Townhouses-PT000607 'n,, c~ wth ^ B""t~ nm* STRUCTIONCON
DEVELOPMENT
PERMIT APPLICATION
1. Name of Applicant: (_.~/k} ~) ~t~ l)¢)Oj5/'m~./O ~L
Phone Number: ~ 7Z- ~0q- ~3Z ~ ~ ~17 - 57}- )~
2. Location ofConsmction (~r, ss): '~ ~ '.~ . ~aC~A<
Subdivision Section ~ Block ~ ~t ~
Or:
Survey/Abstract # Acreage
Location description (attach vicinity map): 5¢ ~ ~]~
3. Type of proposed construction or development:
( ) Residential ( ) Alteration of a natural waterway drainage course
( ) Non-residential ( ) Other (describe & attach drawing or sketch)
(V~Placement of Fill (in right-of-way or on private property)
4. Description of Construction Permit requested:
( ) Paving ( ) Median or Landscaping ( ) Box Culvert
( ) Sidewalk ( ) Water Main ( ) Rip Rap
( ) Drive Approach ( ) R.C.P. (1/fFill Area
( ) Excavation ( ) Sanitary Sewer Main ( ) Drainage Channel Excavation
( ) Fire Lane ( ) Flume ( ) Slope Protection Retaining Wall
( ) Bridge ( ) Inlet ( ) Parking Lot
· Please provide the name, address and 24 hour phone number for supervisor of every contractor working
under this general permit.
Revised 3/99
CONSTRUCTION DEVELOPMENT
PERMIT APPLICATION
Page 2
5. All construction shall follow the City of Coppell Subdivision Ordinance, Standard Construction
Details, Streetscape Plan and stamped approved plans. The activity shall be in compliance with
Erosion and Sedimentation Ordinance. ~' gl0 i ~ ~ Od dt ~,~,, ce
6. Applicant shall provide one copy of approved plans, specifications and related cost estimate or
contract of the proposed construction for the purpose of permit fee calculations.
7. A Construction Permit Fee in accordance with the City of Coppell Fee Ordinance shall be paid
prior to beginning work.
!
Amount Paid ~/f~ 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.
Signature of Date
FOR CITY USE ONLY
Is the f'fll area located in an identified flood hazard area? ( ) Yes ~ No
If yes, then a Floodplain Development Permit is required before any construction can
begin.
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
Form~/permits/constdev