Work Order #59103 A copy of the approved permit must be on the job site at all times.
T • I CC: Applicant 14 ` C T v o ` Page 1 of 4
Public Works C I:TELL
P
ermit File Rev. 06/2012
10-1 1- ' A10:33 R C
Orig. to Project File x „ 8'' ,
ApaowElRIGHT-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.or e-mail to engineer@coppelltx.gov(see button below)
Date of Submittal: 10/11/2013 .Applicant's Job # /Work Order # 59103
PERMIT FEE: $100.00
(No charge to Utility Companies with approved Franchise/ROW Use Agreement)
Refer to the City of Coppell Ordinance No. 2001-944. Certificated Telecom Provider? Yes Co' No C
1 Plans provided and approved (Erosion Control/Safety fences must be installed prior to beginning work)
Project Name/Location or address 2941 Lake Vista Dr
General Contractor Housley Group Contact# 972-931-2686
E-mail address to return permit cmitrani @hc-inc.corn
q 4 C Representative: Joel Singleton
Franchise Telephone#: 214-869-8628
1Company
E-mail address: j oel.singletonotwcable.com'
(for contact if needed/if e-mail of approved permit is desired/permit cannot be e-malled unless complete)
Utility Company Represented:
C Oncor Electric Delivery C Atmos Energy C Verizon C SBC/ AT&T
(: Time Warner Cable C' CoSery Electric/Gas C' Other
General Desk ption of Work On accordancewrithOrd No 2001 944J:PLEASfE ATTACH PLAN OF PROPOSED WORK
T"iei chibore appr ximatelly 3920 feet.' PullFcableihrough exisiting conduit forrapproximately 680 feet Place'1'WCfber cable
to errice customer(f=irstChoice®ER)located at 2941 LakeVista Dnvie ng ¢
s l lad a '�
r} i iw�� t q" 2 ;.!?... Iini f ! 4.!' 5 ::; . . a .
Estimated Start Date 10-15-2013 Estimated Completion Date* 11-15-2013
* 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: (i Yes C No
>Is removal of existing streets, alleys, or sidewalks necessary? C Yes Cis No
if YES,project must have City inspection prior to concrete replacement
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
applicant's expense)and barricading according to the Texas Manual on Uniform Traffic Control Devices.
Areas) a ff e c t d_PusI lb. 4 + h. , t, ',.,! I x+'I E t' '.f•r • • •n I ;3 . •f , # , (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(g3 972-304-3600
Fire Department @ 972-304-3512
Street Department @ 972-462-5150
Engineering Department a 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 3:30 p.m.ONLY unless otherwise approved by City
Engineer.
➢Attach Work Order(franchise only)and/or 1 set of prints showing proposed work.
LP Locates for existing franchise utilities must be done 48 hours prior to beginning work
' For City.utility locates, cali,972-4625155 to scheduie,48 hoursgprior to beginning work
The application with signatures of Franchise and Contractor representatives must be submitted to Engineering
Dept.for approval prior to beginning work. Submittals by e-mail should go to engineer @coppelltx.gov.
Printing your name indicates your acceptance of the terms and conditions of this form:
(if you want the approved permit returned via e-mail,provide a valid e-mail address on Page 1.)
Joel Singleton 10/11/2013
Signature of Utility Company Representative Date
Juan Rubio 10/11/2013
Signature of Contractor Representative Date
irro
S' �' 'R' ity Representative Date
Comments
>NOTE: Notify City Inspector at 972-304.367 pri r to beginning 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.
TIME
C A B L E
GENERAL PROJECT NOTES
FIRST CHOICE ER 1. ALL CONSTRUCTION WORK WITHIN HE PUBLIC RIGHT-OF-WAY SHALL DONE IN ACCORDANCE H THE
ORDINANCES AND REGULATIONS OF THE MUNICIPALITY IN WHICH THE WORK IS TO BE PERFORMED.
2. EXISTING UTIUTY LOCATIONS SHOWN ARE TAKEN FROM AVAILABLE RECORDS AND MAY NOT BE ALL INCLUSIVE
UTILITY LOCATIONS ARE GENERALLY SCHEMATIC IN NATURE AND MAY NOT ACCURATELY REFLECT THE SIZE AND
2941 LAKE VISTA DR LOCATION OF EACH A PARTICULAR EDUTY.THE CONSTRUCTION CONTRACTOR SHALL ASSUME RESPONSIBILITY FOR
ACTUAL LINE LOCATES IN THE FIELD AND THE PROTECTION OF AU.EXISTING ILL ASSUME
WHEFHER SHOWN OR NOT.
