Parks Coppell-PT 930129Bore/Excava=~on ~n Public R£gh=-Of-Way Pe~mu~
City of Coppell - Public Works Depar=ment
De :e= I / ?,fi'/g3
Permi= Issued To: Name:
Address:
Phone:
Emergency Phone:
Represen=ing:
Zrave ~1 Ci=y a~/or Franchise U=ili~ies Been Con=ac=ed and
E~s=ing U=ili=ius ~ca=~d: YES / NO
Will It Be Necass~-y to Excava=c Street, A~ley or Sidewalk
Pavemon=? YES (aC=ach permit) I/ NO
Representative(s) of the Franchise/Contractor mus= adhere to all
cons=rue=ion s=andards approved by =he City of Coppell, which
includes but is no= limited to: Compac=lon of Trenches and Bores,
and Barricading according to =he Texas Manual on Uniform Traffic
Control Devices. Area(s) affected must be restored =o as good
condi=ion as before the commencemen= of work.
Any excavation requiring closing of a s=ree= or alley mus= be
reported =o the Police, Fire, and Public Works DepaL-~men=s prior
to closing (462-1144, 462-1133 and 462-8495).
Attach Work Order (Franchise 0nly)
PAGE 2
PERMIT
A==ach Barricading/De=our Plan if a lane or s=ree= closure is
applicable.
Franchise/Con=fac=or Represen=a=ive
Da=e
Franchise Inspec=or/or City Inspector
Da=e
Applican= shall indemnify and forever hold harmless agains= each
and ever~ claim, demand or cause of ac=ion =hat may be made or come
agains= it by reason of or if any way arising out of the closure,
blocking, excava=ing, cut=ing, =unneling, or other work by =he
applican= under permi= from =he City, if such permi= is granted.
PERMIT