Waterside E P2-PT 940214Bore/Excavation in public Right-Of-Way Permit
City of Coppell - Public Works Department
Date:
Permit Issued To: Name:
Address:
Phone: ( ~IQ %
Emergency Phone: _{ ~7~
Inspector:
~ype of Work/General DescriptiOn:
Phone
Location of Work:
IIave A~i City and/or Franchise utilities Been Contacted and
Existing utilities Located: ~- YES NO
Will It Be Necessa--~Y to Excavate Street, Alley or sidewalk
~ NO
Pavement? YES (attach permit)
, ' of the Franchise/Contractor must adhere to ~11
Represen~t~vet%h~~-~. a~rovea bv the City of Coppell! _which
construction S~anu~ . =E ~ . --Jh~*~on of Trenches aha ~ores,
includes but is not £~te~ =~-"~J~i'nual on Uniform Traffic
and Barricading accor=lng =o un= ~= .... be restored to as good
Control Devices. Area(s) affected must
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 or street closure is
applicable.
~ranchise~Contractor Representative
Dat~ ' '
Franchise Inspector/or City Inspector
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.
PEr, MIT. 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.