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ST0301C-PT130822 A copy of the approved permit must be on the job site at all times. CC: Applicant T " a ' a ' T 'V ° * Page 1 of 4 Public Works F' Permit File Rev. 06/2012 Orig.to Project File - 08-22-13 A09:57 P C D RIGHT-OF-WAY USE PERMIT APPLICATION Permit valid for 90 calendar days from date of approval ubmit permit application to the Engineering Dept.,Town Center,255 Parkway Blvd.or e-mail to engineer @coppelltx.gov(see button below) Date of Submittal: 8/22/13 Applicant's Job # / Work Order# 32154°3 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 r ❑ lans provided and approved Erosion Control/Safety fences must be Installed prior to beginning work) Project Name/Location or address Bethel and Coppell road, construction ( T 03_01 j) eneralContractor Wi1lbros Contact# 214 ''-4B6-2237 E-mail address to return permit chri s t opherbl ake.harre l son @oncor'.com Representative: Chris Harrelson Franchise Telephone#: 214-486-2237 Company: E-mail address:christoppherblake.harrelson6oncor.com for contact If needed/if e-mail of approved permit Is desired/permit cannot be e-mailed 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 eneral Description of Work in accordance with Ord No2001 su) LEASE ATTACH PLAN OF PROPOSED WORK Replacing and removing Oncor facilities along Bethel and Coppell road Replacing approximately nine poles along Coppei! road and transferring overhead facilities Estimated Start Date 10/15/13 Estimated Completion Date*12/20/13 * 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: C' Yes C No ➢Is removal of existing streets, alleys, or sidewalks necessary? C' Yes C No f YES,project must have City inspection prior to concrete replacement ,t-o -Wa PeIt.t't A ,licatitn 'as t 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. Vie: >Any excavation requiring closing e Dae street/alley ari fey 972-304-3600 s reported prior to closing to the following: g g: F re 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: treet closures are allowed from 9:00 a.m.until 3:30 p.m.ONLY unless otherwise approved by City Engineer. ➢Alta h Work Order(franchise only)and/or 1 set of prints showing proposed work. Locates for existing franchise"utilities must be done 48 hours prior to beginning work. For City utility locates, call 972462-515546 schedule 48 hours prior"to beginning work. he 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 yo r name indicates your acceptance of the terms and conditions of this form: (I you want the approved permit returned via e-mail,provide a valid e-mail address on Page 1.) Chris Harrelson 0/22/201 Signature of Utility Company Representative Date Signature of Contractor Representative Date 2 2-//!, Signature of City 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. S N M �' s 1, La , LID L�LCD : 1 0.g2 La.:: 1-I , d LJ_ F— LLJ w I v--11 ,q In o .--1 5� �., F 4916893.- IL —r-r �-i-fI 99£— f ---.--+ .w I -3662191 I ~ 069916£ tb C...0 _ f -- �EFI-' t Lf) 4 , z Lon• 3 1 - I LJ ; IS 1 , o� w ; el LCD et; Oil , CO . r, 6 ys (!"1 P m 0. 3 Jam' LC) 2144359 CD rya 711 in +� if)L0 LO S �sdlz N oq. LO r Q £65 ¢ A ce ct 9 2a �.,, C�1 © bOl9. I I % 366` U Q V LO • M • ••l ark 0 � �' •• col or 41 , U M / d s) °o C0` *3 ? o co `/1111111M9Ba ri1. il ti lo� �U Sri .'b otN LCD co t� 4.0,._ ,-� Q�j ' M tiON N I �`a tir tOti P N LC) `TM II I to P ? 3�r¢ Nt I 3 v)le ;;41 m oi, C: 13 („)--1 in'a 0.�tL� n MP") 0 0 re) ..) i i •...: il ,,,, 13",a" ����� (MfJ ELECTRIC CO r °` "-Th ( � NCR LCD A 25 205T60 USERID F t DESIGNER HARRELSON,CHRISTOPHER • • PHONE (214)486•2237 PROJECT MANAGER ■ c , PHONE r O $813 Oneer Elaetrae Odwar NN a Meths,d.eau,ge,end electron. eta Iproduotel ere created ((pp im 4oetaen of au,tebal,ty or fatroae for the Intended wa .�t0 I etPort.to pronde products thst ere Tres from orror bw MM , The locations Aeon era approe.mat,ena end ore not ante: I Onoor Eleotr.e Delivery re For the Internal wee of the i the products or any portion of the products to third per. ■.—.,J ■ The rxspaant further agrees to hold hermlen and endow damages remittal From or predroeled upon ptrcct leehalal NW s I ore •feet+,n VW property provrdad hereunder. ^� t9 WR NAME FBRt BETHEL AND COPPEI FBRaBETHEL AND COPPEL i A 1 ?88fi0 CUSTOMER ADDRESS COPPELL • LOCATION