Gateway BP(1.4)-PT 960709The Cily With A 8eaulilul future
0 D
Project Name•
Permit Issued to
Address
Telephone
Representing
Inspector
l/ 96 -71
437. X60
Location of Work (location map required):
7 o
TPIephnne•
BORE STREET CUT/ SAW CUT
PERMIT
IN RIGHT -OF -WAY EASEMENT PRIVATE PROPERTY
Engineering Department
PERMIT FEE: $100.00
(No Charge to Franchise Utility)
Approved plans must be provided. Erosion Control is required.
A letter from the Property Owner /Engineer /Developer is required before permit will be issued.
Date
'S Dt sr -r r su-c o rC
f-((zL t (VSc
'z:
Fmrrgnry Telephone•
General Description of type of work (provide copy of approved plans):
'r r n1 Die/ (le AP0,2- o/t-cirii s To /47 4>' UtAl
Contact made with City and /or franchise utility to locate existing utilities?
(48 hours prior to excavation)
Is any excavation of pavement in street, alley or sidewalk necessary?
(If YES, attach Permit) YES
9'07. ,5Z:7. 75 1
NO
Revised 5/95
Bore /Street Cut /Saw Cu c Permit
Page 2
Representative(s) of the Franchise /Contractor must adhere to all construction standards
approved by the City of Coppell, which includes but is not limited to: Compaction of trenches
and bores, 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, erosion control).
Any excavation requiring closing of a street or alley must be reported to the Police (304- 3600),
Fire (304- 3500), Street (304 -3546) and Engineering Departments (304 -3679) prior to closing.
Attach Work Order (franchise only).
Attach barric
ise
1 borepmt frm
e plan trench safety plan if a lane or street closure is required.
Contractor Representative
ranc ise nspector or ty nsi•ctor
Approved ity Representative
7 9�
Date
ate
Date
Applicant shall indemnify and forever hold harmless against 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.
All franchise utilities must contact 304 -3545 or 304 -3546 for trench, ditch and open pit
inspections prior to backfill. Backfilling must meet all construction standards approved by the
City of Coppell.
I U
CASH
RECEIPT
Received From
Date r�
19__ 003i19
S OP (,v,
Address
For
I O lgrs, L Q11,
AMT; or-
ACCOUNT
AMT. PAID'
BALANCE
DUE
I cf.)
CASH
CHECK
MONEY
ORDER
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PAY
TO THE ORDER OF
City of Coppell
HILL WILKINSON, INC.
11969 PLANO RD., SUITE 190 DALLAS, TX 75243 -5486
(214) 437 -1600
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