Carter Addn-PT121127 T $ ti - C I T Y - 0 F Page 1 of 4
COFI'ELL
DRY BORE/STREET CUT/SAW CUT PERMIT APPLICATION
FOR WORK IN e.,, „i C�
RIGHT-OF-WAY/EASEMENT `w�
Submit permit application to the Engineering Dept.,Town Center,255 Parkway Blvd.or by e-mail to engineer @coppelltx.gov(see button below)
Date Submitted:11/27/2012 Work Order#(if applicable)
PERMIT FEE: $100.00
(No charge to Utility Companies with approved Franchise/ROW Use Agreement)
❑ Plans provided and approved
(Erosion Control/safety fences must be installed prior to beginning work)
Project Name/Location: 517 Christi Street
Company Name: cross Utilities, LLC
Address:Po BOX 331521
Telephone#:817-305-3777 Emergency Telephone#:
Permit issued to(Contractor Name) Cross Utilities, LLC
Utility Company Represented:
Oncor Electric Delivery (: Atmos Energy Verizon SBC/AT&T
Time Warner Cable C CoSery Electric/Gas :" Other
*If"Other"is checked,please note that franchise or right-of-way use agreements will be required.
General Description of Work(provide copy of approved plans):
Install gas service line (bore)
Was contact made with City and/or utility companies to locate existing utilities?
if NO,Reason: Yes No i
>Is removal of existing streets,alleys,or sidewalks necessary? Yes " No
if YES,must have City inspection prior to concrete replacement
A COPY OF THE APPROVED PERMIT MUST BE ON THE JOB SITE AT ALL TIMES.
Dry Bore/Street Cut/Saw Cut Permit Page 2 of 4
Representative(s)of the Contractor must adhere to all construction standards approved by the City 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 Traffic Control Devices. Area(s)
affected must be restored to as good condition as before the commencement of work (grading, drainage,
vegetation,and erosion control).
➢Any excavation requiring closing of a street/alley must be reported prior to closing to the following:
Police Department @ 972-304-3600
Fire Department @ 972-304-3512
Street Department @ 972-462-5150
Engineering Department @ 972-304-3679
)Attach barricade plan/trench safety plan if a lane or street closure is required.
NOTE: Street closures are allowed from 9:00 a.m.until 4:00 p.m.ONLY unless otherwise approved by City
Engineer.
>Attach Work Order(franchise only).
Contact must be made with City and utility companies to locate existing utilities 48 hours prior to beginning of
work.
Printing your name indicates your acceptance of the terms and conditions of this form:
Marty Kirby - Atmos Energy 11-27-2012
Signature of Utility Company Representative Date
Ty Tasby - Cross Utilities 11-27-2012
Signature of Contractor Representative Date
it
Sig ature of City ;epresentative Date
(Application with signatures needs to be submitted to the Engineering Department before approval.)
>Comments: 6/1T I )(1 7/) 4, Y 1 01 V1/4 ',1ct.l,n"0
S-e-�- ► 4vel ,1^t d CLAA/ ()5 'Po L v l- 1 .
NOTE: Notify City Inspector at 972-304-3679 prior to beginning work and prior to backfill for concrete,trench,ditch and
open pit inspections. Backfill must meet all construction standards approved by the City of
Coppell.
Applicant shall indemnify and forever hold harmless against the City of Coppell 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.
T K c C I T Y • O F Page 3 of 4
COFFELL
s t
UTILITY RELOCATION CHECKLIST FOR WORK WITHIN
CITY OF COPPELL RIGHTS-OF-WAY OR EASEMENTS
Listed below are minimum requirements for utility relocation projects:
1.A copy of the valid approved City of Coppell permit is required on the project at all times.
2.Notify adjacent property owners(commercial&residential)of project timeline;provide them with contact
names and phone numbers.
3.Proper erosion control measures must be taken.
4.Follow Texas MUTCD standards for work in traffic zones.
5.Sod is to be replaced when necessary.
&.Irrigation repairs must be performed in a timely manner.
7.Follow OSHA recommended trench safety at all times.
8.Repair existing utilities that are damaged,including but not limited to clean-outs,water valves,and SS
manholes.
9.Densities may be required in trench lines(ASTM).
10.Care and repair of street signage is the responsibility of the contractor.
11.No work is to be done in collector roadways before 9:00 a.m.or after 3:00 p.m.
12.Prior notice of work activity on weekends and holidays must be in writing.
