HomeMy WebLinkAboutApplication (12-99)(Worq"
CITY OF COLLEGE STATION
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FOR
CASE NO.:
DATE SUBN
TIME:
STAFF: L
PRIVATE IMPROVEMENT IN PUBLIC ROW PERMIT (PIP) APPLICATION
MINIMUM SUBMITTAL REQUIREMENTS:
$350 PIP Application Fee.
❑
Application
completed in full. This application form provided by the City of College Station must be used
and
may not be adjusted or altered. Please attach pages if additional information is provided.
❑
Notarized indemnity agreements from abutting property owners.
®
Attach four (4) copies of a facility layout plan, which shall include the following:
Location, identification, and dimensions of ROW and pavement edge/curb.
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Location of all proposed improvements.
Location of all public utilities (existing) - dimensioned from right-of-way or back of curb, material, size.
❑
A signage plan - include dimensions of sign(s), location from back of curb, materials, elevation
drawing (if applicable).
❑
Drainage and/or erosion control plan (if applicable).
❑
Proposed waterway alterations with supporting drainage report (if applicable).
�f
Landscape plan showing the location and type of plantings - existing and proposed, both common
names and scientific (if applicable).
The cost estimate for relocating any public facilities associated with the work (if applicable).
❑
An electrical plan (if applicable).
❑
Sealed irrigation / plumbing plan (if applicable).
❑
Sealed structural plan showing details with anchoring, attachment, and material description (if
applicable).
Private utility plan -dimensioned from right-of-way or back of curb, material, size (if applicable).
LOCATION OF IMPROVEMENTS:
APPLICANT/PROJECT MANAGER'S INFORMATION (Primary contact for the project):
Name RadakorLLC E-mail radakorllc@gmail.com
Street Address P.O. Box 7445
City Houston
Phone Number (713) 829-3808
State Texas
Fax Number
Zip Code 77248
(832) 202-2700
PARTY RESPONSIBLE FOR MAINTENANCE (If party is a group, please provide information for contact person):
Name Randy Klein E-mail radakodfc@gmail.com
Street Address P.O. Box 7445
City Houston
Phnno Niimhor (713) 829-3808
State Texas Zip Code 77248
Fax NnmhPr (832) 202-2700
IDENTIFY THE FOLLOWING:
The total valuation of the work: g 76,650
The total valuation of the signage: $ --
Estimated cost of future relocation/remodel of improvements: $ 70,000
The total footage of the site: 42,963 sf
The total linear feet of water lines crossing under paved road: 10 feet
IDENTIFY THE TYPE OF WORK TO BE PERFORMED
❑
Awnings
Structural Contractor: i
❑
Benches
Number of Benches: 4
❑
Bike racks
Number of Bike Racks:
❑
Cafe
*Structural Contractor.
❑
Canopy
*Structural Contractor:
N
■
r
Demolition
Structural Contractor. F `q,;F11 I N f AtV-jj
Electrical
L�r��tl
rS
Master Electrician:
Facade
Structural Contractor:
Irrigation System
State Licensed Irrigator.
Landscaping
*Landscape Architect/Company: UJONG 1t�.1D J(i�1�[
Masonry fence
*Structural Contractor. 13/A
Sign(s) *Sign Contractor:
Waterway Alterations Design Engineer.
❑ Wood fence *Structural Contractor: —W
[I Other (please describe) Identify party to perform this
STORM SEWER RELOCATION/
Kieschnick General Contractors, Inc.
P.O. Box 200
Wellborn, TX 77881
(979) 679-0710 (y)
*The starred items may not require that structural contractors, sign contractors, or landscapers perform the work -
contact applicable City Departments for determination
I hereby verify that the information contained in this application is true and complete, to the best of my knowledge. l
understand that the City has the authority to inspect the work to be conducted within the public right-of-way at any time. I
also understand that this permit may be revoked at any time at the discretion of the City Officials.
and title
Conditions of Approval:
Au orization of C y Engineer
Date
&— 9-7 ' l�
Date approved
10110 Page 2 of 4
INDEMNIFICATION
Date:
=01
Indemnitor's Address:
(including county)
Indemnitee: CITY OF COLLEGE STATION
indemnitee's Address: 1101 Texas Avenue
(including county) Brazos County
College Station, Texas 77840
LEGAL DESCRIPTION OF PROPERTY:
To the fullest extent permitted by law, I/we the owners of the property described above (Indemnitor), shall indemnify, hold
harmless, and defend the Indemnitee, its officers, agents, and employees from and against any and all claims, losses,
damages, causes of action, suits and liability of every kind, including all expenses of litigation, court costs, and attorney's
fees, for injury to, or death of, any person, for damage to any property, or for any breach of contract, arising out of or in
connection with the installation, operation, and maintenance of the facilities authorized by the Private Improvement Permit
issued by Indemnitee to , including, but not limited to, any premise defect or special
defect arising out of or in connection with said facilities. This Indemnification shall apply regardless of whether such
injuries, death, damages, or breach are caused by the NEGLIGENCE or omission of Indemnitee, the contractor installing
said facilities, or any third party.
All provisions of this Indemnification shall be binding upon and inure to the benefit of the undersigned and the City of
College Station, Texas, and their respective successors and assigns.
Property Owner
STATE OF TEXAS
ACKNOWLEDGEMENT
1 • - • EGG_•
Subscribed and sworn to before me, a Notary Public, this
Printed Name
day of
Notary Public in and
the State of Texas
, 2009 by
10/10 Page 3 of 4
Property Owner
STATE OF TEXAS
ACKNOWLEDGEMENT
COUTY OF BRAZOS
Subscribed and sworn to before me, a Notary Public, this
Printed Name
day of
Notary Public in and for
the State of {8xas
, 2009 by
10/10 Print FOYm Page 4 of 4