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Irby Addition-PT160113A copy of the approved permit must be on the job site at all times. CC: Applicant r x e- e r T v 0 rr Page 1 of 4 Public Works COPPELL Rev. 0612012 Permit File Y '_sue `�y / ��• T Orig. to Project File yx ^tea' 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: 1/5/2016 Applicant's Job # / Work Order # PERMIT FEE: $100.00 (No charge to Udlr'ty Companies with approved Franchise/ROW Use Agreement) Refer to the City of Coppell Ordinance No. 2001 -944. Certificated Telecom Provider? Yes C No (0- H Plans provided and approved (Erosion Control /Safety fences must be installed prior to beginning work) Project Name /Location or address 9 Oaks General Contractor Cross Utilties Contact# 817 -305 -3777 E -mail address to return permit Brandon. bal 19atmos energy, com Franchise Telephone #: 972 -360 -4428 Company. E -mail address: brandon . bal 1@atmo sene rgy. com ffor contact if needed /if e-mail of approved permit is desired /permit cannot be e- marled unless complete) Utility Company Represented: C Oncor Electric Delivery (* Atmos Energy C Verizon C' SBC/ AT &T C Time Warner Cable C CoSery Electric /Gas C Other General Description of Work tin accordance with Ord. No. 2001 -944): PLEASE ATTACH PLAN OF PROPOSED WORK Bore two 3/4 inch service lines under Oak Grove Ln. Estimated Start Date 1/11/16 Estimated Completion Date* 2/19/2016 * Completion requires submittal of Completion Verification Notice (see page 4) p Was contact made with City and /or utility companies to locate existing utilities? if NO, Reason: G Yes C No 9Is removal of existing streets, alleys, or sidewalks necessary? C Yes (@' No if YES, projectmust have Cityinspection prior to concrete replacement lti2ht -of Way Use Permit ADAlication Pap-e 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 972 -462 -5155. AAny 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 Q 972 - 462 -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 9:00 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. 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 @coppelitx.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.) Brandon Ball 1/5/21316 Signature of Utility Company Representative Tyrone Tasby Signature of Contractor Representative �'cettL Date 1/5/2016 Date 14 January 2016 Signature of City Representative Date Comments 91VOTE: Notify City Inspector at 972-304-3679 '9 prior to beginning work and prier to backfill for concrete, trench, ditch and open pit inspections. Backfill 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, canting, tunneling, or other work by the applicant under permit from the City, if such permit is granted. T w K c I T V, O F Page 3 of COPPELL UTILITY RELOCATION CHECKLIST FOR WORD WITHIN CITY OF COPPELL 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, 2.Notify adjacent property owners (commercial & residential) of project timeline; provide them with contact names and phone numbers. 3.Proper erosion control treasures must be taken. 4.Follow Texas MUTCD standards for work in traffic zones. 5.Sod is to be replaced when necessary. G.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. 13.1-ine locates must be performed in advance by contacting - .1800 DIG TESS and/or the following: CITY OF COPPELL UTILITIES DIVISION coppelltx. og vlutiliiy- operations- division 972/462 -5155 CITY OF COPPELL ENGINEERING DEPT. 972/304 -3579 HOMEOWNER. ASSOCIATIONS 972/ 304 -3678 (Planning Department) TIME WARNER CABLE 2141320 -5455 (Mike Rasmussen) AT &T LOCAL NETWORK 214/ 215 -3031 (Rich Millenman) COSERV Gas & Electric 9401321 -7800 x 7524 (Greg Ward) EXPLORER PIPELINE 918/ 493 -5100 (Patrick Nwakoby) ONCOR Electric Delivery 972/ 323 -8917 (Larry Redick) VERIZON COMMUNICATIONS 972/ 318 -5277 FEDERAL EMERGENCY MGMT. ADMIN. 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 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 H t, C I T Y - o F COPPELL y 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 Atmos Energy Project Location 1 Applicant's 'Work Order # (if applicable) Oak Grove Ln. Sub- contractor Company Name Cross Utilities 24 hr.Contact Number 817 - 305 -3777 Bate 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 C N© Follow -up scheduled for 4-Inspected by of Streets Maintenance Division on and found to be acceptable I not acceptable because Follmv -up needed? C' Yes C' No Follow -up scheduled for A copy of this completed notice can be provided to the address 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 Print Faun