HomeMy WebLinkAboutMAVERIK - FDP210003 - SUBMITTAL DOCUMENTS - ROUND 2 - SUPPLEMENTAL INFORMATIONDEVELOPMENT CONSTRUCTION PERMIT
APPLICATION
(1/16/06)
For City use only: Application Number: ________ Application Date:________________
Permit application fee: $ 400.00
INSTRUCTIONS:
1. Complete this form (some questions may not apply to you) and attach all necessary documents and
submit to the Development Engineering Section of the City.
2. If you have any questions contact the Development Engineer, , at 221-6605.
3. Submit the Application and pay the Application Fee at the Engineering counter at 281 N. College
Avenue.
PROJECT INFORMATION:
Project Name (as approved by the City):
_____________________________________________________________
Project A.K.A. (Marketing name if different from Project Name):
__________________________________________________________________
Project Location: ____________________________________________________________________
_____________________________________________________________________________
Property Owner(At the time of this permit issuance):
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
Applicant/Project Manager (The primary contact person for all matters regarding this project, and the
person responsible for all matters referencing "the Developer" in the Development Agreement for this
project):
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
Permittee (Person who is to sign the Development Construction Permit):
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
Project Engineer (A Colorado licensed professional engineer who is the civil engineer, the person,
responsible for the design of this project, responsible for certification that improvements are constructed
in accordance with approved plans, responsible for making revisions to plans with City approval and for
providing as-constructed plans):
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
Professional License Number:_______________
Architect/Planner (The person responsible for the site design of this project)
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
Developer (The party or parties referenced in the Development Agreement who are responsible for the
Developer's obligations contained in the Agreement–add additional names below):
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
General Contractor (The contractor in overall charge of the public infrastructure construction):
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
If you have no General Contractor, list all other contractors below.
Grading contractor:
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
Utility contractor:
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
Concrete contractor for flat work:
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
Concrete contractor for structures:
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
Paving contractor:
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
Landscape contractor:
Individual Name:
Company Name :
Address:
Phone number(s):
Office: ___________________________
Cell phone: ________________________
Fax number: _______________________
Email: __________________________________
Other contractors and parties involved in the project:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
__________________________________________
SUBMIT THE FOLLOWING ITEMS (Required for all projects):
• 81/2"x11" copy of the Site Plan
• Proposed Project Schedule
• Project quantities and cost estimate for all of the public improvements to be constructed. In
addition, include all private improvements that are required to be inspected by the City
Construction Inspectors. This information must be submitted in the format shown on the
attached form titled "Project Quantities and Cost Estimate Sheet."
ADDITIONAL SUBMITTALS (Required if checked):
Traffic control plan(s) for the project
Proposed haul routes shown on a City map
Shop drawings
Other __________________________________________________
________________________________________________________
CONSTRUCTION COORDINATION MEETING: A construction coordination meeting to discuss
plans and special requirements for your project, is required for all development projects. The people
required to attend the meeting are the Project Manager, Project Engineer, Developer, Architect/Land
Planner and General Contractor (if no General Contractor, representatives for each of the contractors
expected to work on this project)
.
People to Attend: List the people’s names and titles for those who will attend the pre-
construction meeting:
Name Title
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
ESTIMATED COST OF INFRASTRUCTURE IMPROVEMENTS: Provide the estimated value of
all public infrastructure improvements that will be constructed and accepted by the City to own and
maintain. In addition provide the value of all private infrastructure improvements that the City will
inspect and require certification for. The estimate shall be in the same format as the attached sheet titled
"Project Quantities and Cost Estimate Sheet."
Public infrastructure, estimated cost: $__________________________
Private infrastructure, estimated cost: $__________________________
I certify that the information on this permit application along with the required additional submittals are
true and correct to the best of my knowledge, and that in filing this application I am acting with the
knowledge, consent, and authority of the owners of the property (including all owners having legal or
equitable interest in the real property, as defined in Section 1-2 of the City Code; and including common
areas legally connected to or associated with the property which is the subject of this application) without
whose consent and authority the requested action could not lawfully be accomplished. Pursuant to said
authority, I hereby permit City officials to enter upon the property for purposes of inspection and, if
necessary, to enter upon such property to perform work required of the applicant if the applicant were to
fail to perform the required work.
Applicant Signature:__________________________________Date:_______________________