Item 4D - Attachment A - Encroachment Form - 2628 Park Grove INSTRUCTIONS FOR COMPLETING AN ENCROACHMENT AND JOINT USE AGREEMENT
OF A PUBLIC EASEMENT
All forms shall be signed in ink only by a property owner, legal partner or corporate officer. An authorized agent of
the landowner must submit a Power of Attorney.
PLEASE SUBMIT ALL OF THE FOLLOWING REQUIRED DOCUMENTS:
1. One copy of the Application with an original signature.
2. One copy of the Easement Joint Use Agreement with an original signature, signed and notarized. Do not
submit copies of signatures and notary acknowledgments.
3. One copy of EXHIBIT NO. 1 that contains the precise metes and bounds description of the part of the
easement to be used. This information is best provided by a registered land surve or. Note that the City
staff is not authorized to prepare this information. Do not place drawings or plats on this exhibit.
4. One copy of EXHIBIT NO. 2 which shows in graphic form the nature of the encroachment with dimensions.
Please limit the area of usage of the easement to only that needed to accommodate your needs. Plans or
drawings may be reduced, provided the final document is legible. City staff will make final decision on
legibility.
5. The Public Works Department may require an additional EXHIBIT NO. 2A which may include a detailed
drawing or cross sectional drawings of decks, signs, retaining walls, fences, driveways, piers, footings, etc. to
fully evaluate the extent of the encroachment
6. One copy of EXHIBIT NO. 3 with original signatures, signed by all agencies listed regardless of whether they
have utility equipment in the easement. This will need to be done before submitting to the City of Southlake.
7. After this agreement is filled out, you will need to return it to Public Works Department and pay:
• The Public Easement Encroachment Permit Fee of$155.
8. This agreement will be circulated through the Public Works, Planning and Development and Building
Inspection Departments within the City of Southlake. Please allow approximately seven to ten working days
to complete the circulation process.
9. This agreement's final review and approval rests with the Director of Public Works.
10. After approval by the Director of Public Works, a copy of the signed agreement is forwarded to the Building
Permit Department for retention in any pending permit files, a copy is retained in the Public Works
Department and a copy is sent to the applicant for their records.
Submit these documents to:
City of Southlake
Department of Public Works
1400 Main Street, Suite 320
Southlake, TX 76092
0A00-New N Drive\ADMINISTRATION-PW DEPT\Forms\Agreements\Joint Use and Encroachment Agreement-Public Easement-2022 Update.docx
APPLICATION FOR ENCROACHMENT AND JOINT USE AGREEMENT
OF A PUBLIC DRAINAGE AND I OR UTILITY EASEMENT
Date of Submittal
To the City of Southlake:
The undersigned hereby makes application to allow an encroachment and joint use of a portion of the public
drainage and / or utility easement situated on or abutting property located at
2628 Park Grove Loa , Southlake TX 76092 and described by metes and bounds in Exhibit No. 1 of the
attached agreement_
The reason for the encroachment and use of the easement is as follows:
The proposed fence is being placed in the center of, and crosses,the public drainage easement on the west side of the
property and will require an encroachment agreement. 5,68
AaTTroperty Owne Telephone
i nat a of Prop w r Fax Number
City tate Zip
0
Easement Joint Use Agreement
THE STATE OF TEXAS §
COUNTY OF Nao-A- §
Be it known, that the City of Southlake, herein after referred to as "City," and its franchised Utility Companies,
herein referred to as "Utilities," do consent and agree to permit the following
g& Dee %D5"= herein after re rred to as "Applicant," to use an easement, situated on or
abutting LOT �F , BLOCK_, OF cpk IN THE CITY OF
SOUTHLAKE, TEXAS, as described on the attached Exhib No. 1, depicted graphically on the attached EXHIBIT
No. 2 and consented to by the public u corn ani a listed on the attached EXHIBIT No. 3, to be used for the
purposes of :L0 0 I1-A;,- En tilit ry :4ur. PCncc _ _-
ar 6r and being subject to the following conditions:
I.
