Northlake 635(3)-PT 980728Bore/Excavation in Public Right-Of-Way Permit
City of Coppe!l
Date: 7 /2~ /qg
Permit Issued To: Name:
AdcLress:
- Public Works Department
Project Name: ~A/
Phone:
~ergency Phone: ,/ ~
Representinq: ""/'- ~
%~fpe of Work/General Description:
Location of Work: .~. ~ttLilU~- ~. (~ )~l'~-I~l~ ~,lR,ge
lIave All City and/or Franchise Utilities Been Contacted and
Existing utilities Located: YES L~"~NO
Will It Be Necessary to Excavate Street, Alley or Sid~w~
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 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 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
P EP~qIT
Attach ~arricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contractor Representative /
Dar_e
Franchise Inspector/or City Inspector
Date
Appr~-vec/Ci~y Repr~sennaJ_i~e 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 or if any way arising out of the closure,
bleckinq, excavating, cutting, tunneling, or other work by the
applicant under pe-~m, it from the City, if such permit is granted.
P ER~IT. PIII3
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!
' ~-} ] ~ TEST LEAD BOX
(wi~ ri~er)
FIRE LANE
~1~--- ,SERViA_,.E LINE
(CAPPED W/ MARKER BALL
t(10'behind P.L. (~ Lot Line)
BELT ,LINE
LONE STAR GAS COMPANY
ILSS'
3" IR PoL~ II