Asbury Manor-PT 971120Bore/Excavation in PuJDlic Right-Of-Way Pel-mit
CiUy of Coppe!l -
Date: // /20 / ~7
Permit Issued To: Name:
Address:
Phone:
Public Works DepartmenU
~ergency Phone
Ins~ctor: ~ Phone
of Work/General Description: _,~--'-/~.~'~"'~LL
IIave ,~!! City and/or Franchise Utilities Been Contacted and
Existing Utilities Located:
Will It Be Necessaz-y to Excavate
Pavement? YES (attach
YES / NO
Street, Alley or Sidewalk
permit)
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.
Any excavation requiring closing of a street or alley must be
reported to the Police, Fire, and Public Works Departments prior
to closing (462-1144, 46~-1133 and 462-8495).
Attach Work Order (Franchise Only)
PAGE 2
PERI<iT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Date
Franchise Inspector/or City Inspector
Apprevec/Ci~y ~epr se~a~ive
Date
Date '
Applicant shall indemnify and forever hold harmless against each
and eve~; claim, demand or cause of action that may be made or come
aqains~ it by reason of or if any way arising out of the closure,
blcckinq, excavatinq, cursing, ~unneling, 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 WET BORES ALLOWED!