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Frontier-PT190530A copy of the approved permit must be on the job site at all times. CC: Applicant _ dr M r, a i rt v a r Public Works COFFELL Permit File,`, 1 . Orig. to Project File x , a RIGHT-OF-WAY USE PERMIT APPLICATION Page 1014 Rev. 06/2012 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: may 3 o Applicant's Job # /Work Order # 5 2 3 8 64 8 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 i R Plans provided and approved (Erosion Control/Safety fences must be installed prior to beginning work) Project Name/Location or address Green Planet 21/Frontier Utility Extraction General Contractor Green Planet 21 E-mail address to return permit kpick@greenplanet2l, com Franchise Telephone #: 214-789-3607 Company: Representative: Stephen Higgins E-mail addresss stephen . a. higgins@str . com Contact# 1-513-491-8644 (for contact ifneeded/if a -mail of approved permit isdesired/permit cannot be e-mailed unless complete) Utility Company Represented: C` Oncor Electric Delivery C' (' Time Warner Cable Atmos Energy C' Verizon CoSery Electric/Gas C' Other C'' SBC/ AT&T Frontier Communications General Description of Work (in accordance with ord. n1o.2001-944): PLEASE ATTACH PLAN OF PROPOSED WORK Temporary lane closures starting from West Bethel School Rd, Southbound on Denton Tap, ending at Southwestern Blvd. Each right lane closure will be approximately 5-700 feet and length and will be 1-2 hours per closure as we are a rolling operation. Estimated Start Date May 3 o Estimated Completion Date* June 7 * Completion requires submittal of Completion Verification Notice (see page 4) ➢Was contact made with City and/or utility companies to locate existing utilities? if NO, Reaso�z: C: Yes C1 No ➢Is removal of existing streets, alleys, or sidewalks necessary? C' Yes l'e No if YES, project must have Cityinspection pr0 or to concrete replacement Representatives) 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 972462-5155. ➢Any excavation requiring closing of a street/alley must be reported prior to closing to the following: Police Department @ 972-304-3600 Fire Department @ 972-304-3512 Street Department @ 972462-5150 Engineering Department Q 972-304-3679 ➢Attach barricade plan /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@coppelltx.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 avalid e-mail address on Page 1.) Stephen Higgins May 30 Signature of Utility Company Representative Date Kalvin Pick Signature of Contractor Representative Signature of City Representative Unmments Date Date ➢NOTE: Nottfy City InspectoiN at 972-304-3679 pfzor to beginning work and prior 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, cutting, tunneling, or other work by the applicant under permit from the City, if such permit is granted. M Y F Page 3 of 4 OFFELL A b 5 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.Irri9ation 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/utiliiy.operationsmdivision 972/ 462-5155 CITY OF COPPELL ENGINEERING DEPT. 972/304-3679 HOMEOWNER ASSOCIATIONS 972/ 304-3678 (Planning Department) TIME WARNER CABLE 214/ 320-5455 (Mike Rasmussen) AT&T LOCAL NETWORK 214/ 215-3031 (Rich Millenman) COSERV Gas & Electric 940/ 321-7800 x 7624 (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. 940/ 898-5138 TEXAS COMM. on ENVIRONMENTAL QUALITY 817/ 588-5800 DENTON CO. LEVEE DISTRICT 214/ 352-5118 (Richard Hightower) Atmos Energy 972/3604428 (Gary Dickinson) 1 800 DIG TESS for litre locates (344 - 8377) 14.Contaminants must be removed from work area daily and disposed of properly out 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 li C I Y D !► OPPELL a 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 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 ❖Inspected by of Utilities Maintenance Division on and found to be acceptable /not acceptable becarese Follow-up needed? C' Yes C ❖Inspected by No Follow-up scheduled for of Streets Maintenance Division on and found to be acceptable /not acceptable because Follow-up needed? C' Yes (No Follow-up 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=3570 Submit by E-mail Print Form