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Denton Co Levee-PT 921029CITY OF COPPELL P. O. BOX 478 COPPELL, TEXAS 750 9 (214) 393 -1016 1. Revised 3/12/92 f A lic nt• Denton County Levee Improvement District No. 1 Name o pp Address: 2001 Bryan Tower, Suite 750, Dallas, Texas 75201 Phone Number: 214 954 -6300 2. Location of P: If Located in N/A erty• Denton Creek East of Denton Tap Road Address Subdivision: Name of Subdiv Sion Section No. Block No. Lot No. If Not Located in a Subdivision: Clarinda Squires Survey A -1327 Name and Number of Survey /Abstract Denton Creek East of Denton Tap Road Location Description Attach a V Acreage Map 3. Nature of Proposed Construction or Development (Check and Complete): ( ) Residential ( ) Non - Residential (X) Alteration of a Natural Waterway ( ) Other (Describe & Attach Drainage Course a Drawing or Sketch ( ) Placement of Fill 4. Description of Proposed Construction or Development (Check and Complete): (X) New Construction ( ) House ( ) Mobile H me ( ) Non - Residential (specify) Substantial Improvement to Existing Structure Commercial Name and Type of Business 5. Description o� Construction Permit Requested (Complete as Appropriate): ( ) Paving ( ) Drive Approach ( ) Sidewalk ( ) Median or ( ) Excavation ( ) Fill Area Landscaping ( ) Water Main ( ) Sanitary Sewer (X) Drainage Main Channel ( ) R.C.P. ( ) Box Culvert Excavation ( ) Bridge ( ) Rip -Rap ( ) Inlet * Please provide the name, address, and 24 hour phone number for a contact supervisor for each and every contractor working under this general permit. 6. All construction will follow the City of Coppell Subdivision Ordinances and stamped approved plans. The activity shall be in compliance with Erosion and S dimentation Ordinance. 7. Applicant wil provide one copy of approved plans, specifications, and related cost stimate or contract of the proposed construction for the purpose of pe mit calculation fee. 8. Construction Permit Fee: Amount Paid 2 % Contract Construction Cost on Items to be Dedicated N/A NOTE: A s parate excavation permit is required anytime pavement is cut or that there s work in the right -of -way not approved by the City Engineer. Sig ature of Applicant William N. Vanderstr aten, Chairman Denton County Levee improvement District No. 1 FOR CITY USE ONLY /0r001- �9 Date Is the fill area llocated in an identified flood hazard area? ( ) Yes ( ) No If yes, then a Flo dplain Development Permit is required before any construction can start. Is additional information required? ( ) Yes ( ) No Are other federal, state, or local permits required? ( ) Yes ( ) No ( ) Per it Application Approved ( ) Pe it Application Disapproved City Approval CONDEV Date