Lovett Coppell BP-PT240712We will construct and maintain the line on the highway right of way as shown on the attached drawing and in accordance
with the rules, regulations and policies of the Texas Department of Transportation (TxDOT), and all governing laws,
including, but not limited to, the “Texas Engineering Practice Act,” “Federal Clean Water Act,” the “National Endangered
Species Act,” “Americans with Disabilities Act,” and the “Federal Historic Preservation Act.” Upon request by TxDOT at any
time, we will submit to TxDOT proof of compliance with all governing laws, rules and regulations before commencement of
construction. Plans shall include the design, proposed location, vertical elevations, and horizontal alignments of the facility
based on the department's survey datum, the relationship to existing highway facilities and the right of way line, traffic
safety and access procedures, and location of existing utilities that may be affected by the proposed utility facility. The
location and description of the proposed line and appurtenances is more fully shown by a complete set of drawings
attached to this Utility Installation Request (Request). We will give plans to TxDOT for each future proposed modification or
expansion to our facility and TxDOT will have 30 days to review and approve the plans prior to commencement of the work.
A new Request may be required as a condition of approval.
When installing, modifying or maintaining our utility on controlled access facilities, we shall conform to the Texas
Transportation Code, Title 6 Roadways, Chapter 203, Subchapter C, Control of Access, §203.031 (http://www.statutes.
legis.state.tx.us/). We shall limit access for servicing this installation to access via (a) frontage roads where provided, (b)
nearby or adjacent public roads or streets, (c) trails along or near the highway right of way lines, connecting only to an
intersecting road; from any one or all of which entry may be made to the outer portion of the highway right of way for normal
service and maintenance operations. Our rights of access to the through traffic roadways and ramps shall be subject to the
same rules and regulations that apply to the general public.
It is expressly understood that TxDOT does not purport hereby to grant any right, claim, title or easement in or upon
highway right of way. TxDOT may require us to relocate this line, subject to the provisions of governing laws, by giving us at
least 30 days written notice. We understand a new Request will be required for the relocation. We will notify TxDOT prior to
commencement of any operation which requires pruning of trees so that TxDOT may provide specifications to govern
performance of work, including trimming, topping, tree balance, type of cuts, painting cuts and clean up. We understand
that these specifications are intended to preserve TxDOT's considerable investment in highway beautification plantings and
by reducing damage due to trimming and to protect known endangered species.
c/o District Engineer Texas Department of Transportation
To the Texas Transportation Commission
County Texas, MNT Sec. No.
line within the right of way of
proposes to place a
Formal notice is hereby given that
Date
as follows: (give location, length, general design, etc.
inDispl., RM
, Texas
Utility Installation Request
Our organization will use Best Management Practices to minimize erosion and sedimentation resulting from the proposed
installation, and we will revegetate the project area as indicated under “Revegetation Special Provisions.” We will also
ensure that traffic control measures complying with applicable portions of the Texas Manual of Uniform Traffic Control
Devices will be installed and maintained for the duration of this installation.
Our installation shall not damage any part of the roadway structure or associated appurtenances. We will make adequate
provisions to cause minimum inconveniences to the traveling public and adjacent property owners. We will not open-cut
driveways or intersecting roadways without specific written permission from the owner.
Month/Day/Year
Following approval, we will begin construction on or after
Form 1082
(Rev. 12/09)
Page 1 of 2
07/12/24
Denton
Lovett Industrial_
12" Water
SH-121 N/A
Dallas County
Bore and extend waterline from South of 121 to north of 121 as a public waterline for City of Coppell.
See attached sheet for design..
10/01/24
PERMIT NUMBER
, Displ.N/A , to RM
N/A
END
BEGIN
LATITUDE (DD)LONGITUDE (DD)
GLOBAL POSITIONING SYSTEM COORDINATES (GPS)
NORTH AMERICAN DATUM 1983, (1993 ADJUSTMENT)
IN DECIMAL DEGREES(DD)
Use additional sheet as needed)
Docusign Envelope ID: BB8ED299-2B8A-470E-AF9D-F35035489F46
If approved, we understand we will assume all risks associated with this installation within the TxDOT right of way. These
risks include injuries to our workers, damage to contiguous utility lines that may be in the area and injuries or damage
resulting from our failure to properly install and maintain the line.
If the character, use or function of our installation is materially changed from that approved under this Request, we will
notify TxDOT within 30 days after the change. In the event of a voluntary or involuntary loss of public utility status, or other
legal authority for longitudinal placement of the utility facility in the highway, or there is an abandonment of the facility
without the approval of TxDOT, we will at our expense remove the unauthorized portion of the facility from the right of way.
If installation of the line is not begun prior to the 91st calendar day from date of issuance, we acknowledge that, unless
otherwise extended, TxDOT's approval of this Request will automatically expire, and we will be required to resubmit our
Request. All Request submissions, whether due to expiration of approval under this paragraph or new Requests for
modifications and relocations shall be in accordance with the governing laws, rules, regulations and policies existing at the
time of submission. In the event we fail to comply with any or all of the requirements as set forth in this Request, the State
may take such action as it deems appropriate to compel our compliance.
