Townhouses-PT020122copy 6f the approved permit must be on the job site at all times.
GO
DRY BORE / STREET CUT / SAW CUT PERMIT
IN
RIGHT-OF-WAY / EASEMENT
Submit permit request to the En~ineerin~ Dept.t Town Center? 2S$ Parkway, Blvd.
.ate:
PERMIT FEE: $100.00
(No charge ~o Utility Companies with approved Francltise/ROW Use AgreemenO
[] Plans provided and approved
(Erosion Control/$afeO~ fences mast be installed prior to beginning work)
Project Name / Location: ~cJ ~,_~ O~'
General Contractor:
Permit issued to Company / Representative: GA~t~ f~C.~,~r~mo/I,~"~'/~',x'~ -~.
Telephone #:~ Emergency Telephone #:
Utility Company Represented:
[] TXU Electric [] TXU Gas [] Verizon [] SWBell [~aragon/AT&T Broadband
[] CoServe Corem [] CoSern*e Elect. [] Other
~ ~f"~tker~~sc~ec~ed~p~easen~tethatfronc~e~rrigkt-~f.wayuseagr~em~ntsr;~berequiredandnesdC~uncil
approval prior to beginning work Permit cannot be approved until that flaw.
General Description of Work (provide copy of approved pinns):
Was contact made with City and/or utility companies to locate exJsting utilities?
if NO, Reason: YES ~
NO[]
~ Is removal of existing streets, alleys, or sidewalks necessary?
if YES, mast have City inspection prior to concrete replacement
[] o
., i
Dr~ Bore / Street Cut / Saw Cut Permit
~epresenttttive(s) of Ute Contractor must adAere to all construction standards approved by the City of Coppell, which
includes b~ is not limited to: Erosion Control Ordinance, cong~aetion requiremen~ (density tests may be required at
the appilesmt$ expense) and barricading according to the Texut Manual on Uniform Tragic Control Device~ Area(s)
a~eeted mutt be restored to as good condition as before the commencement of work (gr~m~g, drainage, vegetation,
and erosion centreO.
Any excavation requiring dosing ora street/alley must be reported prior to closing to the following:
Police Depaflmcat ~ 972-304-3600
Fire Department ~ 972..304-3500
Street Deportment ~ 972-~304-3S46
Engineering Depar~nent ~ 972-304-3679
Attach baFricade plan / trench safety plan if a lane or street closure b requiFed.
NOTE: Street closures are allowed £rom 9:00 :m. until 4:00 a.m. ONL ]r tmle~ othcrwbe approved by City
Engineer.
~ Attoch Work Order (franChise only).
Contact mast be made with City and utility companies to locate ex~ting utilities 48 hours prior to beginning of
werl~
~Representative
Signature of Contractor Representative
Si~natu~ of City Repr--~-aenmt!ve
· '~rinted Name
Date
Printed Name Date
Printed Name
(Application with original signatures needs to be submitted to the Engineering Department before approvaL)
~ NOTE: Notify City lutpector at '2-$04-$679 prior to beginning work and prior to &aekflll for concrete,
trench, ditch and open pit lnspectiona
(Backfill must meet all construction standards approved by the City of CappeH)
Applicant shall Indemnify and forever hold harmless against the City of Cappail each and every claim, demand or
caase of action that may be made or come agalutt it by reason of or if any way ar~ing out of the closure, blocking,
excavating, cutting, tunneling, or other worh by the applicant under permit from the City, if such permit i~ grantet~
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