10305 DAKOTA WAY 2017-08-17 - Laserfiche WebLink

• PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 4/1/2016 Permit#: C1604-001 PROJECT ADDRESS: 10305 DAKOTA WAY DESCRIPTION OF WORK: CONVERT GARAGE TO HABITABLE, NEW ATTCHD SHED CONTACT INFORMATION: OWNER: APPLICANT: NAME: MEYER DANIEL E NAME: [AppName] ADDRESS: 13623 PUGET SOUND BLVD UNIT A ADDRESS: [AppAdd] EDMONDS,WA, 98026 [AppCi], [AppSt], [AppZip] PHONE: PHONE: [AppPhone] EMAIL: EMAIL: [AppEmail] CONTACT: ❑ Owner ❑ Applicant ❑Other NAME: [ContactName] PHONE: [ContactPhone] EMAIL: [ContactEmail] COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required? ❑ YES ,4 NO W.O. #: Notes: Associated Bldg./PW Permit#: 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 ❑ NO ❑ 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/Repair, ❑ Cap-off/Reconnect ❑ NO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENT FEE? ❑YES—Amount$ ❑ See Attached Spreadsheet ❑ NO—No Change of Use/Other Explanation: (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? ❑YES—Amount$ ❑ See Attached Spreadsheet ❑ NO ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) ❑ YES—TYPE ❑ See Attached Letter ❑ NO Public Works Reviewer Signature Date REVISED 2124/2016