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Spectrum-PT190717 Submit permit application to the Engineering Dept., Town Center, 255 Parkway Blvd. or e-mail to engineer@coppelltx.gov (see button below) 3F7A8+G4?;FF3> BB>;53@FME"A4/AD='D67D (*%!, 4(-&7,*94$9.1.9>425&3.*8<.9-&5574;*)7&3(-.8*!%$8*,7**2*39 *787DFAF:7;FKA8ABB7>>'D6;@3@57&A 7DF;8;53F76,7>75A?(DAH;67D -F;>;FKA?B3@K*7BD7E7@F76 '@5AD>75FD;57>;H7DK F?AE@7D9K .7D;LA@ +,, ,;?7/3D@7D34>7 A+7DH>75FD;53E 'F:7D EF;?3F76+F3DF3F7 EF;?3F76A?B>7F;A@3F7 A?B>7F;A@D7CG;D7EEG4?;FF3>A8A?B>7F;A@.7D;8;53F;A@&AF;57E77B397 /3E5A@F35F?367I;F:;FK3@6ADGF;>;FK5A?B3@;7EFA>A53F77J;EF;@9GF;>;F;7E .+!*&843',:&A !ED7?AH3>A87J;EF;@9EFD77FE 3>>7KE ADE;67I3>=E@757EE3DK',:&A if YES, project must have City inspection prior to concrete replacement BB>;53@F (G4>;5/AD=E (7D?;F;>7 'D;9FA(DA<75F;>7 (397A8 "#)"&##$"(#$ & '%&"!&"%&&& % ',:6 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) 7/16/19 1389882 7/18/19 9/5/19 REPLACE UNDERGROUN SPAN 241 N MCARTHUR BLVD ARCHEY WAY COMMUNICATION GREG CHAPMAN ROW.LOC@AWC -UNDERGROUND.COM BRENT.BASCOM@CHARTER.COM 817-298-3605 BRENT BASCOM *;9:F A8 /3K-E7(7D?;FBB>;53F;A@ (397A8 !*57*8*39&9.;*84+9-*4397&(9472:89&)-*7*94&11(43897:(9.4389&3)&7)8&5574;*)'>9-*.9>4+455*11<-.(- .3(1:)*8':9.83491.2.9*)94748.434397417).3&3(*(425&(9.437*6:.7*2*398)*38.9>9*8982&>'*7*6:.7*)&9 &551.(&398*=5*38*&3)'&77.(&).3,&((47).3,949-*#*=&8&3:&143$3.+472#7&++.(439741*;.(*8 D73E38875F76?GEF47D7EFAD76FA3E9AA65A@6;F;A@3E478AD7F:75A??7@57?7@FA8IAD=9D36;@9 6D3;@397 H797F3F;A@ 3@67DAE;A@5A@FDA>#48(-*):1* :'1.(%4708+.3&1.385*(9.43 &,* (&11 @K7J53H3F;A@D7CG;D;@95>AE;@9A83EFD77F3>>7K?GEF47D7BADF76BD;ADFA5>AE;@9FAF:78A>>AI;@9 (A>;577B3DF?7@F Fire Department @ 972-304-3512 +FD77F7B3DF?7@F @9;@77D;@97B3DF?7@F FF35:43DD;5367B>3@FD7@5:E387FKB>3@;83>3@7ADEFD77F5>AEGD7;ED7CG;D76 #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. ! $ ! "!! " !" !# !%"!!%! ! "" !# 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. #49.+>.9>385*(947&9 57.4794'*,.33.3,<470&3)57.4794 '&(0+.11+47(43(7*9*97*3(-).9(-&3)45*35.9.385*(9.438&(0+.112:892**9 &11(43897:(9.4389&3)&7)8&5574;*)'>9-*.9>4+455*11 644,5;: 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.) (;,"0.5(;<9,6-0;@!,79,:,5;(;0=, (;,"0.5(;<9,6-65;9(*;69!,79,:,5;(;0=, (;,"0.5(;<9,6-$;030;@647(5@!,79,:,5;(;0=,6- $;030;@ 647(5@ the approved permit 7/16/19 17 July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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 4114<:53**)*) 4114<:58(-*):1*)+47',:6 &3)+4:3)94'*&((*59&'1*349&((*59&'1*'*(&:8* 4+"97**98&.39*3&3(*.;.8.4343 &3)+4:3)94'*&((*59&'1*349&((*59&'1*'*(&:8* 4+$9.1.9.*8&.39*3&3(*.;.8.4343 4114<:53**)*) 4114<:58(-*):1*)+47 ',: 6 SPECTRUM 1389882 ARCHEY WAY COMMUNICATION Submit by E-mail Print Form