Westhaven 1-PT150925A copy of the approved permit must be on the job site at all times.
CC: Applicant T" ` - ` I T r Or Page 1 of 4
Public Works COFFELL
P
ermit File Rev. 0612012
Orig, to Project File
a
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. or a -maiIto engineer @coppelltx.gov (see button below)
Date of Submittal: 05/21/2015 Applicant's .lob # / Work Order # 154490
PERMIT FEE: $100.00
(No charge to Utility Companies with approved FranchiseIROW Use Agreement)
Refer to the City of Coppell Ordinance No. 2001 -944. Certificated Telecom Provider? Yes (0- No
Plans provided and approved (Erosion ControlfSafety fences must be installed prior to beginning work)
Project Name /Location or address westhaven Ph 1
General Contractor Bridgepoint Communications, Inc Contact# 8107- 372 -1508
E -mail address to return permit 7 oe_toone@kinetic -eng. com
Representative: Jose Galarza
Franchise Telephone #: 214 -405 -7140
Company:
E -mail address: ] ose . galarza @twcable . corn
(for contact if neededlif e-mail of approved permit is d esiredlpermit cannot be e- marled unless complete)
Utility Company Represented:
C` Oncor Electric Delivery r Atmos Energy C` Verizon C-' SBCl AT &T
C+ Time Warner Cable C' CoSery Electric /Gas C, Other
General Description of Work (in accordance with Ord. No. 2001-5944): PLEASE ATTACH PLAN OF PROPOSED WORK
Begiining at the SW intersection of the SHI 121 NBFR and Westhaven Rd, extend buried CATV in ROW of streets throughout
subdivision as indicated on permit drawings.
Estimated Start Date 0 6 / 0 412 015 Estimated Completion Date* 07/04/2015
* Completion requires submittal of Completion Verification Notice (see page 4)
YWas contact made with City and/or utility companies to locate existing utilities?
if NO, Reason :Locates to be requested 48 hrs prior to cons+ C 'Yes (* No
YIs removal of existing streets, alleys, or sidewalks necessary? C Yes G No
if YES, project must have City inspection prior to concrete replacement
Right -of -W av Use Permit ADDlication 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 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 972462 -5155.
➢Any excavation requiring closing of a street /alley must be reported prior to closing to the following:
Police Department Q 972 -304 -3600
Fire Department @ 972- 304 -3512
Street Department @ 972462 -5150
Engineering Department c@ 972 -304 -3679
➢Attach barricade plan 1 trench safety plan if a lane or street closure is required.
NOTE. Street closures are allowed from 9:00 a.m. unti13:30 p.m. ONLY unless otherwise approved by City
Engineer.
yAttach 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 972- 462 -5155 to schedule 48 hours prior to beginning work.
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 you want the approved permit returned via e-mail, provide a valid e-mail address on Page 1.)
Jose Galarza 05/21/2015
Signature of Utility Company Representative
Mike Lucas
Signature of Contractor Representative
S'cett-L�tt�
Signature of City Representative
Comments
Date
05/21/2015
Date 25 September 2015 at the request
of Mike Lucas, swl
05 June 2015
Date
➢NOTE: Nod GU Ins ector at 972" -304 -3679 prior to beginning work and prior to
back, f ill for concrete, trench, ditch and open pit inspections. Back, fill 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.
Y k K. c i r Y. a COFFELL
0
UTILITY RELOCATION CHECKLIST FOR WORK WITHIN
CITY OF COPPELL RIGHTS -OF -WAY OR EASEMENTS
Listed below are minimum requirements for utility relocation projects:
Page 3 of 4
LA copy of the valid approved City of Coppell permit is required on the project at all times.
?.Notify adjacent property owners (commercial & residential) of project timeline, provide them with contact
names and phone numbers.
3.Proper erosion control measures must be taken.
4.Follow Texas MUTCD standards for work in traffic zones.
5.Sod is to be replaced when necessary.
6 Irrigation repairs must be performed in a timely manner.
7.Follow OSHA recommended trench safety at all times.
#.Repair existing utilities that are damaged, including but not limited to clean -outs, water valves, and SS
manholes.
9.Densities may be required in trench lines (ASTM).
10.Care and repair of street signage is the responsibility of the contractor.
11.No work is to be done in collector roadways before 9 :00 a.m. or after 3:00 p.m.
12.Prior notice of work activity on weekends and holidays must be in writing.
13.Line locates must be performed in advance by contacting - 1 800 DIG TESS andlor the following:
CITY OF COPPELL UTILITIES DIVISION coppelltx.govlutility- operations- division
9721462 -5155
CITY OF COPPELL ENGINEERING DEPT.
9721 304 -3679
HOMEOWNER ASSOCIATIONS
9721304 -3678 (Planning Department)
TIME WARNER CABLE
2141 320 -5455 (Mike Rasmussen)
AT&T LOCAL NETWORK
2141 215 -3031 (Rich Millenman)
COSERV Gas & Electric
9401321 -7800 x 7624 (Greg Ward)
EXPLORER PIPELINE
9181493 -5100 (Patrick Nwakoby)
ONCOR Electric Delivery
9721 323 -8917 (Larry Redick)
VERIZON COMMUNICATIONS
972! 318 -5277
FEDERAL EMERGENCY MGMT. ADMIN.
9401 898 -5138
TEXAS COMM. on ENVIRONMENTAL QUALITY
8171588 -5800
DENTON CO. LEVEE DISTRICT
2141 352 -5118 (Richard Hightower)
Atmos Energy
9721360 -4428 (Gary Dickinson)
1800 DIG TESS for line locates
(344 -8377)
14. Contaminants must be removed from work area daily and disposed of properly outside the City.
15. Streets, sidewalks and alleys must be kept clean of construction material and debris.
16. "Clean -up" requires returning work area to pre - project condition or better.
17. Contractor is required to contact Public Works Division for Completion Verification Notice. (see pg. 4)
T K r - G I T Y 0 f1
COPPELL
�3
UTILITY RELOCATION IN RIGHT -OF -WAY OR EASEMENT
COMPLETION VERIFICATION NOTICE
Page 4 of 4
Contact City of Coppell Public Works Division at 972 -462 -5155 to schedule an inspection
with Utility & Streets personnel to verify that your project has been completed to City of
Coppell specifications. Failure to schedule verification inspection may delay future projects.
Franchise Utility Name Time warner Cable
Project Location / Applicant's Work Order #(;f applicable)
Westhaven Ph 1 / 154490
Sub- contractor Company Name Bridgepoint Communications, Inc
24 hr.Contact Number 817 - 372 -1508
Date of Verification Appointment
Time of Verification Appointment
INFORMATION BELOW TO BE COMPLETED BY CITY OF COPPELL PUBLIC WORKS PERSONNEL
•:Inspected by
of Utilities Maintenance Division on
and found to be acceptable I not acceptable because
Follow -up needed? C•` Yes (- No Follow -up scheduled for
❖Inspected by
of Streets Maintenance Division on
and found to be acceptable / not acceptable because
Follow -up needed? C Yes C No Follow -up scheduled for
A copy of this completed notice can be provided to the address below
or e- mailed by using the button below:
City of Coppell Engineering Dept.
255 Parkway Blvd., Coppell TX 75019
Office: 972-304-3679 Fax: 972-304-3570
Submit by I Print Form