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IP Case No.:
Date Submitted: ( D
COLLEGE STATION
PUBLIC IMPROVEMENT PERMIT (PIP) APPLICATION
MINIMUM SUBMITTAL REQUIREMENTS
al $150 PIP Permit Application Fee
Attach 4 copies of a facility layout plan, which may include the following:
a Location, identification, and dimensions of ROW and pavement edge /curb)
L Location of all proposed improvements
[g 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 drainage report
❑ Proposed waterway alterations with supporting 9 ere p
❑ 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
APPLICANT /PROJECT MANAGER'S INFORMATION (Party responsible for completion of all work associated with the project):
Name -
J . _ cam- E -Mail WA-toe oi0 / . C
S
Street Address 7 (' .) 0y r
City V Z . / %/ ;
S tate �/c Zip Code T7 N � 3 2 j
.. (o
Phone Number q 4 7 5 5 - -lvof Fax Number to g to ✓
PARTY RESPONSIBLE FOR MAINTENANCE (if party is a group, please provide information for contact person):
rd.o Of A E -Mail
Name ��f�Y1 l�v ++ , A , {{��
Street Address 0, S �r�F kr-A4) J"'1 ►`i
�"",,�� Zip Code 7 7 f
City Gf j1� e .S yjh k� State
Phone Number
Fax Number
IDENTIFY THE FOLLOWING:
The total valuation of the work: $
The total valuation of the signage: $
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:
1 of 2
1- Aug -02
IDENTIFY THE TYPE OF WORK TO BE PERFORMED:
❑ Awning Structural Contractor:
Q"Benches Number of Benches p C✓/ fj
❑ 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:
❑ 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 strucural contractors, ors, sign contractors, or landscapers perform
the work - contact applicable City Departments
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 - - way at any
time. I also understand that this permit may be revoked at any time at the discretion of the City Officials.
Ap icant's signature Date p lie
Conditions of Approval:
ie/3 4
/�/ `/Z7OZ
Authoriza 'ono City Engineer Dat approved
2 of 2
1- Aug -02
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Deacon Condominiums (02- 00500252)
ENGINEERING REVIEW
COMMENTS No. 1
1. Provide executed original of improvement indemnity (form attached).
2. Provide two sets of plans for approval stamping.
3. Provide cash deposit, letter of credit or performance bond on approved forms
and in the amount of $1000 to guarantee the potential removal of the facilities.
Reviewed by: Brett McCully, P.E. Date: November 27, 2002
NOTE: Any changes made to the plans, that have not been requested by the City of College Station, must
be explained in your next transmittal letter and "bubbled" on your plans. Any additional changes on these
plans that have not been pointed out to the City of College Station will constitute a completely new review.
Home of Texas A &M University
Date:
Development Engineer
City of College Station
Department of Development Services
P.O. Box 9960
College Station, TX 77842
Re: Permit for Private Improvements within City Right of Way (PIP)
Development:
Dear Sir /Madam,
To the fullest extent permitted by law, I /we, the owners of the property listed below,
shall indemnify, hold harmless, and defend the City, 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 this permit. This indemnity shall
apply regardless of whether such injuries, death, damages, or breach are caused in
part by the negligence or omission of the City, any other party indemnified
hereunder, the Contractor, or any third party.
Signature of Owner:
Name of Property Owner:
Legal Description of Property Owned
STATE OF TEXAS
CORPORATE ACKNOWLEDGMENT
COUNTY OF BRAZOS )
This instrument was acknowledged before me on the day of
, 2001, by in his /her capacity as
of , a corporation,
on behalf of said corporation.
Notary Public in and for
the State of Texas
STATE OF TEXAS
INDIVIDUAL ACKNOWLEDGMENT
COUNTY OF BRAZOS )
This instrument was acknowledged before me on the _ day of
, 2001, by , in his /her capacity as Owner of the property described
above..
Notary Public in and for
the State of Texas