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PUBLIC WORKS REQUEST • <br /> OLT <br /> FOR WATER DEPARTMENT COST ESTIMATE <br /> (ATTACH 1 WATER PLAN FOR REFERENCE) Date Request Sent: 6/26/2018 <br /> Associated Permit.#: PW1801-037 <br /> PROJECT ADDRESS: 607 RIVERSIDE RD <br /> DESCRIPTION OF WORK: SITE DEVELOPMENT LOT 5 NEW TILT UP WAREHOUSE BLDG <br /> CONTACT INFORMATION: F� <br /> OWNER: APPLICANT: <br /> NAME: GLACIER PEAK INDUSTRIAL OWNER NAME: AHBL e <br /> LLC ADDRESS: ADDRESS: 2215 N 30TH ST#300 ,� <br /> w <br /> 900 SW 16TH ST STE 330 TACOMA,WA,98403 <br /> RENTON,WA,98057-2637 PHONE: 2533832422 <br /> PHONE: 4252593164 EMAIL: dbelk@panattoni.com <br /> EMAIL: <br /> CONTRACTOR: CONTACT: ❑ Owner, ❑ Applicant, ❑Other <br /> NAME: [ConName] NAME: BART BRYNESTAD AHBL <br /> ADDRESS: [ConAdd] PHONE: 2533832242 <br /> [ConCi], [ConSt], [ConZip] EMAIL: sgreene@ahbl.com <br /> PHONE: [ConPhn] <br /> EMAIL: [ConEmail] /f <br /> REQUEST FROM PUBLIC WORKS REVIEWER: <br /> COST ESTIMATE REQUESTED BY: &honk 1 ' t&r <br /> (3)1/z y <br /> COST ESTIMATE REQUESTED FOR: <br /> tECCITY CREWS TO MAKE NEW CONNECTION TO Me <br /> • #OF CONNECTIONS NEEDED: <br /> r/ <br /> • TYPE OF CONNECTION: 8�1 an. <br /> tl <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: ❑ CONTRACTOR, ❑ CITY CREWS <br /> • TRAFFIC CONTROL BY: ❑ CONTRACTOR, ❑ CITY CREWS <br /> • INSTALLATION AND PIPE THROUGH VAULT BY: ❑ CONTRACTOR, ❑ CITY CREWS <br /> OTHER DESCRIPTION OR REQUEST: <br /> gfAllerE, gds 9el , rfnnscf' -fa 04AI esivb nsto emain ( s+ y <br /> lit <br /> knot. cugukCennic e(-C'.I 40 cxt 811,SJv_b wig w�t (iliVfAC. fZ Alyea*Al <br /> n tined-- ga s4vb S sivb -tram Lot erasit bolumn te+y# tot5. 7hru <br /> 6601 -fo be ctenci CenfnulerAcklalk, l <br /> & Gb62€113 <br /> Public Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />