Level 3-PT220801A copy of the approved permit must be on the job site at all times
Page 1 ofRIGHT-OF-WAY USE PERMIT APPLICATION Rev.08/2020
Permit Valid for Days From Date of Approval
All activity authorized by this permit shall be in accordance with
%∗#26∋4ΘΗςϑΓ6ΓΖΧΥ.ΘΕΧΝ)ΘΞΓΤΠΟΓΠς%ΘΦΓΧΠΦ the City of
Coppell Public Rights-of-Way Management ordinance No. 2001-944
Date of Submittal:__________________ Applicant’s Job # / Work Order #_____________________
Project Name / Location and Address:__________________________________________________
Permit Fee: $100.00 (No fee for applications submitted on behalf of Utility Companies with a current Public
Rights-of-Way Management Ordinance Registration).S.P.C.O.A. Certificate #____________________
Utility Company Information:
Oncor Electric Delivery Atmos Energy Frontier Spectrum
Level 3 Other:________________________________________________________
Utility Company Representative:____________________________________________________
E-mail Address:__________________________________Telephone:______________________
Contractor Information:
General Contractor:______________________________________________________________
General Contractor Representative:_________________________________________________
E-mail Address:__________________________________Telephone:______________________
Project Information:
General Description of Proposed Construction (Attach2ΝΧΠ2ΤΘΗΚΝΓ5ΓΓ2ΧΙΓΗΘΤ∋ΖΧΟΡΝΓ
Estimated Start Date:_______________ Estimated Completion Date:_________________
Has and/or utility companies been contacted 48 hours prior to locate existing utilities?
Yes No If No, state reason:_________________________________________________
Is removal of existing streets, alleys or sidewalks necessary? Yes No
If YES, repair must have a City inspection prior to completion. Call 972-304-3679.
Is closure of any traffic lanes or driveway approaches necessary? Yes No
If YES, a traffic control plan in accordance with TMUTCD standards must be submitted, and
the following departments must be notified of the location and duration of the closure:
Police Department, 972-304-3600 Fire Department, 972-304-3512
Street Department, 972-462-5150 Engineering Department, 972-304-3679
Traffic lane closures are allowed from 9:30 a.m until 3:30 p.m. ONLY unless otherwise
approved by the City Engineer.
Work activity is permitted from 7:00 a.m. until 7:00 p.m., Monday through Friday only
07/22/2022 22237
1111 NORTHPOINT DRIVE COPPELL,TEXAS
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08/01/2022Scott Latta
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Right of Way Use Permit Application Page 4 of
Contact Coppell Public Works1ΡΓΤΧςΚΘΠΥ at 972/462-5150 to schedule an inspection with
Utility and 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 or Address:_______________________________________________________
Sub-contractor Company Name:____________________________________________________
24 hr. Contact Number:____________________________________________________________
Date of Verification Appointment:_________________________ Time:____________________
-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 because:___________________________
Follow-up needed? No Yes, follow-up scheduled for:__________________________
Inspected by:__________________ of Streets Maintenance Division on _______________
and found to be acceptable, not acceptable because:___________________________
Follow-up needed? No Yes, follow-up scheduled for:__________________________
A copy of this completed notice can be e-mailed to ςϑΓ %ΘΡΡΓΝΝ2 ublic Works
1ΡΓΤΧςΚΘΠΥ&ΚΞΚΥΚΘΠ , or delivered to the address below:
City of Coppell Public Works Department1ΡΓΤΧςΚΘΠΥ&ΚΞΚΥΚΘΠ
816 S. Coppell Road
Coppell, TX 75019
COMPLETION VERIFICATION NOTICE
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