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Public Works Reviewer to C-. late and Fill Out All Information OW: Permit#: PW1507-044 <br /> FIRE SPRINKLER REQUIRED? (by Fire Department/Code) <br /> ❑ YES -Type , Reason <br /> 6d N O <br /> (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEE? �- �V � 4:� � �j ��- ���� <br /> �YES -Amount $� �i � �� ��� �� ��� � � <br /> � <br /> �Meter Only, ❑ Complete Service, Type/Size 3 y <br /> � N O �, � t �fi, � m i� ;� �fc\, i�l�� <br /> . ( > � �` <br /> , L, Z <br /> Ex U Permit # <br /> Explanation: �X f��h61 S'��2V�'c',f'.�S 7`p fj� i'�2��. -�i U/��� �{c i�"'E��� <br /> SEWER FEE? <br /> �YES -Amount $ ��? <br /> ❑ New Connection, ❑ Alteration/Repair, L� Cap-off econnect\ <br /> ❑ NO <br /> Ex U Permit # <br /> Explanation: <br /> SYSTEM DEVELOPMENT FEE? <br /> ❑ NO - No Change of Use / Other <br /> �YES -Amount $ �. ��., °� 5� See Attached Spreadsheet <br /> Explanation: � `j�f� l��lJlra� �/�i'�s�F'^�1 <br /> N�,t�) l�t��� (��yd ���F ^'� <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 /> �N o � �F� t�`� �?8L�l'�Y! <br /> r`L.� �.;T���'���t�- l� .� �'�S <br /> Public Works Reviewer Signature ate <br /> RFVISFl7?0/70/70i i <br />