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HomeMy WebLinkAboutApplication 1 FOR OFFICE E OY CASE N O.: (.11/ DATE SUBMITTED: 0.1rir TIME: CITY OF COLLEGE STATION` Home ofTexasAerM University' STAFF: i PRIVATE IMPROVEMENT IN PUBLIC ROW PERMIT (PIP) APPLICATION MINIMUM SUBMITTAL REQUIREMENTS: [xJ $350 PIP Application Fee. El 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. El Notarized indemnity agreements from abutting property owners. ❑ Attach four (4) copies of a facility layout plan, which shall include the following: El Location, identification, and dimensions of ROW and pavement edge /curb. ❑ Location of all proposed improvements. El 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). El Private utility plan- dimensioned from right -of -way or back of curb, material, size (if applicable). LOCATION OF IMPROVEMENTS: Through the intersection of William D. Fitch and Rock Prairie Road thence along the southeast right -of -way line of William D. Fitch to the Golf Course. APPLICANT /PROJECT MANAGER'S INFORMATION (Primary contact for the project): Name Pebble Creek Country Club Inc. (Davis Young) E -mail davis.y ©pebblecreektx.com Street Address 5102 Stonewater Loop City College Station State TX _ _ Zip Code 77845 Phone Number 979.690.0992 Fax Number 979.690.6081 PARTY RESPONSIBLE FOR MAINTENANCE (If party is a group, please provide information for contact person) Name Same as Applicant E -mail Street Address City State _ Zip Code Phone Number Fax Number 10/10 Page 1 of 4 IDENTIFY THE FOLLOWING: The total valuation of the work: $ �sr The total valuation of the signage: $ _ Estimated cost of future relocation /remodel of improvements: $ The total footage of the site: Approx. 2216 feet The total linear feet of water lines crossing under paved road:Appox. 119 feet 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: t . Irrigation System State Licensed Irrigator: ❑ Landscaping *Landscape Architect /Company: ❑ Masonry fence *Structural Contractor: ❑ Sign(s) *Sign Contractor: ❑ Waterway Alterations Design Engineer: ❑ Wood fence *Structural Contractor: Other lease describe) Identify party to perform this work: (p ) Y p Y p �.50,441 �(1�. S t [ oSt1 *The starred items may not require that structural contractors, sign contractors, or land cap s perfon the Cvork - 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. ? �� IZ 1y 1 t Z ignature d title Date Conditions of Approval: '"'/A 4 / i.. .A.r ( " i O t L- Autho za ion of City ngineer Date approved 10/10 Page 2 of 4 INDEMNIFICATION Date: beLeM' O 4 / 7-DlZ Indemnitor: cbt efee_K. Cl 111 0 +l4 Indemnitor's Address: 1- ‘61:30 ".. . 1 (including county) C6I , "ItAr#1,6 J —� t)L ' 'IBr.4c Indemnitee: CITY OF COLLEGE STATION indemnitee's Address: 1101 Texas Avenue (including county) Brazos County College Station, Texas 77840 LEGAL DESCRIPTION OF PROPERTY: Remainder of Tract 5 Pebble Creek Development Company Called 677.49 Acres 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, o eration, and maintenance of the facilities authorized by the Private Improvement Permit issued by Indemnitee to ]UG C [j11kjf1[ C,LzJp , including, but not limited to, any premise defect or special defect arising out of or in connection with said lfacilities. 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. v AV IS µ klp J NI Prop er r Printed Name U STATE OF TEXAS § § ACKNOWLEDGEMENT COUTY OF BRAZOS § ao t�, Subscribed and sworn to before me, a Notary Public, this __ day of 0..-0-4..-411-11-1- , 2;109 by � , ,,Y u lic in and for ��� . �� SHERI LYNN iAR1+IL1 St a of Texas " 3 , ' �i Notary Public, State of Texas y. +t My Commission Expires 10/10 , ,, , z ;,,, June 26, 2016 Page 3 of 4