ST0502B- PT151222A copy of the approved permit must be on the job site at all times.
CC: Applicant T K_- c i T Y Page 1 of 4
Public Works COFFELL Rev. 0612012
Permit File
AL
Orig. to Project File # ti
Ay
RIGHT -CF -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 engineerPcoppelltx.gov (see button below)
Date of Submittal: December 17, 2015 Applicant's Job # l Work Order # 3266189
PERMIT FEE: $100.00
(No charge to Utility Companies with approved FranchiselROW Use Agreement)
Refer to the Cite of Coppell Ordinance No. 2401 -944. Certificated Telecom Provider? Yes C No C*'
FXJ Plans provided and approved (Erosion ControllSafetyfences must be installedprior to beginning work)
Project Name /Location or address Freeport Pkwy. North -- Overhead to Underground Conversion
General Contractor Wi l lbros T &D Contact #
E -mail address to return permit richard. brewster@oncor. com
Representative: Richard Brewster
Franchise Telephone #: 214- 549 -6590
Company:
E -mail address: richard. brews ter@oricor.com
(for contact if neededrf e-mail of approved permit is desired/permit cannot be e- mailed unless complete)
Utility Company Represented:
(e Oncor Electric Delivery C Atmos Energy C VVeri2on C SBC/ AT &T
C Time Warner Cable C CoSery Electric /Gas C Other
General Description of Work (in accordance with Ord No. 2007-944): PLEASE ATTACH PLAN OF PROPOSED WORK
Remove 2 poles, 2 spans of overhead conductor, install l pad mounted transformer, and underground cable in conduit
supplied by the City's contractor.
Estimated Start Date Jan. 4, 2016 Estimated Completion Date* Jan. 29, z 016
* Completion requires submittal of Completion Verification Notice (see page 4)
A Was contact made with City andlor utility- companies to locate existing utilities?
if NO, Reason: will contact Digtess prior to starting C Yes (e No
),,Is removal of existing streets, alleys, or sidewalks necessary? C' Yes 6 no
if YES project must have City inspection prior to concrete replacement
Rieht- of -Wav 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
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 Worksfiinal 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 0 972 - 3043600
Fire Department @ 972 -304 -3512
Street Department @ 972462 -5150
Engineering Department @ 972 - 3043679
➢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. until 3:30 p.m. ONLY unless otherwise approved by City
Engineer.
r 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
Dept. for approval prior to beginning work. Submittals by e-mail should go to engineen&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.)
Richard Brewster December 17, 2015
Signature of Utilit }° Company Representative Date
Signature of Contractor Representative
5'ceit-L
Date
Signature of City Representative Date
Comments
22 December 2015
�,NOT'E: Notify City Inspector at 972 -304 -3679 pdor to beginning work and prior to
backfzll for concrete, trench, ditch and open pit inspections. Backfall 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.
I N K- c I T x- a Pr Page 3 of 4
COPPELL
UTILITY RELOCATION CHECKLIST FOR WORK WITHIN
CITY OF COPPEIJL RIGHTS -OF -WAY OR EASEMENTS
Listed below are minimum requirements for utility relocation projects:
LA copy of the valid approved City of Coppell permit is required on the project at all times.
!.Notify adjacent property owners (commercial cot 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.
!Follow OSHA recommended trench safety at all times.
8.Repair existing utilities that are damaged, including but not limited to clean -outs, water valves, and SS
manholes.
4.Densities may be required in trench lines (ASTM).
10.Care and repair of street signage is the responsibility of the contractor.
I I.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.govhi iiity- operations- division
9721462 -5155
CITY OF COPPELL ENGINEERING DEPT.
972/ 304 -3679
HOMEOWNER ASSOCIATIONS
9721 304 -3678 (Planning Department)
TIME WARNER CABLE FEDERAL EMERGENCY MGMT. ADMIN.
2141 320 -5455 (Mike Rasmussen)
AT&T LOCAL NETWORK
2141 215 -3031 (Rich Millenman)
COSERV Gas & Electric
9441321 -7800 x 7624 (Greg Ward)
EXPLORER PIPELINE
9181493 -5100 (Patrick Nwakoby)
ONCOR Electric Delivery
9721 323 -8917 (Larry Redick)
VERIZON COMMUNICATIONS
972/318-5277
9401 898 -5138
TEXAS COMM. on ENVIRONMENTAL QUALITY
8171588 -5840
DENTON CO. LEVEE DISTRICT
2141352 -5118 (Richard Hightower)
Atmos Energy
9721360 -4428 (Gary Dickinson)
1 800 DIG TESS for lane locates
(344- 8377)
14.Contaminants must be removed from work area daily and disposed of properly outside the City.
I5.Streets, sidewalks and alleys must be kept clean of construction material and debris.
1 6i. "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 11 d - C I T Y'
COPPELL
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UTILITY RELOCATION IN RIGHT -GF -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
Project Location 1 Applicant's Work Order # (if applicable)
Sub- contractor Company Name
24 hr. Contact Number
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 (-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 E -mail I I Print Form