Fairways-PT 931221Bore/Excavation in Public Right-Of-Way permit
City of Coppell - Public Works Department
permit Issued To: N e: t
Adchress: ~/D ~' ~
Phone:
Emergency Phone:
epresen g: ~hu ~-~-~
Ty~e of work/General Description:
~/ ~ ~~1~ Been Contacted and
Have ~1 City end,or Franchf~ Utl
/ YES~ NO
Existinq utilities Located:
Will It Be Necess~ to Excavate Street, ~ley or ~lkNo
payment? YES (attach pe~it)
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.
~ny excavation requirinq closing of a street or alley must be
reported to ~he Police, Fire, and Public Work~ Depart-merits prior
=o closing (462-1144, 462-1133 and 462-8495).
Attach Work Order (Franchise 0nly)
-%¸
PAGE 2
PERMIT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contractor Representative
Date
Franchise Inspector/or City Inspector
Da%e
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,
blockinq, excavating, cutting, tunneling, or other work by the
applican~ under permit from the Ci=y, if such permit is granted.
PERMIT. P I'IIB
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.
FORM 304'2 4/82
M.R. -Z-A-IV
~ Inside C/L [] R/W
[] Outside C/L
LOCATION (~/~ PP~' L/-
TOWN
PLANT
~ (if other than location)
SCHOOL DIST. '
~ (Dallas & Tarranr Counties)
LONE STAR GAS COMPANY
j Proposed } Project
Sketch of t Completed
Co. No.:.,/_.e~ Region:~/,~,~:)b-~
MAP SHEET NO.(s)
4.00='/'
/$
Sv
SUMMARY OF PIPELINE CHANGES IN
DISTRIBUTION PLANTS
ABANDONED
RETURNED TO
WAREHOUSE
NEW INSTALLATION
a Original ER No. or Date of Installation for replacement and
Size Kind Feet ~ retirement projects only: