Lakewood Estates-PT 930719Bore/Excavation in Public Right-Of-Way Permit
City of Coppell
Date: ~ / /4/ 73
Permit Issued To: Name:
Address:
- Public Works Department
Project N~me: ~~~-~
Phone:
Emergency Phone: ~Q/
Representing:
Ty~e of Work/General Description:
Location of work:
TIave A~i City and/or Franchise utilities Been Contacted and
Existing utilities Located: ~~YES NO
Will It Be Necessary to Excavate Street, ~lley or sidewalk
Pavement7 ~ YES (attach permit) NO
Representative(s) of the Franchise/Co~tra~or m~st_adhe~ t~=~
construction standards approved by. the c~ty o: Coppe~, wn~u~
includes but is not limited to. Compaction of Trenches and Bores,
and Barricading according to the Texas Manual on Uniform Traffic
affected must be restored to as good
Control Devices. Area(s)
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).
At=ach Work Order (Franchise Only)
or alley must be
Departments prior
PAGE 2
PERMIT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franckise/Contractor Representative
Date
eInspect°r
Date
Dat~
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,
blocking, excavating, cutting, tunneling, or other work by the
applicant under permit from the City, if such permit is granted.
PERMIT. PHB
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.
.... '" ,~.. ...-LONE STAR GAS COMPANY
Co. No.~
MAP SHEET
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4,
~,IMMAI~y OF PIPELINE CHANGES IN
DIETRIBUTION PLAN11
La~r- .~. '~. WAREHOUSE NEW INSTALLATION
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,.I'7
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o+ooz b~¢.J~
Original ER No. or Date of IMt. llatlon fc~ replmeemJnt and
re~res~ent projlctJ on~y: