Hunterwood-PT020423"° ~ "~ ~ I A copy of th .pproved permit must be on the job sloe at alr 1 times.
coe~
F~~~ ...
T H E C 1 T Y O F
COPPELL
~T * o~
F x A g ' 8 9
~k~„~.~
05-Jc-O~AG:4~ RCVD
DRY BORE /STREET CUT /SAW CUT PERMIT
IN
RIGHT-OF-WAY /EASEMENT
Submit permit request to the Engineering Dept., Town Center, 255 Parkway Blvd.
Date: ~1 / 2 3/ ~ Z
PERMIT FEE: $1011.00
(No charge to Utility Companies with approved Franchise/ROW Use Agreement)
^ Plans provided and approved
(Erosion Control/safety fences must be installed prior to beginning work)
Project Name /Location: SO~ ~c.cr~ ~ S'I
. ~
General Contractor: ~K ~ ~c. s c~ ~ ~• S
~ hermit issued to Company /Retpresentative: a c..~ ` ~ i c~ ~ ^ S
Address: S~ ( 1-tc.~r ~ i S .s"~
Telephone A~: c(7 Z y<oZ OS7o Emergency Telephone /{: Sa ~-. L.
Utility Company Represented:
^ Oncor Energy Delivery Co. ^ TXU Gas ^ Verizon ^ SWBell
^ Paragon/AT&T Broadband ^ CoServe Comm ^ CoServe Elect. ^ Other
- 4t' "Other" is checked, please note that franchise or right-of-way use agreements will be required and need
Council approval prior to beginning work. Permit cannot be approved until that time.
General Description of Work (provide copy of approved plans):
G,.~ ~`. ~o ~ ~ Sc.~~; o ^ o ~ GN ,.1.. 0.~ c7 /^~' t~ Inc ~ (~~~,',-E~ ~ C,~~1~ ~~-4-
pntlkUGS O~ hV C. (~iGi~ ~C9r ~'~1`~.,nw3t biro ti. n "*~'t~~~ ~PQ.~
- Was contact made with City and/or utility companies to locate existing utilities?
if NO, Reason: YES ~' NO ^
- Is removal of existing streets, alleys, or sidewalks necessary? YES ^ NO
if YES, must have City inspection prior to concrete replacement
_. ~^+ ~
Dry Bore /Street Cnt /Saw Cut Permit PaIIe 2
Representative(s) of the Contractor must adhere to al! construction standards approved by the City of Copper whkh
includes but is not limited to: Erosion Control Ordinance, ;compaction requirtnunts (density tests may be required at
the applkants expense) and barricading according to the Texas Manual on Uniform ?Ya,,fJ7c Control Devkes. Area(s)
affected must be restored to as good condition as before the commencement of work (grading, drainage, vegetation,
and erosion control.
- Any excavation requiring closing of a streeUalley must be reported prior to closing to the following:
Police Department (a~ 972-3043600
Fire Department ad 972-3043500
Street Department ~ 972-3043546
Engineering Department ~ 972-3043679
- Attach barricade plan /trench safety plan if a lane or street closure is required.
NOTE: Street closures are allowed hom 9:00 ant untU 4:00 nm. ONLY unless otherwise approved by City
Engineer.
- Attach Work Order (franchise only).
- Contact must be made with City and utility companies to locale existing utUities 48 hours prior to beginning of
work.
Utility Company Representative
Representative
Printed Name
K < 2o.,`U 1 ~ ~
Printed Name
Date
S-S-oZ
Date
~OYD~ O~~r~oX ~~.re~ rv~er ~ ~Z
Signature of City Representative Printed Name Date
(Applkation with original signatures needs to be submitted to the Engineering Department before approval)
- Comments:
- NOTE: Notify City Inspector at 972-304-3679 prior to beginning work and prior to backfUl for concrete,
trench, ditch and open pit inspectiottG
(Backfill must meet all construction standards approved by the City ojCoppell)
ALL
Applkant shall indemn fy and forever hold harmless against the City of CoppeU each and every c/aim, demand or
cause ojaction that may be made or come against U by reason ojor ijany way arising out ojtke closure, blocking,
excavating, cutting, tunneling, or other work by the opp/leant under permit from flee City, ijsuch permit is granted
~2,'' - ~„ ~od~
~op tJ;c,.J
~~~
~-~`
1
a
,~
J
C-ri2L ~iC~...)
-a-
oa
p~~~,~`~~ ~:~~
_ _~
.~
s
i
T
n~'
z
.~",
4- i rpo+-
0
M
O~
O
N
O
0
~,
0