13.Line locates must be performed in advance by contacting-
CITY OF COPPELL UTILITIES DIVISION coopelltxgov/utility-operations-division
972/462-5155
CITY OF COPPELL ENGINEERING DEPT.
972/304-3679
HOMEOWNER ASSOCIATIONS
972/304-3678(Planning Department)
TIME WARNER CABLE FEDERAL EMERGENCY MGMT.ADMIN.
214/320-5433(Phillip Gwin) 940/898-5138
AT&T LOCAL NETWORK TEXAS COMM.on ENVIRONMENTAL QUALITY
214/215-3031 (Rich Milleman) 817/588-5800
COSERV Gas&Electric DENTON CO.LEVEE DISTRICT
940/321-7800 x7624(Greg Ward) 214/352-5118(Richard Hightower)
EXPLORER PIPELINE Atmos Energy
918/493-5100(Patrick Nwakoby) 972/360-4428(Gary Dickinson)
ONCOR Electric Delivery
972/323-8917(Larry Redick)
VERIZON COMMUNICATIONS 1800 DIG TESS for line locates
972/318-5277 (344-8377)
14.Contaminants must be removed from work area daily and disposed of properly outside the City.
15.Streets,sidewalks and alleys must be kept clean of construction material and debris.
16."Clean up"requires returning work area to pre-project condition or better.
Contractor is required to contact Public Works Division for Completion Verification Notice.(see pg.4)
E t7 a T t• O R
COFFELL*
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.
Franchise Utility Name Atmos Energy
Project Location /Applicant's WorkOrder # (If applicable)
Sub-contractor Company Name Cross Utilities, LLC
24 hr.Contact Number 817-305-3777
Date of Verification Appointment
Time of Verification Appointment
INFORMATION BELOW TO BE COMPLETED BY CITY OF COPPELL PERSONNEL
+Inspected by of Utilities Maintenance Division on
and found to be acceptable/not acceptable because
Follow-up needed? Yes - No Follow-up scheduled for
+Inspected by of Streets Maintenance Division on
and found to be acceptable/not acceptable because
Follow-up needed?r'Yes C'No Follow-up scheduled for
A copy of this completed notice can to be provided to the address below
or e-mailed by using the button below:
City of Coppell Engineering Dept.
255 Parkway Blvd.,Coppell TX 75019
Office:972-304-3679 Fax: 972-304-3570
Submit by E-mail Print Form
1 .
\-....
----
J,J415-R( i
AlL
i
! GA3 .
5E Ri iCL,
kflii\I
4cp I ce,62/
L..., (
i1
P 30,
............- ,
----A5-----Mikii\i------- .-----
r 7 r \
apto-6--- 1 inx. 7 Ti int
, W4, r)ar
,
Iligg
0
C r
IC)
! .e: r...
il Cj
■
0 i
3
‘ \
\ \ .
,,, \ .
\
\ \
r
GIS CHRISTI Page 1 of 1
GIS CHRISTI
, tt. ,- p "..•,..- \ 14
4 .
w
�. to f
sacs 1 _.r,- _ .1 f
, I - \\ ;-"N '-',- ` ' •�r r te ,.
jr_____,
\ . °,.-.- -, , ,., .- \ .
.„. •, \ , t
�'
` flit.7 gp. P _
•
City GroundBox Storm_Outfall Water Main
• 0 —WATER MAIN
City Fiber Optic Storm_Main
--IRRIGATION LINE
-p-Main Private Water
Sanitary_Cleanout
+Box - Water Private
•Culvert Streets
Sanitary_Fitting
-0-Private Streets
•
Sanita -0-Lateral City Limit
ry_JunctionBox
0 -*Abandoned
Sanitary_Manhole Storm_Channel County Line
-
0
Sanitary_Valve Storm_RipRap Railroad
Storm Weir Structure PointsOflnterest
Sanitary_Main
-*Abandoned
Fire Hydrant Valve Buildings
-0-Collector
a Building
-0-Private Hyd ra nts_Private FUTURE
—Force
F
Service Water Features Parcels
Interceptor
v'CROSS
LiftStati on_Structu re Hydrology
HYDRANT
Lift Station
•PLUG Parks
Storm_Fitting
ID 1 I TEE
Storm_Inlet 0VALVE
0 0 VAULT
Storm_Junction_Box Abandoned Water
ER 44-Rule 1
11/1/2012
http://gis/aspnet_client/ESRI/WebADF/PrintTaskLayoutTemplates/default.htm