Burch Lot 1-PT 950530CITY OF COPPELL
P. O. BOX 478
COPPELL, TEXAS 75019
(214) 393-1016
Revised 3/12/92
Construction Development Permit Application
1. Name of Applicant: ~(,((~~ tJtJ ~C I~-~
Address : 23Q~ SA N F} 2!~ ~2c,.~ ~1c"ror~~ ~7C~O l z-
Phone Number : ( ~ ~ T ) ~ty Z` ~(~
2. Location of Property: ~C9'j- ~ ~4Ex:~C„ ~ ~V 2G~ /~~IJ~TlO ti
Address
If Located in a Subdivision:
Name of Subdivision Section No. Block No. Lot No.
If Not Located in a Subdivision:
E [~w,A~.p ,q crzoc~ ~ 3D ( 2 . ( ~~
Name and Number of Survey/Abstract Acreage
~-~T .~. (3Ld[':~e,. ~ T3v2~ l~ •4-D~<7~ioN
Location Description Attach a Vicinity Map
3. 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
4. Description of Proposed Construction or Development (Check and
Complete):
( New Construction ( ) House
( ) Mobile Home
( ) Non-Residential
~ ...r'....~~'-I 1
( ) Substantial Improvement to Existing Structure
( ~~Commercial
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Name and Type of Business
/f
5. Description of Construction Permit Requested (Complete as Appropriate):
(~ Paving
( ) Median or
Landscaping
( ) Water Main
( ) R.C.P.
( ) Bridge
( ) Drive Approach
( ) Excavation
( ) Sanitary Sewer
Main
( ) Box Culvert
( ) Rip-Rap
( ) Sidewalk
( ) Fill Area
( ) Drainage
Channel
Excavation
( ) 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.
8. Construction Permit Fee:
Amount Paid
2 % Contract Construction
Cost- on Items to be Dedicated ~ z('7~ f~U c~~ 2 ~ = ~~ oa ~dd• "~
NOTE: A separate excavation permit is required anytime pavement is
cut or that there is work in the right-of-way not approved by
the City Engineer.
~ 3wic.~ ~ 3v g s~
Signature of Applicant
D to
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?
Are other federal, state, or local permits required?
( ) Permit Application Approved
( ) Permit Application Disapproved
CONDEV
City Approval
( ) Yes ( ) No
( } Yes ( } No
Date
. Date s-~~ ,9 9~ 0026499 i
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