Asbury Manor-PT 971204Bore/Excavation in Pu2Dlic Right-Of-Way Permit
Cit-; of Coppe!i - Public Works Departmen~
Date: /Z / 4 / ~7 Project Name:
Permit Issued To:
Address:
~aergency Phone:
%~q~e of Work/General Description:
7-o
Location of Work:
Irave ~!1 City and/or Franchise Utilities Been Contacted and
Existinq Utilities Located: YES ~/
Will It Be Necessary to Excavate Street, Alley or Sidewalk
Pavement? YES (attach permit) ~/ 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 Manual on Uniform Traffic
Control Devices. Area(s) affected must be restored to as good
condition as before the commencement of work.
A~y 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
PERxq!T
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contra~t6r R.e~?r~n~ative
Date
Franchise Inspector/or City Inspector
Approvec/City Repres
Applicant shall indemnify and forever hold harm. less against each
and eve~; claim, demand or cause of action that may ke made or come
against it by reason of or if any way arising out of the closure,
bleckinq, excavating, cutting, tunneling, or other work by the
applicant under pe-~rmit from the City, if such pe-~rmit is granted.
P E R~MI T. Plli3
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 WET BORES ALLOWED!