3321 30TH DR 2018-01-22 - Laserfiche WebLink

PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 9/14/2016 Permit#: PW1609-061 PROJECT ADDRESS: 3321 30TH DR DESCRIPTION OF WORK: NEW TOWNHOME/TRAFFIC MITIGATION LOT 81 CONTACT INFORMATION: OWNER: APPLICANT: NAME: POLYGON WLH LLC NAME: PNW Riverfront LLC ADDRESS: 11624 SE 5TH ST ADDRESS: 11624 SE 5th Street#200 BELLEVUE, WA, 98005 BELLEVUE,WA, 98005 PHONE: PHONE: 4255867700 EMAIL: EMAIL: nicka@polygonhomes.com CONTACT: ❑ Owner ❑ Applicant ❑Other NAME: PANI ALAN PHONE: 4255867700 EMAIL: ALAN.PANI@POLYGONHOMES.COM COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required? � YES ❑ NO W.O.#: Notes: Associated Bldg./PW Permit#: �.��"�(��_ FIRE SPRINKLER REQUIRED? (bv Fire DepartmenUCode) ❑YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) '6�'N O Explanation: �� (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: !1 FIRE SERVICE: �YES—Amount$ �1��°� 3,) �� ❑ YES—Amount$ �Meter Only, ❑ Complete Service, Size r� ❑ 3/4" Detect Meter Only, ❑ Fire Service Size ❑ NO �NO Explanation: Explanation: ❑Water Department Cost Estimate Needed-(If yes, PW Reviewer to send cost estimate request to Water Department, attach copy) Existing Utility Permit#(if applicable): SEWER FEE? YES—Amount$ �� '6�New Connection, ❑Alteration/Repair, ❑ Cap-off/Reconnect ❑ NO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENTFEE? $�YES—Amount$�`��';Z.� ❑ See Attached Spreadsheet ❑ NO—No Change of Use/Other Explanation: !�j -� (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FE ? �'S'ES—Amount$ r � ❑ See Attached Spreadsheet ❑ NO ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) 'C�YES—TYPE S� �(See Attached Letter ❑ NO � Public Works Reviewer Signature Date REVISED 2/24/2016