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PUBLIC WORKS I) <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 4/11/2016 <br /> Permit#: C1604-015 <br /> PROJECT ADDRESS: 7804 19TH DR SE LOT 21 <br /> DESCRIPTION OF WORK: NEW TOWNHOUSE(MARION 1816) <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: MATTR@SEAPACHOMES.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? 'YES 0 NO W.0.#: <br /> Notes: Associated Bldg./PW Permit#: p1U/6�1�-05 <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> ttYES—Type 1312 (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> NO <br /> E❑xplaanation: StW (DILA F l' 'L <br /> (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: FIRE SERVICE: <br /> ]S-YES—Amount$ 5 4C. 0 YES—Amount$ <br /> 'Meter Only, 0 Complete Service, Size / 0 3/4" Detect Meter Only, 0 Fire Service Size <br /> ❑ 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 /> lrES—Amount$ -(), l 'New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> 'YES—Amount$ 73-‘16 0 See Attached Spreadsheet <br /> ❑ NO—No Change of Use/Other <br /> Explanation: I D d SE <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 /> k(NO Aty-tu, pa <br /> ADDRESS LETTOt (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> EYES—TYPE S See Attached Letter <br /> ❑ NO <br /> AdOIk <br /> /2di <br /> Public Works Reviewer Signature ate <br /> REVISED 2/24/2016 <br />