Townhouses-PT011205A copy of the approved permit must be on the job site at all times.
T H E - G 1 T Y - O F
COPPELL
T o
o P
DRY BORE / STREET CUT / SAW CUT PERMIT
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IN
RIGHT -OF -WAY / EASEMENT
Submit permit request to the Engineering Dept., Town Center, 255 Parkway Blvd.
Date: ` i - a - O l
PERMIT FEE: $100.00
(No charge to Utility Companies with approved Franchise/ROW Use Agreement)
❑ Plans provided and approved
(Erosion ControUsafety fences must be installed prior to beginning work)
Project Name /Location: Owc� 1-ZO me s C Z:k FJ P l ,
General Contractor:
Permit issued to Company / Representative: Ts c .
Address: S55
Telephone #: al'-1 �6$a - 23 b 5 Emergency Telephone #: `lZ .).- - 9. 3 3
Utility Company Represented:
❑ T Electric ❑ TXU Gas ❑ Verizon ❑ SWBell Paragon /AT &T Broadband
❑ CoServe Comm ❑ CoServe Elect. ❑ Other
➢ If "Other" is checked, please note that franchise or right -of -way use agreements will be required and need Council
approval prior to beginning work. Permit cannot be approved until that time.
General Description of Work (provide copy of approved plans):
L. IN
> Was contact made with City and /or utility companies to locate existing utilities?
i NO, Reason: YES NO ❑
➢ Is removal of existing streets, alleys, or sidewalks necessary? YES ❑ NO
if YES, must have City inspection prior to concrete replacement
Dry Bore / Street Cut / Saw Cut Permit Page 2
Representatives) of the Contractor must adhere to all construction standards approved by the City of Coppell, which
includes but is not limited to: Erosion Control Ordinance, compaction requirements (density tests may be required at
the applicants expense) 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 (grading, drainage, vegetation,
and erosion control).
➢ Any excavation requiring closing of a street/alley must be reported prior to closing to the following:
Police Department @ 972 - 304 -3600
Fire Department @ 972 - 304 -3500
Street Department @ 972 - 304 -3546
Engineering Department @ 972 - 304-3679
➢ Attach barricade plan / trench safety plan if a lane or street closure is required.
NOTE: Street closures are allowed from 9:00 am. until 4:00 a.m. ONLY unless otherwise approved by City
Engineer.
➢ Attach Work Order (franchise only).
➢ Contact must be made with City and utility companies to locate existing utilities 48 hours prior to beginning of
work.
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Sig6ature of Utility Company Representative
Signature of Contractor Representative
Printed Name
Printed Name
Date
1k -as%-o t
Date
41
Signature of City Representative Printed Name D to
(Application with original signatures needs to be submitted to the Engineering Department before approval)
➢ Comments:
➢ NOTE: Notify City Inspector at 972 - 304 -3679 prior to beginning work and prior to backfdi for concrete,
trench, ditch and open pit inspections.
(Backfill must meet all construction standards approved by the City of Coppell)
Applicant shall indemn#y andforever hold harmless against the City of Coppell 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
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