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4 <br /> gn. <br /> Fe' <br /> PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 4/11/2016 <br /> Permit#: C1604-014 <br /> PROJECT ADDRESS: 7802 19TH DR SE LOT 20 <br /> DESCRIPTION OF WORK: NEW TOWNHOUSE(RAMSEY 2435) <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: ALPINE HEIGHTS DEVELOPMENT NAME: [AppName] <br /> ADDRESS: 120 SW EVERETT MALL WAY SUITE ADDRESS: [AppAdd] <br /> EVERETT,WA,98204 [AppCI], [AppSt], [AppZip] <br /> PHONE: PHONE: [AppPhone] <br /> EMAIL: EMAIL: [AppEmail] <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: STEVE SNYDER <br /> PHONE: 4253190122 <br /> EMAIL: STEVE.S@SEAPACHOMES.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?id YES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> EYES—Type 1312 (If yes,add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> ❑ N <br /> Explanation: z R / �-_ /t- <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: , FIRE SERVICE: <br /> (YES—Amount$ 50 v !of 0 YES—Amount$ <br /> (Meter Only, Q Complete Service, Size / x'3/4" Detect Meter Only, 0 Fire Service Size <br /> O NO ❑ NO <br /> Explanation: Explanation: <br /> ❑Water Department Cost Estimate Needed-(/f yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? <br /> 11(YES—Amount$ New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> 14 YES—Amount$ Mtn- 0 See Attached Spreadsheet <br /> ❑ NO—No Change of Use/Other <br /> Explanation: /435 SF SFR., <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> ❑YES—Amount$ 0 See Attached Spreadsheet <br /> t(NO ic,X4-a PQ GJ[ <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> IdYES—TYPE SF Z, s(See Attached Letter <br /> ❑ NO <br /> 4.04‘616/V. qi/g/Ulf4 <br /> ublic Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />