Laserfiche WebLink
OF- 4 <br />City of La Porte Planning Department <br />A 604 West Fairmont Parkway, La Porte, TX 77571 <br />Office: 281.471.5020, Fax: 281.470.5005; www.laportetx. <br />APPLICATION for FILL DIRT PERMIT <br />(Note: Complete info. in dashed box only. Partial or incomplete information will delay processing of your application) <br />Date: <br />Property Owner: Owner's Agent: <br />Name: Name: <br />Address: Address: <br />Phone#: Phone#: <br />Alt. Phone#: Alt. Phone: <br />E -Mail: E -Mail: <br />Property Information: <br />Current Property Address (if existing): <br />Describe Work: <br />Acreage: Max. # Truckloads: <br />Please Note: <br />1. Include survey, sketch plan, or site plan illustrating subject property showing (a) any existing applicable and <br />proposed fill dirt improvements (b) and proposed drainage patterns as a result of new fill dirt. <br />2. A Grading and Drainage Plan signed and sealed by Professional Engineer licensed in the State of Texas is <br />required for applications for 50+ truckloads. <br />3. Fee Schedule: 1-5 Loads: No Fee; 6-49 Loads: $25.00; 50+ Loads: Add $2.00 per load over 49 loads. Fee <br />not to exceed $5000.00 <br />4. The Planning Department reserves the right to inspect the placement of soil and recommend changes <br />necessary to alleviate possible flooding of neighboring properties. <br />------------------------------------------------------------------------------------------------------------------------------------------------ <br />------------------------------------------------------------------------------------------------------------------------------------------------ <br />** This Area for City Staff Use Only ** <br />Y <br />N <br />Ownership Verified: <br />❑ <br />❑ BY/DATE: <br />Sketch Reviewed: <br />❑ <br />❑ BY/DATE: <br />Sketch Approved: <br />❑ <br />❑ BY/DATE: <br />Permit Approved: <br />❑ <br />❑ BY/DATE: <br />Flood Zone: BFE: <br />HCAD Acct. No. of Property (13 digits) - - - <br />Permit Fee: HTE I. D.: <br />Special Conditions: <br />Permit Number Issued: Date: <br />--------------------------------------------- - ------------------------------------------------------------------ ----------------------- <br />S:\City Planning Share\Fill Dirt PermitslApplication Form\Fill Dirt Application rev.docx <br />