Stonemeade-PT 930802Bore/Excavation in Pu2Dlic Right-Of-Way Permit
City of Coppe!i - Public Works Department
Date: ~ / ~- / ~ Project Name:
Permit Issued To: Name: ' c~3~
~mergency Phone: ~/~
Type of Work/General Description:
Ha e ~1 City and/or Franchise U~Aities Been Contacted and
Existing Utimities Located: ~ .... ~ES NO
Will It Be Necess~ to Excavate Street, ~ley or Sidewalk
Payment? ~ YES (attach pe~it)
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 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 Depaz~cments prior
to closing (462-1144, 462-1133 and 462-8495).
Attach Work Order (Franchise 0nly)
PAGE 2
PER/~IT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contractor Representative
Date
Franchise Inspector/or City Inspector
Date
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 permit is granted.
P E~MIT. PHB
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.
' (~ Inside C/L [] RAN
[] Outside C/L
LOCATION ~./~ PP~'I~
TOWN PLANT.,
(1! ether th~ I~*atfon)
SCHOOL DIST.
LONE STAR GAS COMPANY
I Proposed 1
Sketch of I Completed I Project
Co. No,: /~'~.~J Region:,,~2~
MAP SHEET NOds), ~-~
II
EUMMARY OF PIPELINE CHANGES IN
DISTRIBUTION PLANTS
ABANDONED RETURNED TO
WAREHOUSE NEW INSTALLATION
,Size Kind Feet Size Kind Feet Size Kind Fee~-
Original ER No. or Date of Installation for replacement;
relirement projects only:
Date of this report..