St Joseph-PT031015CC: ~c]nt
A copy of the approved permit must be on the job site at ail times.
T H g · C ! T Y 0 F
COPPELL
Page 1 of 4
Permit File
RIGHT-OF-WAY USE PERMIT APPLICATION
Approved permit valid for 90 calendar days from date of approval
Submit permit request to the Engineering Dept., Town Center, 255 Parkway Blvd.
Date of Submittal: /0"[~'0~ npplicant'sJob#/WorkOrder# [~)1~ tq4'~OSq
PERMIT FEE: $100.00
(No charge to Utility Companies wah approved Franchise/ROW Use Agreement)
License Agreement Approved (date) __/__/ Certified Telecom Provider? Y(~
Plans provided and approved
(Erosion Control~safety fences must be installed prior to beginning work)
Project Name / Location: G'F. 3'o eta b'ittt a -ih ito bb.- 45 g _ID'lt6
General Contractor:
Permit issued to Company / Representative: _ ~'.X/~ ~ /~t'~ /~t'~[d,;~
Address: 14L]O0 Ita t t? . 7 ; 14
Telephone #: ~ Emergency Telephone #:
Utility Company Represented:~
[] Oncor Electric Delivery Co. Gas [] Verizon [] SBC [] ComCast Cable
[] AT&T Local Services [] CoServe Communications [] CoServe Elect. [] Other
~ If "Other" is checked, please note that franchise or right-of-way use agreements will be required and need
Council approval prior to beginning work. Permit cannot be approved until that time.
General Description of Work (pro. F'~opy of approved plans):
Estimated Start Date
]~- Z l- O ~ Estimated Completion Date* ID ' ~ t- o ~
* Completion requires submittal of Completion Verification Notice (see page 4)
Was contact made with City a. nd/or utility companies to locate existing utilities?
if NO, Reason: ~O~ff~g'~ t-,il{ ~. ~'~'a,t~e~'t'.~ .~ i-t~n~ ~,'ot YES []
~s removal of existing streets, alleys, or s~dewalks necessary? YES []
if YES, must have City inspection prior to concrete replacement
Revised 06/03
Right-of-Way Use Permit Application
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Representative(s) of the Contractor must adhere to all construction standards approved by the City of Coppell, which
includes but is not limited to: Erosion Control Ordinance, compaction requirements (density tests may be required at
the applicants expense) and bar~cading 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 (grading, drainage,
vegetation, and erosion control).
), Any excavation requiring closing of a street/alley must be reported prior to closing to the following:
Police Department @ 972-304-3600
Fire Department @ 972-304-3500
Street Department @ 972-304-3546
Engineering Department @ 972-304-3679
Attach barricade plan / trench safety plan if a lane or street closure is required.
NOTE: Street closures are allowed from 9:00 a.m. until 3:00 p.m. ONLY unless otherwise approved by City
Engineer.
Attach Work Order (franchise only).
Contact must be made with City and utility companies to locate existing utilities 48 hours
prior to beginning of work.
(Application with original signatures needs to be suOmitted to t. he Engineering Department before approval.)
Signature of Utility ,Q~y Representative Printed Name Date
Signature of ~o~l~c~r Representauve
Signature of City Representative
Printed Name Date
Printed Name Date
Cormnents: V'~-~_ ~S 1~ ,~._~ ~O_~ LL~[i~--~r
NOTE:
Notify Cit~ Inspector at 972-304-3679 prior to beginning work and prior to
backfill for concrete, trench, ditch and open pit inspections. (Backfill must
meet all construction standards approved by the City of Coppell.)
Applicam shall indemnify and forever hold harmless against the City of Coppell each and every claim, demand or cause
of action that may' be nmde or come against it by reason of or ~f 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.
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T H E: · C I T Y . 0 F
COPPELL
UTILITY RELOCATION CHECKLIST FOR WORK WITHIN
CITY OF COPPELL RIGHTS-OF-WAY OR EASEMENTS
Listed below are minimum requirements for utility relocation projects:
l. A copy of the valid approved City of Coppell permit is required on the project at all times.
2. Notify adjacent property owners (commercial & residential) of project timeline; provide them with contact
names and phone numbers.
3. Proper erosion control measures must be taken.
4. Follow Texas MUTCD standards for work in traffic zones.
5. Sod is to be replaced when necessary.
6. Irrigation repairs must be performed in a timely manner.
7. Follow OSHA recommended trench safety at all times.
8. Repair existing utilities that are damaged, including but not limited to clean-outs, water valves, and SS
manholes.
9. Densities may be required in trench lines (ASTM).
10 Care and repair of street signage is the responsibility of the contractor.
11. No work is to be done in collector roadways before 9:00 a.m. or after 3:00 p.m.
12~ Prior notice of work activity on weekends and holidays must be in writing.
13. Line locates must be performed in advance by contacting -
CITY OF COPPELL UTILITIES DIVISION ci.coppell.tx.us
972/462-5155
CITY OF' COPPELL ENGINEERING DEPT.
972/304-3679
HOMEOWNER ASSOCIATIONS (City Secretary Office).
972/304-3669
COMCAST CABLE
214/320-7546 (Kevin Mulhaney)
AT&T LOCAL NETWORK
214/215-0880 (Jim Peck)
COSERV
800/274-4014
EXPLORER PIPELINE
918/493-5100 (Patrick Nwakoby)
ONCOR Electric Delivery Company
972/570-4126 (Jeff Curry)
VERIZON COMMUNICATIONS
972/318-5276 (Ron Hilton)
1 800 DIG TESS for line locates
(344 - 8377)
14. Contaminants must be removed from work area daily and disposed of properly outside the City.
15. Streets, sidewalks and alleys must be kept clean of construction material and debris.
16. "Clean-up" requires returning work area to pre-project condition or better.
17. Contractor is required to contact Public Works Division for Completion Verification Notice. (see pg. 4)