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Townhomes Ph 2-PT131202 ^ , i''''' all tunes •• the job s4e at a --- caliti;taat be °n f the'epp d rave P . Paoe.1 of 4 A eOPYe • CITY ' b 7,2012 t' C1-4' uppELL' 7. --' ..A: iicAt, ` ",' ,. ..- - , ' , ..).„%.4,4t,tt * 0," --.. * `" '', , •,•'''' T CC* - Ptw1,1vOiks ''':: pub;.„1 -„,,,,,,„ ‘4 "•• 1..r APPLICATION , p' 4' ' -*' '-' ..,......?,,,..,I.,.,„1 IT,trItILE g E,pER nil 11'.„ orIglita„,to - 7.-. ,,, imAy , -A0,1 OF 1G H Tt7.9., ,v , 1,----s,_-_-;,,,--,_Liiri,thedatl, , ,,, ...,,,,,,, .. „!)'!#4.,”'...' k`pe; ft vaii4Ar Yuaa-Y •/',-,,,,:,L,,1- - - '' ' blvd,CuPPell l'.• 'IulY " ' ',' ir,..: "-"...;4,:*-:,''''', . "'"','_ „ TIvii 6entei:,,,;55 Parkway ,...,..„ -... , rill' r- t,;', :‘, --: ,atio,,..t(iitliering P.'!!”)`''' a 32.2. (4 i 0 r) . P '1 I k...- • b .,", ,0.- mit aP ii. ' 8 b '4' ^ , Job#/ Work Order.It _ = Applicant s . , 1 /.. 2 2 '13 f companies 0 Date of Submittal. PERMIT FEE: Y /0 $100 (No charge to franchise utility ies with ith R ,0. , Agreement) Refer EMA.ILADD „ to City of Coppell Ordinance ADDRESS SNFo FOR 2R00s1t-I9B4,4. Certificated Telecom ustbe Provider?W U seA g r , 2....cr L i 4 1-11:5 z LIZ — Reloe#9•rir • Plans provided and approved?(Erosion Control/Safety‘:ilTFTeAncLes:mellgineer(alc°"Pel'Itk.-°1 installed prior to beginning work) Contact # Project Name/Location or address General Contractort Email address to re urn approved permit seiaatlil 44,1_, 7 6.1 -5-25-5-- Representative: ,-_ , ..,5-25- e e2meog.4.-4>rp? or e. Emergency#: Telephone#: ' 'At _4'7.04 4, ‘. c4, § Email address: if : (for contact if needed/if email of approved permit is desired/permit cannot be emailed unless complete) Utility Company Represented: Olicor Electric Delivery ( Time Warner Cable 0 Time Atmme Wn o sEanreregry 0 Verizon 0 AT&T/SBC ) Telecom 0 Other General Diippo,,prifion'teintoin of Work(in..taccorda,;Wereiztweriiti h,TOrdinrite,24). ....i.c..9.:,,,,,,),,,Provide !„,, :,j , ,.....t,,,...,(4,4x,,,,,,, e..4.„.04,...r. - a 1/6"-- Cu'‘11'. .- a....'' '.4..)- e1%**'4141"4‘4°4°31 .44 :::of prints. rt 0 Al 2- 57 I.r$ t ., , 15,,,yroLi, 2_ 41' -1) 01,,,c,,f2, wilt r-e- 4.---,--.. -s,tit`,„are-•',-t'<it-y-.',741t:,ae,l,,-'ri. D'e le 7 3 n..,,,,„,n•4. ., L, ---- t7,,-`- ed C'-°4•,'w 1 P l'e''f''!'.o. i''D'''"e--ate* /2 -` 7/-, i , e6ipl .„r- rn n.res ', netiot al,- ijiiitO ore°1P i e tioi Vrf a tion Notice(Pe-g e.,. 4.) , ., 4 v4 1-- S tv( t( *was City . _.A.__-. 111 Utility Dept. contacted to oloceateizexeistd2iaxng,eusnideorgrciundeuti)=Yes 0 No I ' D ;416” If not,reason riziort 1.... i yes rt No f Yes,project must have -- sidewalks to co Is removal of existing city streets, i s inspection prior alleys or alksit necessary? Yes 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. *r. Attach the Franchise Work Order(if applicable)and 1 set of prints showing the proposed work. Lneates far existing frifichise,utpitics,mtistjaeAm$ tnpeginning work. ioeqq--,:ollootafes,eitt:9724622gis'fil'i 4. a'head14 hours prior to beginning 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 engineerOt coppelltx Roy. El> if • want the approved permit returned via email,provide a valid email address on Page 1. <44i] Permit c .e emailed unless a mired signatures are present. 4400010111111.' 1114. riek tiol 22. - 11 Signa - of Utility Col .,ny Representative Printed Name Date elf L 4 jor__ ignature of,ontrac .0"-epresentative "rinted Name Date 0101 _ Laos /2,it,3 S tn-1111111.1kCity Representative Printed Name Date COMMENTS: NOTE:Notifj,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 indemniA,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, if such permit is granted . :1468 v ,,J�J� t 7976 0 ' .. Fes` , ✓ ! I __ ; �M D 1 "T `. 1:51.pSTD t2 - - I— 80) ,)(1 .61K- i s - �jf �' S1 O \ fu~ __ /ANC) L-EJM 1 NA I KC' P Ok) 3T 7201 00/ TO "/f'' 005 s . 3 f366a2 (004)T :SL Ili_, 2 3917208 fT;SL STO t ' . ALLEY ---0 a Of OR KM 5f Lf e ` 42249.__... _ 1TAtG§PO L! i IlA I t t _ .. . atO f AT CO F, 5116 01-8 1 I$ N 7'1 1...., 0 1 V I I- 1 5 O M L-61- � # "AI. - 61Vl ,Ur-i- '1r4 , -1 , I§ 351:222 1 N0L-U0C5 FOU '9A-r 1 ON 366122 ir. fN:k , UNOtJ I is 0G � 711,€I - r,/" " 013' ! X 17- ._. S n�z ...._ ..... . _.._._.__ _.s _.._..... 7 51 PS 11 s- `r - 119 ;, SL F-1 12', .,_ m "3917221. 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