Windsor Estates-PT100909 T H E • C 1 T Y • O F Page 1 of 4
COFFELL
Ampil T _
rIED
F s ' 09- 08- I0P01 :29 RC
DRY BORE / STREET CUT / SAW CUT PERMIT APPLICATION
FOR WORK IN
RIGHT -OF -WAY / EASEMENT
Submit permit application to the Engineering Dept., Town Center, 255 Parkway Blvd.
Date Submitted: Dl - OS 1 0 Work Order # (if applicable) ?J /D Q.3 O /a
PERMIT FEE: $100.00
(No charge to Utility Companies with approved Franchise /ROW Use Agreement)
g Plans provided and approved
(Erosion Control /safety fences must be installed prior to beginning work)
Project Name / Location: , ( WI/ t JDS ' o R. EST"
Company Name: 1/ ZD A.
Address: 2.0 -I /V • M C'.. G CE I-/■ e L evlOY ✓il! t cT 75077
Telephone #: 4 1 2 -- 3 1 a _52 $2 Emergency Telephone #: a l -53 Z-5
90
/
Permit issued to (Contractor Name) O ) 5 I3AR ,ey 84
Utility Company Represented:
❑ Oncor Electric Delivery ❑ Atmos Energy "Verizon ❑ SBC / AT &T
❑ Time Warner Cable ❑ CoSery Elec /Gas ❑ Other *
* If "Other" is checked, please note that franchise or right -of -way use agreements will be required.
Genral Description of Work (provide copy of approved plans): p T
P/Ac"r r J 3.5" /3Dg6 3(o , r'✓ /e pee /v
111 ..D *Fo/?6si f'd
➢ Was contact made with City and /or utility companies to locate existing utilities?
if NO, Reason: L -f 5 • ! YES ❑ NO ❑
➢ Is removal of existing streets, alleys, or sidewalks necessary? YES ❑ NO
if YES, must have City inspection prior to concrete replacement
A COPY OF THE APPROVED PERMIT MUST BE ON THE JOB SITE AT ALL TIMES.
Dry Bore / Street Cut / Saw Cut Permit 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
the applicants expense) and barricading according to the Texas Manual on Uniform Traffic Control Devices.
Area(s) affected must be restored to as good condition as before the commencement of work (grading, drainage,
vegetation, and erosion control).
D 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
D Attach barricade plan / trench safety plan if a lane or street closure is required.
NOTE: Street closures are allowed from 9:00 a.m. until 4:00 p.m. ONLY unless otherwise approved by City
Engineer.
D Attach Work Order (franchise only).
D Contact must be made with City and utility companies to locate existing utilities 48 hours prior to beginning of
work.
, , A,�MIQr o49— —/0 •
Sign e o Utility Company Representative Printed Name Date
6vj7/ 5 Cpl -R ClL vP 7 i /'
Si Contractor a esentative Panted Name 7 Date
Signature of City Representative Printed Name Date
(Application with original signatures needs to be submitted to the Engineering Department before approval.)
If
D Comments: 11 W b h Dr CD
D NOTE: Notify City Inspector at 972 -304 -3679 prior to beginning work and prior to backfill for concrete, trench, ditch and
open pit inspections. Backfill 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.
Dry Bore / Street Cut / Saw Cut Permit 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
the applicants expense) and barricading according to the Texas Manual on Uniform Traffic Control Devices.
Area(s) affected must be restored to as good condition as before the commencement of work (grading, drainage,
vegetation, and erosion control).
➢ 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 from 9:00 a.m. until 4:00 p.m. ONLY unless otherwise approved by City
Engineer.
➢ Attach Work Order (franchise only).
➢ Contact must be made with City and utility companies to locate existing utilities 48 hours prior to beginning of
work.
Signa e o Utility Company Representative Printed Name Date
G/ t7/ 5:4A/ C- P:ctR via 7701 4
Signature of Contractor Representative Printed Name Date
I AM 1 4z7.q- of cif, it\
Signature of City Representative Printed Name Date
(Application with original signatures needs to be submitted to the Engineering Department before approval.)
(� Li
➢ Comments: Y, W L r1, 01 67
➢ NOTE: Notify City Inspector at 972 - 304 -3679 prior to beginning work and prior to backfill for concrete, trench, ditch and
open pit inspections. Backfill 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.
i
N 1 11 ,�i CD
'I
1
W ' .1 , /
I 11
i / / .
I 1 , /
1 ' . / /
I '
1 `�t -- EX. FIBER CABLE CO �,/ / ' / ,`� �/
1 , 1 `L J , �
I 1
1 , // ' Q � ,
DEFOREST RD '9 1 � \ � / �' /
'I' - ; x ` EX. FIBER CABLE // / / "/ -
- - - -- ---- --------------------- - - - - -- -------- - - - - -- V E R I Z O N SERVICE D R O P \, / e
,
zo �' \' 1 / \ 1
. ` o /"
10" SS o ' /
s.
.o \ /" �/
,
v'
1 -
co, r 0 36 " RCP ,, ACA
o O ,,
o ,' 7
' ,.
EX. FIBER CABLE \''—
...... ' ,
,
,
�' ,
,
' i' y0 I
6" W/L
DEFOREST RD
10 S.S.
,
---- — fi ---- N
-- 36" RCP
NOTE AREA VERIZON 9TS AREA STATE: TX
Safety 1st a t all times DIVISION: NORTHEAST I EXCH.: 5647 _ REM. CD.: 005
W,C,; 4620 Iwo NO.: 9PFIODB CONTROL NUMBER: 010
All measurements a pproximate €ontractors ultimately responsible for accuracy TITLE: ROAD BORE TAX DST.: •
Notify city 24 hours prior to construction, TWP: I • RNG.: ISEC.: SAL: XXX
Irrigation lines are present. DATE: 09/07/10 IREV DATE: SCALE: NONE
p FILE: WP1 DRWN ENG APRVD PRINT
ISO :109 /15/10 COPPELL REZ REZ 1 OF 1
c: \dgn \4620 \9PF1 ODB \010 \wpl .dgn 9/8/2010 10:25:08 AM