Cozby Addn-PT120213 T N E• C 1 T Y• O F
COPPELL
9 5 ti 6
CONSTRUCTION DEVELOPMENT PERMIT APPLICATION
Name of Applicant: RA ! - o1 CCUn.Urt & Date Submitted: Z /O /z /t
Address of Applicant: 3�, Cl( k.e,(Irs' #`c Gc,S Q A ( k et(
es Tl�
Phone Number: e f 7- 33 7--,516"5
-- < 6"5 FAX NUMBER: 8( 7- 3 3 7-,55
Location of Construction (address, if available): - 76 q S, (0
Coz,B
Subdi ision Section # Block # Lot #
OR
Survey /Abstract # Acreage
Location description (attach vicinity map):
1. Type of proposed construction or development:
() Residential ( ) Alteration of a natural waterway drainage course
( ) Other (describe & attach drawing or sketch)
() Placement of Fill (in right -of -way or on private property)
2. Description of Construction Permit requested:
( ) Paving ( ) Median or Landscaping ( ) Box Culvert
(4 ( ) Water Main ( ) Rip Rap
(rive Approach ( ) R.C.P. ( ) Fill Area
( ) Excavation ( ) Sanitary Sewer Main ( ) Drainage Channel Excavation
( ) Fire Lane ( ) Flume ( ) Slope Protection /Retaining Wall
( ) Bridge ( ) Inlet ( ) Parking Lot
Provide an attachment containing the name and 24 -hr. contact phone number
of supervisor(s) for every contractor working under this general permit.
3. All construction shall be in compliance with, but not limited to, the City of Coppell
Subdivision Ordinance, Standard Construction Details, Streetscape Plan and approved plans.
The contractors shall adhere to the City's Erosion Control & Sedimentation Ordinance.
4. Applicant shall provide a copy of approved plans, specifications and related cost estimate or
contract for the purpose of permit fee calculation verification.
CONSTRUCTION DEVELOPMENT PERMIT APPLICATION Page 2
5. A Construction Inspection Permit Fee shall be paid prior to beginning work, in accordance
with the City of Coppell Fee Ordinance. See Page 3 for calculation formula.
Amount Due: $ ,)�5. "S ' I Date Paid: 1311
NOTE: A separate excavation permit is required anytime pavement is cut or when there is work in the
right -of -way not approved by the City Engineer.
> Any work requiring closure of a lane of traffic, street, or alley must be approved
in advance by the Engineering Dept., with notification to the following prior to
closure:
Police Department CO 972 -304 -3600 Street Department @ 972 - 462 -5150
Fire Department @ 972 - 304 -3500 Engineering Dept. @ 972 - 304 -3679
> Attach barricade plan / trench safety plan of a lane or street closure. (Required)
> It is a requirement of this permit that As -Built Drawings be turned in at the end of
this project. As- Builts consist of 1 set full size paper copy, 1 set full size mylar and
CD with Autocad.dwg files.
NOTE: Street closures are allowed from 9:00 a.m. until 3:00 p.m. ONLY unless otherwise approved
by City Engineer.
➢ A pre- construction meeting is required prior to beginning work related to this permit.
Contact the inspector assigned to your project to schedule the meeting.
4/„.44e, te,i.,A g :
Signature scant Printed Name ' Contact Number
c iG lc O i 0 cu_- --I( 51(0 1 el /
City Inspector Contact Number(s)
FOR CITY USE ONLY
Is the fill area located in an identified flood hazard area? ( ) YES /(\610
If YES, a Floodplain Development Permit is required before any construction can begin.
Is additional information required? ( ) YES (moo
Are other federal, state, or local permits required? ( ) YES (\.
P RMIT APPLICATION APPROVED () PERMIT APPLICATION DENIED
7, ii / 1 z._
l-m s ty Approval Date
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.
T H E• C 1 T Y • O F
COPPELL
0
� INSPECTION FEE CALCULATION SHEET
PROJECT NAME (.,6 �j /�:? 11 - 5 DATE - /
As per the City of Coppell Subdivision Regulations, the Developer shall pay 4% of the cost of the items to be permitted and inspected by the
Engineering Department and dedicated to the City. The Developer shall pay 2% of the items to be inspected by the Engineering Department, but not
dedicated to the City such as parking lots, private utilities, private drainage systems and so forth. Inspection fees are due on or before the date of the
Pre - construction Meeting.
