Devonshire 2-PT 921005o qq
Bore/Excavation in Public Right-Of-Way Permit
City of Coppell - Public Works Department
Date:
Permit Issued To: Name:
Address:
Have All City and/or Franchise Utilities Been Contacted and
Existing Utilities Located.~i~./~yEs NO
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.
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 2
PERMIT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contractor Representative
Date
Franchise Inspector/or City Inspector
A~r~/C~i~t~ Representative
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
? -~-A-~V
/[~ Inside C/L [] R/W
[] Outside C/L
LOCATION ~t~to PPg'/_g.
TOWN PLANT
SCNOOL DIST,
(if other than location)
(Dallas & Tarrant Counties)
LONE STAR GAS COMPANY
{ Proposed } Project
Sketch of Completed
Co. No.: /,,~.'~
ER/RR NO. eS-
MAP SHEET NO.(s)
SUMMARY OF PIPELINE CHANGES IN
DISTRIBUTION PLANTS
ABANDONED RETURNED TO
WAREHOUSE NEW INSTALLATION
Size Kind Feet Size Kind Feet Size Kind Feet
Original ER No. or Date of Installation for replacement and
retirement projects only:
Date of this report
By