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PUBLIC WORKS • <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 9/13/2016 <br /> Permit#: PW1609-031 <br /> PROJECT ADDRESS: 3306 31ST DR LOT 87 <br /> DESCRIPTION OF WORK: NEW TOWNHOME/TRAFFIC MITIGATION <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: POLYGON WLH LLC NAME: PNW Riverfront LLC <br /> ADDRESS: 11624 SE 5TH ST ADDRESS: 11624 SE 5th Street#200 <br /> BELLEVUE,WA, 98005 BELLEVUE,WA, 98005 <br /> PHONE: PHONE: 4255867700 <br /> EMAIL: EMAIL: nicka@polygonhomes.com <br /> CONTACT: ❑ Owner ❑ Applicant ❑Other <br /> NAME: PANI ALAN <br /> PHONE: 4255867700 <br /> EMAIL: ALAN.PANI@POLYGONHOMES.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?�YES ❑ NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: �l�d�"O� <br /> FIRE SPRINKLER REQUIRED? (by Fire DepartmenUCode) <br /> ❑YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> T�NO <br /> Explanation: ��� �`4� <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> �NATF_R FEFS? <br /> '� ' �)Ci���ri_��1�'�; ::� I''Vi(�L: c� �z� Flf ' �_I;VrC=L: j <br /> $7YES Amount$ � pti , `� �, �� ❑ Y�S—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? <br /> C� <br /> b�YES—Amount$ � ,"'— ❑ New Connection, ❑Alteration/Repair, ❑ Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> �YES—Amount$ �`�f,� ..�' ❑ See Attached Spreadsheet <br /> ❑ NO—No Change of Use/Other <br /> Explanation: �3�� � <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> �YES—Amount$ 3�j/.� ❑ See Attached Spreadsheet <br /> ❑ N O �, ��' f'1'�I�UL B`S �c�nsl�� ' <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> �(YES--TYPE- �F� �See Attached L etier <br /> ❑ NO <br /> ��� a �—f�—Z0�'-d' <br /> Public Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />