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Town C AddL1/SPAm-CS 990315City of Coppell Planning Department 255 Parkway Blvd. Coppell, TX 75019 Phone: (972) 304-3678 Fax: (972) 304-3570 Name of Applicant: Address: ~ ~ O Telephone Number: Firm Preparing Plat: Address: ~'..~. ~ ) Telephone Number: Site Plan Application Filing Date: --L%. '7~"o / ~ Fax Number: Address: ~',-~' All Correspondence relative to this application should be directed to: Fax Number: Name of Subdivision or Plat: General Location of Property: Proposed Site Plan Contains: Townhouse Commercial Duplex Retail Multi-Family Light Industrial Mobile Home Planned Development Office Flood Plain Owner's Signature: I II CHRIS L OR CAROLYN A. ELKINS 61 6341 COBBLESTONE IN. ARUNGTON, TX 76001 o~o~o~ ._ 7r ~ C~.~~& ~~/~. MEMO Received From Address ~ ~ I~ 041112 Dollars $ AM~ OF ACCOUNT AM'E PAID BALANCE DUE CHECK