Parks Coppell-PT 930719Bore/Excavation in Public Right-Of-Way Pe~~
City of Coppell - Public Works Department
Date: Project Name:
Permit
Issued To: Name:
Address:
Phone:
~mergency Phone:
Representing:
Ty~e of Work/General Description:
IIave A~i City and/or Franchise Utilities Been Contacted and
Existinq Utilities Located: ~b~0~u~ YES NO
Will I~ Be Necessa_~y to Excavate Street, Alley or Sidewalk
Pavement? YES (attach permit) NO
Representative(s) of the Franchise/Contractor must adhere to all
cons=ruction 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 ~o as good
condition as before the commencement of work.
Any excavation requiring closing of a street or alley must be
reported to ~he Police, Fire, and Public Works Depax~ments prior
=o closing (462-1144, 462-1133 and 462-8495).
A~tach Work Order (Franchise Only)
PAGE 2
PERMIT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contractor Representative
Date
Franchise Inspector/or City Inspector
Date
Date
Applicant shall indemnify and forever hold harmless against each
and every claim, demand or cause of action that may be made or come
against it by reason of or if any way arising ou= of the closure,
blockinq, excavating, cutting, tunneling, or other work by the
applicann under permit from the City, if such pe=mit is granted. ·
PERMIT. PHB
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.
' ~ Inside C/L E] RAN
e] Outside C/L
LOCATIoN_C
TOWN PLANT__
SCHOOL DIST. _
ABANDONED
LONE STAR GAS COMPANY
Proposed I
Sketch of { Completed I Project
I¥
Co' N°': -/-=~[~r~
/
MAP SHEET NO.(s)_
t!
CH
RETURNED TO :~,~ ~ C ~ ~r
~ Original ER No. or Date of n~tallet~n for repl~nt
,, ~ retlre~nt proje~s only:
Date of this re~ ~ . _ ,,