That the Applicant, his successors or assigns shall maintain in good condition all of the easement area and the
improvements situated thereon; and, that City and Utilities shall not become responsible for such maintenance at
any time in the future.
II.
That the Applicant shall and does hereby agree to indemnify and hold harmless the City and the Utilities from any
and all damages, loss or liability of any kind whatsoever by reason of injury to property or third person occasioned
by its use of the easement or act of omission, neglect or wrong doing of Applicant, his officers, agents,
employees, invitees or other persons, with regard to the improvements and maintenance of such improvements;
and the Applicant shall, at his own cost and expense, defend and protect City and Utilities against any and all
such claims and demands.
Ill.
That the Applicant shall arrange for all activities and improvements in the easements to be discontinued and 1 or
removed within thirty(30) days of written notification, at the discretion of City, for:
(1) Lack of maintenance to the easement;
(2) Failure to provide access to the City or its designees; or
(3) Compliance with a City Council directive that use of the easement by the Applicant be
discontinued and the cost associated with the discontinuing of such activities, and the removal of
such improvements, as well as property adjacent to the easement necessitated by such
discontinuation of the easement, shall be borne by the Applicant.
IV.
That the Applicant, his successors or assigns shall not seek compensation from City or Utilities for loss of the
value of the improvements made hereunder when such improvements are required to be removed by Applicant.
0:100-New N Drive\ADMiN1STRATION-PW DEPTIForms\Agreements\Joint Use and Encroachment Agreement-Public Easement-2022 Update.docx
v.
This agreement shall be filed of record in the Deed Records of Tarrant County Texas, and shall bind all future
owners of this lot and shall for all purposes be considered a covenant running with the land.
IN TESTIMONY WHEREOF, Applicant executes this Easement Agreement on this 16�r, _clay of
y►4 20_1-6—.
C :0'e��N-1-4 City of Southlake
Print e
By:
B
Applican s Signature Mayor
NOTE: Complete the attached acknowledgements.
Note- Only complete the appropriate acknowledgements
------------------- ------- ..........................
I THE STATE OF TEXAS § Corporate Acknowledgment
COUNTY OF TARRANT §
BEFORE ME, the undersigned authority, A Notary Public in and for the State of Texas, on this day personally
appeared known to me to be the person and officer whose name is
I subscribed to the foregoing instrument and acknowledged to me that same was the act of said
j a corporation, and that he executed same for the purposes and consideration
therein expressed and in the capacity therein stated.
GIVEN UNDER MY HAND AND SEAL OF OFFICE this the day of 20
Notary Public in and for the State of Texas
My Commission Expires:
—--------------- ------------ ------
-------------------------------------------------
THE STATE OF TEXAS § Individual Acknowledgmen
COUNTY OF TARRANT
i
BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally
appeared Ro beet Qe_rr 12 5 e known to me to be the person whose name is subscribed to the
foregoing instrument and acknowledged to me that he executed same for the purposes and consideration therein
expressed.
SEAL OF OFFICE this the I(P_f lay of Jvne- 20 2G.
JEANNE M STEFFEN
Notary ID#8102117
My Commission Expires
February 28, 2025
No Public in and for the Stat0dMxas
1 My Commission Expires:.
L -------------- ------- ------ ....................................................
THE STATE OF TEXAS § City of Southlake Acknowledgment
COUNTY OF TARRANT §
BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally
appeared known to me to be the person and officer whose name is
subscribed to the foregoing instrument and acknowledged to me that same was the act of said
a municipal corporation, and that he executed same for the purposes and
consideration therein expressed and in the capacity therein stated.
GIVEN UNDER MY HAND AND SEAL OFFFICE this the day of 120
Notary Public in and for the State of Texas
I My Commission Expires:
—--------------
EXHIBIT NO. 1
Being that portion of that certain public utility easement 1 drainage easement situated in
Addition/Survey to the City of Southlake, Tarrant County, Texas, and being
more particularly described by metes and bounds as follows:
FORM SURVEY Q&ES
BRAIN S. RHODES Registered Professional Land Surveyor (972) 475-8940 SURVEYING
This is to certify that I have, this date, made a careful and accurate survey on the ground of property
located at No. 2628 Park Grove Leoo . in the City of SOUTHLAKE Texas.
