Fountain Park 1-PT 931221Bore/Excava=ion in Public R/ghn-Of-Way Pexm~it
Ci=y of Coppe!l - Public Works Depar=men=
Dane:
Pezmit Issued To: Name:
Address:
/ ProJecn Name:
Phone: f z)'~ ~ ._~_~-~11
Represen=ing: ~m_6
Inspector: ~.~%~4 C,~-t~d~--
Type of work/General Descrip=ion:
Phone:
I~ave A~i City and/or Franchise U=ilicies Been Contacted and
Will I= Be Necess~t =o Zxcava=e S~ee=, ~ley or Sid~a~
Pav~cn=? Y=S (a=nach pe~i~) ~ NO
en:a=ive s of ~he Franchise/Connracnor mush adhere =o all
Repres ( )
ccns=ruc=lon snandards approved by :he Ciny of Coppell, which
includes bur is no= limited no: Compaction of Trenches and Bores,
and Barricading actor=in: =o nhe Texas Manual on Uniform Traffic
Area(s) affecned mush be res=ored no as good
Any excava=ion requiring closing of a streeC or alley mush be
repot=ed to the Police, Fire, and Public Works Depax~.men=s prior
=o closing (462-1144, 462-113~ and 462-8495).
Work Order (Franchise Only)
Connrol Devices.
condi=ion as before the commencemen= of work.
P£R.M~T
Attach Barricading/De=our Plan if a lane or street closure is
Franchise/Co=cra=tot Representative
Date
~rano~ise Znspec=or/or City Inspec=or
Dace
DaCe /
Applicann shall indemnify and forever hold harmless agains= each
and eve~f claim, demand or cause of ac=ion char may be made or come
aqainsc iC by reason of or if any way arisinq DUC of the closure,
blockinq, excavating, cuCninq, tunneling, or ocher work by CAe
appl£can= under permi= from uhe City, if such penni= is granted.
All contractors will contact Public Works @ 462-8495 ~o have
trenches and/or open cuts inspected prior to hack fill operation
tak/~g place. Staff w~11 be sent to inspec~ '~he p~4~Jet~.
BLUEBAY. LANE
4/0
4/0
017
SANDY
LAKE
_LEGEND_
P~DPDSED
PROPOgE~
PROPOSED
PROPOgEB
PROPOSED
P~DPDSED
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