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Primrose-PT 950622Bore/Excavation in Public Right-Of-Way Permit City of Coppe!l - Public Works Department Permit Issued To: Name: Address: Phone: ~ergency Phone: Inspector: Phone: 5~rpe of Work/General Description: l[ave ~1 City and/or Franchise Utilities Been Contacted and Existing Utilities Located: YES Will It Be Necess~ to Excavate Street, ~ley or Sidewalk Payment? YES (attach 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. ~rea(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 Depal~-ments prior to closing (462-1144, 462-1133 and 462-8495). Attach work Order (Franchise Only) PAGE 2 P EP~qIT Attach Barricading/Detour Plan if a lane or street closure is applicable. Franchise/Contractor R~tive Date Franchise Inspector/or City Inspector Ap ~r e ve~-~Ciuy Representative Da:e Date Applicant shall indemnify and forever hold harmless against each and eve~; claim, demand or cause of action that may be made or come against it by reason of or if any way arising out of the closure, blockinq, excavating, cutting, tunneling, or other work by the applicant under permit from the City, if such permit is granted. P E P~MI T. PHB 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. * NO WET BORES ALLOWED!