Peninsulas-PT 951009Bore/Excavation in Public Right-Of-Way Permit
City of Coppe!l - Public Works Department
Permit Issued To: Name:
Address:
Phone:
Emergency Phone:
Type of Work/General Description:
Have ~1 City and/or Franchise utilities Been Contacted and
Existing Utilities Located: / YES NO
Will It Be Necess~ to Excavate Street, ~ley or Sidewalk
payment? YES (attach pe~it) / NO
Representative(s) of the Franch~e/Contrac~ r mu~t adhere ~o 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 ~nual on Unifo~ Traffic
Control Devices. ~ea(s) affected must be restored to as good
condition as before the co~encement of work.
Any excavation requiring closing of a street or alley must be
reported to the Police, Fire, and Public Works Departments prior
tO closing (462-1144, 46~-1133 and 462-8495).
Attach Work Order (Franchise Only)
PAGE 2
PERMIT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contractor Re~f~senta '
Date
Franchise Inspector/or City Inspector
Date
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,
blocking, excavating, cutting, tunneling, or other work by the
applicant under permit from the Ci=y, if such permi= is granted.
PEri. IT. 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.
* NO WET BORES ALLOWED!
EXHIBIT "A'
LONE STAR GAS COMPANY
THE PENINSULAS OF COPPELL
DRAWN KBP J GATE 6/!:)/95
CHK*D. J SCALE NONE
6
MAP SHEET NO.
5-B & 5-C
COPPELL
ER-95-
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