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Fountain Park 1-PT 940127Bore/Excavation in Public Right-Of-Way Permit City of Date: Permit Coppe!! - Public works Department / / ~ ~ / ~ Project Name(~ Issued To: Name: Address: Phone: ~mergenCy Phone: Representing: Have ~1 City and/or Franchise utilities Been Contacted ~nd Existing utilities Located: /~ YES NO Will It Be Necess~ to Excavate Street, ~ley or Sidewalk payment? 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 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 462-0495). Attach Work Order (Franchise 0nly) PAGE 2 PERMIT A~tach Barricading/Detour Plan if a lane or s=reet closure is applicable. Fr a~n--~hise/Contractor Representative Date / Inspector App!ican~ shall indemnify and forever hold harmless against each and eve-~.; 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 =he City, if such permit is granted. PERMIT · 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. * NO WET BO~S ALLOW~D~ · 1 304-2 4/82 LONE STAR GAS COMPANY ~ Inside C/L [] R/W [] Outside C/L LOCATION city or town TOWN PLANT (if other than location) SCHOOL DIST. $ Proposed } Project Sketch of ! Completed (Dallas & Torrent Counties) Co, No.:..~._~ negion:,~"'[,'~/X~",~ ER .R NO. MAP SHEET NO.(s) SUMMARY OF PIPELINE CHANGES IN DISTRIBUTION PLANTS RETURNED TO ABANDONED NEW INSTALLATION WAREHOUSE Size Kind Feet Size Kind Feet Size Kind Feet 30 Original ER No. or Date of Installation for replacement and retirement projects only: Date of this report