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Spectrum-PT181029RIGHT-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: Applicant’s Job # / Work Order # 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? Utility Company Represented: Oncor Electric Delivery Atmos Energy Verizon SBC/ AT&T Time Warner Cable CoServ Electric/Gas Other Estimated Start Date Estimated Completion Date* * Completion requires submittal of Completion Verification Notice (see page 4) ¾Was contact made with City and/or utility companies to locate existing utilities? if NO, Reason: Yes No ¾Is removal of existing streets, alleys, or sidewalks necessary? Yes No if YES, project must have City inspection prior to concrete replacement CC: Applicant Public Works Permit File Orig. to Project File Page 1 of 4 Rev. 06/2012 A copy of the approved permit must be on the job site at all times. Yes No General Description of Work (In accordance with Ord. No. 2001-944): PLEASE ATTACH PLAN OF PROPOSED WORK Plans provided and approved (Erosion Control/Safety fences must be installed prior to beginning work) General Contractor Project Name/Location or address Contact # E-mail address to return permit E-mail address: Telephone #: Representative: Franchise Company: (for contact if needed/if e-mail of approved permit is desired/permit cannot be e-mailed unless complete) 10/25/18 Charter Spectrum 10/29/18 11/15/18 Underground bore 295'. CVS PHARMACY,1000 E. SANDY LAKES RD, COPPELL, TX GW Communication Solutions Brian Bratton brian.bratton@glassandwire.com william.vazquez@charter.com 214-820-5408 Bill Vazquez 29 October 2018 UTILITY RELOCATION CHECKLIST FOR WORK WITHIN CITY OF COPPELL RIGHTS-OF-WAY OR 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 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. 7.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. 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.Line locates must be performed in advance by contacting - 1 800 DIG TESS and/or the following: CITY OF COPPELL UTILITIES DIVISION coppelltx.gov/utility-operations-division 972/ 462-5155 CITY OF COPPELL ENGINEERING DEPT. 972/ 304-3679 HOMEOWNER ASSOCIATIONS 972/ 304-3678 (Planning Department) TIME WARNER CABLE FEDERAL EMERGENCY MGMT. ADMIN. 214/ 320-5455 (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 (Greg Ward)214/ 352-5118 (Richard Hightower) EXPLORER PIPELINE Atmos Energy 918/ 493-5100 (Patrick Nwakoby)972/360-4428 (Gary Dickinson) ONCOR Electric Delivery 972/ 323-8917 (Larry Redick) VERIZON COMMUNICATIONS 1 800 DIG TESS for line locates 972/ 318-5277 (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) Page 3 of 4 Page 4 of 4 UTILITY RELOCATION IN RIGHT-OF-WAY OR EASEMENT COMPLETION VERIFICATION NOTICE 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 / 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 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 Follow-up needed? Follow-up scheduled for Yes No and found to be acceptable / not acceptable because of Streets Maintenance Division on ™Inspected by and found to be acceptable / not acceptable because of Utilities Maintenance Division on ™Inspected by Follow-up needed? Follow-up scheduled for Yes No Submit by E-mail Print Form 3URMHFW1DPH1$7/B60%&963+$50$&< $GGUHVV(6$1'</$.(5'17/&233(//7;0DS1XPEHU35,60,''HOLYHU\0HWKRG6SHFLDOW\3URGXFWV'DWHRI6XUYH\6XUYH\HGE\-$0,(/(217,(32,17%8,/'1(:81'(5*5281'6(7 63/,&((48,30(17$66+2:1&+$1*()$&(3/$7(