LOT 12, BLOCK 3• STONY BROOK, AN ADDITION TO THE CITY OF SOUTHLAKE, TARRANT COUNTY. TEXAS, ACCORDING TO
THE PLAT THEREOF RECORDED IN CCU D22CO32281, PLAT RECORDS, TARRANT COUNTY, TEXAS.
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20'PRIVATE DRAINAGE 20'BL —
EASEMENT 0.2'
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3.2' 1.0'
1.2' 3.3' 1. 5aG37
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p1.0'(( _
z IJ4M)NtF' 84.85' 0.2°'z N 89'45'36" W 131.27'
LOT 42R BLOCK 1 LOT 1,BLOCK 1
WATERMERE AT UNION CHURCH ESTATES
ADDITIONSOUTHLAKE ATION INST.NO.0 21 61 9274B
INST.Nm 0212033579
THIS CERTIFICATION DOES NOT
TAKE INTO CONSIDERATION
ADDMOKAL.FACTS THAT AN
ACCURATE TITLE SEARCH AND OR
DEAMINA71ON MIGHT INSCWGE LEGEND
752E E.I-30,STE. 108,GARLAND,Tx 75043-FIRM REGIS1AATgN N0. 10194052 MOW TEPCE-f;- 1R011 FENCE 4" SF,t7F T f
The plot hereon Ir true,correct,one role mp—n.1oeon of the Property cxw LMYc �- WE FENCE-H- ;
oea
as determined by survey.the lime and dimensions of eaitl property hainq oT � �'LIME
� y.• y R•'•.,ep
Indboted W the Pat, size,iocaiian and type of building and improvement• cy _ HONAaLr e
one or ehoen,aII improvements being xithin the bcundariee of the Property, set Ld0-IBAM01f 6 RECCIm mum ..:............................
back tmm property lines the distance ind7aabd,or visible and apparent seeemer�. t Pw+T Fox LbM1ER Bf21AN S. fiH00£5
TITLE AND ABSTRl4 rl WORK FURNISHED BY HOLMES BUILDERS r�1n 1ULEV-d''FED Mil RCD SET •••'•••••'•••••'•••••••••:••••
THERE ARE NO ENCROACHMENTS,CONFLICTS,OR PROTRUSIONS.EXCEPT AS SHOWN. (Gx �ON gi�Gs term) '•.'0�5962�a�':'
Seale: 1'-30' USE OF THIS SURVEY FOR ANY OTHER PURPOSE CMONL PAST tM taledt '••F 550•'pQ•
OR OTHER PARTIES SHALL BE AT THEIR RISK AND CILGTASLOrf �-nr.•rve•lain
Dote: Q2/13/2025 Bearings Texan horror arc referenced CLEW E-Pa"S N�SURVEY
UNDERSIGNED 6 NOT RESPONSIBLE TO OTHER FOR �-aFAN art tR-POCL Epp
G.F.No.: 2025WRIs ANY LOSS RESULTING THEREFROM. >°the Texas Coordinate System of _ LETFR Pau POLE
THIS SURVEY WAS PERFORMED EXCLUSIVELY FOR 1983, North Central Zone(4202),and FM pgxy0 F._TBERM
Job no.: 1 13825 HOLMES BUILDERS a bored upon the North Amedwn I191r POLE "-am Iyeg7n
Mnwn hw ar a Oat—or 1983(NAP 83n5r2011 (DWiES OD7D1L NOiE:D)
EXHIBIT NO. 2
The following is a drawing depicting the area or portion of the easement and property described in Exhibit No. 1,
that is subject to the encroachment and joint use agreement in this application showing the nature of the
encroachment and use with dimensions.
This drawing shall include a north arrow, legal description of the subject property and adjoining properties.
Indicate on the drawing whether the encroachment is for a utility, drainage, private access, easement or right-
of-way.
