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Fresenius-PT130807T H 9 - c r T Y - O F COFFELL E pro, A b i CONSTRUCTION DEVELOPMENT PERMIT APPLICATION Name of Applicant: Lvej&, Cr�eeK Cel,S*fttC iid Date Submitted: 7` / 3 Address of Applicant: quo, co -etst LL j"cc�• v ,? �� c� F���. z� _ f 3 6 ,r6 Phone Number: f f- yk 7- ,�-%c/a FAX NUMBER: f �'� & Location of Construction (address, if available): 371 Subdivision HE Section # Block # Survey /Abstract # Acreage �0 Location description (attach vicinity map). C6-rN 1. Type of proposed construction or development: {) Residential O Alteration of a natural waterway drainage course O Non - residential O Other (describe & attach drawing or sketch) O Placement of Fill (in right -of -way or on private property) 2. Description of Construction Permit requested: } Paving (} Median or Landscaping ( ) Box Culvert () Sidewalk () Water Main ( ) Rip Rap ( } Drive Approach () R.C.P. ( ) Fill Area Lot # ( } Excavation O Sanitary Sewer Main ( ) Drainage Channel Excavation O Fire Lane O Flume ( ) Slope Protection /Retaining Wall ( ) Bridge O 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: $ �► ` %U . Date Paid: �l 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 @ 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 4.00 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. S,'bna -e of Applicant Printed Name Contact Number Ci Inspector Contact Number(s) FOR CITY USE ONLY Is the fill area Iocated in an identified flood hazard area? O YES ( NO If YES, a Floodplain Development Permit is required before any construction can begin Is additional information required? O YE (�NO� Are other federal state or local permits required? ( YES O NO — s � p q ( ) PERMIT 2 ICAT ED O PERMIT APPLICATION DENIED City Approval Date Applicant shall indemnify anti forever hold hartnless 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 I T Y • O F COPPELL INSPECTION FEE CALCULATION SHEET PROJECT NAME Fac 9/1-t DATE F- 7- ) 3 As per the City of Coppell Subdivision Regulations, the Developer shall pay 4% of the cost of the items to be pennitted 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: Construction Development Permit GRAND TOTAL $ 3 ` Page 3 PUBLIC IMPROVEMENTS CONTRACT AMOUNT X4%= PRIVATE IMPROVEMENTS CONTRACT AMOUNT X2%= PAVING WATER 75- �'J/C�. ZZ / � r �� l�. SANITARY SEWER � , 3 STORM SEWER ALLEYS SIDEWALKS OTHER TOTAL Construction Development Permit GRAND TOTAL $ 3 ` Page 3 Confidential MAVERICK UTILITY CONSTRUCTION, INC. P.O. Box 728 Phone: 817 - 684 -0858 Euless, TX 76039 Fax: 817 - 684 -0360 Coppell Public Schedule of Values Date Proposal # 8/7/2013 MUC- Client Proiect aecuon w - waxer uisinouzion TruBlu Logistics 8" Bore With 16" Steel Casing Coppell (DFW Airport) Please Direct All Questions to Bryan Yule 3 byule@mavutility.com 4 Item IDescription lQuantity Unit I Unit Price Total aecuon w - waxer uisinouzion 1 8" Bore With 16" Steel Casing 2 8" DR -14 PVC Water 3 16'x 8" Tapping Saddle & Valve 4 2" Water Service (No Meter) 5 8" DDCV w/ Vault 70 I.f. $ 255.33 $ 17,873.10 156 11 $ 25.52 $ 3,981.12 2 ea. $ 6,824.00 $ 13,648.00 4 ea. $ 2,948.00 $ 11,792.00 2 ea. $ 14,062.00 $ 28,124.00 Total Water $ 75,418.22 11tem IDescription I Quantity nit I Unit Price I Total Section B - Sewer Distribution 1 8" SDR -26 PVC Sewer 73 ►.f. $ 29.21 $ 2,132.33 2 5' Diameter Manhole 1 ea. $ 5,467.00 $ 5,467.00 3 Connect To Existing Manhole 1 ea. $ 1,734.00 $ 1,734.00 Total Sewer $ 9,333.33 Total Schedule $ 84,752.00 Page 1 of 1