Riverchase (4)-PT 930222Bore/Excavation in Public Right-of-Way Permit
City of Coppell - Public Works Department
Date= ~ / ~ ~ / ~ Project Name:
Permit Issued To= Name= ~
Emergency Phone, , ~ ~) ~ ) ~4 / - ~ ~S ~
/~/~ ,/'~/~X~ Phone=
Have ~1 ' - ~ '
Ex~sting ~t~Zit~es ~cated~ ~ YES NO
~-~- ~
~ill It ~ ~ecemsa~ to ~cavate 8treet~ ~le~ or
Pav~nt~ ~ 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. 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 Plan if a lane or street closure is
applicable.
~'rahchise£Contractor Representative
Date
Franchise Inspector/or City Inspector
Date
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, t~nneling, or other work by the
applicant under permit from the City, if such permit is granted.
PERMIT.PHB
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LONE STAR GAS COMPANY
Sketc~ of { Propoted t
Completed I Project
/f
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¥
RETURNED TO
ABANDONED WAR EHOUSE
NEW INSTALLATION
Fiat
OrlglnBI ER NO, or DIt~ of Intt~ll.tion for rapll¢~men
retirement pmJe~l only;
Dit* ~ this rein ~
By