Valley R Center-PT 900119Bore/Excavation in Public Right-Of-Way Permit
City of Coppell - Public Works Department
Project Name:
Permit Issued To: Name:
Address:
Phone:
Emergency Phone:
Representing:
Inspector:
Type of Work/General Description:
Location of Work:
Have All City and/or Franchise Utilities Been Contacted and
Existing Utilities Located: // YES NO
Will It Be Necessary to Excavate Street, Alley or Sidewalk
Pavemaent? w// YES (attach permit) ~/ NO
Representative(s) of the Franchise/Contractor must adhere to all
construction standards approved by the City of Coppell, which
includes but is not limited to: Compaction of Trenches and Bores,
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.
Any excavation requiring closing of a street or alley must be
reported to the Police, Fire, and Public Works Departments prior
to closing (462-1144, 462-1!33 and 462-8495).
Attach Work Order (Franchise Only)
PAGE 2
PERMIT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franc his ~'/C-~nt rac~or Representative
Date
Franchise Inspector/or City Inspector
Approved / C'~-y Representative
Date
Date
Applicant shall indemnify and forever hold harmless against 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.
PERMIT.PHB
~ Date
Received From'-
Address