THE CONSTRUCTION CONTRACTOR SHALL ALSO ASSUME RESPONSIBILITY FOR REPAIRS TO ANY EXISTING FACILITY
DAMAGED AS A DIRECT RESULT OF THE CONSTRUCTION ACTWITIES WHETHER THE FACILITY IS SHOWN ON THE
DRAWINGS OR NOT.
3. ME CONSTRUCTION CONTRACTOR SHALL BE RESPONSIBLE FOR A PALL DEPARTMENTS WITHIN THE
MUNICIPALITY AND THE UTILITY COMPANIES AT LEAST TWO WORKING DAYS G TO THE COMMENCEMENT O
F WORK.L E W I S V I L L E, TEXAS
CALL BEFORE YOU DIG
1-800-DIG-TESS
ITS THE LAW
VICINITY MAP 4. IT SHALL BE THE RESPONSIBILITY OF THE CONSTRUCTION CONTRACTOR T0:A)PREVENT DAMAGE TO PRNATE AND
PUBLIC PROPERTY.B)RESTORE ALL AREAS EFFECTED BY THE CONSTRUCTION TO ORIGINAL OR BETTER CONDITION.
5. BARRICADING AND TRAFFIC CONTROL SHALL BE THE RESPONSIBILITY OF THE CONSTRUCTION CONTRACTOR AND
1' SHALL CONFORM TO THE TEXAS MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES'.TRAFFIC FLOW AND ACCESS
d . SHALL BE MAINTAINED DURING ALL PHASES OF CONSTRUCTION.THE CONSTRUCTION CONTRACTOR IS RESPONSIBLE
%S7' FOR PROVIDING TRAFFIC SAFETY MEASURES FOR WORK ON THE PROJECT.THE WORK SITE SHALL BE SUITABLY LIT
1 AND BARRICADED AT NIGHT.
1 TWMAr 6. THE CONSTRUCTION CONTRACTOR SHALL ABIDE BY ALL APPUCABLE FEDERAL.STATE AND LOCAL LAWS GOVERNING
zLV'I'8 EXCAVATION.THE CONSTRUCTION CONTRACTOR SHALL PROVIDE ALL TRENCH SAFETY SYSTEMS THAT COMPLY WITH
ALL LAWS GOVERNING EXCAVATION.THE CONSTRUCTION CONTRACTOR SHALL BE SOLELY RESPONSIBLE FOR ALL
•
ASPECTS OF WORK RELATED TO EXCAVATION.
7. ALL CONCRETE USED IN ANY ROADWAY SHALL BE IN COMPLIANCE WITH THE SPECIFIED CLASSES OF OF NONCE IN
Iw6 YLVA Ni F` THE STANDARD SPECIFICATIONS 5.8"PORTLAND CEMENT CONCRETE PAVEMENT'AND 7.4.5'QUALITY OF CONCRETE'
�,y AS AMENDED BY THE ADDENDUM TO THE NORTH CENTRAL TEXAS STANDARD SPECIFICATIONS FOR PUBUG WORKS
y� CONSTRUCTION-2004.ALL OTHER CONCRETE SHALL BE CLASS A CONCRETE.
- S �` _ 8. ALL REINFORCING STEEL ANO DOWEL BARS IN PAVEMENT SHALL BE SUPPORTED AND MAINTAINED AT THE COflftECT
9(+"_ / CLEARANCES BY THE USE OF BAR CHAINS OR OTHER APPROVED SUPPORT.
Of
'� ray / R. ALL CONDUIT MUST BE PLACED WITH A MINIMUM 42'OF COVER,UNLESS OTHERWISE SPECIFIED.
txN'4N111 10.ALL BACKFILLING WILL BE MECHANICALLY TAMPED IN LIFTS TO A DENSITY OF 955 PROCTOR.THE REQUIRED
DENSITY WILL BE OBTAINED BY USING TAMPERS,RAMMERS OR ROLLING EQUIPMENT.LIFTS MAY VARY ACCORDING TO
THE TYPE OF EQUIPMENT USED TO OBTAIN THE REQUIRED DENSITY.SAND AND DEBRIS FREE MATERNAL WILL BE
I USED FOR BACKFLL
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