Deforest Court-PT050118A copy of the approved permit must be on the job site at all times.
T H
CO?i-ELL
D~O~STREET CUT / SAW CUT PE~IT
~ / ~GHT OF WAY/EASEME~
Sub~t per~t requ~t to the En~nee~g Dept., To~ Center, 2~ Parkway Blvd.
·
PERMIT ~E: $100.00
(No c~rge to U~ Companies ~h approved Franchise/ROW Use AgreemenO
Plans pro~ded and approved
(Erosion Control/safe~ fences must ~ instMled~r to b~nn{ng ~ori)n
Per~t issued to Company / Represent~ve:~
Telephone& ~ ~/~- ~ Emergency Telephone &
Utility Company Represented:
[] TXU Electric [] TXU Gas [~5}~erizon [] SWBell [] Pa.ragon/AT&T Broadband
[] CoServe Corem [] 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. Pe~nit cannot be approved until that time.
Ge~ral Dess_~ption of Worv~ (provideT~opy ofapp~vedvlans):
Was contact made wi,'~City~nd/or utili,t.y companies/~o lo~te existing
if NO, Reason: / ~. ,/) .,/~d~3 ~-y,~'t~ ,]//,,(S,(/5
Is removal of existing streets, alleys, or sidewalks necessary?
if YES, must have City inspection prior to concrete replacement
utilities?YES~ ~" NO [~/
[] M
Right-of-Way Use Permit Application
Page 2 of
Representative(s) of the Contractor tnust adhere to all consrructt'ofi staridards approved by the City of CoppeR, whtc
includes but is not bruited to: Erosion Control Ordinance,. compaction requirements (density tests may be required
the apph'cants expente) and barricading according to the Texas Manual on Unifortn Traffic Control Device
Area(s) affected must be restored to as good condition as before the commencement of work (grading, drabtag
vegetation, and erosion control).
~ Any excavation requiring closing of a street/alley must be reported prior to closing to the follo~dng:.
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 ff a lane or street closure is required.
NOTE: Street closures are allowed from g:OO a. m. until 3:OO p. m. ONLY unless otherwise approved by Ci(
Engineer.
Attach Work Order (franchise only).
Contact must be'made with City and utility companies to locate ex(sting utilities 48 hour.
prior to beginning of work.
(Application with o~ginal signatures needs to be submitted to the Engineering Depanment before approval.)
S f,~arure of Uti!ky Com. pa.~y
S~atu~ orCo~c~c-ror
> Comm nU:0 t t
Printed Name
Printed Name
CL-h' h'-ffes
Date
'- NOTE
A'oti£v Cio/ Inspector at 972-304-3679 prior to beginning work and prior to
backfill for concrete, trench, ditch and open pit inspections. (Backfill must
meet all construction standards approved by the City of Coppell.)
,4/~ph'cant stzall ie~?em...t55, g~.d forever hold harmless against the City of Coppell each and eve~. claim, demand or cat,':;
of action that m~s'. be f,'~de or come agar'nsf t't by rea~on of or ~f any way arising out of the closure, block!t:L
e. rcava;tng, ctatir, g, r:emehng, or ori~er ~:'ork b)' t,he ap£h'cant under permit from the Ci(y, O~ such permit l's granted.