2116 LEXINGTON AVE 2017-01-13 - Laserfiche WebLink

PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 2129/2016 Permit #: P'W1602-050 PROJECT ADDRESS: 2116 LEXINGTON AVE DESCRIPTION OF WORK: NEW SFR WITH ATTACHED GARAGE CONTACT INFORMATION: OWNER: APPLICANT: NAME: RV HARDT PROPERTIES LLC NAME: ADDRESS: 7714 78TH PL NE ADDRESS: MARYSVILLE, WA, 98270 PHONE: EMAIL: CONTACT: ❑ Owner ❑ Applicant ❑Other NAME: HAACK JOEL PHONE: 4252902429 EMAIL: JOEL@HAACKBROTHERS.COM COMMENTS FROM PUBLIC WORKS REVIEWER: PW Permit Required?�YES ❑ NO Notes: PHONE EMAIL: HAACK JOEL >> 4252902429 JOEL@HAACKBROTHNRS.COM LAND USE PROJECT #: W.O. #: Associated Bldg./PW Permit #: FIRE SPRINKLER REQUIRED? (bv Fire Department/Code) e❑� ES —Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) �NO xplanation: (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: FIRE SERVICE; �YES — Amount $ �l ❑ YES — Amount $ ❑ Meter Only, Complete Service, Size�� ❑ 3/4' Deduct Meter Only, ❑ NO ❑ NO Explanation: Explanation: ❑ Fire Service Size ❑ Water Department Cost Estimate Needed-(If yes, PW Reviewer to send cost estimate request to Water Department, attach copy) Existing Utility Permit # (if applicable): SEWER FEE? � C� �YES — Amount $ �� J� New Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect ❑ NO Explanation: Existing Utility Permit # (if applicable): SYSTEM DEVELOPMENTFEE? YES — Amount $ ❑ NO — No Change of Use / Other Explanation: '� See Attached Spreadsheet (Note: Public Works Reviewer to Add Traffic Mitigation to PW Permit (if applicable)) TRAFFIC MITIGATION FEE? ❑ YES — Amount $ ❑ See Attached Spreadsheet �,N O ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu <�nd include) ❑ YES — TYP ❑ See Attached Letter ❑ NO ; �� / Works Reviewer Signature REVISED 2/24/2016 a te