ZoneChangeSignVendor#:
Pay to:
Address:
Charge to:
Total Amount:
Description/
Explanation.
Approval:
CITY OF COPPELL
PAYMENT AUTHORIZATION MEMO
Date: 4/2/18
Peter Hennessey
1417 W. Main Street, #100, Carrollton, TX 75006
ity Employees - Please put in your department name
Fund -Department -Division -Expense Code
If more than one, please use bottom section
$200.00 Total at Zeft should match total at bottom of page.
Zonin>; Chane Si>;n Request Refund
Please use the space below for additionaNaccount numbers and amounts
Account Number Amount
TOTAL $200.00
Approved for payment by:
Invoice No.
Invoice Date:
DEPOSIT FORM
CITY OF COPPELL
ZONING CHANGE SIGN REQUEST
NAME OF DEVELOPMENT:
DEVELOPER/REPRESENTATIVE:
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LOCATION OF DEVELOPMENT:
This is to verify that a deposit in the amount of $ has been received for _ zoning
change request sign(s). The sign shall be posted ten (10) days prior to consideration by the
Planning and Zoning Commission.
The applicant shall place the sign on site where, preferably, it can be easily seen from a public
street. The sign must be left in place until after final consideration by the Coppell City
Council. The applicant shall return the sign to the Planning Department in good condition
within thirty (30) days of the Council meeting. At such time, the Finance Department will
begin processing your deposit refund. Failure to return the zoning change request sign
within the stated time will result in the forfeiture of your deposit.
SIGN RECEIVED BY - - - - -
02. 2. 20 B
DATE SIGN RECEIVED
THE ABOVE-MENTIONED ZONING CHANGE SIGNS) HAS BEEN RETURNED IN
GOOD CONDITION TO THE PLANNING DEPARTMENT.
PL�En AnSE REFUND THE DEVELOPER'S DEPOSIT IN THE AMOUNT OF $
SIGN RETURNED BY,
FINANCE DEPT SEND REFUND CHECK TO$
DATE SIGN RETURNED
� .�- i I
SIGN RECEIVED BY
J:\P&ZSTF\PZ Admin STF\MYStuff\Planning StufflZoning Change Deposit Form.doc
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BILLING CONTACT Y ��
Geoff Walker
4509 Highland ••••••
Dallas, 75205
INVOICE NUMBER
INVOICE DATE
INVOICE DUE DATE
INVOICE STATUS
INVOICE DESCRIPTION
INV -00007970
02/01/2018
02/01/2018
Paid In Full
NONE
REFERENCE NUMBER
FEE NAME
TOTAL
PDWA2-000210
Zoning Sign Deposit
$200.00
1703 E Belt Line Rd Coppell, TX 75019 SUB TOTAL
$200.00
REMITTANCE INFORMATION
City Of Coppell
P.O. Box 9478
Coppell, TX 75019
TOTAL $200.00
BILLING CONTACT
Geoff Walker •••�,•
4509 Highland
Dallas, 75205 �•�®�
Reference Number Fee Name Transaction Type Payment Method Amount Paid
TOTAL $200.00
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