ST0003-CS100408T H E C 1 T Y O F
COFFELL
April 8, 2010
Melissa Wolff
Texas Dept. of Licensing & Regulation
1501 Circle Drive, Suite 215
Fort Worth Texas 76119
RE: EABPRJA8000134
Dear Ms. Wolff:
Enclosed please find an original Inspection Response Form we are submitting for the
Coppell Road (Sandy Lake Rd to Cooper Ln) project in the City of Coppell. The
information was also emailed to you on the date of this letter.
As noted on the form, all violations cited will be corrected by June 1, 2010. Please call
me if you have any questions.
Sincerely,
Keith R. Marvin, P.E.
Project Engineer
Office: 972 - 304 -3681
Fax:972- 304 -3570
kmarvinkcoppelltx. gov
Enclosure
255 PARKWAY * P.O.BOX 478 * COPPELL TX 75019 * TEL 9721462 0022 * FAX 972/304 3673
? TEXAS DEPARTMENT OF LICENSING AND REGULATION
1501 Circle Drive Suite 215 Fort Worth, Texas 76119
(817)321 -8368 a (800) 687 -4102 e FAX (817)321 -8365
www.license.stateAx.us
ARCHITECTURAL BARRIERS - INSPECTION RESPONSE FORM
Building or facility owners or the owners' designated agent may use this form to indicate the status of outstanding violations
associated with the referenced construction project that were identified during the inspection performed by a TDLR Investigator
to verify compliance with the Texas Accessibility Standards (TAS).
This form must be submitted to the TDLR representative noted in Step 4.
STEP 1 - PROJECT INFORMATION
PRINT OR TYPE
Name: C'o
EABPRJ #:
,< ^l
Address:
Suite No:
Ci
e/dP
Zip:
7Shc �1
STEP 2 - INSPECTION STATUS INFORMATION
A• ❑ All violations cited on the inspection report relating to the above referenced project
have been corrected
B All violations cited on the ins ec o re ort r latin to the above referenced p roject
• will be corrected by: p U ?ZZ g (completion date). p j
Request
For
Extension (Completion dates after 270 calendar days of the inspection report must be approved by TDLR)
The following violations cited on the inspection report relating to the above referenced project
C • ❑ will not be corrected
TAS violation reference(s)
A Variance Application has been submitted and /or approved for:
STEP 3 - OWNER /AGENT INFORMATION
Owner/ gent N me:
Comp Firm:
Address:
2
Cit
State: �
�:
one t 3 c y- 3 6 7 1J ;2
- 3 y _ 3g 2
City:
1 am the owner of this building /facility or the agent designated by the owner to act on their behalf (check one):
❑Owner (Person or entity that holds title to this property) Owner's Designated Agent
I certify by my signature below that the information provided
is true and accurate. I also understand that failure to
correct the violation(s) may result in this project being forwarded to the Enforcement Division of TDLR for action.
Signature:
Date:
STEP 4 SUBMITTAL INFORMATION:
FOR TDLR USE ONLY
Name:
Company /Agency:
MELISSA WOLFF
9807
Texas Department of Licensing and Regulation
Address:
City:
tate:
Zip:
1501 Circle Drive Suite 215
Fort Worth
� Tx
76119
Phone:
Fax:
. "Email:
817- 321 -8355
817- 321 -8365
me1issaw@1icense.stateAx.us
T D R AB 029 03 -07 NOTE.' An individual who completes end riles this torn with the Texas Department of licensing and Regulation (the Dept.) Is entitled to the following:
1) to be informed about the information that the Dept. collects about the individual, upon their request and subject to a few exceptions;
2) to receive and review the information, under Sections 552.021 and 552.023 of the Texas Govt. Code; and
3) Have the D.O. corred information about the individual that is incorrect, under Section 559,004 ofthe Texas Govt. Code.
— The Department will add your address to the Architectural Barriers email notification list which automatically provides Department information on matters affecting Architectural Barriers. Your email address Is conridenfiet pursuant to the
Texas Information Ad; the Department will not share it with the public. For additional information rink to: htto license state tx us /ne vslettters/lDLRnotiricationLists aso