Lakewood Estates-PT 940408City of Coppell - Public Works Department
oate: H /
Pezmit Issued To: Name:
Address:
Phone:
~mergency Phone:
Representing:
T~pe of Work/General Description:
Location of Work:
IIave ~11 City and/or Franchise utilities Been Contacted and
Existinq Utilities Located: ~ YES NO
Will IC Be Necessary to Excavate Street, Alley or Sidewalk
Pavement? Y~S (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 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 =he Police, Fire, and Public Works Departments prior
to closing (462-1144, 462-1133 and 462-8495).
Attach Work Order (Franchise Only)
PAGE 2
PERMIT
Barricading/Detour Plan if a lane or street closure is
apglicable.
. fan'tractor RePresen=anive
Franchise Inspector/or C£ty Inspector
Date
Applicant shall indemnify and forever hold harmless agains~ each
and eve=-.; claim, demand or cause of action that may be made or come
against it by reason of or if any way arisinq out of the closure,
blockinq, excavating, cutting, ~unneling, or other work by the
applicant under permit from the City, if such permit is granted.
P ER~HIT. PIIB
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.
* NO WETBORBS~T.?~Y~!