Northlake WE P10A-PT 940614Bore/Excavation in Public Right-Of-Way Permit
City of Coppe!l - Public Works Department
Date: ~ / lq Project Name:
permit Issued To: Name:
Add=ess:
Representing:
InspeCtor:
Phone:
~ergency Phone:
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."~rpe of work/General Description:
Phone: ( %
G.b TV
Have a~ll City and/or Franchise UtiliZes Been Contacted and
Existinq utilities Located: ~// YES NO
Will It Be Necessu-r~ to Excavate Street, A~ley or Sidewalk
Pavement? YES (attach permit) J 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 Departments prior
to closing (462-1144, 462-1133 and 462-8495).
Attach Work Order (Franchise Only)
PAGE 2
PER/~IT
Attach Barricading/Detour Plan if a lane
applicable.
or s~reet closure is
Date
Franchise Inspector/or City Inspector
Date
Date .......
Aoo!icant shall indemnify and forever hold harmless against each
a~ eve~; claim, demand or cause of action that may be made or come
against ~t by reason of or if any way arising out of the closure,
blockinq, excavating, cutting, tunneling, or other work by the
applicant under pe-~m, it from the City, if such permit is granted.
P Er~I T. PHB
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!
24.2
$0.7
21.2
28.:3