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Neighborhood CU-PT130606 IA copy of the approved permit must be on the job site at all times. I CC: Applicant T H ° r `�- - Page 1 of 4 Public Works COPPELL Rev. 06/2012 Permit File Orig. to Project File t X. „` 'a 06- 6-1 3 A d :20 R C VD D D D O D RIGHT-OF-WAY USE PERMIT APPLICATION u Permit valid for 90 calendar days from date of approval Submit permit application to the Engineering Dept.,Town Center,255 Parkway Blvd.or e-mail to engineer @coppelltx.gov(see button below) Date of Submittal: g-- g- 13 Applicant's Job # / Work Order # 3 2 08 737 PERMIT FEE: $100.00 (No charge to Utility Companies with approved Franchise/ROW Use Agreement) Refer to the City of Coppell Ordinance No. 2001-944. Certificated Telecom Provider? Yes C No C ❑ Plans provided and approved (Erosion Control/Safety fences must be installed prior to beginning work) Project Name/Location or address REPLRCE ELOCf4TE ftielle.POLE, 360 S ©awraM Th p ROAD General Contractor ONCOR ELECTRIC DFLfYE 'Y Contact# 77Z.323_g!/ E-mail address to return permit 1 L ryim'.nkkErt ©Na W_ corn . Representative: R 19utry GREE- i Telephone#: 972 . 3'2 3. 5915 i om.a g E-mail address: Gip-Atil.'/frl1F.E'a l7NC0g. CU/fl (for contact if needed/if e-mail of approved permit is desired/permit cannot be e-mailed unless complete) Utility Company Represented: 0 Oncor Electric Delivery C Atmos Energy C Verizon C SBC/ AT&T C' Time Warner Cable C CoSery Electric/Gas C Other i 1 -7 ! 1: i • o k n z acc da ce i}} t a a "& . - �� 4 R . Estimated Start Date 6-2/-13 Estimated Completion Date* 67-2 8-13 * Completion requires submittal of Completion Verification Notice (see page 4) >Was contact made with City and/or utility companies to locate existing utilities? if NO, Reason: 1 Yes C No >Is removal of existing streets, alleys, or sidewalks necessary? C Yes • No if YES,project must have City inspection prior to concrete replacement 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 applicant's 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). To schedule Public Works final inspection (Page 4) call 972-462-5155. • >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 3:30 p.m.ONLY unless otherwise approved by City Engineer. >Attach Work Order(franchise only)and/or 1 set of prints showing proposed work. P21 o c es or xising fra G 3i'S ilttie— s; E e do ho 0 " nn1 © ., 0 � o ity utility locates a 72- , 2- ,5 s ,a, 11 e o prior o beginning o -14;p m. The application with signatures of Franchise and Contractor representatives must be submitted to Engineering Dept.for approval prior to beginning work. Submittals by e-mail should go to engineer@coppelltx.gov. Printing your name indicates your acceptance of the terms and conditions of this form: (if ou want the approved permit returned via e-mail,provide a valid e-mail ad dress on Page 1.)/ Signa e of Utility Company Representative Date Signature of Contractor Representative Date IP-4 Likott, Signature .f ity Representative Date Comments >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. ELECTRIC CO \STRUCTIO \ PRINT WR NO. 3208737 SHEET 1 OF 1 WR NAME FBR:COPP:REPLACE DETERIORATED POLE DATE 05-29-2013 N C R CUSTOMER FBR:COPP:REPLACE DETERIORATED POLE SCALE 100 ADDRESS 360 S DENTON TAP RD SERVICE CENTER FBR OFFICE 191 LOCATION DENTON TAP & VANBEBBER MAPSCO 1A-X DESIGNER MCKEE,GLENN R PROJECT MANAGER MCKEE,GLENN R USERID PHONE NUMBER (972)323-8915 PHONE (972)323-8915 ©2013 Oncor Electric Delivery Maps,drawings.and electronic data!products)are created for the Internal purposes of Oncor Electric Delivery with no implication of suitability or fitness for the intended use of the recipient.Oncor Electric Delivery will make good faith efforts to provide products that ore free from error.but does not warrant the accuracy or quality of such products.The locations shown are approximations and are not Intended to show exact locations.Products provided to other parties by Oncor Electric Delivery are for the internal use of the recipient,and the recipient agrees not to duplicate or distribute the products or any portion of the products to third parties without the prior written permission of Oncor Electric Delivery.The recipient further agrees to hold harmless and indemnify Oncor Electric Delivery against all claims,costs,expenses and damages resulting from or predicated upon strict Lability for personal injuries,death or property damage,on account of any defects in the property provided hereunder. 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