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Valley R Plaza 1P-PT 970220Bore/Excavation in PLLblic Right-Of-Way Permit City of Coppe!l - Public Works Department Date: % / Zo / a7 Project Name: Permit Issued To: Name: Address: Phone: 7'-/.2 EL ~ ¢ ~,'= %'ype of Work/General Description: Looatio. of Work: Phone: Have All City and/or Franchise Utilities Been Contacted and Existing Utilities Located: YES / NO Will It Be Necessa_~-y to Excavate Street, /%l!ey 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 PEP~ZIT Attach Earricading/Detour Plan if a lane or street closure is 9pplicable. Franchise/Contractor ~.~.~e.-f~ative Date ._ancn_se 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 P~MI T. 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. * NO WET BORES ALLOWED!