Laserfiche WebLink
Tat\ploy <br /> 0 • ' <br /> W=4,4&-ry PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 12/8/2015 <br /> Permit#: C1512-001 <br /> PROJECT ADDRESS: 10122 7TH AVE SE <br /> DESCRIPTION OF WORK: NEW DUPLEX <br /> CONTACT INFORMATION: <br /> OWNER: NAME: GASAN RAUF <br /> NAME: SENA INVESTMENT LLC ADDRESS: <br /> ADDRESS: 12305 14TH DR SE <br /> EVERETT, WA, 98208 PHONE: 3478039795 <br /> PHONE: EMAIL: <br /> EMAIL: RAUFGASAN@SAENSAINVESTMENT.COM <br /> APPLICANT: <br /> CONTACT: Owner , Applicant DOther <br /> NAME: [ContactName] <br /> PHONE: [ContactPhone] <br /> EMAIL: [ContactEmail] <br /> COMMENTS FROM PUBLIC <br /> ���WORKS REVIEWER: <br /> ep <br /> PW Permit Required? YES 0 NO LAND USE PROJECT#: <br /> Please provide explanation:/ W.O.#: <br /> Associated Bldg./PW Permit#: <br /> FIRE SPRINKLER REQUIRED? (by Fire Department/Codes <br /> F❑ ES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> 0 <br /> xplanation: <br /> (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEE? <br /> ❑ YES—Amount$ 0 Meter Only, 0 Complete Service, Type/Size <br /> 100 <br /> Explanation: <br /> ki,[5f w1 T(a-f- 2.4-e. — Oe.e-ei `,fib Cam.0ei1 +V Mme# ed W0KMe. -62 <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? <br /> ❑ YES—Amount$ 0 New Connection, 0 Alteration/Repair, , f Cap-off/Reconnect <br /> CS(NO <br /> Explanation: e x{&7(Yj caved Ga Kites- i on <br /> Existing Utility Permit# (if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> 7 YES—Amount$ See Attached Spreadsheet <br /> ❑ NO—No Change of Use/Other <br /> Explanation: <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> g YES—Amount$ 'See Attached Spreadsheet <br /> 0 No <br /> REVISED 12/16/2015 <br />