Chautauqua-PT 921020Bore/Excavation in Public Right-of-Way Permit
City of Coppell - Public Works Department
Date: ' ~ / ~-~ / qb Pro' .
Phone: t~o/4} ~.5-~ ~,~,...? ~7
Emergency Phone: . {~ ) ~/ ~ ~//
~ of Work/~neral ~Scription~ ~~ ~ ~ , .
Have ~l City and/or F~anch~.~til~ti.~ ~en Contact~ and
Existing Utilities ~catedl ~~ __ _ NO
Will It ~ N~essa~ to Exca~te Street, ~ley or ~alk
Parent? YES (attach pe~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 tot Compaction of Trenches and Bores,
and Barricading according t~,~ T?xas Nanual on Uniform Traffic
Control Devices. Area(s) zzec~ea 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, 462-1133 and 462-8495).
Attach Work Order (Franchise Only)
PAGE
PE~4IT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contractor Representative
Date
Franchise Inspector/or City Inspector
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,
blocking, excavating, cutting, tunneling, or other work by the
applicant under permit from the City, if such permit is granted.
PERMIT.PHB
FOnM 304-2 4/82
~ Inside C/L [] R/W
[] Outside C/L
LOCATION t~O
TOWN PLANT
~ (if other ~han location)
SCHOOL DIST.
LONE STAR GAS COMPANY
Proposed ) Project
Sketch of { Completed
Region:
SUMMARY OF PIPELINE CNANGES IN
DISTRIBUTION PLANTS
ABANDONED RETURNED TO
WARENOUSE NEW INSTALLATION
Size Kind Feet Size Kind Feet Size Kind Feet
Original ER No. or Date of Installation for replacement ant
retirement projects only:
Date of this report