Round Oak-PT 941020Bor~/Excava~:ion in Public Right-Of-Way pez:m/C
City of CopSe!! - Public Works
Date:
Permit Issued To: Name:
Address:
Phone:
~mergenCy Phone:
~/~e of Work/General Description:
Looa=io of work:
IIave ,~i1 City and/or Franchise utilities Been Contacted and
Zxistinq utilities Located: YES NO
Will It Be Necessa--~-y to Excavate Street, A_~ley or Sidewalk
Pavement? YES (attach permit) ~ 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 (.%62-1144, 462-1133 and 462-8495).
Attach Work Order (Franchise Only)
or alley must be
DeparTments prior
PAGE 2
PERMIT
Ar=ach Barricad£ng/De=our Plan if a lane or s~ree= closure is
apglicable.
Daue
Franchise InspecUor/or City inspecnor
Da~e
Dare '+ ' ' / x
Apo!icann shall indemnify and =o-=v°' hold harm. less agains: each
an~ eve---./ c!aLm, demand or cause of ac=ion than may he made or come
agains= ~= by reason of or if any way arising ou= of =he closure,
· , -' ~- c=her work by =he
=_n..e .... g or
blcckinq, excava:ing, cu==ing, ,
a~p!ican= under permit from =he Ci=y, if such perm. i= is gran=ed.
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.