HomeMy WebLinkAboutAPPLICATION FOR OFFICF USE ONLY
` g Case No.: - /
COLLEGE STATION Date Submitted: 02" 1 3-04-1
PUBLIC IMPROVEMENT PERMIT (PIP) APPLICATION
MINIMUM SUBMITTAL REQUIREMENTS
❑ $150 PIP Permit Application Fee
Attach 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 utility, plan- dimensioned from right -of -way or back of curb, material, size
Attach one copy of the following:
❑ Indemnity agreements from abutting fee owners
Ji (POOCIMUIP
APPLICANT /PROJECT MANAGER'S INFORMATION (Party responsible for completion of all work associated with the project):
Name -� 1 e7 li/o /jX, /rAct j W /L i Weill a seer lidn E -Mail ivd /sk, P 71z?`vr v- e /
Street Address q 043 f c.-'Jh 161e-t Co uc
City ?'v /�N f State T x Zip Code r T 675
Phone Number `f 7 ! 6 7'7 1 Fax Number
PARTY RESPONSIBLE FOR MAINTENANCE (if party is a group, please provide information for contact person):
Name ( w'r/`I // (3 A E -Mail ( .:e -eq / ',)
Street Address 9c ei a /A/74T C'� e-7
City 1 - 3/ ' je riz Ten State T Zip Code b+
Phone Number /° 9 G 7`71V) Fax Number
IDENTIFY THE FOLLOWING:
The total valuation of the work: $
The total valuation of the signage: $ �,Y
Estimated cost of future relocation of improvements: $ %�
The total square footage of the site:
The total linear feet of water lines crossing under paved road:
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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:
❑ Facade Structural Contractor:
QZ] Irrigation system State Licensed Irrigator: piirrP l friaa - 0'!1
E Landscaping *Landscape Architect/Company: / r ye 7
❑ Masonry fence *Structural Contractor:
❑ Sign(s) *Sign Contractor:
❑ 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.
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.
Applicant's signature Date applied
o ditions of Approval:
3) I
Authorization of City E • ineer Date approved
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