Summit PW-PT 961106Bore/Excavation in Public Right-Of-Way Permit
City of Coppe!l - Public Works Department
Date: /~ /
Permit Issued To: Name:
Address:
Project Name:
Phone:
~ergency Phone:
Inspector: Phone: ! %
lIave ~1 City and/or Franchise utilities Been Contacted .and
Existing utilities Located: YES ~O
will It Be Necess~ to Excavate Street, ~ley or Si~
payment? YES (attach pemit) ~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. A~ea(s) affected must be restored to as good
condition as before the commencement of work.
~ny 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 Rarricading/Detour Plan if a lane or street closure is
applicable.
Date
Franchise Inspector/or City Inspector
Date
Represenuative
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 City, if such per~. it is granted.
P ER~HIT. PI[B
Ail 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.
* NOW-ET BORES ALLOWED!
RTE
11/12
TIME
16:48
MESSAGE
CONF I RMAT I ON
DATE: 11/12~
ID:
TX-TIME
81'19'
TIME:1G:49
DISTANT STATION ID MODE PAGES RESULT
2148881~4 G3-S ~3 OK
The City With A Beautiful Future
p.O. Box 478
~T~EET/UTILITIES DMSION
732 DEFOP. BST RD.
P.O. BOZ 478
COPPBLL, TBZ]~ 75019
P~ ~ (214) 304-3547
FAX MAIL COVER PAGE'
PLEASE DELI~ PAGES TO:
NUMBER OF PAGES (INCLUDING COVER SHEET)
DATE
FROM
OUR FAX ~ 214-304-3547
*If yOU do not receive all of ~he pages, please call back as soon
as possible. Telephone NoS (214) 304-3545 or 304-3546
Matt Cast, Superintend,.ent of Public S~rvic~s