Laserfiche WebLink
• PUBLIC WORKS • <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/25/2016 <br /> Permit#: C1603-061 <br /> PROJECT ADDRESS: 1928 78TH PL SE LOT 34 <br /> DESCRIPTION OF WORK: NEW TOWNHOUSE (MARION 1816) <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: MATTR@SEAPACHOMES.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? ❑ YES ❑ NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: <br /> FIRE SPRINKLER REQUIRED? (byFire Department/Code) <br /> %YES—Type / (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: _./ �G/Jn A <br /> %2G FIRE SERVICE: <br /> ❑YES—Amount$ 5 t�D ❑YES—Amount$ <br /> I1 Meter Only, ❑ Complete Service, Size ❑%" 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 ❑ New Connection, ❑Alteration/Repair, ❑ Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> I(YES—Amount$ 5!R G) 4Z ❑ See Attached Spreadsheet jIVvsV <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 /> VNO P.,4a PA-If y,0C/,91 V <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> VrYES—TYP T 1�See Attached Letter <br /> ❑ NO <br /> /7/ f / <br /> is Works Reviewer Siat a Da e <br /> REVISED 2124/2016 <br />