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Mobil Sta MacA-CS 890521 P.O BOx 478 ° '- 'r- ' ........ Coppell, Texas 75019 utif~ F~r~ 2]4 -462 - STATE OF TEXAS : COU~Y OF DALLAS : CI~ OF COPPELL : 2. LOCATION OF PROPERTY (complete as appropriate) If located in a subdivision: NAME OF SUBDIV~'SION SECTION NO. BLOCK NO, LOT NO. NOT located in a subdivision: NAME & NUMBER of SURVEY/ABSTRACT . ACREAGE LOCATION DESCRIPTION - ATTACH A VICINITY~iAP 3. NATURE OF PROPOSED CONSTRUCTION OR DEVELOPHENT (check and complete) ( ) Residential (~on-Residential ( ) Alteration of a Natural Waterway or Drainage Course ( ) Placement of Fill ( ) Other 4. DESCRIPTION OF PROPOSED CONSTRUCTION OR DEV~.OPMENTS (check and complete) (~ew Construction ( ) Substantial improvement to existing structure ( ) House ( ) Mobile Home ( ) Non-Residential (Specify) (Name and Type of Business) 5. APPLICANT WILL PROVIDE ONE COPY OF PLANS AND SPECIFICATIONS OF THE PROPOSED CONSTRUCTION: FOR USE BY THE ADMINISTRATOR Is the property located in an identified flood hazard area '-...,' '.( ') yes : ..( ) .no'.x?. Is additional information required ' ' .)i~;'i': ( .' ) .yes.'..};:i!.(..'),!no "~','~I Are other Federal, State or Local permits required '"':"; '~' '(' ) yes "?;:(' .)'~no .... ' ( ) Exemption Certificate' Issued .... - .',>,,'ik ' .-- ':' .... . .",i:" ..... .. .,. ~,~' ,...,:. .. -, ,-,-.1- ,..~ ,... ... · ~ 1.,:(~'}~.~", ...,. . .. '.:.~,'.~.-.'i....;..,~1. ..... .,.: ( ) Permit Application Approved . .. ' ": ....... ':;~'-~,i~. ;'~' h,A:~' }i~':-t":/,~ ,','5..:-~ ::.' ~. ( ) Permit Application Disapproved '": ",'. ',,~. .,",~. '-,~,'-...'.', ~':;:.',', ...;"".'~.:. ".. ' : ,. ,,~,.~, .~!!....~., ,~ ~.. ,..,,.~... ·., ...~.~;. ,~.,~,... · - ' . '"',: ,'~:~'.',..';' "' ....... '" "~','~?~?' ~,¥i~". '.',:"~'.:: .. . ":..::.~:~?.~,~:;:.. ' -',.,.'. · ' · . '-,',F0~,~.-- -: ~ "j-: -i'"- ' ." ~ ~ ' ~ '!.- ~. ~'.~. ~:~' .: ..-.. ,.,,,, <. t ...... ~., ........ ~ ....,..~.~ .: ~ :.~- · . ..... . .,~.,:..,,.::...,,,.,;,,..:.,. ;....~..,:..;,~,!~;~!~ · ~' .... : .:' .. SIGNA~E OR. ADMIN~S~TO~,~,., ..... .. ',,.~':~m.~.[~',~'.~!' ,EV.AP~. ' .'. :.-' : - :-" ':' ' . ':' ' '.,":'-.:'.'._' '.'" ..:.;;a:~.¥.,_~,[:a.'..:~:~i: · .:,-'~,.'~::-......'...~:..~:.,~.~ ..... ,,~, .. ;,:; ./ ,,,; .~. ,:,-i:~,~:.~:.~...~l,~' ~ · ~,,F,,.?',' .'~,,'::~' "1~.,.~t-~92 - . ~.-.I.;~...... > ......, t'.' -'-~:,,.' ,', ': .',' '., ,-'...-/, .:i" 'I I'.."-;."/",'.i'~':'~)-~ ' ~i ~ = , PZACN ' '~ - ~' '-. "'..',: ¢': ~ '"' i:i ::',~.-~ .'>.,' :.~,~ ':', ~'-.'.~'?~ " '~, ~"~-:i · .,5~;'~' "'6' : ::'-.-. "~." , , ' ~ ~ '=~.~' '}"; =' ,",:: : ~'~",Vt,'r.' ,,.:,t .......... ," ,. ~~,,".'~. ~,,~,.~..v~.,. ~t~