Austin Place-PT 960426_'
The City vWth A Bputi
~'~1'/2L~ G2L1-~I hI Cr
PERMIT
APPLICATION
1. Name of Applicant:
Address• S.~Z S' /ji'.~-~ ~.~~-~ .~~~ ,s?~ .std Lam- ~ _ T
• -fo2i~f~ S S a - C~S~zy ~-sQ3~
Phone Number:
2. Location of Construction (address):
Or:
Location description (attach vicinity map):
3. T of proposed construction or development:
( Residential ()Alteration of a natural waterway drainage course
( )Non-reside~ial ()Other (describe & attach drawueg or sketch)
( )Placement of Fill (in right-of--way or on private property)
4. Description of Construction Permit requested:
( )Paving
( )Sidewalk
() a Approach
( xcavation
( )Fire Lane
( )Bridge
s.
~ 3$
~~. ~
( )Median or Landscaping
( ) Water Main
( ) R.C.P.
( )Sanitary Sewer Main
( )Flume
( )Inlet
( )Box Culvert
( ) ~P ~P
( )Fill Area
()Drainage Channel Excavation
( )Slope Protection Retaining Wall
( )Parking Lot
* Please provide the name, address and 24 hour phone number for supervisor of every contractor working under
this general permit.
lary~ S//5~-~~~~ CCJa ~~, ~ 2~5~
~tf.~~ s1~S ~-
. CONSTRUCTION DEVELO, ..LENT
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.
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 calculation.
7. A Construction Permit Fee in accordance with the City of Copped Fee Ordinance shall be paid
prior to beginning work.
Amount Paid 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.
/~~~~
ign a Applicant 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 begin.
Is additional information required? ()Yes () No
Are other federal, state or local permits required? ()Yes () No
() PERMIT APPLICATION APPROVED
() PERMIT APPLICATION DLSAPPROVED
City Approval
Date
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