ST1501A- PT171023A copy of the approved permit must be on the job site at all times.
CC: Applicant T N; C I T V a K
Public Works COPPELL
Pagc 1 of a
Permit File j„ Rct 06 70/ '
Orig. to Project File < r
RIGHT -OF -WAV USE PERMIT APPLICATION
Pernnii rn!!(tfor 90 calendar dugs frons dare of approrrrl
Submit permit application to lheEnglnaering Dept., Town Center, 255 Parkway Blvd, or email to engineerScoppellix-govIsee button below)
Date of Submittal: Q8/02/2017 Applicant's Job # / Work Order R
PERMIT FEE: spp.of
(No chalfe to Utility Companies witli approved Franchise/ROW Use Agreemeul)
Refer to the City of Coppell Ordinance No. 2001-944. Certificated Telecom Provider? Yes f No
Q Plans provided and approved (Eros/on Control/Safety fences must be Installed prior to beginning work)
Project Name/Location or address Freeport: Parkway -Dividend to West Bethel Road
General Contractor Can -Fez Utility Services, LLC Contactit 972-484-4344
Email address to return permit christopherblake . harrelsonwoncor. nom
Representative: Oncor Electric Delivery, LLC
Cempanpattey: Telephone#: 214-486-2237
Company:
E•maH address: christopbarblaks . harreleommncor. com
(lorcontoct Nneeded/!l &mo►l of approved parmit tr deshed/prrmit cannot be a malled unless complete)
Utility Company Represented:
1e Oncor Electric Delivery
Thee Warner Cable r
Atmos Energy c Verizon t SBC/ AT&T
CoSery Electric/Gas i Ofber
General Description of Work (rngavaence with am, No.2aot-swr PLEASE ATTACH PLAN OF PROPOSED WORK
Rebeate exkdng Oncor fadllttes for the reconstruction oPFreeport Parkway starting at W. Bethel'd. to D
R hrtdend Or.
P/11/,?0p _?11(J ?61K
Estimated Start Da Estimated Completion DateO
* Completion requires submittal of Completion Verification Notice (see page 4)
Was contact made with City and/or utility companies to locate existing utilities?
{ j NO, Reason: ro Yes r No
FIs removal of existing streets, alleys, or sidewalks necessary? c Yes fe No
NYM project must have Cityinspection prior to concrete replacement
Ri� tor Wad Use permit Auulication Pape 2 of 4
Representative(s) of the Contractor nual 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 an Un(fo»u 7Ygffic Cartrol Devices.
AceAGd. af[ccted rrtM1 bt r . rsg 14 ift=a" dlllar_M Ilei lk eemmenUMt pj lyRrk (grading, drainage,
vegetation, and erosion control). To schedule Public Works jhtal inspection (Page 4) call 972-462-5155. 1
.Any excavation requiring closing of a stred/alley must be reported prior to closing to the following:
Police Department ® 972-3043600
Fire Department @ 972-304-3912
Street Department ® 972-462-5150
Engineering Department ® 971304-3679
.Attach barricade plan / trench safety plan J a lane or street closure is required.
NOTE: Street closures are allowed tram 9jp0 atm, 4 tlrn 13;30 Mm. Q= unless otherwise approved by Gty
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 872.467-5155 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 bye -mail should go to enalneeracoppe/ltx.gay.
Printing your name indicates your acceptance of the terms and conditions of this form:
(if want app ad permit returned via email, provide a valid r( It a res on page t.)
Signature of
g uNry Company Representative Date
ZQ,?
Signature 4tor Representative ll,t
Signature of City Representative Date
Comments
NOT& N9M MY Inspector at 979-304 3679 prior to begidnil, a work and prior to
backfill for concrete, trench, ditch and open pit inspections. Backfrll must meet
all construction standards approved by the City of Coppell.
Applicant shall indemnify and forever hold harntiess against the City of Coppell each and every claim, demand
or cause of action that nnay be made or come against it by reason of or if any way arising out of the closure,
blocking, excavating, cutting, funneling, or other ivork by the applicant under permit from the City, if such
permit is granted.
T N 9- a 1 T r o r Page 3 of 4
COPPELL
T
DTILIT1j RCI.OGAT1QjV CNECKLI4T FOR WORK WITHIN
CITY OF COPPELL RIGHTS -Q ;1?y1►,Y O>Ei
EASEMENTS
Listed below are minimum requirements for utility relocation projects:
1.A 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 he taken.
4,Follow Texas MUTCD standards for work in traffic zones
5_Sod is to be replaced when necessarv.
,¢-.Irrigation repairs must be performed in a timely manner.
7.Follow, OSHA recommended trench safety at all times.
9,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).
IO.Care and repair of street signage is the responsibility of the contractor.
L.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 - 1800 DIG TESS end/or the following;
CITY OFCOPPELLUTILITIES DIVISION
ePclli��;n, Iitllll�-OI1CCiI11U11S•d11I�Ipll
9721 462-5155
CITY OF COPPELL ENGINEERING DEPT.
972/ 304-3679
HOMEOWNER ASSOCIATIONS
972/ 304-3678 (Planning Department)
TIME WARNER CABLE FEDERAL EMERGENCY MGMT. ADMIN.
2141320-5455 (Mike Rasmussen) 940/ 898-5138
AT&T LOCAL NETWORK TEXAS COMM. on ENVIRONMENTAL QUALITY
214/ 215-3031 (Rich Millenman) 817/ 588-5800
COSERV Gas & Electric DENTON CO. LEVEE DISTRICT
940/ 321-7800 x 7624 (dreg Ward) 2141 352-5118 (Richard Hightower)
EXPLORER PIPELINE Atmos Enemy
918/ 493.5100 (Patrick Nwakoby) 972160.4428 (Gary Dickinson)
ONCOR Electric Delivery
972/ 323-8917 (Larry Redick)
VERIZON COMMUNICATIONS 1800 DIG TESS for line locales
972.' 318-5277 (344 -8377)
14.Coniaminants 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 r c I r r Q v Page 4 of 4
COPPELL
UTILITY RELOCATION IN RIGHT-OF-WAY OR EASEMENT
CO RLETWNYEMUCAIMNAMCE
Contact City of Coppell Public Works Division at 972462-5155 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 oncor Electric Delivery, LLC
Project Location / Applicant's Work Order # lir applicable)Freepert Pky
Brom W. Bethel Road to Dividend Drive.
Sub -contractor Company Name Can Fer Utility Services, LLC
24 hr.Contact Number 1 -Bee -313-47a7
Date of Verification Appointment
Time of Verification Appointment
INFORMATION BELOW TO BE COMPLETED BY CITY OF COPPELL PUBLIC WORKS PERSONNEL
4P Inspected by of Utilities Maintenance Division an
attd found to be acceptable / not acceptable because
Follow -tip needed? Yes No Follow-up scheduled for
I- Inspected by of Streets Maintenance Division on
and found to be acceptable / not acceptable because
Follow-up needed? ( Yes r No Follow -tip scheduled for
A copy of this Completed notice can be provided to the address beloK
or e-mailed by using the button below:
City of Coppell Engineering Dept.
255 Parkway Blvd., Coppell TX 75ol9
Office: 972-304-3679 Fax.. 972-304-3570
Submit by E -mall Pdnt Fomt