FTTP-CR051115 (2) Nov 15 05 04: 02p p. 3
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T H E • C J T Y • O F
COPPELL
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UTILITY RELOCATION IN RIGHT-OF-WAY OR EASEMENT
COMPLETION VERIFICATION NOTICE
;ontact City of Coppell Public Works Division at 972-462-5155 to schedule an inspection
vith Utility & Streets personnel to verify that your project has been completed to City of
;oppell specifications. Failure to schedule verification inspection may delay future projects.
Franchise Utility Name ,�f 4 5'111 e i , (
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Project Location / pplicant's WorkOrder # Or applicable)ZP1U/ Aik
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Sub-contractor Company Name A/Z,1M.g/n .-- e
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24 hr.Contact Number - Fro • 4. / 3 4 _. ..-
Date of Verification Appointment 7//f/t (
Time of Verification Appointment I ?a a , -
INFORMATION BELOW TO BE COMPLETED BY CITY OF COPPELL PERSONNEL
In,cpected by py s/ I 1 0Id/I-Utilities Maintenance Division on . ,
uzdfound to b acceptable of acceptable because
4'ollow-up needed? NO/ YES Follow-up scheduled for
Inspected by of Streets Maintenance Division on -
znd found to be acceptable/not acceptable because •
Follow-up needed? NO/ YES Follow-up scheduled for
A copy of this completed notice is to be provided to: _
City of Coppell Engineering Dept.
255 Parkway BIvd., Coppell TX 75019
Office: 972-304-3679 Fax: 972-304-3570
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