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Level 3-PT151015A copy of the approved permit must be on the job site at all times. CC Applicant r w z c r a r Page 1 of 4 Public Works COFFELL Permit File Rev. (16/2012 Orig. to Project File 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 e-mail to engineer @coppelltx.gov (see button below) Date of Submittal: 10-15-15 Applicant's Job # / Work Order # TWT s 6 7 PERMIT FEE: $100.00 (No charge to Utility Companies with approved FranchiselROW Use Agreement) Refer to the City of Coppell Ordinance No. 2001 -444. Certificated Telecom Provider? Yes C' No 0 Plans provided and approved (Erosion Control /Safety fences must be installed prior to beginning work) Project Name /Location or address 1233 Lakeshore Dr., Coppell, TX General Contractor Texstar Enterprises Contact# Eric McColl 972 -672 -2229 E -mail address to return permit 7 berka @gxtltd _ com Representative: Don Hurla Franchise Telephone #: 214-764-2517 Company:. E -mail address: Don. Hurla@level 3. com (for contact ifneededlif 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 C©Sery Electric /Gas C Other Level (3) Communications Genera! Description of Work (in accordance with Ord. No. 2001-944): PLEASE ATTACH PLAN OF PROPOSED WORK Bore and place 808' of conduit and fiber cable on Lakeshore Dr. Place 469' of aerial fiber cable on Wrangler Dr. New fiber to connect 1233 Lakeshore Dr to the existing Lervel3 network. Estimated Start Date 10 - 2 6 - 1 s Estimated Completion Date's 12 - 4 -15 * Completion requires submittal of Completion Verification Notice (see page 4) 9 Was contact made with City and/or utility companies to locate existing utilities? if N©, j, eason Contractor will call in locates upon permit C Yes (+ No 9Is removal of existing streets, alleys, or sidewalks necessary? C Yes C: No if YES, project must have City inspection prior to concrete replacement Right- of -Wav Use Permit AwDlication 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 rewired at applicant's expense) and barricading according to the Texas Manual on Uniform Traffic Control Devices. Area(ss 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. Any excavation requiring closing of a street /alley must be reported prior to closing to the following:. Police Department @ 972- 304 -3600 Fire Department @ 972 -304 -3512 ,Street Department @ 972462 -5150 Engineering Department @ 972 - 304 -3679 ➢Attach barricade plan 1 trench safety plan if a lane or street closure is required. NOTE. Street closures are allowed from 9:08 a.m. until 3:38 p.m. ONLY unless otherwise approved by City Engineer. ➢Attach 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 D far approval prior to beginning work. Submittals by e-mail should go to engineerOpmelltx goy. Prin ing your na a mdica s your acceptance of the terms and conditions of this form: (if y apt the air r ved per it etur� is e-mail, provide a valid e-mail address on Page 1.) "'o- /6- -Q-1S Signature of Utility Company Representative Date Signature of Contractor Representative �aett.L_at� Signature of City representative Comments '/C- Date 15 October 2015 Date >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 Copped. 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. T H S - C 1 7 Y U F COPPELL f � r � r 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. 2.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.Densltles may be required in trench lines (ASTM). M.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 and /or the following: CITY OF COPPELL UTILITIES DIVISION coppelltx.,Vt)v /utility -ot) rations- division 9721462 -5155 CITY OF COPPELL ENGINEERING DEPT. 9721 304 -3679 HOMEOWNER ASSOCIATIONS 9721304 -3678 (Planning Department) TIME WARNER CABLE 214/ 320 -5455 (Mike Rasmussen) AT &T LOCAL NETWORK 214/ 215 -3031 (Rich Millenman) COSERV Gas & Electric 94011321 -7800 x 7624 (Greg Ward) EXPLORER PIPELINE 918/ 493 -5100. (Patrick Nwakoby) ONCOR Electric Delivery 972/ 323 -8917 (Larry Redick) VERIZON CONII'IrIUNICATIONS 9721 318-5277 FEDERAL EMERGENCY MGMT. ADM1N. 9401 898 -5138 TEXAS COMM. on ENVIRONMENTAL QUALITY 817/ 588 -5800 DENTON CO. LEVEE DISTRICT 214/ 352 -5118 (Richard Hightower) Atmos Energy 972/360 -4428 (Gary Dickinson) 1 800 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 clears, 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 H i • C F T T - O F COFFELL JI g 5 1 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 """ Communications Project Location l Applicant's Work Order # cif appHcablej TWT867 1233 Lakeshore Dr., Coppell, TX Sub- contractor Company Name Texstar Enterprises 24 hr.Contact Number Eric McColl 972 - 672 -2229 Date of 'Verification Appointment Time of Verification Appointment INFORMATION BELOW TO BE COMPLETED BY CITY OF COPPELL PUBLIC WORKS PERSONNEL 4-Inspected by of Utilities Maintenance Division on and found to be acceptable 1 not acceptable because Follow -up needed? (- Yes t" No 4-Inspected by Follow -up scheduled for of Streets Maintenance Division on and found to be acceptable I not acceptable because Follow -up needed? C- Yes (- 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 E -mail Print Form