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ST0301C-PT110824 I A copy of the approved permit must be on the job site at all times. � CC: Applicant T " E ` ' r " o R Page 1 of 4 Public Works COPPELL Permit File - Rev. 07/2010 Orig. to Project File V' x e 6 , 55 APPROVED 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: R.11. 11 Applicant's Job # / Work Order # 50705S 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 1) jgi Plans provided and approved (Erosion Control /safety fences must be installed prior to beginning work) Project Name / Location: 8er -L. g ®eta Taw.,' Cd LL General Contractor: Y 448,005 c T Contact # IA. 2 (. (• G $D Permit issued to Company / Representative: ge.4.420 „er,F,I _ Address: /C /6 Wex)04L4 P PG ZS / 5 7S2o2 -/2J L Telephone #: Z/4 • 6 5 Emergency Telephone #: g366 •.13.4662 Utility Company Represented: .Oncor Electric Delivery ❑ Atmos Energy ❑ Verizon ❑ SBC/ AT &T ❑ Time Warner Cable ❑ CoSery Electric /Gas ❑ Other General De ription of )'ork (provide four [41 sets of pi= n accord nce with Or 2 . No. 4 91 -944. l�e�o P�Ctyfi j oleo d 11( et ti GibQ t ar it/ tyre_ road cart Svc /v>t. i.. old `‘4A,v Coe,oi_L -. Estimated Start Date f- 6 . /1 Estimated Completion Date* /0 '/q // * Completion requires submittal of Completion Verification Notice (see page 4) sp Was contact made with City and /or utility companies to locate existing utilities? if NO, Reason: D/GTE - % Mice- 1b Co" 5p e ?- YES ❑ NO g. Is removal of existing streets, alleys, or sidewalks necessary? YES ❑ NO zr if YES, must have City inspection prior to concrete replacement 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 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). To schedule Public Works final inspection (Page 4) call 972- 462 -5155. ' Any excavation requiring closing of a street /alley must he reported prior to closing to the following: Police Department ® 972- 304 -3600 Fire Department c) 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) and /or 4 sets of prints showing proposed work. t Contacts must be made to locate existing utilities 48 hours prior to beginning work. (Application ith original .; , tures should be submitted to the Engineering Department before approval.) 1 I, mi l ' %4g, Ib7z '/7'7� Signature of Utility Company Representative Printed Name Date g 14:444.1K FEE A1.17,2011 Signature of Contractor Representative Printed Name Date tiefri ______---, / i.( /t7e4(C4" riftr/i/ Signature of City Representative // Printed Name Date ➢ Comments: C /161 't"' 1 / r k G G > 7 / t 4,3 e e / 7 / s pco, cc 4, Y /j,,_ 1 � e; // / e - 41647--3-76 710q i'v / s f L l.'61/ C, ➢ 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. 4 t!h ! i I C A T I c .c1----, f.'•iq'': " - ill'iqf Pao \ \ F LJ 1 <I CC Li_ CL. •-'•1 ' I g S;.4•,k °: •-• A•i"S'r ' ,1 3 (A 0 LO LO 0 i .1,siipk '3 9 !•-• 0 •-tf P `.= ie l' j 2 vap u -- ',?• . t • CC 06■ 8 8 i eagag )1.- cs_ . 1— ,. i:P15. z z W a ,,- V) Z ti"AtIk a . pi p g il 8 8 _,'• 0 t g a ▪ B rdi - OG ,...) (.) O C 0 I .< 4. Cc P Pilq111 T i I la :4 0 W eg u cr 1 • 00:0 I LL, 0 ' 1 i c. S : A 25 ..." • I FZ ,..,'" L '=■'<r`Z' - Ii:Vi:d < 4 ,9 W '.. (S D q A 25 tiLl 15; 1 I '------ ..im o a et .., 605. • 0 \--/ 0 ZimmfdllgMllp. • • 0. 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