Riverchase (4)-PT 930406City of
Date:
Bore/Excavation in. Public Right-of-Way permi~
Coppell - Public Works' Department
· :',: ..' t:-, Permit Issued To:
Name
Address
Phone:
Emergency Phone:
Representing:.
Inspector: /)~;~
Type of Work/General.Descrip~ion:
30 ,, ~,~
Location of Work:
Phone:
~-~ave /%11 City and/or Franchise Utili en Contac~ed and~
Existing Utilities Located: J YES //
NO
Will It Be Necessary to Excavate Street, Alley or
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 or alley must be
reported to the Police, Fire, and Public Works Departments prior
to closing (462-1144, 462-1133 and 462-8495).
Attach Work Order (Franchise Only)
PAGE 2
PERMIT
Attach Barricading/Detour
applicable.
Plan if a lane
?ranc~ontractgr. Representative
Franchise Inspector/or City Inspector
App/
tative
or street cl6sure
Date
Date
Dat~
Applicant shall indemnify and forever hold harmless against each
and every 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 City, if such permit is granted.
PER/~I T. PHB