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PUBLIC WORKS REQUEST <br /> t FOR WATER DEPARTMENT COST ESTIMATE <br /> (ATTACH 1 WATER PLAN FOR REFERENCE) Date Request Sent: 10/17/2017 <br /> Associated Permit#: PW1704-048 <br /> PROJECT ADDRESS: 11229 19TH AVE SE <br /> DESCRIPTION OF WORK: SITE WORK FOR 16 NEW TOWNHOMES <br /> CONTACT INFORMATION: FILE COPY <br /> OWNER: APPLICANT: <br /> NAME: MVM Development&Construction NAME: Peter Anderson <br /> ADDRESS: 19528 VENTURA BOULEVARD,SUITE 573 ADDRESS: 3918 SW Orchard St. <br /> TARZANA,CA, 91356 SEATTLE,WA,98136 <br /> PHONE: 818-822-6560 PHONE: 2069495828 <br /> EMAIL: (Gil Moalem)gmoalem@gmail.com EMAIL: pga.imagodelineo@msn.com <br /> CONTRACTOR: CONTACT: Owner, 0 Applicant, ❑Other <br /> NAME: NAME: Gil Moalem (Owner) <br /> ADDRESS: PHONE: 818-822-6560 <br /> PHONE: EMAIL: gmoalem@gmail.com <br /> EMAIL: <br /> REQUEST FROM PUBLIC WORKS REVIEWER: � C��l/[A <br /> COST ESTIMATE REQUESTED BY: S <br /> 0ti �+ �® 19' f ss �/ <br /> COST ESTIMATE REQUESTED FOR: pg �f?XYfr '1 pedserf cm S s QI op1fsely <br /> CITY CREWS TO MAKE NEW CONNECTION TO MAIN <br /> • #OF CONNECTIONS NEEDED: <br /> • TYPE OF CONNECTION:eb1U t1 nett) Aid4o weal,Ex, s'fit& k)!yS° <br /> e�eitruc, mnu)8 rrhn. lo . IZ cash i in mt M t res.6 <br /> • SIZE OF CONNECTION: egaonl2" „Nl, S"on 9" <br /> • SIZE OF MAIN: C/ ail fitA I/ fAeirhey A?dh1, <br /> 0 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: Jr- einvileD li iei. f- 1 timet /Ala <br /> 1 /0111-100517" <br /> •ublic Works Reviewer Signature Date <br /> Clr9 <br /> REVISED 2/24/2016 <br />