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Date of Submittal:
Applicant's Job#/Work Order# i (II kCS 14C
PERMIT FEE: $100 (No charge to franchise utility companies with ROW Use Agreement)
Refe to City of Coppell Ordinance No. 2001-944. Certificated Telecom Provider?(' / N
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EMAIL ADDRESS FOR SUBMITTAL: engineer(it.coppelitx.g
Plans provided and approved?(Erosion Control/Safety Fences must be installedpapriarcrpto bettirgww:11(e)t...p 4 e
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Project Name!Location or address B. .-1-1-1\-6-ERE ‘ L'IthflioAS i 0"
lz.- -1 S iv\etc/ Contact# (IA 4-) 5e -f 722-
General Contractor ts-1-evv.--e. . ,Nazi, 8.., t.r.a, € Osite,vsej.,,zdo
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Email address to return approved permit VA. Q..lt
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Representative: 2-Ø -t 0 Wp ww_k t
. 2 r3-G 45-9
/ `2_,V..6—ialt-5c1 Emergency #: (q-1-2) -
1;-- Telephone #: 61,1'.?..) , p..A.:1-W,A CIWY.1
Email address: 0..-evisk.,'A, 1,1:41'301N-4-vt- ".
(for contact if needed!if email of approved permit is desired!permit cannot be mailed unless complete)
Utility Company Represented:
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0 Oncor Electric Delivery 0 Atmos Energy Verizon 0 AT&T/SBC
0 Time Warner Cable 0 Time Warner Telecom 0 Other
:
General Description of Work(in accordance with Ordinance 21,01,0 -941)Provide 3ist.. .tof prints.
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Was City Utility Dept. contacted to locate existing underground utilities? Yes V-4/NO 11 f.
If hot,reason
KV :
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4Is removal of existing streets, alleys or sidewalks necessary?9 Yes 0 No
:
if Yes project must have City inspection prior to concrete replacement.
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Right-of-Way Use Permit Application - 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 applicant's expense) and barricading according to the
Texas Manual on Uniform Traffic Control Devices.
Affected area must be restored to same condition as before the commencement of work
(grading,drainage,vegetation and erosion control).
To schedule a Public Works final inspection as required on Page 4;call 972-462-5155.
Any excavation requiring the closing of a street/alley must be reported to the following prior to closing:
Police Dept. 972-304-3600 Fire Dept. 972-304-3512
Street Dept. 972-462-5150 Engineering Dept. 972-304-3679
• Attach a barricade plan or trench safety plan if a lane or street closure is required. NOTE: Street
closures are allowed from 9:00 a.m.until 3:30 p.m. ONLY unless otherwise approved by City Engineer.
• Attach the Franchise Work Order(if applicable)and 3 sets of prints showing the proposed work.
_Locates fcir'existingfranchise utilities must,be done 48 liour prior to begwning York
Fiihpty utility locates?ca11972-462.5155th schedule 48 hour prior to beguining work
This application with signatures of Franchise and Contractor representatives must be submitted to Engineering
Department for approval prior to beginning work.Submittals by email should go to enaineer(a coppelltx.gov.
• if you want the approved permit returned via email,provide a valid email address on Page 1.
Permit cannot be emailed unless all required signatures are present. /�, ,3
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Signature of Utility Company Representative Printed Name Date
Signature of Contractor Representative Printed Name Date
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1'6k.A.44 LG 41/13 ,(3
Sign. - • City Representative Printed Name Date
COMMENTS:
NOTE:Notify Engineering Dept. at 972-304-3679 prior to beginning work and for open trench,ditch or pit
inspection prior to backfilling. Backfill material must meet City of Coppell standards.
Applicant shall indemnify and forever hold harmless the City of Coppell against each and every claim,demand,or
cause of action that may be made or come against it by reason of or if in any way arising out of the closure, blocking,
excavation,cutting,tunneling,or other work performed by the applicant under permit from the City, ifsuch permit is
granted.
Page 668 ( 1Jc 2009 Edition
Notes for Figure 611-18--Typical Application 18 glCO. e.
Lane Closure on a Minor Street /
Standard:
I. This TTC shall be used only for low-speed facilities having low traffic volumes.
Option:
2. Where the work space is short,where road users can see the roadway beyond,and where volume is low,
vehicular traffic may be self-regulating.
Standard:
3. Where vehicular traffic cannot effectively self-regulate,one or two Baggers shall be used as
illustrated in Figure 6H-10.
Option:
4. Flashing warning lights and/or flags may be used to call attention to the advance warning signs.
5. A truck-mounted attenuator may be used on the work vehicle and the shadow vehicle.
c _
Sect.611.01
December 2009
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., '—� PRCPCSED LOWERI \ G CF ( EXISTING )
°y. , � ��ry 3 8•zenitorH serer
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... . VERIZC \ CABLES FOR \ EW
� ` t50` ROWS
'�a LEISURE LANE
SEWER LIVE I \ ALLEY BE - 1N1
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��° 140 S VVER PLACE
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3 3 200 (it. BELLAC - RF SUBiIVISIC \ )
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13. 2.5'ROM NOTE: NO CITY UTILITIES ARE LOCATED IN THE
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m r I .... WHERE THE WORK WILL BE PERFORMED
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Eri ] I { N 5'ROW
t�l 0 II. I lI THE LOCATION OF WORK TRUCKS IN ALLEY WILL
8Q I I N ALLOW AT LEAST ONE ALLEY ENTRANCE
\ I i I —II AND EXIT TO BE ACCESSIBLE AT ALL
AT ALL TIMES IL tr.! - 15' >I D=PTH DETAIL
�3''� m -� 2.5' I1— >I 2.5' H
B-8 0 a
ti .2 5' " I I� 10' (not to scale)
2' - IROW I alley I ROW
s s 2' cable �1 2, I- 1 2' 1-i cable
3 3 �=� - - —1- depth=36"— �- -
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NOTE AREA VERIZON
(1) LOCATES WILL BE DONE BEFORE WORK IS STARTED CITY: LEWISVILLE { STATE: TX
(2) ALL LANDSCAPING WILL BE RESTORED TO ITS ORIGINAL CONDITION REV LS 1 0 NI WORK ORDER NUMBER: 8P0AOHC
(3) TRAFFIC PLAN INCLUDED TITLE: LOWERING CABLE IN ALLEY BEHIND 140
SUMMER PLACE FOR NEW SEWER LINE
(4) ANY QUESTIONS OR COMMENTS, CALL MIKE GRAY (VERIZON ENGINEERING) 972-318-3457 DATE: 04/16/13 REV. DATE: ti7/a SCALE: r=50.00'
FILE: y/p1 DRWN ENG APRVD PRINT
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