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Parks Coppell-WO 930309 City of Coppell Water Utilities Water Isolation Request The following information must be provided i er to allow isolation of any part of the City of Coppell Water System. This form must be completed and submitted to the Utilities Division for processing forty-eight (48) hours prior to the date the isolation is requested. Time: ~ '~/P.M. Date: ~- ~-~-~ Project Name: Contractor: Contractors Representative Area Affected (Street, Block No.): Time Off: Time On, Water Main Size: A.M.~ Inches Water Service: /" Inches Water Department Notified: 7 - ~-~ ~ Time: f~tr~ A~.~/P.M. Date~ ~ -~--~3 If water customers of the system will be affected, contractor shall provide a list of each of those business or residential structures affected. * Note: The City of Coppell Utilities Division shall perform all water line shut-downs. Contractors are not permitted to turn any valves in the system. Contractors Representative Date