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PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 4601 31ST AVE SE Permit#: C1901-006 <br /> TENANT: OVERLOOK AT RIVERFRONT -91/JJ901-c <br /> DESCRIPTION OF WORK: NEW SFR- 1_04- <br /> PW <br /> ofPW 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: (Attach Calculation& Cost Est.) <br /> lit-New Connection to main plus I connections to building 0 New Connection, Size -0 Per Cost Estimate <br /> ❑Alteration Meter Only, Size 3kyn -0 Per Cost Estimate <br /> ❑ Repair Ef Water System Development Fee Total: $ 3t9.-'.v <br /> ❑Cap-off,quantity_ . bi Sewer System Development Fee Total: $5)121.91 <br /> ❑ Reconnection to stub ❑ Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ NOT REQUIRED 0 NOT REQUIRED <br /> Explanation/Utility Permit#: Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size 0 New Connection, Size -0 Per Cost Estimate <br /> ❑ Meter Only, Size ❑'/<"Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total: $ 0 Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA KNOT REQUIRED <br /> ' (NOT REQUIRED Explanation/Utility Permit#: <br /> Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> ISNOT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit) <br /> 3 <br /> TtWater Service Line(behind meter), Size H <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 /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> g YES, Stormwater Total: $ 622. 0 YES,Traffic Mitigation Total:$ <br /> 0 See Attached Spreadsheet for calculations 0 See Attached Spreadsheet for calculations/credit <br /> ❑ NOT REQUIRED / NOT REQUIRED_�!, ,, 044, <br /> m iVl P.115s-©12 <br /> ZI IZ4 CN.1041111 N�6 <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> YES-TYPE: IS('SFR 0 DUPLEX ❑ADU ❑ INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> OK See Attached Letter,2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> 6Q <br /> Digital copy attached to permit record, Permit# 1910501-(J3`j <br /> �(Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES-Type <br /> Et NOT REQUIRED. <br /> Reason: FIIeE CO , WI IN OF Flf <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> AYES, Permit#PW Igol-OVA <br /> Stormwater NPDES Tab Completed in TRAKiT DADA Tab Completed in TRAKiT ttlnspections Added in TRAKiT <br /> ❑ NOT REQUIRED /46- <br /> / <br /> Worksheet Completed By: 4 /-I V '�(� Date: -2e/ <br /> Worksheet Checked By: Date: <br /> REVISED 111/2019 <br />