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Lakewood Estates-PT 930505Bore/Excavation in Public Right-Of-Way Permit City of Coppell - Public Works Department Permit Issued To: Name~ Address: Phone: ~ergen~ Phone: ZIave Ail City and/or Franchise Utilities Been Contacted and Ex~sting Utilities Located: ~ YES NO Will It B~ Necessa~-~ to Excavate Street, Alley or Sidewalk Pavement? YES (attach ~ermit) NO Representative(s) of the Franchise/Contractor must adhere to all construction standards approved b~ the City of Coppell, which includes but is not limited to= Compaction of Trenches and Bores, and Barricading according to the Texas Manual on ~niform Traffic Control Devices. Area(s) affected must be restored =o 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 Departments prior Attach Work Order (Franchise 0nly) PAGE 2 PERMIT Attach Barricading/Detour Plan if a lane or street closure is applicable. Franchise/Contractor Representative Date Franchise Inspector/or City Inspector Ap~o~d/-~i{y B~presenta~i e Date Date / Applicant shall indemnify and forever hold harmless against each and every claim, demand or cause of ac=ion =ha= may be made or come against it by reason of or if any way arising out of =he closure, blocking, excavating, cutting, tunneling, or other work by ~he applicant under permit from =he City, if such permit is granted. PERMIT. 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.