By signing as/for the requestor below, I certify that I am authorized to represent the requestor, that I agree to the provisions
and requirements included in this Utility Installation Request, and our commencement of construction will further attest to
our review and acceptance of said additional provisions and requirements.
Additional Provisions and Requirements (for TxDOT input only)
General Special Provisions:
As-built Plans/Certifications of Construction:
Re-vegetation Special Provisions: In order to minimize erosion and sedimentation resulting from the proposed
installation, the project area will be re-vegetated:
as indicated on the attachment.
to be used, or:
in accordance with TxDOT's Standard Specification Item 164 which specifies the appropriate grass seed mix
TxDOT Representative to be notified 48 hours prior to beginning construction:
Are required and shall be certified as accurate by an authorized representative of the company.
Are required and shall be signed and sealed by a State of Texas Licensed Professional Engineer.
Certification that utility was installed as approved
Are not required
Area Code Telephone Number
City State Zip Code
Address:
Title:
Signature:
By:
Date:
APPROVED BY TxDOTREQUESTOR
Are attached.
Are not attached.
Dan Gallagher
P.E.
2600 N Central Expy
Richardson Tx 75080
214 6170535
07/12/24
()
Area Code Telephone Number
City State Zip Code
Address:
Title:
Signature:
By:
Date:
Leonard Chapman
Utility Coordinator
2624 W Praiere St
Denton tx 76201
940 230-5350
07/12/24
()
Form 1082 (Rev. 03/09)
Page 2 of 2
Gary Matthews 214-392-2106
We understand TxDOT may place additional provisions and requirements as listed below, based upon, but not limited to,
the type of utility being installed, local site conditions, soil types and traffic.
Docusign Envelope ID: BB8ED299-2B8A-470E-AF9D-F35035489F46
EOHEOHEOHEOHEOHE
OHEC ::::::::::::6666666
66668*E8*E8*E8*E8*E8*E8*E8*E8*E8*E8*E8*E8*E8*E8*E8*E8*E8*E:::::*
*
*
*
*
**$6*$6*$6*$6*$6E
35O3O6E'/)O)
67EE/C$6,1*%<%O5E
3E5C,7<O)CO33E//
'E7$,/
67$ 38%/,C:$7E5/,1E
,167$//
5O//E'%E1'
67$ 38%/,C:$7E5/,1E
,167$//
CO11EC77OE;:$7E5
*$7E9$/9E
C87,17EE
CO175$C7O57O9E5,)<
7,E,1/OC$7,O1
CO175$C7O57O9E5,)<
E;,67,1*)/
E;),5EH<'5$17
$66E0%/<7O5E0$,1 67$7EH,*H:$<%<3$66 9$5,$%/E:,'7H5,*H7O):$< 67$7EH,*H:$< 9$5,$%/E:,'7H5,*H7O):$< E;81'E5*5O81'E/EC75,C$//,1E
CO175$C7O57O9E5,)<
E;O9E5HE$'E/EC75,C$//,1E
E;:$7E5/,1E
E;:$7E5/,1E
E;81'E5*5O81'*$6
E;E/EC75,C$/3O/E
E;67O505C3
E;6$1,7$5<6E:E5/,1E
E;E/EC75,C$/9$8/7
35O367O505C3
E;
[
5C%
/)O)39C#
E;5C3
E;CO0081,C$7,O16
9$8/7
7['O75O:
7['O75O:
E1'%O5E
67$
67$ 38%/,C:$7E5/,1E
,167$//
9E57,C$/%E1'
/)O)39C#
/)O)39C#
E;,67,1*),%E5O37,CC5O66,1*
E;,67,1*),%E5O37,CC5O66,1*
67$ 38%/,C:$7E5/,1E
,167$//
HO5,=O17$/%E1'
/)O)39C#
%E*,1%O5E
67$
67$ 38%/,C:$7E5/,1E
,167$//
9E57,C$/%E1'
:$7E56HC5O66,1*
7O
HO5,=O17$/6C$/E
9E57,C$/6C$/E
7['O75O:
