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Texas Shoot-Out-CS 930716CITY OF COPPELL P. O. BOX 478 COPPELL, TEXAS (214) 393-1016 75019 Revised 3/12/92 Construction Develo_c-~cDt per-it ~lication Name of Applicant: William S. Powell Address: / Z~- Phone Number: Location of Property: If Located in a Subdivision: Address Name of Subdivision If Not Located in a Subdivision: Section No. Block No. LOt NO. Name and Number of Survey/Abstract Acreage Location Description Attach a vicinity Map Nature of Proposed Construction or Development (Check and Complete): ( ) Residential ( ) Non-Residential ( ) Alteration of a Natural waterway ( ) Other (Describe & Attach Drainage Course a Drawing or Sketch ® (~ Placement of Fill Description of Proposed Construction or Development (Check and Complete): ( ) New Construction ( ) House ( ) Mobile Home ( ) Non-Residential (specify) ( ) Substantial improvement to Existing Structure ( ) commercial ~ ~ " " Description of Construction Permit Requested (Complete as Appropriate): ( ) Paving ( ) Median or Landscaping ( ) Water Main ( ) R.C.P. ( ) Bridge ( ) Drive Approach ( ) Sidewalk ( ) EXCavation (~ Fill Area ( ) Sanitary Sewer ( ) Drainage Main Channel ( ) Box Culvert Excavation ( ) 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. 6. All construction will follow the city of Coppell Subdivision Ordinances and stamped approved plans. The activity shall be in compliance with Erosion and Sedimentation Ordinance. 7. Applicant will provide one copy of approved plans, specifications, and related cost estimate or contract of the proposed construction for the purpose of permit calculation fee. NOTE: cut or that there is wor/~n the right-of-way not approved by the city Engineer~ ' Signature of Applicant Construction Permit Fee: 2 % Contract Construction Cost on Items to be Dedicated A separate excavation permit is required anytime pavement is Date FOR CITY USE ONLY Is the fill area 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 CONDEV federal, state, or local permits required? ( ) Yes ~ No ( ) Permit Application Approved ( ) ~z~l~t ApplicaAion Disapproved