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Westhaven 1-PT160215A copy of the approved permit must be on the job site at all times. CC: Applicant Public Works Permit File Orig. to Project File T M i - C I T Y - 0 R COPPELL r t „4j 0 x A ; I � Page 1 of 4 Rev. 061201-7 RIGHT -OF -WAY USE PERMIT APPLICATION Permit valid for 90 calendar days fi -oin 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: 02/15/2016 Applicant's Job i# / Work Order # 254491 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 C No C` © Plans provided and approved (Erosion ControlJSafety fences must be installed prior to beginning work) Project Name /Location or address Weathaven PH 1 General Contractor Gardner Telecom Contact# Kevin Mullaney E -mail address to return permit kevin@gardner100 . com Utility Company Represented: C' Oncor Electric Delivery C` Atmos Energy C Verizon C' SBC/ AT &T (e Time Warner Cable (' CoSery Electric /Gas C' Other General Description of Work fin accordance with Ord. No. 2001 -944): PLEASE ATTACH PLAN OF PROPOSED WORK Install Time Warner cable in city held easements and install pedestals inside of subdivision Estimated Start Date 42/18 /2016 Estimated Completion Date* 03/31/20161 * Completion requires submittal of Completion Verification Notice (see page 4) Was contact made with City and /or utility companies to locate existing utilities? if tVO, Reason: (*- Yes (` No :Is removal of existing, streets, alleys, or sidewalks necessary? i Yes 1: No if YES, project must have City inspection prior to concrete replacement RitLjht -of -Way Use Permit Annlication Pace 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 berore the commencement of %►ork (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 - 3043512 Street Department @ 972 -462 -5150 Engineering Department @ 972- 304 -3679 yAttaeh 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 3.30p.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- 482 -5155 to schedule 48 hours prior to beginning work. J 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 @coppelttx.aov. 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 02/15/2016 Signature of Utility Company Representative Date Kevin Mullaney Signature of Contractor Representative �'ceti-L.a�tm Signature of City Representative Comments 02/1.5/2016 Date 15 February 2016 Date r NOTE: Notify +Gifu Inspector at 972 - 304- 3679,121ior to beg' k and prior to back„fll for concrete, trench, ditch and Open pit inspections. Backfill must meet all construction standards approved by the City of Coppell. Applicant shall indemnify crud 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, blacking, excavating, cutting, tunneling, or other work by the applicant under permit from the City, if such permit is granted. r M a - c r T Y - a i- Page 3 of 4 COPPELL *P4�1 It 7S s ,, s . r $ 4 L?TILITY RELOCATION CHECKLIST FOR WORK 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. JNotify adjacent property owners (commercial & residential) of project timeline; provide them with contact names and phone numbers. ,,Proper erosion control measures must be taken. 4,Follow Texas MUTCD standards for work in traffic zones. ,,,Sod is to be replaced when necessary. ,¢,,Irrigation repairs must be performed in a timely manner. LFollow 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. ,.Densities may be required in trench lines (ASTM). ,,Care and repair of street signage is the responsibility of the contractor. .LLNo 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 U'T'ILITIES DIVISION coppelltx.govlutili - operations- division 9721462 -5155 CITY OF COPPELL ENGINEERING DEPT. 9721 304 -3679 HOMEOWNER ASSOCIATIONS 9721304 -3678 (Planning Department) TIME WARNER CABLE FEDERAL EMERGENCY MGMT. ADMIN. 2141320 -5455 (Mike Rasmussen) 9401 898 -5138 AT &T LOCAL NETWORK TEXAS COMM. on ENVIRONMENTAL QUALITY 2141215 -3031 (Rich Millenman) COSERV Gas & Electric 9401 321-7800 x 7624 (Greg Ward) EXPLORER PIPELINE 9181493 -5100 (Patrick Nwakoby) ONCOR Electric Delivery 9721323 -8917 (Larry Redick) VERIZZON COMMUNICATIONS 9721 318-5277 8171 588 -5800 DENTON CO. LEVEE DISTRICT 2141 352 -5118 (Richard Hightower) Atmos Energy 9721360 -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 M i - C l T Y- O R COPPELL x A a to UTILITY RELOCATION IN RIGHT -OF -WAY OR EASEMENT COMPLETION VERIFICATION NOTICE Page 4 of 4 Contact City of Coppell Public Works Division at 972 -4+62 -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 s -� y_,.° + Project Location 1 Applicant's '"work Order ## (if applicable), E .- sub- contractor Company Name r 24 hr.Contact Number-. Date of Verification Appointment :A 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 1 not acceptable because Follow -up needed? C' Yes r No Follow -up scheduled for +:•Inspected by i of Streets Maintenance Division on and found to be acceptable I not acceptable because Follow -up needed? C" Yes C" No Follow -rip 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: 972-304-3S70 Submit by E -mail Print Enrm