In order to verify the inspection fee due, please provide a copy of the development contract(s) and this spreadsheet with completed
calculations to the Engineering Dept. The contract(s) should indicate the cost to construct the following improvements:
PUBLIC IMPROVEMENTS X 4% = PRIVATE IMPROVEMENTS X 2% =
CONTRACT AMOUNT CONTRACT AMOUNT
PAVING � t 735a- 8 LI
WATER
SANITARY SEWER
STORM SEWER
ALLEYS
SIDEWALKS
OTHER
TOTAL
T t
Construction Development Permit GRAND TOTAL $ 3 \ 6 `' Page 3
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. , PROPOSAL
CONCRETE CONSTRUCTION
DATE PROP # REP
P.O. BOX 708
KELLER, TEXAS 76244
2/2/2012 1 k18 LDP
Office 817- 337 -5155 — Fax 817- 337 -5585
JOBSITE LOCATION
Allstate Huemmer
Rick Huemmer
709 S. Coppell Road
Coppell, Texas
Customer Phone 46q- 7o7 -8850 j Customer Fax Customer Email rirkhuommer<< :n e.rom
QTY DESCRIPTION UNIT SAM IT TOTAL
3,784 5" 3500psi Broom finish pavin0 with #3 -18" ocow. sy. ft. 3.05 11,541.20
150 h' 3500psi Broom finish approach tvith #3 -18" otow. sy. It. 3.30 495.00
31 t," Curh. & linear ft. 18.50 573.50
41)0 Demolition & haul 011 of concrete. sq. 0. 2.50 1,000.00
Haul ell loads of dirt (us Hooded). each 200.00 800.00
851 4" Broom (finish sidewalk with #3 -18" 0, s9. ft. 2.80 2,382.80
VISA, MASTER & DISCOVER credit cards are accepted. TOTAL $16,792.50
2% Processing fee does apply.
TERh1s A < l )Nl -t1Tll This .lo, ument is 0 good laith estimate of the mists no, ess ry to omplelo this prole(t based upon the information 0v ailahle at the time
of the estimate. The total hill, Ne amount ould v a ry Irom this proposal based 00 0 trial field measurements. Pennington Con, rote Conslrurtion extends 0 one
< < 1 1 ) 0rrantt on lho Lon, fete Ior unseen damages but dogs not 1) ,tri , stress r ks due to soil movement It in the event am damages to the proper■ uo u
∎chile .working onsite, Pennington Corn rote Construrlion will repair those damages prom plk . l menl is due at jog com pletion 10 <IN old penalties, unless
olhe•cise notated 011 this agreement.
, sih this do, ument \ are slating t ou understand and agree to the ahov e terms and Condit ions.
Customer Signature Date
li) 2595
Frost National Bank
PENNINGTON CONCRETE, INC. Coppell, Texas 75019 e`—
PO BOX 708
KELLER, TEXAS 76244 30 - 1140
(817) 337 -5155 2/10/2012 1
0
PAY TO THE 2
ORDER OF City of Coppell $ * *335.84
v
Three Hundred Thirty -Five and 84/ 100******************"*********************************** * * * * * * * * * * * * * * * * * * * * * **. * * * * * ** DOLLARS a
3
City of Coppell 8
f
MEMO .- A l it' D SIGNATURE
- r - -.I"? ":- - 11 11 ' ® _ _W� -=mac ,
PENNINGTON CONCRETE, INC.
2595
City of Coppell 2/10/2012
335.84
Frost Bank Checking Rick Huemmer 335.84
PENNINGTON CONCRETE, INC.
2595
City of Coppell 2/10/2012
335.84
CASH 1, 082533
RECEIPT Date 1
Received From i::: ri 1.,! t °,' ' ; f /‘s Ai, E -
a --
Address t. • / s (, f f - r L- t ,
Dollars $ , ,_� ) . ,'' � -f
I For ,f F l e ii," " i t /t /1 j r`r r '', f /r ''-'' r ".
6 4 ACCOUNT HOW PAID
- Ip 1 = AMT OF CASH
CCVV ACCOUNT
m
ix
U AMT. PAIBA r' (` f4 CHECK ) r C( t i
BALANCE > .r` . MONEY ORDER ❑ ' `"° By t�. ( .-
Frost B< DUE CREDIT CARD 34
PRODUCT SSL7160 USE WItH9i663 ENVELOPE - -- -