7['O75O:'E37H
'E37H
'E37H
CO17,18$7,O1
3E5O16,7E3/$16
35O3O6E'/)O)
67EE/C$6,1*%<%O5E3E5
C,7<O)CO33E//'E7$,/
/)O)39C#
/)O)39C# 67$ 38%/,C:$7E5/,1E,167$// CO11EC77OE;:$7E5*$7E9$/9EC87,17EECO175$C7O57O9E5,)<7,E,1/OC$7,O1CO175$C7O57O9E5,)<E;,67,1*)/67$ 38%/,C:$7E5/,1E,167$// 5O//E'%E1')/ )/ 67$ 38%/,C:$7E5/,1E,167$// 9E57,C$/%E1''E37H
E;39C
6E:E5C5O66,1*
7O3
CO175$C7O57O9E5,)<
CO175$C7O57O9E5,)<
%E*,1%O5E67$
E1'%O5E67$
E;,67,1**5$'E 35O3O6E'*5$'EC/$66,95C3C5O66,1*
7O3
,19
%O7
E/EC75,C$/C5O66,1*
7O3
,19
%O7
),%E5O37,CC5O66,1*
7O3
,19
%O7
5C3C5O66,1*
7O3
,19
%O7 )/ )/ )/ )/ )/ CO175$C7O57O9E5,)<
CO175$C7O57O9E5,)<
),%E5O37,CC5O66,1*
7O3
,19
%O7
CO175$C7O57O9E5,)<)/ )/ 67$ 38%/,C:$7E5/,1E,167$// 9E57,C$/%E1'/)O)39C#
/)O)39C#
E;,67,1**5$'E
E/EC75,C$/C5O66,1*
7O3
,19
%O7
CO175$C7O57O9E5,)<
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
*5$3H,C6C$/E,1)EE7
6H:$7E53/$1$1'35O),/EC
/E*E1'
35O3E57</,1E
35O3O6E':$7E5
E;,67,1*:$7E5
35O3O6E'6$1,7$5<6E:E5
E;,67,1*6$1,7$5<6E:E5
35O3O6E'67O506E:E5
E;,67,1*67O506E:E5
E;,67,1*81'E5*5O81'E/EC75,C/,1E
E;,67,1*1$785$/*$6/,1E
35O3O6E'),5EH<'5$17
E;,67,1*),5EH<'5$17
E;,67,1*67O506E:E50$1HO/E
35O3O6E'6$1,7$5<6E:E50$1HO/E
E;,67,1*6$1,7$5<6E:E50$1HO/E
::
66 66
66 66
::
8E 8E
*$6 *$6
6
6
'
1O7E6
$//CO16758C7,O16H$//%E,1$CCO5'$1CE:,7H7HE6E3/$16C,7<
O)CO33E//67$1'$5'63EC,),C$7,O16$1'CO00O1/<$CCE37E'
CO16758C7,O167$1'$5'6
'E37HO):$7E50$,166,=E'$1'81'E56H$//%E$0,1,080O)
81'E5,035O9E'685)$CE6$1'
81'E581,035O9E'
685)$CE6
$//:$7E5E0%E'0E176H$//)O//O:7HEC,7<O)CO33E//
67$1'$5'6
7HECO175$C7O56H$//),E/'9E5,)<7HEHO5,=O17$/$1'9E57,C$/
/OC$7,O16O)$//E;,67,1*87,/,7,E635,O57O67$57O)
CO16758C7,O1$1'6H$//1O7,)<7HECO16758C7,O10$1$*E5$1'
E1*,1EE5O)$1<CO1)/,C76',6CO9E5E'CO175$C7O5,6
5E63O16,%/E)O535O7EC7,1*E;,67,1*87,/,7,E6 6HO:1O51O7
6HO:1 :,7H,16CO3EO)CO16758C7,O1,)$1<E;,67,1*87,/,7,E6
$5E'$0$*E'7HECO175$C7O56H$//5E3/$CE7HE0$7H,6O:1
E;3E16E
7HECO175$C7O56H$//9E5,)<$1'COO5',1$7E$//',0E16,O16
6HO:1,1C/8',1*7HEHO5,=O17$/$1'9E57,C$//OC$7,O1O)$//
87,/,7,E6C5O66,1*6
$//:$7E5/,1E),77,1*66H$//%E0ECH$1,C$/-O,17
/OC$7,O1O)),5EH<'5$1766H$//CO03/<:,7H7HEC,7<O)
CO33E//67$1'$5''E7$,/
)O5$'-8670E17O)C,7<O)CO33E//:$7E587,/,7,E6
$33857E1$1CE6O57O9E5,)</OC$7,O16O)E;,67,1*:$7E5$1'
:$67E:$7E50$,16,1$5E$C$//7HEC,7<O)CO33E//$7/E$67
7H5EE:O5.,1*'$<635,O57OCO16758C7,O1
),5EH<'5$176,1/$1'6C$3E'$5E$67O%E3/$CE'O1CO1C5E7E
3$'3E5C,7<O)CO33E//67$1'$5''E7$,/
:$7E50E7E566H$//%E/OC$7E',11O13$9E'$5E$6
Know what's below.
Call before you dig.
Know what's below.
Call before you dig.
:$51,1* E;,67,1*87,/,7,E66HO:1$5E%$6E'
O1$9$,/$%/E5ECO5''5$:,1*6$1'$%O9E
*5O81'),E/'6859E<'$7$7HE5E)O5E7HE5E
0$<%E87,/,7,E635E6E177H$7$5E1O76HO:1
O17HE6E3/$16CO175$C7O57O),E/'9E5,)<
35E6E1CE$1'E;$C7/OC$7,O1O)$//87,/,7,E6
35,O57OCO16758C7,O1$1'86EC$87,O1
'85,1*CO16758C7,O11O7,)<E1*,1EE5$1'
O:1E5O)$1<',6C5E3$1C,E61O57HDocusign Envelope ID: BB8ED299-2B8A-470E-AF9D-F35035489F46