Townhomes Ph 2-PT140218 , I A copy of the approved permit must be on the job site et all times. .J
I -.V.:11 It • 0 : T Y . 4.
i CC:Applicant Page 1 of 4
Public Works C-01"PELL- Rev.06/2012
Permit Fite
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...0 RIGHT-OF-WAY USE PERMIT APPLICATION
Permit valid for 90 calendar days from date of approval
Submit permit application to the Engineering Dept..Town Canter,255 Parkway Blvd.or e-mail to anginterproppelitx.gov(see button below)
Date of Submittal:....._,2ftS=1.±..__Applicant's Job#I Work Order# A Z-1
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
0 Plans provided and approved (Erosion Control/Safety fences must be installed prior to beginning work)
Project Name/Location or addiress ili 4 1 ' t/ ' '+ '
General Contractor . '.0.0 4-..4 ts. Contact# .1--1 ''" COW fiAili.- •
E-mati address to return permit - , ' ;.:,,- ;8: : -et iirattango Att,r.
, Representative: , ., ' , . .., 4.
4, E-mail address: -4 ..A' e, , p, -.,: , (....,) ......., ,..( .... '
(for contact Ifneeeledfif emall of approved permit Is deskedlpermit cannot be e-mailed unless complete)
Utility Company Represented:
• Oncor Electric Delivery C Atmos Energy (..) Verizon C SRC!AT&T_
C Time Warner Cable C CoSery Electric/Gas C Other
_ .
.;.4.;114,i^kol- . -40„.44oitt4.a',),I,fieUMtat.:4i.!),,0:4-411.4%**,M.
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Estima*Completion Snp;etit DoaL tle'L ;! .b;:mitzkil'o,f Est
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CompletioVerification,Notice(see page 4)
>Was contact made with City and/or utility companies to locate existing utilities?
if NO, Reason:,_-...: -- - '', - " ' ,' •Yes C No
>is removal of existing streets,alleys,or sidewalks necessary? 0 Yes •No
if YES,project must have City inspection prior to concrete replacement
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Mat-of-Way Use Permit Annlictton Pate 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 Un(form TS ffie Control Devices.
'..t: .i...• ,i 4 ,: ,IJ i.• . y.... h.i..,:€J,, .: • .'._lam commencementSt.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 dosing to the following:
Police Department 0 972-304-3600 ,
Fite Department(61972-304-3512
Street Department 0 972-462-5150
Pngineering Department 0 972-304-3679
>Attach barricade plan/trench safety plan if a lane or street closure is required.
NOTE: Street closures are allowed front 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.
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The application with signatures of Franchise and Contractor representatives must be submitted to Engineering
Dept.for approval prior to beginning work.Submittals by a-mall should go to engineercmcoopelitx.gov.
Printing your name indicates your acceptance of the terms and conditions of this form:
i •n t the •,, • permit rater via e-mai,provide a valid e-mail address on Pa a 1.)
S gnature of Utility Company Representative ' Date ii .,-.-re . _
Si i t rc Contractor pr `ntative Date
Signature of City Representative Date
Comments
pcc c,et,,o,{ tok'o-t,tt„c. ha. c,v... e..4-... 4.-4-4...t 191- -rna,-;. s-ritAet-
40 4.,441-t. ALL— ' AMc1,..4-t u-i ft'4,:e.ai .40 Pat-c paa-2444 Le7s -,
>NOTE: Notify
yinspector at 972-304-3679 prior to beginning work and prior to
back,fill for concrete, trench, ditch and open pit inspections. Backfill must meet
all construction standards approved by the City of Coppell.
Applicant shall indemnf'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.
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S Proposed Bore locations t,r 1�g °. • M `` •
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CONSTRUCT:
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TEXAS_ VO . 2003034, PC. 7 7, TRAC II, L.R.D.0 T+ 1 (ex....
Tr/TrSti-T;;-NG C/STIn G DESCRIPTION
Pole set
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PARKING PARK-LNG 6y_ ! I
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SAWED .OIM1 ., -"°6" PARABOLIC CROWN
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�I" LIME S1rk @ILIZ St1C RPAE '',- - REINFOR ED COt RE1E
A RINN 'CEC 4" REIN RCED
v01 RET a ;17EW4 PAVEMENT (MIN, ifs F IF CORER„ SIDEWALK
WITH N0. 3 BARS AT
36" 36"
*E1' G_r BOTH ,ppy>
OT TO SCALE 6ft
6ft •
0 7ft 2" PVC bore
40 8"SS
16" W 36" SS