Fiberlight-PT091208A copy of the approved p®rmlt must be on the job site at all times.
CC: Applicant T H E C I T Y O F
Public Works D D D COPPELL
Permit File 6 D ~ ~ ~ , . ~
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Orig. to Project File ~~ s x ,, a , 8 4
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Page 1 of 4
Rev. 11 /07
10-14-0 9A08 ~ 04 RCVD
. _.
~/' ~ '~ RIGHT-OF-WAY USE PERMIT APPLICATION
Permit valid for 90 calendar days from date of approval
Submit permit application to the Engineering Dept., Town Center, 255 Parkway Blvd.
Date of Submittal: Applicant's Job # /Work Order # ~ ~ - ~ ~ - (~ `~
PERMIT FEE: $100.00
(No charge to Utility Companies with approved Franchise/ROW Use Agreement)
Refer to the City of Coppell Ordinance No. 2001-944. Certificated Telecom Provider? Y~ N
^ Plans provided and approved
(Erosion Controllsafety fences must be installed prior to beginning work)
Project Name /Location:
U~to~ 7~~l' ~~ls
1eAiL
Contact # ~ 1L~-GOS-~ ci 1 ~
General Contractor:
Permit issued to Com any /Representative: '~ c ~ ~ ~ ~. ; ~j;~~ ~
Telephone #:~~-~>>y-~) tr..~_ ~~~~~ Emergency Telephone #: g~.~
Utility Company Represented:
^ Oncor Electric Delivery
^ Time Warner Cable
^ Atmos Energy
^ CoServ Electric/Gas
^ Verizon
[~ Other ~ I~~t"U6flT
{G~,e_neral D~{esc~`.iption of Work (provide four [4J sets of plans): In accordance with Ord. No. 2001-944.
•~t=EilN/1~i~ /~T ~ ~'~C. ~ c'.-I>>0`/~~/ > `,?`~ (t~~/!~'DX/»?A~l ~' G~17(7~ /e~^,~T~,% (~~ %PfTt725EC?/cN i ~~ ; -ti i f1i%.'E~~~ i F: N
~n-Tpr~ TAI° l~~ !~ T ~=t'~E ~i ~t~CC~ ~~ ` 1 ~2~~ ~~~~~E ~ArnJi1 /~~~~~T11 ~e'r~ JL~ ~ ..To ~'~ SF~~ l'ot ~~
~= Z151~9(,~~50~~-
Estimated Start Date Estimated Completion Date*
* Completion requires submittal of Completion Verification Notice (see page 4)
- Was contact made with City and/or utility companies to locate existing utilities?
if NO, Reason: YES ^ NO ^
Is removal of existing streets, alleys, or sidewalks necessary? YES ^ NO (~'
if YES, must have City inspection prior to concrete replacement
^ SBC/ AT&T
Right-of-Way Use Permit Application Page 2 of 4
Representative(s) of the Contractor must adhere to all construction standards approved by the City of Coppell, which
includes but is not limited to: Erosion Control Ordinance, compaction requirements (density tests may be required at
~e applicants expense) and barricading according to the Texas Manual on Uniform Traffic Control Devices.
Area(s) affected must be restored to as food condition as before the commencement of work (grading, drainage,
vegetation, and erosion control). To schedule Public Works final inspection (Page 4) call 972-462-5155.
Any excavation requiring closing of a street/alley must be reported prior to closing to the following:
Police Department ~ 972-304-3600
Fire Department ~ 972-304-3500
Street Department ~ 972-462-5150
Engineering Department ~ 972-304-3679
Attach barricade plan /trench safety plan if a lane or street closure is required.
NOTE: Street closures are allowed fmm 9:00 a. m. until 3:00 p. m. ONLY unless otherwise approved by City
Engineer.
Attach Work Order (franchise only) and/or 4 sets of prints showing proposed work.
Contacts must be made to locate existing utilities 48 hours prior to beginning work.
(Application with original signatures should be submitted to the Engineering Department before approval.)
Signature of Utility pany Representative
~- 5 ..
Printed ame
I ~
Date
Signature of Contractor resentative
Printed Name
Jo ~ c.~%
Date
Sign t re of City Representative Printed Name Date
Lines must be buried underground at the following
locations: W. Bethel Rd at Royal Ln; W. Bethel Rd
~ Commerlts~._ f' ,~l,t~ 1%..I.~p~ ~ . ~v~-rt 1~ "s ~~ between Royal Ln and Freeport Pkwy; Southwestern
~_,a')s ~~~~L t Blvd at S. Coppell Rd; and Denton Tap between
~~ Braewood and Sandy Lake Rd.
Minimum clearances as prescribed by either state law or
Oncor regulations on sag and pole connections with no
wires being lower than 12 feet.
Wires will run only along existing line configuration.
NOTE: Notify City Inspector at 972-304-3679 pr_-yo new poles will be installed.
back~ll for concrete, trench, ditch and open pit inspections. Back~ll must meet
all construction standards approved by the City of Coppell.
Applicant shall indemnify and forever hold harmless against the City of Coppell each and every claim,
demand or cause of action that may be made or come against it by reason of or if any way arising out of the
closure, blocking, excavating, cutting, tunneling, or other work by the applicant under permit from the City,
if such permit is granted.
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