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• PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/1/2016 <br /> Permit#: B1603-006 & <br /> PROJECT ADDRESS: 5�' S1 /ZOO <yr (!� B1603-008 <br /> DESCRIPTION OF WORK: PICNIC SAIL STRUCTURE EAST&WEST-BOXCAR PARK <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: PORT OF EVERETT NAME: [AppName] <br /> ADDRESS: 1205 CRAFTSMAN WAY SUITE 200 ADDRESS: [AppAdd] <br /> EVERETT,WA, 98201 [AppCi], [AppSt], [AppZip] <br /> PHONE: 4252593164 PHONE: [AppPhone] <br /> EMAIL: EMAIL: [AppEmail] <br /> CONTACT: ❑ Owner ❑ Applicant ❑Other <br /> NAME: BRANDON WHITAKER <br /> PHONE: 4253880613 <br /> EMAIL: BWHITAKER a@PORTOFEVERETT.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: SMR �w0�1�1►Q►�� 111d <br /> PW Permit Required? Ef YES ❑ NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#:_19A1160 3 <br /> FIRE SPRINKLER REQUIRED? (by Fire Department/Code) <br /> ❑ YES–Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> 1] NO <br /> Explanation: <br /> (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> _19 l QftW a 70 rY kern Irl FIRE SERVICE: <br /> Q YES–Amount$ ❑YES–Amount$ <br /> ❑ Meter Only, ❑ Complete Service, Size // __ ❑%" Deduct Meter Only, ❑ Fire Service Size <br /> OExplanation:ation : f�ack:A= Pf.✓ -B2 )IaOnation- <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 /> Ef NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> ❑YES–Amount$ ❑ See Attached Spreadsheet <br /> Z 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 /> qNO <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> 13 YES–TYPE ❑ See Attached Letter <br /> ❑ NO <br /> y- 8 <br /> Public Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />