316 SE EVERETT MALL WAY 2019-01-16

Am AN& PUBLIC WORKS IRMW REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 9/22/2016 Permit#: PW1609-085 PROJECT ADDRESS: 316 SE EVERETT MALL WAY DESCRIPTION OF WORK: SITE WORK FOR TI-MCDONALDS CONTACT INFORMATION: OWNER: APPLICANT: NAME: MCDONALD'S REAL ESTATE CO LC04 NAME: FREIHEIT& HO ARCHITECTS ADDRESS: PO BOX 182571 ADDRESS: COLUMBUS, OH,43218 PHONE: PHONE: EMAIL: EMAIL: CONTACT: ❑ Owner ❑ Applicant ❑Other NAME: [ContactName] PHONE: [ContactPhone] EMAIL: [ContactEmail] COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required?'K YES ❑ NO W.O. #: / Notes: Associated Bldg./PW Permit#: '�Q6 FIRE SPRINKLER REQUIRED? (by Fire Department/Code) ❑YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) ❑ NO Explanation: (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: FIRE SERVICE: ❑ YES—Amount$ ❑ YES—Amount$ ❑ Meter Only, ❑ Complete Service, Size ❑ %" Detect Meter Only, ❑ Fire Service Size `4 NO #A NO Explanation: Explanation: ❑Water Department Cost Estimate Needed-(/f yes, PW Reviewer to send cost estimate request to Water Department, attach copy) Existing Utility Permit#(if applicable): SEWER FEE? YES—Amount$ ❑ New Connection, Alteration epair, ❑ Cap-off/Reconnect 0 N Explanation: MA in (affAL�j 14'1_/� -h 3�� Existing Utility Permit#(if applicable): T SYSTEM DEVELOPMENT FEE? ❑ YES— ount$ ❑ See Attached Spreadsheet ItNO No Change of Us /Other Explanation: (Note:Public Works Reviewer to Add Tra Ic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? ❑ YES—Amount ❑ See Attached Spreadsheet N'NO ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) ❑ YES—TYPE ❑ See Attached Letter ANO -�a- Public Works Reviewer Signature Date REVISED 212412016