Riverchase (4)-PT 930308Bore/Excavation in Public R/gh=-Of-Way Permit
City of Coppell - Public Works Department
Date: ~ / ~ / 9~
Permit Issued To: Name:
Address:
Project Name:
Phone:
Emergency Phone:
Representing: --t, ~] ~L6~ .
Inspector: %-f~-~C¢~q~-z~
Type of Work/General Description:
Phone:
I~ave All City and/or Franchise Utilities Been Con=acted and
Existing Utilities Located: YES ~/ NO
Will I= Be Necessary to Excavate S~reet, Alley or Sidewalk
Pavement? YZ$ (attach permit) ~ NO
Representative(s) of the Franchise/Contractor must adhere to all
construction s=andards approved by. the City of Coppell, which
includes but is not limited to: Compaction of Trenches and Bores,
and Barricading according to :he Texas Man~al on Un~form Traffic
Control Devices. Area(s) affec=ed 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 Depax~men~s prior
to closing (462-1144, 462-1133 and 462-8495).
A~tach Work Order (Franchise Only)
PAGE 2
PERMIT
Ar=ach Barricading/De=our Plan if a lane or street closure is
apglicable.
Franchise/Con=fac=or Regresen=a~ive
Dare
Franchi~ Inspector?or C£uy Inspector
Dare
A~plican= shall indemnify and forever hold harmless against each
and every claim, demand or cause of ac=ion ~ha= may be made or come
agains= i= By reason of or if any way arising ou= of =he closure,
blocking, excavaning, cutting, ~unneling, or other work by =he
ap~licann under permi~ from =he City, if such permit is granted.
P ~'-P.24IT. PIIIt
All contractors will contact PublicWorks @ 462-8495 to have
trenches and/or open cuts inspected prior to.basrA11 operation
taking place. Staff will be sent to inspec~th~'~Pro~ect.~
J