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Parks Coppell ABQ-CS 930719 Bore/Excavation in Public Right-Of-Way Permit City of Coppe!l - Public Works Department Date: ~ / it! / ~ Project Name: ~ergency Phone: ~ ~ Representing: Inspector: ~; ~'~ ~,c.'-~-'~'~%.~ Phone: " ?3qpe of Work/General Description: Location of Work: /C~-;% ~'/' 'w~/~ ~ ~ - -u,v;9 c+' g~ %.=.-.& - . IIave ,111 City and/or Franchise Utilities Been Contacted and Existing Utilities Located: ~'¢~_~~ YES NO Will I~ Be Necossam-y to Excavate Street, A~ley or Sidewalk Pavement? YES (attach permit) '"'"" NO Representative(s) of the Franchise/Contractor must adhere to all construction standards approved by ~he City of Coppell, which includes but is not limited to: Compaction of Trenches and Bores, 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. ~ny excavation requiring closing of a street or alley must be reported to the Police, Fire, and Public Works Depa~-tments prior to closing (462-1144, 462-1133 and 462-8495). Attach Work Order (Franchise Only) PAGE 2 PER~.iT Attach Barricading/Detour Plan if a lane or street closure is applicable. Franchise/Contractor Representative Date Franchise Inspector/or City Inspector Date Applicant shall indemnify and forever hold has-Tm!ess against each and eve~; claLm, 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 permi~ from the City, if such pe---m, it is granted. PERMIT. PItB Ail contractors will contact Public Works @ 462-8495 to have trenches and/or open cuts inspected prior to back fill operation taking place. Staff will be sent to inspect the project. · ; ,v LONE STAR GAS COMPANY ·, ' {~ Inside C/L [] R/W . Proposed [] Outside C/L Sketch of { Completed ~ ~'rojec~ LOCATION (~ PPE'/J ~ , ~ ~. No.: I~.~ R~Ion:.~~ Tow..L~.~ "' ~ ~ ~ ~ ~.~.R .O. 03-~/~ / SCHOOL DIST. ~=~~. =~ ~ MAP SHEET NO.{s) [Dalla~ & Tarrant Counter) I_ -~~ _~ , ,,.,,,~ r ~--~ ~ _ ~ ~oa] ' s ~ SUMMARY ,OF PIPELINE CH ~S DISTRIBUTIONPLANTS IN pA~K ~ ~- ABANDONED RETURNED TO WAREHOUSE ; NEW INSTALLATION I Original ER No, or Date of I~stallation for replacement and Size Ki~ Feet Size Kind F~et. Size Kind Feet retirement projects only: ~ '/ ~Y ~ Date of this report