Villages of CC P4-PT 930406Representing: ~, .~/]]. ~
Date:
Permit Issued To: Name:
Address:
t' ,' ' ¥ I '
~rave ~1i City and/or Franchise Utilities .Be~n ~on~ac~ed and
Existinq Utilities Located. /~ ~YES
NO
will It Be Necessary to Excavate Street, A~ley 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 Depax~_men~s prior
to closing (462-1144, 462-1133 and 462-8495).
A~=ach Work Order (Franchise 0nly)
PAGE 2
PERMIT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
ranchise/C~ntrac{or Representative
Franchise Inspector/or City Inspector
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, ~unneling, or other work by the
applicant under permit from the City, if such permi~ is granted.
PERMIT. PHB
All contractors will contact Public Works @ 462-8495 to have
trenches and/or open cuts inspected prior to beck fill operation
taking place. Staff will be sent to inspect the project.
· ' [~ Side C/L
[~ Outside C/L
[] R/W
LONE STAR GAS COMPANY
~roposed }, Proiect
Sketch of { Completed
LOCATION ~
TOWN PLANT_
SCHOOL DIST,_
MAP SHEET NO.{s)__ /-"~_~
f',
r' .... "~.-'- .- .r',f ,~,
I (,?,l+~.~..I lll~-~.Y HAy.chi' .~4.
· . DISTRIIIUTION PLANT~
RETURNED TO
WAREHOUSE EW INSTALLATION
Original ER No. or Date of Installation tot replacement
et lrement projects Only:
Date of this report ._ /'/-/.~ '
[:3 R/W
LOCATION
city or tOWn
TOWN PLANT
(if other then location)
SCHOOL DIST.
(Dallas & Tarrant Counties)
LONE STAR GAS COMPANY
Pro'posed t
Sketch of { Completed I Project
Co. No.: /¢~, Region:~_.~
ER/RR NO. ~'-~/~ /~
MAP SHEET NO.{s} ./','~' ,c~--~
/~'
SUMMARY OF PIPELINE CHANGES IN
DISTRIBUTION PLANTS
ABANDONED RETURNED TO
WAREHOUSE NEW INSTALLATION
Size ,~Kind Feet Size Kind Feet Size Kind Feet
/~., ~./;~
Original ER No. or Date of Installation for replacement end
retirement projects only:
Date of this report