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HomeMy WebLinkAboutApplication (11-18) it FOR OFFICE SE O Y . CASE NO.: I T.- DATE SUB ED: TIME: CITY OF COIJEGE STATION Home of TexasAerM University' STAFF: PRIVATE IMPROVEMENT IN PUBLIC ROW PERMIT (PIP) APPLICATION MINIMUM SUBMITTAL REQUIREMENTS: ❑ $350 PIP Application Fee. 'F;eQ, \N&jVin5A ❑ 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. ❑ 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). ❑ 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: W OA- V% to be P f(Gj. " i CO ~ OW v-hc i;YV~ 011 ab 3 w3t q1 ~IMa. P r o- ► ~eQ 0 r-DIvN) r\0' S' ?-x APPLICANT/PROJECT MANAGER'S INFORMATION (Primary contact for the project): Name' E-mail Street Address i ( a, t--" t 1'~u, ,:4 City (0 1 State I' X Zip Code -7-76 41S Phone Number q~ q -105 (P L{0 1 Fax Number PARTY RESPONSIBLE FOR MAINTENANCE (If party is a group, please provide information for contact person): Name Cy7C~ (~i ~0~' ~'111'►NUp/~t,1 I~(~ vis _ E-mail Street Address l h?) r n nw City @ S State Ty Zip Code -T-794_ Phone Number of D 3 4L10 -1 Fax Number 10/10 Page 1 of 4 v N 0 Q I IDENTIFY THE FOLLOWING: The total valuation of the work: $ The total valuation of the signage: $ Estimated cost of future relocation/remodel of improvements: $ hw- ty rnoye, S"Ogn The total footage of the site: I Coq t MQeC., QUA C 35h h" CA 5c( pkfrt r1 ~y S~• F~. S~j►1 4c(i~ The total linear feet of water lines crossing under paved road: 1k ~k-YIQ (,t)►1 IDENTIFY THE TYPE OF WORK TO BE PERFORMED: ❑ Awnings Structural Contractor: ❑ Benches Number of Benches: ❑ Bike racks Number of Bike Racks: ❑ Cafe *Structural Contractor: ❑ Canopy *Structural Contractor: ❑ Demolition Structural Contractor: ❑ Electrical Master Electrician: ❑ Facade Structural Contractor: ❑ Irrigation System State Licensed Irrigator: © Landscaping *Landscape Architect/Company: 'F9}_ r1' M ~A9A' ❑ Masonry fence *Structural Contractor: Sign(s) *Sign Contractor: Clow 3twb V" ❑ Waterway Alterations Design Engineer: ❑ Wood fence *Structural Contractor: ❑ 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. 1 understand that the City has the authority to inspect the work to be conducted within the public right-of-way at any time. 1 also understand that this permit may be revoked at any time at the discretion of the City Officials. Signature and title Date Conditions of Approval: Authorization of City Engineer Date approved 10/10 Page 2 of 4 M INDEMNIFICATION Date: Indemnitor: ~V tyl&fl. Fojt(4a 1r10A Indemnitor's Address: 1~-; yinq 1 (including county) ~ a-,2 as eQ~hl to LW-4 5WA 4-S 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. 1 Vti~~ ~~1C I~C~elIf1,1 S k~ - y- Property Owner Pnnted Name - STATE OF TEXAS § § ACKNOWLEDGEMENT COLITY OF BRAZOS § S scribed nd swot to before me, a Notary ublic, this day 200 by e DEBORAH ORAMM ROiER NotryPoIr. 1 oofT~ Notary Public in nd for E4:D MyCwwnW eiE*w the State of Texas APRIL 14.2013 10/10 Page 3 of 4 . ~ 4 Property Owner Printed Name STATE OF TEXAS § § ACKNOWLEDGEMENT COUTY OF BRAZOS § Su scribed ~ndsworn to before me, a~N,otary %ublic, thisQ day of 2011 by Notary Public i for DEBORAH GRACE R01 the State of Texas Notary Public, State of Toe MtrComn~hNonE~ ApPAL 14.2013 10/10 Print Form Page 4 of 4 0 4 Application for Public Improvement Permit (PIP) Applicant: Foxfire Homeowners Association - Kimberly McAdams, Sign Committee Chair (The applicant is defined as the party responsible for completion of all work associated with the project) Applicant's Address: 1112 Finney, College Station, TX 77845 Work to be performed at the Foxfire "triangle,"1400a Foxfire Dr, College Station, TX. Applicant's Phone 979-703-6407 Identify the type of work to be performed: Electrical Master Electrician x Irrigation system Master Irrigator The Land Design Group Demolition Structural Contractor Wood fence *Structural Contractor Masonry fence *Structural Contractor x Sign(s) *Sign Contractor Cooper Stone Corp. Fagade Structural Contractor Awning Structural Contractor Cafe *Structural Contractor Canopy *Structural Contractor x Benches Bike racks x- Landscaping *Landscape Architect/Company The Land Design Group- Waterway Alterations Design Engineer X- Other (please describe): City of College Station Utilities to add a water meter and 3/4" faucet. 0 0 Identify party to perform this work: * starred items may not require that structural contractors, sign contractors, or landscapers perform the work - contact applicable City Departments for determination State whether applicant intends to pursue City participation in the funding of these improvements and describe: The Foxfire HOA is applying for matching funds from the city's Gateway Grant Funding program for the Fall 2010 cycle. Identify the following: The total valuation of the work: $6,060 The total square footage of the site: approximately 3,200 square feet land area; new gateway sign has a 128 square foot footprint and approximately 56 square feet of sign face. The total linear feet of water lines crossing under paved road: unknown The party responsible for maintenance: Foxfire HOA, Kimberly McAdams Address: 1112 Finney, College Station, 77845 Phone 979-703-6407 (if party is a group, please provide information for contact person) Estimated cost of future relocation of improvements: -500 to move stone sign if ever needed to be moved Attach 4 copies of a facility layout plan, which may include the following: Location, identification, and dimensions or 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 ~ Q a i pro P o -r C) ClA E4c)o 0 0 0 u. 4 y~ ~ F ~~tMt a T 3 'ONf 7.^ r The D~17 ll it 14th ~ X rL C) r - 0 0 g vki- w 17 f~ Dr - O Q 0 sg ws. b ~s ~4t . a uW~ ~ n F fah.. T Pao P OS C 1 400