Cambridge Phase 1-PT 950911 Fulure
CONSTRUCTION DEVELOPMENT
PERMIT
APPLICATION
1. Name of Applicant:
Address: "~,~. ['~ '~-
Phone Number: (Z-[4~.~
2. Location of Construction (a~lress):
Subdivisit;n .... Section # Bloc'l~-~--" Lot #
Or:
Survey/Abstract # Acreage
Location description (attach vicinity map):
3. Type of proposed construction or development:
( ) Residential ( ) Alteration of a natural waterway drainage course
/~Non-residential ( ) Other (describe & attach drawing or sketch)
( ) Placement of Fill (in right-of-way or on private property)
4. Description of Construction Permit requested:
( ) Paving ( ) Median or Landscaping ( ) Box Culvert
( ) Sidewalk ( ) Water Main ( ) Rip Rap
( ) Drive Approach ( ) R.C.P. ( ) Fill Area
( ) Excavation ( ) Sanitar.' Sewer Main ( ) Drainage Channel Excavation
( ) Fire Lane ( ) Flume ( ) Slope Protection Retaining Wall
( ) BHdge ( ) Inlet ( ) Parking Lot
* Please provide the name, address and 24 hour phone number for supervisor of every, contractor working under
this general permit.
CONSTRUCTION DEVELOPMENT
PERMIT APPLICATION
Page 2
5. All construction shall follow the City of Coppell Subdivision Ordinance, Standard
Construction Details, Streetscape Plan and stamped approved plans. The activity shall be in
compliance with Erosion and Sedimentation Ordinance.
6. Applicant shall provide one copy of approved plans, specifications and related cost estimate
or contract of the proposed construction for the purpose of permit fee calculation.
7. A Construction Permit Fee in accordance with the City of Coppell Fee Ordinance shall be paid
prior to beginning work.
Amount Paid Date Paid
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.
Si~da, t~l;e of Applicant Dat~ /
FOR CITY USE ONLY
Is the fill area located in an identified flood hazard area? ( ) Yes ( ) No
If yes, then a Floodplain Development Permit is required before any construction can begin.
Is additional information required? ( ) Yes ( ) No
Are other federal, state or local permits required? ( ) Yes ( ) No
( ) PERMIT APPLICATION APPROVED
( ) PERMIT APPLICATION DISAPPROVED
City Approval Date