Country Estates-PT 921118 Bore/Excavation ~n Public i~tght-Of-Way Permit
City of Coppell - Public Works Department /Y~~
Date, ~ / /~'/,9'~- Project Na~e~__~~
Address, ..~ / o ~9~.
Phone,
E~ergency Phone,
Inspector ,~0~ ~J. ~ Phone,
~ of Work/General Dascr~pt~on, ~
Have /%/1 City and/or~rancb/se UtiXitles Been Contacted and
Existing Utilities Located, YES NO
WIX! 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 Coppe11, which
includes but iS no~ 1halted tot Compaction of Trenches and Bores,
and Barricading according to the Texas Nanua! on Un~form 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, end Public Works Departments prior
to closing (462-1X44, 462-1133 and 462-8495).
Attach Work Order (Franchise Only)
PAGE 2
PERMIT
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
[~. Inside C/L [] R/W
[] Outside C/L
LOC^T ON C= PPE//
city or town
TOWN PLANT
(if other than location)
SCHOOL DIST.
(Dallas & Tar~ant Counties)
LONE STAR GAS COMPANY
Si(etch of { Proposed } Project
Completed
MAP SHEET NO.(si
Co. No.: /.2~ Region:/"/_~'_~)_~
ER/RR NO.
/I
4.
/3
SUMMARY OF PIPELINE CHANGES IN
DISTRIBUTION PLANTS
ABANDONED RETURNED TO
WAREHOUSE. NEW iNSTALLATION
Size Kind Feet Size Kind Feet Size Kind Feet
;2 P~l',l I ~l.,S'~
Original ER No. or Date of installation for replacement and
retirement projects only:
Date of this report *'~--/~- ~;~,~.