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Qwest-PT080207
A copy of the approved permit must be on the Job site at all times. cc: ~:::;;~rks ~~_rel' . C , T T . 0 · Permit File 16 OPPELL ~ "* .. ~ ~ Page 1 of 4 Rev. 11/07 Olig. to Project File 02-05-0 8P04: 15 R CVD Ii RIGHT-Of-WAY USE PERMIT APPLICATION Permit valid for 90 calendar days from date of approval Submit permit application to the Engineering Dept., Town Center, 255 Parkway Blvd. Date of Submittal: 2 - 5" .. 0 B PERMIT FEE: $100.00 (No charge to Utility Companies with approved Franchise/ROW Use Agreement) (VN Applicant's Job # / Work Order # 82 €:.. 9 F..J D Refer to the City of Coppell Ordinance No. 2001-944. Certificated Telecom Provider? ~ Plans provided and approved (Erosion Control/safety fences must be installed prior to beginning work) Project Name / Location: 445 0. KOYJlqL k.A) General Contractor: MAS T6.-~ / FI!.I9IJIC OEAJtJI5 Contact # 214 202- Z IS 3 Permit issued to Company / Representative: Q w6S I /<-~C.OTT /.A.JH#!Lc/r' Address: /2oc> l fJ. ~J=:.~T~L F;. '( p # IO~O DALLA-=; 7s: 2-4~ Telephone #: 9'12 -7;?/)-2989 Emergency Telephone #: 2/4.32'3- 5'55' ~ Utility Company Represented: o Oncor Electric Delivery o Time Warner Cable o Atmos Energy o CoServ Electric/Gas o Verizon 0 SBC/ AT&T [lJ'Other Q wE. s T General Description of Work (provide four [4J sets of plans): In accordance with Ord. No. 2001-944. P/...ltc~ H/JJJnlf(JL~~ AA//J [)IP~~_TIL>~L 15~,.e.~ ,So ROy,4L LA) @ '36t' A'uGLL /d PhJ~/)~ AMtJ ~~J20t!1=- 70 +15 S. RoYALLIJ Estimated Start Date .2.. 12 -C> B Estimated Completion Date* 2....., 9 - DB * Completion requires submittal of Completion Verification Notice (see page 4) ~ Was contact made with City and/or utility companies to locate existing utilities? ~ if NO, Reason: YES ~ ~ Is removal of existing streets, alleys, or sidewalks necessary? if YES, must have City inspection prior to concrete replacement YESD NOD NO~ Right-of-Way Use Permit Application Page 2 of 4 Representative(s) 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 ~ood condition as before the commencement of work (grading, drainage, vegetation, and erosion control). To schedule Public Works final inspection (Page 4) call 972-462-5155. ~ 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 @ 972-462-5150 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 a.m. until 3:00 p.m. ONLY unless otherwise approved by City Engineer. ~ Attach Work Order (franchise only) and/or 4 sets of prints showing proposed work. Contacts must be made to locate existing utilities 48 hours prior to beginning work. (Application with original signatures should be submitted to the Engineering Department before approval.) Representative Oc:::.o-rT tJHJt1/-E1" Printed Name 2-5-D8 Date G Signature of Contractor Representative Printed Name Date ~ Signa ure of City Representative ('-'\ l~L.-.. 0l~z.A Printed Name 'J-./1/o8 Date ~ Comments: ~ NOTE: Notify City Inspector at 972-304-3679 prior to bel(inninl( work and prior to backfill for concrete, trench, ditch and open pit inspections. Backfill must meet all construction standards approved by. the City of Coppell. Applicant shall indemnify and forever 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. CD o o ^ --Jo. o '1 ---J.. .." ~ rr1 ~ m 0 (J1 ~~8Ul J> (/)-0" ;0 -I -0 ;0 -< ,PO OJ>I-< ~ -I'" )> rrl-ll N ;;Xr O Z r 0 o CO VI :J: IT'I IT'I ::l o ." .... 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Apr 17 08 04:37p Debbie Ingram 972-462-5199 p.1 Page 4 of 4 THE.CiTY.OF COPPELL I> UTILITY RELOCATION IN RIGHT-OF-WAY OR EASEMENT COMPLETION VERIFICATION NOTICE Contact City of Coppell Public Works Division at 972-462-5155 to schedule an inspection with Utility & Streets personnel to verify that your project has been completed to City of Coppell specifications. Failure to schedule verification inspection may delay future projects. Franchise Utility Name Q LV E.S T Project Location I Applicant's 'York Order # (ifapplicable)~~S- ROjALI../J. ~~~l) }-q/' j7vc. j/zAQEO J-2.'{ nl5~ ~~ '1"~~ Y~CllfrJy4{..lII. Sub-contractor Company Name f\Il A S T ~ c.. 24hr.ContactNumber 2./4 - 5"71 -1..-$'10 Date of Verification Appointment 4 - liP . 09 Time of Verification Appointment q: DO INFORMATION BELOW TO BE COMPLETED BY CITY OF COPPELL PUBLIC WORKS PERSONNEL .:. Inspected by Oflhil/irw'd1- of UTIUTIES Maintenance Division on $I-It. .-o?l s::;s=r and found to be r(C;~ / not acceptable because Follow-up needed?(t!!/ I YES Follow-up scheduled for .:. Inspected by of STREETS Maintenance DiJ'ision on and found to be acceptable / not acceptable because Follow-up needed? NO / YES Follow-up scheduled for A copy of this completed notice is to be pro"ided to: City of Coppell Engineering Dept. 255 Parkway Blvd., Coppell TX 75019 Office: 972-304-3679 Fax: 972-304-3570 I:: ,.. 0% "'0 ~s X", ;0'" Q~ ~~ "''''' ",'" ~; ~ ..... Z iiir::; Fi . o~ ~ ~~ ~ro >~ ~!; n~ ~ ~n _0 '1 Jd7<. ~~ I -0 . fT1 :.. ~ "'Q ~ Ifi I:: ?! ON 5:! . %6 :1J-a gl' ~~ '" ~~ ~~ ~!i "'~ l!1:;:; ~:;:; O~ ;2 o '" '" '" ~~ il:~ i= "'''' ~~ ~8 gl' -<~ ~~ ~;;; o ;0 -011I <..... nC .... ~ :& ~;;. 8~ "'~ ni!i; ~~ -~~~ ~ ~~ "'~ I a liE~ &i~ J::~ :si:c t=:r: ~~ o~ ij!"" ~8 c:,...., ~ ~)., g h ~S 5 ~6 m::;; '" '" ~i!i .eITl ~'" El. o~ i~ ~~ ~!!l l<i~ ~ at.o<: ;t ?! 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