Taco Bell-PT 960319Bore/Excavation in Public Right-Of-Way
City of Coppe!l - Public works Depa_-~ment
Da=e:
Po=mit Issued To: Name:
A~dress:
Zmergen~ Phone:
T',.~,.e of work/General Desc---i~:ion:
Phone:
ITave All City and/or Franchise Uti!i=ies Been Contacted and
Ex_~stinq utilities Located: YES ~. NO
'.Will I= Be Necessary to Excavate $~reet, Alley or Sidewalk
' Pavcmont7 YES (a~tach permit) NO
Representative(s) of :he Franchise/Contractor must adhere to all
construc=ion s=andards approved by the City of Coppell, which
includes but is not limited to: Compaction of Trenches and Bores,
and Barricading according to the Texas Manual on Uniform Traffic
Control Devices. Area(s) affected ~ust be restored to as good
condition as before the commencement of work.
Any excavation requiring closing of a street or alley must be
reported to the Police, Fire, and public Works Departments prior
to closing (.%62-1144, 462-1133 and 462-8495).
A~ach work Order (Franchise only)
PAGE 2
PERMIT
Ar=ach Rarricading/De=our Plan
ag.olicab!~..
if a lane or
closure
Franch£$e/Con=rac=or Represen=a=ive
Franchise Inspecuor/or C£ny inspec=or
A.=~r_%e=/C' . Represenna~ive
A~p!ican= shall inde~ulify and for~ver hold harm. less agains~ each
and eve~! claLm, demand or cause of ac:ion than may ~e made or come
against ;t by reason of cr if any way arisinq oun of the closure,
block!hq, excavating, cut=inq, nunne!ing, or other work by =he
a~plican: under permit from the City, if such pe_-m, it is granned.
Ail contractors will contact Public Works @ 462-8495 to have
trenches and/or open cuts inspected prior to back fill operation
taking place. &tall will be sent to inspect the project.
H'23265~
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PROPOSED
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