Riverchase (6.1)-PT 940526Bore/Excavation in Public Right-Of-Way Permit
City of Coppe!l - Public Works Department
/ /'
Phone:
~mergencS~ Phone:
llave ~11 Ci=y and/or Franchise utilities Been Contac=ed and
Exi=ting Utilities Located: ~ YES NO
will It Be NecessaXy to Excavate S~reet, ~lley or Sidewalk
pavcmont7 YES (a~tach permit) ~ NO
esentative(s) of the Franchise/Contractor must adhere to all
Repr · ' -=---~ .... roved b= the City of Coppell, which
co~str~c~on s~a~ .G~ . ~ . . _ ~ _ __~ ~o~eS
and ~arrica~n~ accor~n~ ~o c~ ~
Control De~ces. A.~e~(s) a~ected muse be restored ~o as good
condition as before ~he commencement e~ work.
Any excavation requiring closing of a s~ree~ or alley mus~ be
reported to the Police, Fire, and Public Works DeparTments prior
=o closing (462-1144, 462-1133 and 462-0495).
A~tach Work Order (Franchise Only)
PAGE 2
PKRHIT
Ar=ach Barricading/Detour Plan if a lane or street closure is
applicable.
Franch'ise/Con~rac=or Representative
Dare
Franchise Inspector/or City Inspecnor
Dare
Dare'
App!ican= shall indemnify and forever hold ha~-nless against each
and eve_--..~ claim, demand or cause of ac=ion =ha= may be made or come
against ~ by reason of or if any way arising our of =he closure,
blocking, excavating, cur=lng, tunneling, or other work by =he
&~plican= under pe~-ni= from =he City, if such perm. i= is granted.
pER.HIT. PIIB
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
LONE STAR GAS COMPANY
[] Inside C/L
I-'1 Outside C/L
LOCATION
TOWN PLANT
SCHOOL DIST.
[] R/W
city or tovm
Of o~er r~an Ior. a~ion)
(D, IM & Tsrr~nt Count/es/
Sketch of ~ Completed I oject
co..o.: /4/) ...ion:
ER/aa NO. ~ - ~'/~/
M^. SHEET.O.(.) /Z-A
SUMMARY OF PIPELINE CHANGES iN .....................................
DISTRIBUTION PLANTS
RETURNED TO NEW INSTALLATION
ABANDONED WAREHOUSE
Size Kind Feet Size Kind Feet Size Kind Feet
Original ER No. or Date of Installation for replacement an::
retirement projects only:
Date of this report ~ -//- ~'~'/