3323 30TH DR 2018-01-22 - Laserfiche WebLink

PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 9/14/2016 Permit#: PW1609-062 PROJECT ADDRESS: 3323 30TH DR DESCRIPTION OF WORK: NEW TOWNHOME/TRAFFIC MITIGATION LOT 80 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#: �.�lCE��'/Q� FIRE SPRINKLER REQUIRED? (by Fire Department/Code) ❑YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) '�NO �� C'�,DE Explanation: (Note: Counter Staff to Create Utility Permit for any WatedSewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: �I ,L�, FIRE SERVICE: �"YES—Amount$ 't�. �� ❑ YES—Amount$ �'"Meter Only, ❑ Complete Service, Size �3l`7` ❑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? l�'ES—Amount$ � �� New Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect ❑ NO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENTFEE? YES—Amount$� ' E �� ❑ See Attached Spreadsheet ❑ NO—No Change of Use/Other Explanation: 13�� `f� (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? YES—Amount$ 35( , ' ❑ See Attached Spreadsheet ❑ NO �_ � �I�+�E' �. ��rl..ccl� ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) �'S'ES—TYPE � �'_ �See Attached Letter ❑ NO � y i .� Public Works Reviewer Signature Date REVISED 2/24/2016