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Stonemeade-PT 930719Bore/Excavation in Public Right-Of-Way Permit City of Coppell Date: ~ / Permit Issued To: Name: Address: Public Works Department q-% Project Name: ~Oo~C~0~ Phone: ~mergency Phone: Representing: T~e of Work/General Description: Have A~i City and/or Franchise Utilities Been Contacted and Existinq Utilities Located: ~l%~u¢~ YES NO Will It Be Necessary to Excavate Street, A~ley or Sidewalk Pavement? YES (attach permit) NO 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 accordinq 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 Work~ DepaxT. ments prior to closing (462-1144, 462-1133 and 462-8495). A~tach Work Order (Franchise Only) PAGE 2 PERMIT Attach Barricading/Detour Plan if a lane or street closure is applicable. Franchise/Contractor Representative Date t Franchise Inspector/or City Inspector Ap~ro e C~y ~ep se~n~a~ive Date Applicant shall indemnify and forever hold harmless against each and every claim, demand or cause of action that may be made or come against it by reason of or if any way arisinq out of the closure, blockinq, excavating, cuttinq, tunneling, or other work by the applicant under permit from the City, if such permit is granted. P ER~IT. 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. ~4-2 4/82 ' [~ Inside C/L [] RAN [] Outside C/L LOCATION (~./) PP II TOWN PLANT (if other than I~carion) SCHOOL DIST. (Dallas & Tarrant Counl:iesJ LONE STAR GAS COMPANY I Proposed Sketch of I Completed } Project Co. No.: MAP SHEET NO.(s) X SUMMARY OF PIPELINE CHANGES IN DISTRIBUTION PLANTS ABANDONED RETURNED TO WAREHOUSE NEW INSTALLATION Size Kind Feet Size Kind Feet Size Kind Feet Original ER No. or Date of Installation for replacement and retirement projects only: Date of this report . /,-~- ~ ~-~(~,