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Townhouses-PT021112A copy of the approved permit must be on the job site at all times. T H E • C 1 T r • W v %O \ \\ \ 1 GHT -OF -WAY USE PERMIT APPLICATION S ubmit permit request to the Engineering Dept., Town Cen ter, 255 Parkway Blvd. Date of Submittal: 1 6 Z PERMIT FEE: $100.00 (No charge to Utility Companies with approved Franchise/ROW Use Agreement) License Agreement Approved (date) ! / Certified Telecom Provider? Y N [] Plans provided and approved (Erosion ControUsafe fences must be installed prior to beginning work) Project Name/ Location: w (0E C WJ General Contractor: ArAAer �L6COM1 710A��A41) r*K Fo(t AT�CT g2v1 © G Permit issued to Company / Representative: Address: GS S <�, a w n C° S t d 1 �l Telephone #: 9'� - 3Lk- 9q -� 3 Emergency Telephone #: 11H - 822 - ? -3 L-5 Utility Company Represented: Oncor Electric Delivery Co. ❑ TXU Gas ❑ Verizon ❑ SWBeH X AT &T Broadband ❑ CoServe Comm ❑ CoServe Elect. ❑ Other ➢ If "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): 1, }reefi'u� eit 60(C ( y)8 Pr R lace. .2' " Dee ➢ 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 - Right -of -Way Use Permit Application Page 2 Representative(s) of the Contractor must adhere to all construction standards approved by the City of Coppell, which includes but is not limited to: Erosion Control Ordinance, compaction requirements (density tests may be required at the applicants expense) and barricading according to the Texas Manual on Uniform Traffic Control Devices. 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 street/alley must be reported prior to closing to the following: Police Department @ 972 - 304 -3600 Fire Department @ 972 - 304 -3500 Street Department @ 972 - 304 -3546 Engineering Department @ 972 - 304 -3679 ➢ Attach barricade plan / trench safety plan if a lane or street closure is required. NOTE. Street closures are allowed from 9:00 a.m. until 3:00 p.m. ONLY unless otherwise approved by City Engineer. ➢ Attach Work Order (franchise only). ➢ Contact must be made with City and utility companies to locate existing utilities 48 hours prior to beginning of work. ?,n ature of Utility Company Representative Signature of Contractor Representative :3ACK.O ---P rinted Name c�dt�c- Printed Name 1 I Date Date Signature of City Representative Printed Name Date (Application with original signatures needs to be submitted to the Engineering Department before approval) ➢ Comments: ➢ NOTE. Notes City Inspector at 972 -304 -3679 prior to beginning work and prior to backfill for concrete, trench, ditch and open pit inspections. (Back/111 must meet all construction standards approved by the City of Coppell) Applicant shall indemnify and forever hold harmless against the City of Coppell each and every claim, demand or cause of action that may be made or come against it by reason of or if any way arising out of the closure, blocking, excavating, cutting, tunneling, or other work by the applicant under permit from the City, if such permit is granted *g 7 ryS, 15'x40' WATER 24' FIRE LANE ? ` i SEMENT EA LLJ _ -- -- -- - ° ---- i 1 v CLUBHOUSE a - - -- � 16' 1 �� - 3 10 I ' i I I 1� 1 23 1 I ! I I II II BLOCK B, ai ~� Wi WIi' —I - -- I 15 I I 26 1 c I I I I 1` 1' 27 � ? 39 35 37 I 36 35 34 : I 30 b NI II 33 32 ? I I 1 1 " 1 i si Q) 44'- 11.9" II 3 ! - SIGHT ESMT. - -- -�' % I ' -- - - i111- +----- - - - --- - '^ SIGHT ESMT. 16 ----------- -- ---- - - - - -- ? - - --- to' U71 T}� - - - - - -- -'r — T' pI _ _ - - _ — — — — — — — — — — — — i — — — eASEMEH - -- -- -- - - - to' UnL SEHi__ __ - --- — — — — — — -' — 1 RO A 24'0 I � � ! I f INDEPENDENCE SCH 40 ry . ; <, 20 - S - AN. SR 2" PVC 4' -11.9" SCH 40 I - -- -- -- ------ Ow — - -- - -- — - -- - - -- CAN - -- _ —I -- — __ _ _ ____110 UTIL E - ----- -- - - -- - - - -- - - -- - - - - -- -- 9 I � � t - T ` / 10' U11 EASEMEH I -- I -- - - -- ��qC I I L T I SIfHT ESMT. _ I I I I 43 i� 50 49 48 47 46 45 44 i '! 55 5c 53 52 5? I 1W 65 :.4 63 62 6? 6G 5'± i 58 5' S6 I I i - -- i l o w gc 66 --- - - - - -- I -- -- -- R EX. 20' SAN. SWR. ESMT.