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T H E C I T V O F
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UTILITY RELOCATION IN RIGHT-OF-WAY OR EASEMENT
COMPLETION VERIFICATION NOTICE
Contact City of Coppell Public Works Division at 972-462-5155 to schedule an inspection
with Utility & Streets personnel to verify that your project has been completed to City of
Coppell specifications. Failure to schedule verification inspection may delay future projects.
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Franchise Utility Name //1/ . S /' %y C/2 T ii '/,
Pro Locatio / Applicant's WorkOrder # (if a ipli •ble) • J /�
'Of ' 62-4/14 ,Pf6:2-ii-i), ir 4„.„--.-_,.-...-;-:„.. .,e44-_-14// -
Sub-contrac or Company Name /&/?Z(S /i')/' Z2i
24 hr.Contact Number x'72- •- ISO -' /_
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Date of Verification Appointment e7/2-1//6 -1
Time of Verification Appointment 5': L' An,
INFORMATION BELOW TO BE COMPLETED BY CITY OF COPPELL PERSONNEL
•:• Inspected by �y�,re' e-' of Utilities Maintenance Division on 2-,7-6 I
and found to be a cceptable / not acceptable because .
Follow-up needed?0 YES Follow-up scheduled for
•:• Inspected by _ of Streets Maintenance Division on 7
and 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 •
cv Damage Contract Located Utility Item Investigated At Fault
Q Date Work Order Type Company YIN Provider Damaged Size Damaged By Location Of Damage By YIN Remarks
• -
7125105 3PF01 HE Telephone RAH Verizon 305 Beechwood Guy Varney
7125/05 3PF01 HE Telephone Talon Verizon 200 Hollowtree Ct Guy Vamey
8/5105 3PF01 HE Gas Allen Undg Atmos 244 Sleepy Hollow Guy Vamey
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