Asbury Manor-PT 980910Bore/Excavation in Public Right-Of-Way Permit
City of C0ppe!l - Public Works Department
Date: ~ / I0 /~ Project Name:
Permit Issued To: Name: ~
~nergency Phone:
~e of Work/General Description: ~3f~Lt
Have ,~i City and/or F~anchi3e Utilities Been Contacted and
Emisting Utili:ies Loca:ed: YES
Will It Be Necessa_~y to Excavate Street, Alley or Sidewalk
Pavement? YES (attach porT, it) NO
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 Mnnual on Uniform Traffic
Control Devices. ~rea(s) affected must be restored to as good
condition as before the commencement of work.
kny excavation requiring closing of a street or alley must be
reported to the Police, Fire, and Public Works Departments prior
to closing (462-1144, 462-1133 and 462-8495).
Attach Work Order (Franchise Only)
PAGE 2
PERMIT
Attach Rarricading/~etour Plan if a lane or street closure is
applicable.
Franchise/Contractor Repres~
Date
Franchise Inspector/or City Inspector
Ao~r-~vec/Cit-z R~p~e~e~ativ~-
Date
Applicant shall indemnify and forever hold harmless against each
and eve~y claim, demand or cause of action that may be made or come
against it by reason of or if any way arising ou~ of the closure,
blocking, excavating, cutting, tunneling, or other work by the
applicant under permit from the City, if such permit is granted.
P E r~MI T. PHB
Ail contractors will contact Public Works @ 462-8495 to have
trenches and/or open cuts inspected prior to back fill operation
taking place. Staff will be sent to inspect the project.
* NO W~ET BORES ALLOWED!