ST9505-ES000316DRY BORE / STREET CUT / SAW CUT
PERMIT
IN
RIGHT-OF-WAY ! EASEMENT
Submit permit request to the Engineering Dept., Town Center, 255 Parkway Blvd.
Date: [- ih,- O c..3
PERMIT FEE: $100.00
(No charge to Utility Companies with approved Franchise/ROW Use Agreement)
Project Name/Location:
General Contractor: {'~- C~ c,x . 'Y~ c...
·
Plans provided and approved
(Erosion Control/safety fences must be installed prior to beginning work)
Permit issued to Company/Representative:
Address:Il qd.~
'
Telephone #:
Emergency Telephone #: qTZ 6,'1o qq ~
Utility Company Represented:
KY TXU Electric KY TXU Gas KY GTE ~SWBell KY Paragon
KY CoServe Comm KY CoServe Electric KY Other
~ If "Other" is checked, pleaxe note that franchise or right-of-way use agreements will be required
and need Council approval prior to beginning work. Permit cannot be approved until that time.
General Description of work ¢,rovide copy of approved plans):
¢
Was contact made with City and/pr ~ltility compvtanies to Iocat.e existing utilities~o
if NO, Reason: g-lt-{-OC> ['~g~cr~, $ {' C_i~r~ ~i~V6,~ ~-~-~-~c'- YES d~ NO KY
Is removal of existing streets, alleys or sidewalks necessary? YES/27 NO~_..~
if YES, must have City inspection prior to concrete replacement
Revised 11199
03/14/00 11:59 CITY OF COPPELL ENGINEERING
~ 9V228678f~8 N0.98~
DryBore/Street Cut/Saw Cut Permit
Page 2
Representative(s) of the Contractor mu~t adhere to all construction standards approved by the Cio/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 Tra~c Control Devices. ,4r~a($) affected must be restored to as good
condition a~ before the commencement of work (grach'ng, drainage, vegetation, and erosion control).
Any excavation requiring closing of a strut/alley must be reported prior to closing to ~he following:
Police Department @ 972/304-3600
Fire Department 0 972/304-3500
Sueet Depa~iient O 972/304-3546
Engineering Department ~ 972/304.-3679
Attach barncade plan / trench safety plan ~f a lan~ or street closure i~ required.
Note: Street closures are altowed ~a.m. until $..00 p.m. onb/ unlez$ otherwise approved by
City £ngineer.
Attach Work Order (franchise only),
Contact rnu~t be made with City and utility companies to locate ~istin8 utilities 4~ hours prior to
beginning of
S of Utility Company Repreacntativ~ Date
epre~en~ativ~ ~ Date
(~pplication with o4$inal ~ignatur? n~ed~ to be l~bmitted to the ~n~inee~ Oepan~ before approval.)
> Comments:
'> Note: Notify Qty Inspector at 972/$04-$679 prior to b~ginning work and prior to backfill for
concrete, trench, ditch and open pit inspections.
(Baclcfill maze meet all constru~ion standards approved by the City of Coppellj
~pplicant shall i~emnify and forever hol~t harmless against the City of Coppell eactt a~l every
claim, demand or cause of actwn that may be made or come against it by reason of or if any way
arising out of the closure, blocking, excavaling, cutting, tunneling, or other work by the applicant
under permit from the City, if such permit i$ granted.
forms/pgnnsn21~re~ut
AIRLINE DR. I
- $~A. 4+00
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