Northlake WE P10A-PT 930429Bore/Excavation in Public Right-Of-Way Permit
City of Coppell - Public Works Department
Date:
Phone:
Emergency Phone:
Representing: 9~[~r°'O~
Project Name:
Phone:
of Work/ ner l oesorip on:-F g, 3
Itave ~1 Ci=y and/or Franchise Utili=ies Been Con=ac=ed and
Exis=ing u~ili~ies ~ca=ed= ~ YES NO
Will I= Be Necess~ =o ~xcava~e S~ree~, ~ley or Sidewalk
Pav~en=7 YES (a~=ach 9e~it) / 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
to closing (462-1144, 462-1133 and 462-0495).
Attach 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.
Franchis~/~ntractor Represer~cat ~
Date
Fran~h~is Inspector/or City Inspector
Date
Applicant 'shall indemnify and forever hold harmless against each
and every claim, demand or cause of action tha~ 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. PI.lB
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.