1318 75TH ST SE 2024-03-01 - Laserfiche WebLink

E V E R E T T PUBLIC WORKS REQUEST WAS H I N GTO N FOR WATER DEPARTMENT COST ESTIMATE (ATTACH 1 WATER PLAN FOR REFERENCE) Date Request Sent: 6/23/2022 Associated Permit #: PW2201-015 PROJECT ADDRESS: 1313 75TH ST SE DESCRIPTION OF WORK: NEW SFR CONTACT INFORMATION: OWNER: APPLICANT: NAME: BLUE MOON REALTY LLC NAME: SONIYA MOON ADDRESS: 4905 33RD ST CT NE ADDRESS: TACOMA, WA, 98422 PHONE: 2533976393 PHONE: 2533976393 EMAIL: SOHEEMOON.96@GMAIL.COM EMAIL: SOHEEMOON.96@GMAIL.COM CONTRACTOR: CONTACT: ❑ Owner, ❑ Applicant, ❑Other NAME: NEED CONTRACTOR INFORMATION NAME: SONIYA MOON ADDRESS: PHONE: 2533976393 EMAIL: SOHEEMOON.96@GMAIL.COM PHONE: EMAIL: REQUEST FROM PUBLIC WORKS REVIEWER: COST ESTIMATE REQUESTED BY: Abiy Tsegaye COST ESTIMATE REQUESTED FOR: ❑ CITY CREWS TO MAKE NEW CONNECTION TO MAIN • # OF CONNECTIONS NEEDED: 1 • TYPE OF CONNECTION: Water service line ■ SIZE OF CONNECTION: 1 Inch • SIZE OF MAIN: 6inch ❑ CITY CREWS TO INSTALL PIPE FROM MAIN TO BACK SIDE OF METER • EXCAVATE, SHORE, AND RESTORE BY: ❑ CONTRACTOR, ❑ CITY CREWS • TRAFFIC CONTROL BY: ❑ CONTRACTOR, ❑ CITY CREWS • INSTALLATION AND PIPE THROUGH VAULT BY: ❑ CONTRACTOR, ❑ CITY CREWS OTHER DESCRIPTION OR REQUEST: 'ry 6 12 3 / Zo 2 -2— PubficRJ-Aeiigder Signature Date REVISED 212412016