HomeMy WebLinkAboutApplicationFOR OFFICE USE ONLY
Case No.: ,� — 1
(*hDate Submitted: C-`
CITY OF COLLEGE STATION ' `A q � C�� Co c° � rq" i qm 0(
Planning & Development Services 1
PUBLIC IMPROVEMENT PERMIT (PIP) APPLICATION
MINIMUM SUBMITTAL REQUIREMENTS
$150 PIP permit application and review fee
Attach 4 copies of a facility layout plan, which may include the following:
[� Location, identification, and dimensions of ROW and pavement edge/curb)
Location of all proposed improvements
Eg-- Location of all public utilities (existing) - dimensioned from right-of-way or back of curb, material, size
If applicable, the facility layout plan must include the following
(these may be drawn on separate sheets):
A signage plan - include dimensions of sign(s), location from back of curb, materials, elevation drawing
❑ Drainage and/or erosion control plan
❑ Proposed waterway alterations with supporting drainage report
Landscape plan showing the location and type of plantings (existing and proposed, both common names
and scientific)
❑ The cost estimate for relocating any public facilities associated with the work
❑ An electrical plan
❑ Irrigation/Plumbing plan (must be sealed)
❑ A Structural plan showing details with anchoring, attachment, and material description (must be sealed)
❑ Private utility, plan -dimensioned from right-of-way or back of curb, material, size
Attach one copy of the following:
❑ Indemnity agreements from abutting fee owners
APPLICANT/PROJECT MANAGER'S INFORMATION (Party responsible for completion of all work associated with the project):
Name 5hawh (vrviev- i Ckqdw'Gk X04 E -Mail S-furnev6) Cay -1,,ienccf,Gon,
Street Address g3oK WA_tftey Lu"c
City Couac 0-t-101 State
Phone Number q -7q _aLf - j�ib2 1 L1,,)
I�
Fax Number
Zip Code
-7 78'fs
PARTY RESPONSIBLE FOR MAINTENANCE (if party is a group, please provide information for contact person):
(r�✓lti„d ilcltvan P�es;;(cwt'
Name �adwZ(L �ri ,�owhe✓$ Rs Soca.+��h E -Mail . W, C_ lveepC% Ver.�°r1,net
Street Address ° 901, [ l toy
City f4ti1,
Phone Number 0-7q) 06 -c -7-7,j Ctfi)
IDENTIFY THE FOLLOWING:
The total valuation of the work: $ �Oal 000
The total valuation of the signage: $ 2,°d°
Estimated cost of future relocation of improvements: $
State T X
Fax Number
Zip Code
`-? 70LI 2
1 -Aug -02 1 of 2
The total square footage of the site: � r,7)(- a, oda f, Z
The total linear feet of water lines crossing under paved road:
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:
❑
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 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.
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.
6 14 f— �G26`OS
Applicant's signature
Conditions of Approval:
Date applied
Authorization of City Engineer Date approved
1 -Aug -02 2 of 2
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.
Property Owner
Printed Name
THE STATE OF TEXAS §
COUNTY OF §
Property Owner
Printed Name
ACKNOWLEDGMENT
This instrument was acknowledged before me on the day of
, 20 , by
THE STATE OF TEXAS §
COUNTY OF §
Notary Public in and for the State of Texas
ACKNOWLEDGMENT
This instrument was acknowledged before me on the day of
, 20 , by
Notary Public in and for the State of Texas
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, will constitute a completely new review.
Page 4 of 4
(*hr"54"
CITY OF COLLEGE STATION
Planning & Development Services
FOR OFFICE USE ONLY
Case No.:
`:)- I
Date Submitted: i( L
PUBLIC IMPROVEMENT PERMIT (PIP) APPLICATION
MINIMUM SUBMITTAL REQUIREMENTS
[� $150 PIP permit application and review fee - Pr2vjvvbly 4 k6W% *d
Attach 4 copies of a facility layout plan, which may include the following:
[� Location, identification, and dimensions of ROW and pavement edge/curb)
Q 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
B 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
h awr, Tvionev
Street Address q 304 W�_dti%ex LA'e
City 5fA+;w, State
Phone Number ��4' ���� �� , q
TX
E -Mail S_tuyner @ Gait -1h-krr,e+,car„
Fax Number
Zip Code -77 SWS
PARTY RESPONSIBLE FOR MAINTENANCE (if party is a group, please provide information for contact person):
Name 54-t 4s 'tb ve
Street Address
City
State
Phone Number
IDENTIFY THE FOLLOWING:
The total valuation of the work: $ 15"000
The total valuation of the signage: $ t tt, Ud 0
Estimated cost of future relocation of improvements: $
E -Mail
Zip Code
Fax Number
1 -Aug -02 1 of 2
The total square footage of the site: `- L400 C2. -P-f
The total linear feet of water lines crossing under paved road:
IDENTIFY THE TYPE OF WORK TO BE PERFORMED:
0 -F-} - neje
❑
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:
Irrigation system
State Licensed Irrigator: {DY;�,�c -j-rr, 44i61
Landscaping
*Landscape Architect/Company: le defcv;,0e4
❑
Masonry fence
*Structural Contractor:
Sign(s)
*Sign Contractor: be defcr,-,Aed
❑
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
Conditions of Approval:
Authorization of City Engineer
7113104
Date applied
Date approved
1 -Aug -02 2 of 2
INDEMNIFICATION
DATE:
INDEMNITOR:
INDEMNITOR'S MAILING ADDRESS:
(including county)
INDEMNITEE: City of College Station
INDEMNITIEE'S MAILING ADDRESS:
(including county)
LEGAL DESCRIPTION OF PROPERTY:
MUN
1101 Texas Avenue
Brazos County
College Station, Texas 77842
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.
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, will constitute a completely new review.
Page 3 of 4