WA9401-CS 940930
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Trinity River Authority Of Texas
Permit Request Form
Submit Permit Request To: (Check The Appropriate TRA Project)
Central Regional Wastewater System (CRWS) /
Technical Services Engineer
P.O. Box 531196
Grand Prairie, TX 75053-1196
(214) 263-2251 or (214) 262-5186 FAX No. (214) 262-0619
Tarrant County Water Supply Project (TCWSP)
Project Manager
11201 Mosier Valley Rd.
Euless, TX 76039
(817) 267-4226 or (817) 267-4227 FAX No. (817) 267-8773
Ten Mile Creek Regional Wastewater System (TMCRWS)
Project Manager
Malloy Bridge Rd, Rt. 2, Box 136
Ferris, TX 75125
(214) 225-3462 or (214) 225-5538 FAX No. (214) 225-5538
Denton Creek Regional Wastewater System (DCRWS)
Project Manager
P.O. Box 1259
Roanoke, TX 76262
(817) 430-4657 FAX No. (817) 491-4173
Red Oak Creek Regional Wastewater System (ROCRWS)
Project Manager
P.O. Box 538
Red Oak, TX 75154
(214) 299-6808 FAX No. (214) 617-5607
Permit for construction to be issued to:
Street
City
Telephone Contact:
\
State
Name
Zip Code
d,.8, t'4.'b ctG, -Go
i'elephone Number
Permit for operation and maintenance to be issued to:
Name
Street
Telephone Contact: '
Engineering Firm: ~ 2 h
Contact~_~a_me
Street City
State Zip Code
Telephone Number
Telephone Number
Zip Code
1'1
Details must be uL ~ni Le~ on . __ modific,ations of THA facilities including
S I t"i a!l Di opo~c'd
plan and profile sheets of each crossing and initial and final ground elevatinns
Proposed Project Name: E~ ~ ~ R~, ~ ;~ ~~ I C ~
8ubmltted by: K~. G¢~ Date: ~-~o-~
Telephon~ Number: ¢~5~ % -~ ~ ~
Date of Plans: ~ I ~ Proposed Project Start Date: ~ I I~
PROPOSED PERMIT MODIFICATIONS
Utility Crossing
SIZE TYPE CLEARANCE
'~' inch C~
inch
inch
inch
inch
inch
inch
inch
inch
Pavements
STREET NAME
OR DRIVEWAY CLEARANCE
2'
TRA FACILITY TRA STA #
TRA FACILITY
94-00
I l+qo
TRA STA #
Fill
MAXIMUM AMOUNT FINAL
OF FILL (ft) ELEVATION (f-t)
TRA FACILITY
TRA STA #
Excavation
MAXIMUM AMOUNT
OF FILL (ft)
FINAL
ELEVATION (ft)
TRA FACILITY
TRA STA #
*SEE LAST PAGE
M~nhole Adjustment A,)/i/-?.-/"""~
FINAL
HEIGHT ADJUSTED (f_t) ELEVATION f~_
TRA FACILITY
TRA STA #
Miscellaneous
TRA FACILITY
TRA STA #
2
3
CLEARANCE - the number of feet between the proposed modification and the
Authority's facility. The clearance should indicate if the modifications are to the
above, below or next to the Authority's facilities,
TRA FACILITY - pertains to wastewater interceptors, water pipelines, meter
stations, lift stations, etc... TRA facility plans may be obtained from the appropri-
ate Project.
TRA STATION NUMBER - TRA station numbers can be obtained from the appropri
ate Project's as-built construction plans and must be included on the Permit Re-
quest Form.
TRA USE ONLY
NORTHERN REGION NUMBER:~
APPROVED BY: ·
DATE:
k. ~/.,.~..~.~._,,*
~,'LLOW LK;
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; ;: SAND'*T ~AKF ....
..... ' ~ *- - ............ -';,1 ~ - ' '
~=
LEDBETTER
" C)
FARMERS
CARROLLTON
BRANCH
-- PET
RO.W
AREA
,,/
P.I. STA. IO7+68 I
A = 5020, L.T. '
CONST. TYPE "A" M.H. ~
.... EXPLORER PIPELINE CO.
METERING STATION
ST. LOUIS ¢r SOU_TTES, o~TiRN
--G
BELT LINE ROAD --
F "6" <;b AMERICAN PETROFINA LINE
RAILROAD
FI2" ~ EXPLORER LINE
I 6II
5~c,. IIl+qo
115 + 00
-- 2,0' UTILITY
E ASEME NT
PROPOSED 33" ~' R.C.P.
PI. STA 110~20
A = 5° 20' R.T.
CONST. TYPE "A" M.H.
PARCEL NO. II
MORRIS ETHRIDGE 6
WINSTON C. JONES
ii
i
Z
f '-r
,.i.=
..... .~- NATU'RAL ~ROljND LI~iE
12" ¢ EXPLORER
.. P_IPE LINE .'~
6" ¢ AMERICAN
............. ./'~PETROFIN~..LtNE;.
VELOCITY ='2.0 F~S
-;
....... C~ASSTrr P~P,E, . .............
SANITARY
COPPE