2514 RAINIER AVE 2022-03-01 - Laserfiche WebLink

Akk F PUBLIC WORKS REQUEST MW OL FOR WATER DEPARTMENT COST ESTIMATE (ATTACH 1 WATER PLAN FOR REFERENCE) Date Request Sent: 6/18/2018 Associated Permit #: PW1711-004 PROJECT ADDRESS: 2514 RAINIER AVE DESCRIPTION OF WORK: SITEWORK FOR SCHOOL MODERNIZATION -NORTH MIDDLE SCHOI 74(4OWNER: CONTACT INFORMATION: APPLICANT: NAME: EVERETT SCHOOL DIST 2 NAME: GIFFORD MARK ADDRESS: 4730 COLBY AVE ADDRESS: V EVERETT, WA, 98203 , , PHONE: PHONE: 2064414522 EMAIL: EMAIL: MGIFFORD@NACARCHITECTURE.COM CONTRACTOR: CONTACT: ❑ Owner, ❑ Applicant, ❑Other NAME: TBD NAME: GIFFORD MARK ADDRESS: PHONE: 2064414522 > EMAIL: MGIFFORD@NACARCHITECTURE.COM PHONE: EMAIL: REQUEST FROM PUBLIC WORKS REVIEWER:_ ,^� COST ESTIMATE REQUESTED BY: V)1(,� t& v COST ESTIMATE REQUESTED FOR: ❑ CITY CREWS TO MAKE NEW CONNECTION TO MAIN AIn ■ # OF CONNECTIONS NEEDED: oC 6' CT -MP ON 6''i lrta, - ✓ T1r�.S�EdVi2� ■ TYPE OF CONNECTION: 0 ■ SIZE OF CONNECTION: 1 ■ SIZE OF MAIN:« .7), /. ❑ CITY CREWS TO INSTALL PIPE FROM MAIN TO BACK SIDE OF METER • EXCAVATE, SHORE, AND RESTORE BY: IdCONTRACTOR, ❑ CITY CREWS • TRAFFIC CONTROL BY: ❑ CONTRACTOR, ❑ CITY CREWS • INSTALLATION AND PIPE THROUGH VAULT BY: ❑ CONTRACTOR, ❑ CITY CREWS OTHER DESCRIPTION OR REQUEST: SEE /7-l.(1 arg, DEFER IC'.E• �i C4�.r Public Works Reviewer Signature Da e REVISED 212412016