PA1501A- PT160209T w a. c i Y r. o r
COPPELL
r •>
A 6 t
CONSTRUCTION DEVELOPMENT PERMIT APPLICATION
Name of Applicant Bahman Zamhariri Date Submitted 2/8/2016
Address of Applicant V ot4t
Phone Number 469-374-1464 Fax Number
Location of Construction (address, if available): Andy Brown Park East - 234 e. parkway
Subdivision Section # Block # Lot #
OR Survey/Abstract # Acreage
Location description (attach vicinity map):
1.
2.
Type of proposed construction or development:
C Residential (* 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)
Description of Construction Permit requested:
0
Paving
❑X
Sidewalk
X❑
Drive Approach
❑X
Excavation
QX
Fire Lane
F
Bridge
Box Culvert
❑ Rip Rap
❑X Fill Area
❑X Drainage Channel Excavation
Slope Protection/Retaining Wall
QX 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.AH 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.
Median or Landscape
X❑
Water Main
X❑
R.C.P.
❑X
Sanitary Sewer Main
Flume
Inlet
Box Culvert
❑ Rip Rap
❑X Fill Area
❑X Drainage Channel Excavation
Slope Protection/Retaining Wall
QX 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.AH 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: $ N/A
Date Paid:
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. until3:30 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:
ignature of Applicant
Signature of Inspector
Contact Number
Contact Number
FOR CITY USE ONLY
Is the fill area located in an identified flood hazard area? (: Yes C No
If YES, a Floodplain Development Permit is required before any construction can begin.
Is additional information required? C Yes Co No
Are other federal, state, or local permits required? C9 Yes C No
C: PERMIT APPLICATION APPROVED C PERMIT APPLICATION DENIED
Zlis
Date
Applicant shall indemnify and forever hold harmless against the City of Coppell each and evefy claim, demand
or cause of action that may be made or comae 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 front the City, if such
permit is granted.
T H_ K , c I 'r T, 0 F Page 3
COPPELL
INSPECTION FEE CALCULATION SHEET
Project Name 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:
Grand Total (total of
both colored fields)
Submit by E-mail Print Form
PUBLIC IMPROVEMENTS
CONTRACT AMOUNT
X4%- _
PRIVATE IMPROVEMENTS
CONTRACT AMOUNT
X2%=
Paving
Water
Sanitary Sewer
Storm Sewer
Alleys
Sidewalks
Other
Total
Grand Total (total of
both colored fields)
Submit by E-mail Print Form