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ST0502A-PT130709 A copy of the approved permit must be on the job site at all times. CC:Applicant r w a - c • r o ' Page 1 of 4 Public Wow COPPELL Rev. 06/2012 Permit File Orig. to Project File a # `` is RIGHT-OF-WAY USE PERMIT APPLICATION Permit valid for 90 calendar days from date of approval Submit permit application to the Engineering Dept.,Town Center,255 Parkway Blvd.ore-mall to engineerecoppelltx.gov(see button below) Date of Submittal:June 26, 2013 Applicant's Job#/Work Order#3189439 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 G © Plans provided and approved (Erosion Control/Safety fences must be installed prior to beginning work) Project Name/Location or address Freeport Parkway Relocation GeneralContractor Willbros T&D Contact# 469-261-6345 E-mail address to return permit richard.brewster@oncor.com '""'))')');0);;; Representative: Richard Brewster k =Telephone*: 214-486-4245 E-mail address:richard.brews ter @oncor.com (for contact If needed/If e-mail of approved permit is desired/permhcannot be a-ma1Nd unless complete) Utility Company Represented: Oncor Electric Delivery C Atmos Energy C' Verizon C' SBC/AT&T C Time Warner Cable C' CoSery Electric/Gas C Other ,�. POND. i �39m'Sh` S : 4M ',V, b pw 4, � D �. � "fir a 4 3 � � S t ^•v „,; ,n e g ^+.+ ,. .t,, del.,.,. ! 4 • 'x I r e,rs ..v,- ✓4 Estimated Start Date 08/12/2013 Estimated Completion Date*09/20/2013 * 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: Willbros to contact C' Yes ( No ➢Is removal of existing streets, alleys, or sidewalks necessary? C Yes f: No if YES,project must have City inspection prior to concrete replacement Eishkof-Wav Use Permit Apiication Pave 2 of 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. Areas) affected mint he restored to as soars cow as before the pmt of work(grading, drainage, vegetation,and erosion control). To schedule Public Works rural inspection(Page 4)call 972-462-5155. DAny excavation requiring closing of a street/alley must be reported prior to closing to the following: Police Department 972-304-3600 Fire Department to 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. > ,v d s e " �f r • a, 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 engineertecoppellbt gov. Printing your name iytlicates your acceptance of the terms and conditions of this form: Of the a o (d ermit returned via e-mail,provide a valid e-mail address on Paget.) June 26, 2013 Signature of Utility Company Representative Date (Zotat q, e June 26, 2013 Signature of Contractor • " •resentative Date Sigma re of 'ty Representative Dat Conunents >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. ■ N Y LAKE K0AI-- WWI a ; - i li 41 I I , , II 1 I j � d., _ , _ i11 I ' I . I .. ,c I _ 1 I0 I III / — --- 0 6 I, g III � --- a I} 0 ; I lit- II it. w� 1 — 1 1 . litql111 -- ilho I i . 1 I ! 1 1 4 . \�_II -omn 1 „ - I 1 i Bid+l� , I ii�i� F e iii = 1 -g 1914 ■ i 3 I O . rnE Iii LI . III\\\ ________________„, ,I +1 I :A 1 fft---g . 0.k 1 I e