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Gibbs Station 2-PT 940125Bore/Excavation in Public Right-Of-Way Permit City of Coppe!l - Public Works Department Date: / ]~/ ~ Project Name:FA Emergency Phone: (' ~ ~W~'''~ ~ Representing: ~7-~-- %'y~e of work/General Desc=ip=ion: Phone: llave All City and/or Franchise utilities Been Contacted and Existinq Utilitios Located: ~ YES NO Will It Be Necessa~'y to Excavate S~reet, Alley or Sidewalk Pavcmont? YES (attach permit) .~ 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 =o: 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 462-8495). A~tach Work Order (Franchise Only) NO WET BORES ALLOWED PAGE 2 PER~{!T Attach Barricading/Detour Plan if a lane or street closure is applicable. Franchise/Contractor Re.uresen=ative Date Franchise ~L~specuor/or C£~y Inspector Date Da~e .... t- / Applicant 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, blookinq, excavating, cutting, tunneling, or other work by the applicant under permit from the City, if such permit is granted. pEr,MIT. PXIB All 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.