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PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 7/26/2016 <br /> Permit#: PW1607-049 <br /> PROJECT ADDRESS: 2017 79TH ST SE <br /> DESCRIPTION OF WORK: CONSTRUCT NEW TOWNHOUSE UNIT <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: ALPINE HEIGHTS DEVELOPMENT NAME: STEVE SNYDER <br /> ADDRESS: 120 SW EVERETT MALL WAY ST100 ADDRESS: 120 SW EVERETT MALL WAY <br /> EVERETT,WA, 98204 EVERETT,WA, 98204 <br /> PHONE: PHONE: <br /> EMAIL: EMAIL: MATTR@SEAPACHOMES.COM <br /> CONTACT: ❑ Owner ❑ Applicant ❑Other <br /> NAME: [ContactName] <br /> PHONE: [ContactPhone] <br /> EMAIL: [ContactEmail] <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?A YES ❑ NO W.O.#: / <br /> Notes: Associated Bldg./PW Permit#: C _gyp o 6 -O a 5 <br /> FIRE SPRINKLER REQUIRED? (bv Fire Department/Code) <br /> AYES-Type 13 (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> ❑ NO <br /> Explanation: �� /1/c�Lt%�c(l �7eQ 2 <br /> (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: 00 FIRE SERVICE: <br /> ❑ YES-Amount$ -5-4 0 — ii ❑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? ~� cc <br /> 4 YES-Amount$ / 1� XNew Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? 2435, ! I <br /> 'YES-Amount$ ��ZO ❑ See Attached Spreadsheet <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? C't <br /> ❑ YES-Amount$ D `- r� El See Attached Spreadsheet <br /> NO T 4ir�G��eh 111GtJ4S / -C"_CyeC'' <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> OYES-TYPE sf= ❑ See Attached Letter <br /> ❑ NO <br /> Public Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />