CVS Driveway S Belt Line-PN200505CONSTRUCTION DEVELOPMENT PERMIT APPLICATION
Address of Applicant
Survey/Abstract #AcreageOR
1.Type of proposed construction or development:
2.Description of Construction Permit requested:
Provide an attachment containing the name and 24-hr. contact phone number
of supervisor(s) for every contractor working under this general permit.
3.All 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.
Section #Subdivision Block #Lot #
Name of Applicant Date Submitted
Phone Number Fax Number
Location of Construction (address, if available):
Location description (attach vicinity map):
Drive Approach
Fire Lane
Bridge
Paving
Sidewalk
Excavation
Median or Landscape
Water Main
R.C.P.
Sanitary Sewer Main
Flume
Inlet
Box Culvert
Rip Rap
Fill Area
Drainage Channel Excavation
Slope Protection/Retaining Wall
Parking Lot
Residential Alteration of a natural waterway drainage course
Placement of Fill (in right-of-way or on private property)
Other (describe & attach drawing or sketch) Non-Residential
8700 N Belt Line Road, Irving Texas
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 cut or when there is work in the
right-of-way not approved by the City Engineer.
ØAny 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
ØAttach barricade plan / trench safety plan of a lane or street closure. (Required)
ØIt 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. until 3:30 p.m. ONLY
unless otherwise approved by City Engineer.
ØA pre-construction meeting is required prior to beginning work related to this permit.
Contact the inspector assigned to your project to schedule the meeting.
FOR CITY USE ONLY
Is the fill area located in an identified flood hazard area? Yes No
Are other federal, state, or local permits required?
Is additional information required?
If YES, a Floodplain Development Permit is required before any construction can begin.
No Yes
Yes No
Applicant shall indemnify and forever hold harmless against the City of Coppell each and every claim, demand
or cause of action that may be made or come 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 from the City, if such
permit is granted.
Printing your name indicates your acceptance of the terms and conditions of this form:
Contact Number
Contact Number
Date
PERMIT APPLICATION APPROVED PERMIT APPLICATION DENIED
Signature of Applicant
Signature of Inspector
City Approval
PUBLIC IMPROVEMENTS
CONTRACT AMOUNT X 4% =PRIVATE IMPROVEMENTS
CONTRACT AMOUNT X 2% =
Paving
Water
Sanitary Sewer
Storm Sewer
Alleys
Sidewalks
Other
Total
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.
INSPECTION FEE CALCULATION SHEET
Project Name Date
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)
Page 3