Sandy Lk Cross L3R-PT190104 (2)T H [ C I T
OPPELL
lit .k ,., 60
Q
CONSTRUCTION DEVELOPMENT PERMIT APPLICATION
Name of Applicant Evans & Son, Inc. Date Submitted 1/4/2019
Address of Applicant 125812 Springbrook Ave. Santa Clarita, CA 91350
Phone Number 1661 m254=8787 Fax Number
Location of Construction (address, q available): 105 S. Denton Tap Rd.
Subdivision Sandy Lake Crossing Section # Block # Lot # 3R
OR Survey/Abstract # Acreage
Location description (attac)c vici�aity Wrap):
1.
2.
Corner of Denton Tap Road and Sandy Lake
Type of proposed construction or development:
C`> Residential C'� Alteration of a natural waterway drainage course
(•� Non -Residential r Other (describe & attack drawing or sketch)
C' Placement of Fill (in right-of-way or on pnvate property)
Description of Construction Permit requested:
❑X Paving
0 Median or Landscape
Sidewalk
0 Drive Approach
K7 Excavation
❑ Fire Lane
❑ Bridge
❑
Water Main
R.C.P.
❑
0 Sanitary Sewer Main
Flume
❑
❑ Inlet
❑ Box Culvert
❑ Rip Rap
Fill Area
Drainage Channel Excavation
❑
❑ Slope Protection/Retaining Wall
Parking Lot
Provide an attachment containing the name and 24 -hr. contact
of supervisors) for every contractor working under this general permit.
phone number
3.A11 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:
Date Paid:
NOTE: A separate excavation permit is required anytime pavement is crit or wlten there is work iia 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 Q 972-462-5150
Fire Department @ 972-304-3512 Engineering Dept. (a3 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. unti13:30 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:
Michael Grimes
661-510=9483
Signature of Ap
Signature of Inspector
Contact Number
Contact Number
FOR CITY USE ONLY
Is the fill area located in an identified flood hazard area? �' Yes � No
If YES, a Floodplain Development Permit is required before any construction: cap: begirt.
Is additional information required? Yes (0 No
Are other federal, state, or local permits required? (�} Yes (9 No
PERMIT APPLICATION APPROVED C) PERMIT APPLICATION DENIED
City Approval
(0141
1
Date
Applicant sl:all iltdemtnify and forever [told I:armtless agar:st the City of Coppell each and every clai»t, de»ta�td
or carese of actio�t tl:at Wray be n:ade or co►�te agai�tst it by reaso�t of or if a�:y way arisi�ig oat of the closrcre,
blocking, excavating, cutting, tunneling, or other fvork by the applicant ander permit from: the City, if such
permit is granted.
INSPECTION FEE CALCULATION SHEET
Project Name ICapital One Date 1/11/19
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 ace
due on or before the date of the Pre -construction Meeting.
In order to verify tl►e inspection fee due, please provide a copy of the development contracts) and this spreadsheet with
completed calculations to the Engineering Dept. The contracts) should indicate tl�e cost to construct the following
improvements:
Grand Total (total of 8,248.13
both colored fields)
Submit by E-mail: I Print Form
PUBL[CIMPROVEMENTS
CONTRACT AMOUNT
° __
X 4�0
PRIVATE IMPROVEMENTS
CONTRACT AMOUNT
° __
X 2/0
Paving
326,310.69
6,526.21
Water
9,138
182.76
Sanitary Sewer
3,525
70.5
Storm Sewer
23,433
468.66
Alleys
Sidewalks
25,000
1,000
Other
Total
25,000
1,000
362,406.69
7,248.13
Grand Total (total of 8,248.13
both colored fields)
Submit by E-mail: I Print Form