Villages CC 1-3-PT 930702Bore/Excavation in Public Right-Of-Way Permit
City of Coppell - Public Works Department
Project Name:
Address: ,_-7/0 /~/- /~o 6-~-,~ -C
Phone:
Emergency Phone:
/
Representing: ~&f ?
Inspector: ,~o~ /--/~Y~'~_~
T'ype of Work/General Description:
Location of Work:
I[ave A~i City and/or Franchise Utilities Been Contac=ed and
Existinq Utilities Located: ~,= ~-G-9~ YES NO
Will It Be Necessary to Excavate Street, Alley or Sidewalk
Pavement? ~/o 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. A.rea(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
repor=ed to the Police, Fire, and Public Works DepaxT. men~e prior
to closing (462-1144, 462-1133 and 462-8495).
AUtach Work Order (Franchise 0nly)
PAGE 2
PERMIT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
j,?//I : .
Franchise/Contractor Representative
Date
Franchise Inspector/or City Inspector
A~ p~~~ ~ d~e:~ss enta ~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 arising out of the closure,
blockinq, excavating, cutting, tunneling, or other work by the
applicant under permit from the City, if such permit is granted.
PERMIT. PHB
All 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.
? [] Outside C/L
LOCATION ~ p/34
TOWN PLANT
SCHOOL DIST,
LONE STAR GAS COMPANY
P~posed },Project
Sketch of { Completed
MAP SHEET NO.(s)_ /~ (~
73
ABANDONED
PIPELINI~ CHAP
OISTI~IJ~UTION PLANTS
RETURNED TO
WAREHOUSE
EW INSTALLATION
OHginal ER No. or Date of Install~}i~ri t~tXreplacemant a;ld
retirement projects Only:
[] Outside C/L
LOCATION ~'~- <~.~PE/]
TOWN PLANT
SCHOOL DIST,
LONE STAR GAS COMPANY
~ Proposed } Project
Sketch of ! Completed
Co. No.:
MAP SHEET NO.(s),./-,~'
Region:~
SUMMARY OF PIPELINE CHANGES IN
ABANDONED
DISTRIBUTION PLANTS
RETURNED~O
WAREHOUSE
NEW INSTALLATION
Origina[ ER No, or Date of Installation for replacement and
retirement projects only:
Date of this report