4322 29TH DR SE 2017-09-20 - Laserfiche WebLink

AINUL PUBLIC WORKS MW REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 8/12/2016 0,0&1 Permit#: PW1 608-On- PROJECT ADDRESS: 4322 29TH DR SE LOT 112 -Aw- DESCRIPTION OF WORK: SITE WORK AND TRAFFIC MITIGATION FOR NEW SFR CONTACT INFORMATION: OWNER: APPLICANT: NAME: POLYGON WLH LLC NAME: PANT ALAN/POLYGON ADDRESS: 4695 MACARTHUR CT 8TH FLR ADDRESS: NEWPORT BEACH, CA, 92660 PHONE: PHONE: 4255867700 EMAIL: EMAIL: CONTACT: ❑ Owner ❑ Applicant ❑Other NAME: PANI ALAN PHONE: 4255867700 EMAIL: ALAN.PAN[@POLYGONHOMES.COM COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required? YES ❑ NO W.O.#: Notes: Associated Bldg./PW Permit#: 4f _ FIRE SPRINKLER REQUIRED? (by Fire Department/Code) ❑YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) ,)irN O Explanation: (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: �J t 0 FIRE SERVICE: 11 YES—Amount$ 4803 ❑YES—Amount$ `Meter Only, El Complete Service, Size ZW— ❑ %," Detect Meter Only, ❑ Fire Service Size ❑ NO ONO 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? 7 �p ❑YES—Amount$ / New Connection, ❑Alteration/Repair, ❑ Cap-off/Reconnect ❑ NO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENT FEE? j pl�f RYES—Amount$ ]9(o Z ❑ 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?CS YES—Amount$ ❑ See Attached Spreadsheet ❑ NO �e� �✓lrke �li�Ck l0" /4'l 1, ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) BYES—TYPE �'�`'/ ❑ See Attached Letter ❑ NO * Public Works Reviewer Signature Date REVISED 2/24/2016