Chautauqua-PT 921113Bore/Excavation in Public Right-Of-Way Permit
City of Coppell - Public Works Department
Permit Issued To: Name:
A~dress:
Phone:
Emergency Phone:
Representing: ~7~
Inspector: /l'3:k= ~=~;~
Type of Work/General Description:
Phone:
Location of Work: J-&..l D. ko a
~ave A~i City and/or Franchise Uti~ies Been Contacted and
Existinq Utilities Located:/ YES NO
Will It Be Necessary to Excavate Street, Alley or Sidew/~
Pavement? YES (attach permit)FNO
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
reported to the Police, Fire, and Public Works
to closing (462-1144, 462-1133 and 462-8495).
A~tach Work Order (Franchise 0nly)
or alley must be
Departments prior
PAGE 2
PERMIT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franc hi~e~nt r'ac tor Representative
Date
Franchise Inspector/or City Inspector
A~rov~d~i~y/k~pr~ enea ~ive
Date
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,
blockinq, excavating, cutting, tunneling, or other work by the
applicant under permit from the City, if such peri, it is granted.
PER~IT. PHB