3325 30TH DR 2018-01-22 - Laserfiche WebLink

PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 9/14/2016 Permit#: PW1609-063 PROJECT ADDRESS: 3325 30TH DR DESCRIPTION OF WORK: NEW TOWNHOME/TRAFFIC MITIGATION LOT 79 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? f�YES ❑ NO W.O.#: Notes: Associated Bldg./PW Permit#: C/t)Q`7"�� FIRE SPRINKLER REQUIRED?(by Fire DepartmenUCode) ❑YES-Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) �N O Explanation: �,�� '�� (Note: Counter Staff to Create Utility Permif for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: F1RE SERVICE: .�YES-Amount$ �$U.�� „ i� ❑YES-Amount$ �'Meter Only, ❑ Complete Service, Size� ❑ 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? �r, � '�'YES-Amount$ -7�y� �New Connection, ❑Alteration/Repair, ❑ Cap-off/Reconnect ❑ NO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENTFEE? � b�YES-Amount$ � � d ❑ See Attached Spreadsheet ❑ NO-No Change of Use/Other Explanation: �� (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? YES-Amount$ j S( .`= ❑ See Attached Spreadsheet ❑ NO ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) �'YES-TYPE S�- �See Attached Letter ❑ NO � , -I� Public Works Reviewer Signature Date REVISED 2/24/2016