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CASE NO.: 40
DATE SUBMITTED:
SUBMITTAL CHECKED BY:
PUBLIC IMPROVEMENT PERMIT (PIP) APPLICATION
MINIMUM SUBMITTAL REQUIREMENTS
*AAttach 150 PIP Permit Application Fee
4 copies of a facility layout plan, which may include the following:
Location, identification, and dimensions of ROW and pavement edge/curb)
Location of all proposed improvements
Location of all public utilities (existing) - dimensioned from right-of-way or back of curb, material, size
If applicable, the facility layout plan must include the following
(these may be drawn on separate sheets):
A signage plan - include dimensions of sign(s), location from back of curb, materials, elevation drawing
Drainage and/or erosion control plan
Proposed waterway alterations with supporting drainage report
Landscape plan showing the location and type of plantings (existing and proposed, both common
names and scientific)
The cost estimate for relocating any public facilities associated with the work
An electrical plan
Irrigation/Plumbing plan (must be sealed)
A Structural plan showing details with anchoring, attachment, and material description (must be sealed)
Private utilities plan- dimensioned from right-of-way or back of curb, material, size
Attach one copy of the following:
Indemnity agreements from abutting fee owners
APPLICANT/PROJECT MANAGER'S INFORMATION (Party responsible for completion of all work associated with the project):
Name ~D FbRr-ST h,WEO"' JE 25 A !5- t0 01120
Mailing Address Po BOX q0 91 City Co UCF, e 6TIlT oo
State C Zip Code ~1~4 Z E-Mail Address & c~ '~XGL~ ~ COr"
Phone Number -7(pq 1-73 Fax Number (Q go
PARTY RESPONSIBLE FOR MAINTENANCE (if party is a group, please provide information for contact person):
Name/Group EN1-F 1? 4,8- (A) M66 Y W clef `r
Mailing Address rx 6C,X 1091 City CeLt-C-i!2 V_H-0 ' 4
17$47- E-Mail Address 0) +xetiber' 60M
State TX Zip Code
Phone Number b 4 - o"1-7 ' Fax Number _ I SGT 5
IDENTIFY THE FOLLOWING:
The total valuation of the work: ' 04
The total valuation of the signage: $ 7 0 6P
$ 22-S,40
Estimated cost of future relocation of improvements:
The total square footage of the site
7 100 sF
The total linear feet of water lines crossing under paved road
PIP APPLICATION
Pipapp.doc 2/5/02
CJA~
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IDENTIFY THE TYPE OF WORK TO BE PERFORMED:
Awning
Structural Contractor:
Benches
Number of Benches:
Bike racks
Number of Bike Racks:
Cafe
*Structural Contractor:
Canopy
*Structural Contractor:
Demolition
Structural Contractor:
Electrical
Master Electrician: U ITT ITT P-1 Cf-::: ie u C 1 G
Facade
Structural Contractor:
Irrigation system
State Licensed Irrigator: T ~RI~F~
Landscaping
*Landscape Architect/Company:
Masonry fence
*Structural Contractor:
Sign(s)
*Sign Contractor: S 1616 A/o w!
Waterway Alterations
Design Engineer:
Weed fence
*Structural Contractor: P~~FF4SZ 1R6AJ(A10P-KS
Other (please describe):
Identify party to perform this work:
*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.
I 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.
A plicant's signature
Conditions of Approval:
6-/-02-
Date applied
Authorization of City Engineer
PIP APPLICATION
Pipapp.doc 2/5/02
Date approved
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