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Parks Coppell-PT 930802Bore/Excavation in Public Right-Of-Way Permit City of Coppe!l - Public Works Departmen~ Address: Phone: ~ -7 ~e~resenting: ~ '~ fl ~- ~-- ~zistin~ otilitios ~oc~to~:~~S will It Be Necess~ to ExCavate Street, ~ley or Sidewalk Payment? ~ YES (a~tach pe~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 or alley must be reported to the Police, Fire, and Public Works Depa~rtments prior to closing (462-1144, 462-1133 and 462-8495). Attach Work Order (Franchise Only) PAGE 2 PERMIT Attach Barricading/Detour Plan if a lane or street closure is applicable. Franchise/Contractor Representative Da=e Franchise Inspector/or City Inspector Date Date* ..... A~p!icann shall indemnify and forever'hold harmless against each and ever'.; c!aLm, demand or cause of ac=ion that may be made or come against i= by r~ason of or if any way arising out of the closure, blocking, excavating, cutting, tunneling, or other work by =he applicant under permit from the City, if such permit is granted. 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. · .,~ ,-'-'- LONE STAR GAS COMP~'%y , ~ In,de C/L (:] R/W TOWN P~NT SCH~L DI~. , ~ ~ - _ -' ~ * I I I:~ ",, I~ ~ ./~ .... . ~ ~ll~ ~. *  ER No. or Date of Installatl~ for recreant retirement ~oJ~l On;y:.,, . Oate of thla re.re ~ , . ,,