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Spencer Est-PT130917 TH1E - CITY Of'. COFFELL .),. 4 a 6 x a CONSTRUCTION DEVELOPMENT PERMIT APPLICATION Name of Applicant IM&S Construction I Date Submitted 18/30/2013 Address of Applicant 1506 Bois D Arc Forney Texas 75126 Phone Number 1214-878-3489 I Fax Number 1972-289-6600 Location of Construction (address, if available): IStonewick Ln. ( Subdivision 1 I Section# I , Block# 'Lot# I1 OR Survey/Abstract# I Acreage I Location description (attach vicinity map): 1 SpoerlAts& s'i Jo/1i /• net I 1. Type of proposed construction or development: ( Residential C Alteration of a natural waterway drainage course C Non-Residential C Other(describe& attach drawing or sketch) C Placement of Fill(in right-of-way or on private property) 2. Description of Construction Permit requested: ❑ Paving ❑ Median or Landscape ❑ Box Culvert ❑ Sidewalk p Water Main ❑ Rip Rap ❑ Drive 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. 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 the 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: $ /69`t`t `! Date Paid: //7//3 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 @ 972-304-3512 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 a CD with Autocad.dwg files. NOTE:Street closures are allowed from 9:00 a.m.until 3:30 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. Printing your name indicates your acceptance of the terms and conditions of this form: c ,-----400e, Signature of Applicant Contact Number LA/2,e 61414.5 +bet-576-770 7 Signature f Inspector Contact Number --1 FOR CITY USE ONLY -.„ Is the fill area located in an identified flood hazard area? C Yes C If YES, a Floodplain Development Permit is required before any construction can begin. Is additional information required? C Yes 410 Are other federal, state, or local permits required? C Yes o pofk. IT APPLICATION APPROVED C PERMIT APPLICATION DENIED City p c. Date kV 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 14 E - Ct , T. Y o Page 3 coppELL et INSPECTION FEE CALCULATION SHEET Project Name f Spey\ce IZ PS iP ■ n I 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 U PRIVATE IMPROVEMENTS CONTRACT AMOUNT X 4/o= X 2%= CONTRACT AMOUNT Paving Water c9 "/C 0 Sanitary Sewer Storm Sewer Alleys Sidewalks Other Total Grand Total (total of /‘ S both colored fields) Submit by E-mail Print Form • 1 CASH RECEIPT Date y/17/1. 096718 Received From f S 60 ArS-77e'1f d--7©111 Q.z N. Address ►`JI r 1-a-4:'.N. j 8 N Dollars Si eQ�„OO O C m~ For / ' y1 �S.u. ACCOUNT HOW PAID AMT OF ACCOUNT" ` CASH AMT.PAI4// 6OffO0 CHECK / 0 Rifielier_ BALANCE v / y , MONfYORDER❑; B ` DUE CREDITCARR❑1 ,, J • M&S CONSTRUCTION 32-1432/1110 1260 506 S BOIS D ARC FORNEY,TX 75126 / Il Z DATE lY J¢ f PAY TO 11L c ' l pjj 1 $ //6'f 3 t . E THE ORDER DER OF 6�t �// ,,/ //�/_ //// v'RD -Ad f7 and /1.4 k�ZL(1\et ��- i f i, a/%'/ DOLLARS 8 �, "`� BiANKOF TEXAS / www.bankoftexas.com �c_ M 1�7f,, , G ---t.A.,MEMO -t" ./ r/t1�t r Pf'S . ' I r 1 Un�'V' e 1 m'