Lakewood Estates-PT 931117Bore/Excavation in Public Right-Of-Way Permit
City of Coppe!l - Public Works Department
Date: // / /? / g-~ Project Name: [~
Permit Issued To: Name:
Address:
Phone:
Emergency Phone:
~e of Work/~neral Description:
~ca~ion of Work: /~ ~C~
Have ~1 City and/or Franchise Utilities Been Contacted and
E~sting Utilities ~catcd: / YES NO
Will It Be Necessa--~y to Excavate ~tree~, ~ley or Sidewalk
pavement? J 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 must be restored to as good
condition as before the commencement of work.
Any excavation requiring closing of a street
reported to the Police, Fire, and Public Works
~o closing (462-1144, 462-1133 and 462-8495).
or alley must be
DeparTments prier
A~tach Work Order (Franchise Only)
PAGE 2
PER/~IT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contractor Representative
Date
Franchise Inspector/or City Inspector
Date
Dat'e';
Applicant shall indemnify and forever hold harmless against each
and eve~z claim, demand or cause of ac=ion than may be made or come
against i= by reason of or if any way arising out of the closure,
blocking, excavating, cutting, tunneling, or other work by the
applican= under permit from the City, if such permit is granted.
PEr.HIT. PIIB
All contractors will contact Public Works @ 462-8495 to have
trenches and/or open outs inspected prior to back fill operation
taking place. Staff will be sent to inspect the project.