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PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/10/2016 <br /> Permit#: C1603-017 <br /> PROJECT ADDRESS: 1921 78TH PL SE LOT 11 <br /> DESCRIPTION OF WORK: NEW TOWNHOUSE (RAMSEY 2435) �(,,L� ���i� — (J7� <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: ALPINE HEIGHTS DEVELOPMENT NAME: [AppName] <br /> ADDRESS: 120 SW EVERETT MALL WAY SUITE ADDRESS: [AppAdd] <br /> EVERETT,WA, 98204 [AppCi], [AppSt], [AppZip] <br /> PHONE: PHONE: [AppPhone] <br /> EMAIL: EMAIL: [AppEmail] <br /> CONTACT: ❑ Owner ❑ Applicant ❑Other <br /> NAME: STEVE SNYDER <br /> PHONE: 4253190122 <br /> EMAIL: STEVE.S@SEAPACHOMES.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? L� YES ❑ NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: <br /> FIRE SPRINKLER REQUIRED? (by Fire DepartmenUCode) <br /> }Zf YES—Type /� i� (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/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: FIRE SERVICE: <br /> ❑YES—Amount$ SG C.� �� ❑ YES—Amount$ <br /> .�(Meter Only, ❑ Complete Service, Size / ❑ 3/4" Detect Meter Only, ❑ Fire Service Size <br /> ❑ NO ❑ NO <br /> Explanation: Explanation: <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 /> SEWER FEE? �,�, <br /> �'YES—Amount$ 7�—' ❑ New Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? � �J <br /> YES—Amount$ r � <br /> � �L9%0 ❑ See Attached Spreadsheet � ,j:� <br /> ❑ NO—No Change of Use/Other <br /> Explanation: <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> ❑ YES—Amount$ ❑ See Attached Spreadsheet <br /> �N� �Lr,^�co/r f k:,� _ <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ,�YES—TYPE ..�'r/` ,L�I"See Attached Letter <br /> ❑ NO <br /> ��6c' ��>z�-�S .j -�C%—/�o <br /> P��blic Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />