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PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 3229 KROMER AVE Permit#: PW1805-047 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: SITE WORK FOR NEW SFR <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) <br /> SANITARY SEWER: DOMESTIC WATER SERVICE: <br /> New Connection IONew Connection, Size <br /> ❑Alteration 0 Meter Only, Size <br /> ❑ Repair ❑ Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ Cap-off 0 NOT REQUIRED <br /> ❑ Reconnect Explanation/Utility Permit#: <br /> ❑ NOT REQUIRED <br /> Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: FIRE SERVICE: <br /> ❑ New Connection, Size 0 New Connection, Size <br /> ❑ Meter Only, Size ❑' " Detect Meter Only, Service Size <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA 0 Backflow Prevention (Outside Building): 0 DCDA <br /> IR NOT REQUIRED ps NOT REQUIRED <br /> Explanation/Utility Permit#: Explanation/Utility Permit#: SMIN410.1 300' .30 t4 Yo. <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(Ifyes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> SNOT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit) <br /> I Water Service Line(behind meter), Size I n <br /> ❑ Backflow Prevention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> ❑ NOT REQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: NO t��Nrt <br /> BYES,Water:$ 4, t312.. oc RYES, $ Z,400•o 0 <br /> Sewer:$ '� 112 .06 ❑ See Attached Spreadsheet for calculations/credit <br /> 0 See Attached Spreadsheet for calculations/credit 0 NOT REQUIRED <br /> ❑ NOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> gi YES-TYPE S l- <br /> ISee Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> lEc Digital copy attached to permit record, Permit# Pv f f"has--04i <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES-Type <br /> s-NOT REQUIRED <br /> Reason: vVr114,•.i 356' nt pKolLam-r <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> YES, Permit#PW 1805-o4"7 ®-Stormwater Tab Completed in TRAKiT DADA Tab Completed in TRAKiT <br /> ❑ NOT REQUIRED <br /> / , <br /> Worksheet Completed By: '� <br /> Date: g <br /> Worksheet Checked By: - - -- Date: e'12//0-0/6" <br /> r <br /> REVISED 8/6/2018 , <br />