Laserfiche WebLink
• PUBLIC WORKS REQUEST': <br /> FOR WATER DEPARTMENT COST ESTIMATE <br /> (ATTACH 1 WATER PLAN FOR REFERENCE) Date Request Sent: 1/25/2019 <br /> Associated Permit#: PW1802-030 <br /> PROJECT ADDRESS: 10725 19TH AVE SE <br /> DESCRIPTION OF WORK: SITE WORK FOR 12 NEW TOWNHOMES <br /> FIL E copy <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: WONG ALVIN&TINA KOO NAME: JAMESON ROSS <br /> ADDRESS: 16309 SE 7TH ST ADDRESS: <br /> BELLEVUE,WA,98008 , , <br /> PHONE: 115 qi ,I rJ j PHONE: 4252522153 <br /> EMAIL: tinaalvinwong gmail.com EMAIL: ROSS ae2812ARCHITECTURE.COM <br /> CONTRACTOR: I CONTACT: Elner, 0 A Iicant, ❑Other <br /> NAME: TBD E-d j 5 Ka/ l(1J - NAME: 28 A ITECTURE <br /> ADDRESS: PHONE: 425 53 <br /> > f r EMAIL: r sea 281 itecture.com <br /> PHONE: <br /> EMAIL: '' CON QI:Penik+: <br /> REQUEST FROM PUBLIC WORKS REVIEWER: <br /> '\(\k. arIACti( <br /> COST ESTIMATE REQUESTED BY: Sc1iDflk <br /> COST ESTIMATE REQUESTED FOR: <br /> ❑ CITY CREWS TO MAKE NEW CONNECTION TO MAIN <br /> ■ #OF CONNECTIONS NEEDED: a <br /> • TYPE OF CONNECTION: d" P'(ZOO , ) on <br /> • SIZE OF CONNECTION: gi <br /> ■ SIZE OF MAIN: 11111 D•I• <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: 0 CONTRACTOR, 0 CITY CREWS <br /> • INSTALLATION AND PIPE THROUGH VAULT BY: 0 CONTRACTOR, 0 CITY CREWS <br /> OTHER DESCRIPTION OR REQUEST: <br /> CadM,Okk ditTr eGliafti WI!irVAAS • <br /> � T <br /> 62) I s vIc.�s <br /> pc <br /> at SS air <br /> Public Works Reviewer Signature ate <br /> REVISED 2/24/2016 <br />