Creekview Add PD-CS 911016CITY OF COPPELL
P. O. BOX 478
COPPELL, TEXAS 75019
(214) 462-8495 --
Construction Deve].oDment Permit ADDlication
1. Name of Applicant: ~A~/~
Address: ~ 0 ~ ~ _~ ~~ ~ ~- ~ ~
Phone
Nu~er:
(
2. Location of Property, /~O ~~~ ?~
- ADDRESS
If L~at~ in a Subdivision:
of Subdivision Section No. Block No. Lot No.
If Not ~ated in a Su~ivision:
Name and Number of Survey/Abstract Acreage
Location Description Attach a Vicinity Map
3. Nature of Proposed Construction or Development (Check and Complete):
( ) Residential ( ) Non-Residential
( ) Alteration of a Natural Waterway or Drainage Course
( ) Placement of Fill (~ Other (Describe & Attach
A Drawin~ or Sketch),
4. Description of Proposed Construction or Development (Check and Complete):
~ New Construction ( ) House
( ) Mobile Home ( ) Non-Residential
(specify)
( ) Substantial Improvement to Existing Structure
( ) Commercial
Name and Type of Business
5. Description of Construction Permit Requested (Complete as Appropriate):
( ) Paving ( ) Drive Approach ( ) Sidewalk
( ) Median or ( ) Excavation ( ) Fill Area
Landscaping
( ) Water Main ( ) Sanitary Sewer ( ) 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. ~C. ~J~DC~- ~ a- l/~ o- ~-/~F.~
6. All construction will follow the City of Coppell Subdivision Ordinances
and stamped approved plans.
7. Applicant will provide one copy of approved plans, specifications, and a
related cost estimate or contract of the proposed construction for the
purpose of permit calculation fee.
8. Construction Permit Fee:
Amount Paid
2 % Contract Construction
COst on Items to be Dedicated ~O~. O~ 60,--'
NOTE: A separate excavation permit is required anytime pavement is cut or
that there is work in the right-of-way not approved by the City Engineer.
Sign f Applicant Date
FOR CITY USE ONLY
Is the property located in an identified flood hazard area?
( ) Yes ( ) No
If yes, then a Floodplain 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
( ) Permit Application Approved
( ) Permit Application Disapproved
City Approval Date
CONDEV.CLD
CASH Jb-J(~ ,9. fit0012102'
RECEIPT
Address
~T. OF
ACCOUNT i
~L~CE