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� _ _ � <br /> PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 9/13/2016 <br /> Permit#: PW1609-034 <br /> PROJECT ADDRESS: 3312 31ST DR LOT 90 <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.�E��—� <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 CQ�b� <br /> (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> VI/ATFR FFFS? <br /> � I.i�)ii�it_ ,lli, "I.:i<1'li�l_: ��ii i_. :ii-F:�1'I�..L: <br /> �"YES—Amount$ �S$�.`- ' �� ❑ Y�S—Amount$ <br /> �Meter Only, ❑ Complete Service, Size�_ ❑ 3/4" Detect Meter Only, ❑ Fire Service Size <br /> ❑ NO L�Q NO <br /> Explanation: Explanation: <br /> ❑Water Department Cost Estimate Needed-(/f 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$ �.`� �f New Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> ❑ YES—Amount$ ' ''% ❑ See Attached Spreadsheet <br /> ❑ NO—No Change of Use/Other <br /> Explanation: �:3�7 � <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> �YES—Amount$ �5� �� ❑ See Attached Spreadsheet <br /> ❑ NO <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> '�"YES—TYPF �_ �'See nttached Leiter <br /> ❑ NO <br /> ,� <br /> 1.e� °� �'—(3—G�,l6 <br /> Public Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />