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T H E • C I T Y • 0 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 -
i oppell specifications. Failure to schedule verification inspection may delay future projects.
Franchise Utility Name /g/1 521/E 1/E ' L b,J5 7
Project Location / Applicant's W,orkOrder # (if appRcabwe)3 Piz)//x
Sub-contractor Company Name / /'yj )/ x
24 hr.Contact Number '77,4 - 3,j j• 4. / 3 4
Date of Verification Appointment / r // 0 / PS.
Time of Verification Appointment 7 1 ✓ � 1�.
INFORMATION BELOW TO BE COMPLETED BY CITY OF COPPELL PERSONNEL
:• Inspected by of Utilities Maintenance Division on • -/0--o
uzd found to be cceptabl 1 not acceptable because
Follow-up neede C9 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 Blvd., Coppell TX 75019
Office: 972-304-3679 Fax: 972-304-3570
Damage Contract. Located Utility. Item investlgatid
Data Work Order Type Company YIN Provider Damaged She Damaged By Location Of Damage By
9/1/05 3PF01GX _Electric McBride Y TXU Primary Bore Rig 624 Phillips Jeff Wesson
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