Freeport NIP(1)-PT 951011Bore/Excavation in Public Right-Of-Way Permit
City of Coppe!l - Public Works Department
Date:
Permit Issued To: Name:
Address. -
Phone:
Emergency Phone:
Representing: ~
InspeCtor: Phone:
Type of Work/General Description: ~/~A~
II.ye ~i Ci[y ~nd/or Franchise U~ilitie~ [ee~ Co~t~cted
Existing utilities L~aCed: YES / NO
will I~ Be Necess~ to Excavate Street, ~ley or Sidewalk
Payment7 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
reported to the Police, Fire, and Public Works
to closing (462-1144, 462-1133 and 462-8495).
or alley must be
Depa_~tments prior
Attach Work Order (Franchise Only)
PAGE 2
PERMIT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contractor RepreSSive
Date
Franchise Inspector/or City Inspector
~n=a~ive
Date
Date .....
Applicant shall indemnify and forever hold harmless against each
and eve_--./ claim, demand or cause of ac=ion that may be made or come
against it by reason of or if any way arising out of the closure,
blocking, excavating, cu%ting, ~unneling, or other work by the
applican: under permit from the City, if such permit is granted.
PEr,HIT. PHB
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 WETBORESALLOWED!