Eagle Point-PT 930903Bore/Excavation in Public Right-Of-Way Permit
City of Coppell - Public Works Department
Date: ~ / ~ / ~ Project Na~ne:
Emergency Phone: _ ~,'~/Y')
~e of Work/General Description:
I[ave ~1 City and/or Franchls~i~ities Been Contacted and
Existing Utilities Located' ~~ YES NO
will It Be Necess~ to Excavate Street, ~ley or Sidewalk
Pav~ent? YES (at=ach 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 to: Compaction of Trenches and Bores,
and Barricading according to the Texas MAnual on Uniform Traffic
Control Devices. 7~rea(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 Depa._~-t..ments prior
to closing (462-1144, 462-1133 and 462-8495).
Attach Work Order (Franchise Only)
PAGE 2
PER2{IT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contractor Representative
Date
Franchise Inspector/or City Inspector
l~ity ~p~sen~a~ive
Date
Applicant shall indemnify and forever hold harmless against each
and every claim, demand or cause of action ~hat 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.
P ER2~IT. PIIB
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.
I1
~[~ Inside C/L [] RAN
[] Outside C/L
LOCATION ~,,3 PPF'/../_
TOWN PLANT
SCHOOL
LONE STAR GAS COMPANY,.'~
~ Proposed
Sketch of I Completed } Project
Co. No.: /c~.~' Region/I..~
ER/RR NO..,,
MAP SHEET NO.(s).
If'
J~ jz
SUMMARY OF PIPI :HANGES IN
DISTRIBUTION PLANTS
ABANDONED · RETURNED TO
WAREHOUSE NEW INSTALLATION
Size Kind Feet Size Kind Feet Size Kind Feet
,,, o?
Original ER No. or Date of Installation for repll~e~t Aha'
-- · retirement proJects only:;.
Date of this report.