Villages of CC 6-PT 951005Bore/Excavation in Public Right-Of-Way Perm£t
City of Coppe!l - Public Works Department
Date: /~ /
Pezmit Issued To: Name:
Address:
Phone:
Emergency Phone:
Project Name:
Type of work/aeneral Description: ~j~// /~FO ~ ~,. ~PWO ~
~;ave ~1 City and/or Franchlse uuili=ies Been Contacted and
Exi=tinq utilities Located: ~ YES NO
Will It Be Necessary to Excavate Street, A~ley or Sldewalk-/~o~ ,
'
Pavement? ~ YES (attach pe~it) NO
Repz~sentat~ve(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
reported to the Police, Fire, and Public Works
to closing (462-1144, 462-1133 and 462-0495).
or alley must be
DepaxT_ments prior
Attach Work Order (Franchise 0nly)
PAGE 2
pERMIT
At=ach Barricading/De,our Plan if a lane or street closure is
applicable.
Franchise/Contractor Re~sen=a=ive
Date
Franchise Inspector/or City Inspector
A.~rove~i=Y Reoresen~-at~.ve
Da~e
Da~e ........
App!icann shall indemnify and forever hold harmless against each
and eve~; claim, demand or cause of action that may be made or come
agains~ ~ by reason of or if any way arising ou~ of the closure,
blocking, excavating, cutting, tunneling, or other work b? the
applican= under permit from =he City, if such permin is granted.
PERMIT
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.
* No W~TBORESALLOWED!