Fillable CITY OF LAREDO Application for Floodplain Development Permit

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CITY OF LAREDO Application for Floodplain Development Permit

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1 Rev. 01/17/2020
CITY OF LAREDO
Application for Floodplain Development Permit
Fee: $200.00 (Ord. No. 2012-O-161)
Date: _____________________________________
1. Applicant ___________________________________ Property Owner ____________________________
Address _________________________________________ Address ____________________________________
Telephone ______________________________________ Telephone _________________________________
Cellular _________________________________________ Cellular ____________________________________
E-Mail Address __________________________________ E-Mail Address _____________________________
*NOTE: If applicant is different from the owner named on the deed, the affidavit on page three of this
application must be completed.
• All owners of the above cited property must sign and date application.
• If the owner of the property is a corporation, proof of legitimacy of signing party must be provided.
Name of designated representative (If different from owner) ___________________________________
Address ______________________________________________________________________________
Telephone ____________________________________________________________________________
Cellular ______________________________________________________________________________
E-Mail Address ________________________________________________________________________
2. Legal description of property:
Platted:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Name of Subdivision Section No. Block No. Lot No.
* FOR PROPERTIES NOT IN A RECORDED SUBDIVISION SUBMIT A CURRENT SURVEY AND
COMPLETE METES AND BOUNDS DESCRIPTION BY A TEXAS REGISTERED PROFESSIONAL
LAND SURVEYOR. (R.P.L.S.)
Unplatted:
____________________________________________________________________________________________
Name & No. of Survey Abstract Acreage
____________________________________________________________________________________________
Attach Vicinity Map Showing Landmarks
2 Rev. 01/17/2020
________________________________
____________________________________________________________
or Appropriate Distances.
3. Nature of Proposed Construction 4. Description of Proposed Construction
( ) New construction
( ) Improvement or repair to existing structure
( ) House ( ) Mobile home ( ) Other (Describe)
_________________
( ) Residential ( ) Non-Residential ( ) Commercial
( ) Alteration of a natural waterway or drainage course
( ) Excavation or placement of fill
( ) Subdivision (New or Expansion)
_________________________________________________________________________________________
_________________________________________________________________________________________
( ) G
rading
( ) Other _________________________________________________________________________________
Explain
5. A
rea of first floor of structure (Square Feet) 6. Will structure(s) be built on
( ) Floating slab fill ( ) Pier
________________________________
_____
7. Estimated cost of improvements or repairs to existing structure $ _________________________________
8. The flood plain administrator may require the filing of supplemental plans, specifications a
nd
in
formation if the documents attached are insufficient.
I hereb
y acknowledge that the information submitted in this application is true and correct.
________________________________
______ ___________________________________
Signature of Applicant Date
Do
Not Write Below This Line
____________________________________________________________________________________________
For use by City Administrator
Flood insurance rate map determination:
Flood plain ( ) Yes ( ) No Floodway ( ) Yes ( ) No
Panel number: _____________________
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3 Rev. 01/17/2020
AFFIDAVIT
(Appointment of Representative)
COUNTY OF WEBB§
STATE OF TEXAS§
BEFORE ME, the undersigned official, on this day personally appeared ____________________________________, who is
personally known to me, and first being duly sworn according to law upon his/her oath deposed and said:
“My name is _____________________________________; I am over eighteen (18) years of age and I reside at
__________________________________________________. I have personal knowledge of the facts stated
herein, and they are all true and correct. I own the property which is the subject. I have designated
________________________________________________ to represent me in filling an application for
Floodplain Development Permit with the Building Development Services Department of the City of Laredo, and
to appear on my behalf at all necessary meetings with respect to this request. It has been explained to me and I
understand that a written notice must be filed with the Building Development Services Department of the City of
Laredo, Texas, to give notice to the City of the termination or substitution of representation with respect to this
application.”
_____________________________________
Affiant
On ________________, 20___, personally appeared ________________________________________________________
and having been duly sworn by me subscribed to the foregoing affidavit and has stated that the facts therein are true and
correct.
__________________________________________
Notary Public, State of Texas
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CITY OF LAREDO Application for Floodplain Development Permit

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Completed 12 March 2021

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