstruction (e.g. drain field, septic tank, well) with at least flags and/or paint. Mark your entire yard all the way the to backside of your home.

IF YOU ARE UNABLE TO OR DO NOT MARK THE ABOVE, we will continue with the installation, however, please be advised, any one or all of the above private underground utilities may be inadvertently damaged during installation.

If you are not the property owner, please provide the property owner name and phone number

Property Owner Name:
Property Owner Phone Number:

NETworx Internet

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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Signed by NETworx Broadband, Inc.
Signed On: October 1, 2024

Timestamp

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July 18, 2024 2:57 pm CDT

NETworx Broadband PRE-Order Right of Access Uploaded by NETworx Broadband, Inc. - sales@networxbroadband.com IP 209.181.241.86