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Summit PW-PT 961025Bore/Excavation in Public Right-Of-Way Permit City of Coppe!l Public works Department Permit Issued To: Name: Ad. ess: Phone: ~mergency Phone: Type of work/General Description: Location of Work: Phone: ,972, 1344 flare ,111 City and/or Franchise Utilities Been Contacted and Existing utilities Located: YES /NO will It Be Necessary to Excavate Street, AZley or Sid~k Pavement7 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 Depa/rtments 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 Approved/City Representative Date ' Applicant shall indemnify and forever hold harmless against each and eve~; claim, demand or cause of acuion 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 ~he applican= under permit from the City, if such permit is granted. PER.MIT. PIIn 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 ALL(~SED! 4690 A 15~~ 15 TU ELECTRIC DESIGNER USERID FJAK PHONE 214'888-1344 PHONE WR NAME __. CUSTOMER LOC~T[ON CONSTRUCTION PRINT