Lakeside V2-PT 960206Bore/Excavation in Public Right-Of-Way Permit
City of Coppe!l - Public Works Department
Date: Z/ & / ~ Project Name:
Permit Issued To: Name:
Address:
Phone:
~ergency Phone:
Representing: ~
Inspector: Phone:
T~e of Work/General Description: -.~'~/~r~L ~V~'~D
Have ~11 City and/or Franchise Utilities Been Contacted and
Existing utilities Located: YES NO
Will It Be Necessa--~y to Excavate Street, A_~ley or Sidewalk
Pavement? 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 to: Compaction of Trenches and Bores,
and Barricading according to the Texas Manual on Uniform Traffic
Control Devices. Area(s) affected mus~ be restored to as good
condition as before the commencement of work.
A~y excavation requiring closing of a street or alley must be
reported to the Police, Fire, and Public Works Depa~--tments prior
to closing (462-1144, 462-1133 and 462-8495).
Attach Work Order (Franchise Only)
PAGE 2
PERMIT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contractort Represe7
z
Date
Franchise Inspector/or City Inspector
ADD..~ec/~i' Representative. .
Date
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 er if any way arising out of the closure,
blockinq, excavatinq, cutting, ~unneling, or other work by the
applicant under permit from the City, if such permit is granted.
P E P~I T. 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 BORES ALLOWED!