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PUBLIC WORKS <br />REVIEW WORKSHEET <br />(ATTACH 1 SITE PLAN FOR REVIEW) <br />PROJECT ADDRESS: <br />DESCRIPTION OF WORK: <br />3710 COLBY AVE <br />TOWNHOME UNIT A <br />CONTACT INFORMATION: <br />OWNER: <br />NAME: <br />CLM PROPERTY SOLUTIONS LLC <br />ADDRESS: <br />14751 N KELSEY ST UNIT 105 183 <br />MONROE, WA, 98272 <br />PHONE: <br />4063903676 <br />EMAIL: <br />cxm820@gmail.com <br />CONTACT: <br />NAME: <br />PHONE <br />EMAIL: <br />❑ Owner ❑ Applicant ❑Other <br />CLETE MESSERLY <br />4063903676 <br />cxm8200-gmail.com <br />COMMENTS FROM PUBLIC WORKS REVIEWER: <br />PW Permit Required? %YES ❑ NO <br />Notes: <br />Date: 2/5/2018 <br />Permit #: C1802-005 <br />APPLICANT: <br />NAME: <br />CLM PROPERTY SOLUTIONS LLC <br />ADDRESS: <br />14751 N KELSEY ST UNIT 105 183 <br />MONROE, WA, 98272 <br />PHONE: <br />4063903676 <br />EMAIL: <br />cxm820@gmail.com <br />LAND USE PROJECT <br />W.O. #: lV hI <br />Associated Bldg./PW Permit #: 01906-027 <br />FIRE SPRINKLER REQUIRED? (by Fire Deoartment/Code) <br />❑ YES —Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br />❑ NO <br />Explanation: <br />(Note: Counter Staff to Create Utility Permit for any Water/SewedSystem Development Fees) <br />WATER FEES? <br />DOMESTIC SERVICE: FIRE SERVICE: <br />-gYES — Amount $ `� . uo II 3 ❑ YES — Amount $ <br />❑ Meter Only, Complete Service, Size ❑ %" Detect Meter Only, ❑ Fire Service Size <br />❑ NO K NO <br />Explanation: Explanation: <br />❑ RPBA Needed at premise? -(Plumbing permit for backflow device needed due to High -Hazard Site per Tim Markham's review) <br />❑ Water Department Cost Estimate Needed -(If yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br />Existing Utility Permit # (if applicable): <br />[YES — Amount $ 2<New Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect <br />❑ NO <br />Explanation: <br />Existing Utility Permit # (if applicable): <br />SYSTEM DEVELOPMENT FEE? <br />IKYES — Amount $ ❑ See Attached Spreadsheet <br />❑ NO — No Change of Use / Other I <br />Explanation: Xlr2aL <br />(Note: Public Works Reviewer to Add Traffic Mitigation to PW Permit (if applicable)) <br />-TRAFFIC MITIGATION FEE? <br />RYES — Amount $ .e ❑ See Attached Spreadsheet <br />❑ NO nb M6-D IT <br />DRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter f om T Ki Pint Menu and includ�,r <br />1 YES —TYPE E WSee Attached Letter j� a / °nE iS r fo I pErm <br />13 NO <br />PW Reviewer: Date: <br />REVISED 1011112016 <br />