EXHIBIT NO. 3
The undersigned public utility companies, using or entitled to use, under the terms and provisions of our
respective franchise with the City of Southlake, do hereby consent to the encroachment and joint use of the
described portion of such drainage and 1 or utility easement requested in this Application for encroachment and
joint use of a public drainage and utility easement.
Oncor Electric Delive Company AT&T 1 Southwestern Bell Telephone Company
B
By: (Please Print) y: (Please Nut)
Title: Title: - Nlk
(Please Print) (Pledse ri t)
Signature: Signature:
Verizon Telephone Company Tri-County Electric Company_
By: By:
(Please Print) R
Pr' t)
Title: A] Title: /A
(Please Print) (Please-Print)
Signature: Signature:
Charter Communications Inc. City of Southlake
By: By:
(Please Print) (Please Print)
Title: ki/A- Title:
(Please Pint (Please Print)
Signature: Signature:
Atmos Energy
By:
(Please Pri )
Title: A)
(Please Print)
Signature:
SERVICE PROVIDER CONTACTS FOR
EASEMENTS IN S®UTHLAKE
Oncor Electric Deliver Tri-County Electric Cooperative, Inc.
Budd Rodgers, Distribution ROW Agent Lauren Baccus, Development Coor.
109 Crestwood Lane 4900 Keller-Hicks Road
Springtown, TX 76082 Fort Worth, TX 76244
Office: (817)443-3434 Office: (817) 7 52-8226
Mobile: (432) 234-9052 Fax: (817) 431-9680
Email: buddy.rodgers@oncor.com
AT&T/Southwestern Bell Verizon Telephone
Eric Williams Joe Garza
Manager Engineering Design Superintendent— Network Engineer
1460 Round Table Drive, Room 1000 Office: (972) 252-0770
Dallas, TX 75247 Cell: (325) 245-5102
Office: (214) 745-2964 Email: joe.garza@ftr.com
Fax: (214) 745-8230
Charter Communications,_I Atmos Energy (Gas)
Marla Collier, Charter Coordinator Greg Zylka, Project Manager
Office. (817) 298-3615 2000 Reliance Pkwy
Email: Marla.Collier@charter.com Bedford, TX 76021
Office: (817) 685-1257 (ext. 1313)
Fax: (817) 359-1338
Email: gregory.zylka@atmosenergy.com
LA /VGA /%/ Technical Excellence
Practical Experience
Client Responsiveness
July 28, 2026
Sandy Endy, PE
Development Engineer
City of Southlake
1400 Main Street, Suite 320
Southlake, Texas 76092
Via Email: sendy@ci.southlake.tx.us
Re: Fence and Drainage Improvements
2628 Park Grove Loop (Stoney Brook Subdivision)
Southlake, Texas
Langan Project No.: ADAMS 2017.171
Dear Ms. Endy:
Based on our review of the proposed fencing and drainage improvements for the subject lot, per
the attached exhibit provided by the home builder, the proposed area inlet and 18-inch storm pipe
along the southern property line should be sufficient to intercept surface runoff from the adjacent
property to the east and convey it to the existing inlet located at the southwest corner of the lot.
The proposed short retaining wall/fence section along the southern property line will also help
prevent surface runoff from migrating to the adjacent properties to the south, while keeping on-
site runoff within the drainage easement and directing it to the area inlet. Therefore, provided the
proposed area inlet and storm pipe are properly installed and maintained, no adverse impacts to
adjacent property owners are anticipated. Please accept this letter as my approval of the
proposed fence and drainage improvements for the subject lot.
If you have any questions or concerns regarding this matter, and wish to discuss in further detail,
please do not hesitate to give me a call.
o F T`� 1+ Respectfully,
AW
*� ! 'S' Langan Engineering and Environmental Services, LLC
* ................... /
*
.............................
I �••. 86184 :•'�
,l+0�s /�ENgE�.•G��=,� G. Robert Adams, PE, CPESC
+!i 8 -.11— E�+' Senior Principal
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ill
2999 Olympus Boulevard, Suite 165 Dallas, TX 75019 T: 817.328.3200 www.langan.com
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Corporate Registration Number: F-13709 I TBPELS Firm#1019488
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