Villages C PW-PT 921006 Bore/Excavation in~.,Public Tttght-of-Way Pe~% !'-~..
City of Coppell '- PUblic W~'~'""Oepartment ,/:'{]~ ~[~
~a~e- .~ ~ o / 7~'~ groJect]~,~N~e: C4 e~h',:~: '/~,~:}:':f$:~
Phone:
~ergency Phone:
Representing: ~ ~
~e of Work/General
~cation of Work:
Phone:
Been Contacted and
~ave All City and/or Franchise Utilities
Existing Utilities Located: ~ YES NO
Will It Be Necessary to Excavate Street, Alley or Sidewalk
Pavement? 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 Departments prior
to closing (462-1144, 462-1133 and 462-8495).
Attach Work Order (Franchise Only)
· PAGE 2
.~ .:: ." PERMIT
Attach Barricading/Detour Plan if a lane
applicable. -~ ~ · '
;i': ii .. Fran~h/e/C-0ntractgr, Representative
Franc~ I.nspector/or City Inspector
~p~e~/~i~ Representative .:
or
Date
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 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.
PERMIT.PHB