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PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 9/13/2016 <br /> Permit#: PW1609-033 <br /> PROJECT ADDRESS: 3310 31ST DR LOT 89 <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#: C'��'�,—li� <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 /> �NO <br /> Explanation: �(�,�',..E C�G�D� <br /> (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATFR FF_ES? <br /> I I UIJIVIL I/l. JL�tiVII�L:. I-�1I\'L .JLlI�VI�.�. <br /> Bf YES Amount$ ��(� , `� �� ❑ YES—Amount$ <br /> �Meter Only, ❑ Complete Service, Size 3/y ❑ '/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 /> '�'YES—Amount$ ��� �New Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENTFEE? <br /> �YES—Amount$ `�;. �f�;Z�`'� ❑ See Attached Spreadsheet <br /> � <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 /> ❑ No '� �� �'���� � �rndel <br /> F -. <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> �"YES -TYF'F $� �'SeeAttacfic;df_etter <br /> ❑ NO <br /> �,�''� ` 1 "1 `�'�3-Z�'� <br /> Public Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />