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0 [A* waer <br /> 41677. PUBL IC WORKS REQUEST <br /> FOR WATER DEPARTMENT COST ESTIMATE <br /> (ATTACH 1 WATER PLAN FOR REFERENCE) Date Request Sent: 5/11/2017 <br /> Associated Permit#: PW1612-011 <br /> PROJECT ADDRESS: 4220 COLBY AVE) gL1? A <br /> DESCRIPTION OF WORK: SITE WORK FOR NEW MULTI-FAMILY <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: COLBY PROPERTY MANAGEMENT LLC NAME: COLBY PROPERTY MANAGEMENT LLC <br /> ADDRESS: 2627 EASTLAKE AVE E ADDRESS: 2627 EASTLAKE AVE E <br /> SEATTLE,WA,98102 SEATTLE,WA,98102 <br /> PHONE: PHONE: <br /> EMAIL: EMAIL: <br /> CONTRACTOR: CONTACT: 0 Owner, 0 Applicant, ['Other <br /> NAME: TBD NAME: AZIZ ENAYAT <br /> ADDRESS: PHONE: 4258916295 <br /> EMAIL: EAZIZ@AZIZNW.COM <br /> PHONE: <br /> EMAIL: <br /> REQUEST FROM PUBLIC WORKS REVIEWER: <br /> COST ESTIMATE REQUESTED BY: SO bYI1/10k, raxott i►� <br /> COST ESTIMATE REQUESTED FOR: <br /> CITY CREWS TO MAKE NEW CONNECTION TO MAIN <br /> • #OF CONNECTIONS NEEDED: <br /> • TYPE OF CONNECTION: <br /> • SIZE OF CONNECTION: <br /> • SIZE OF MAIN: <br /> ❑ CITY CREWS TO INSTALL PIPE FROM MAIN TO BACK SIDE OF METER <br /> • EXCAVATE,SHORE,AND RESTORE BY: 0 CONTRACTOR, 0 CITY CREWS <br /> • TRAFFIC CONTROL BY: 0 CONTRACTOR, 0 CITY CREWS <br /> • INSTALLATION AND PIPE THROUGH VAULT BY: 0 CONTRACTOR, 0 CITY CREWS <br /> OTHER DESCRIPTION OR REQUEST: <br /> • es-Irmo. , t : . h3A i- eonyCC (14.11-iar 1,Y1 ,emew) <br /> • p��N,m 2; tos ea . _,bas n5�� --�rrn� mar s= ufsie£ < <br /> I iih nsta <br /> • es-timt- F iV 3= rz, s cervi connt,effern,ft main. a"s viT,t, on 6''main. om <br /> Pati (ora d siPinki&r rat»,. <br /> Stt, 01/49 )n 9. Udtatir r ec rmcia.. <br /> _40,171,thaL hq/1 -- <br /> Public Works Reviewer Signature Dat *� <br /> REVISED 2/24/2016 <br />