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. 477 <br /> PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 4/11/2016 <br /> Permit#: C1604-019 <br /> PROJECT ADDRESS: 7812 19TH DR SE LOT 25 <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? Vi YES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: <br /> FIRE SPRINKLER REQUIRED? (by Fire Department/Code) <br /> DYES—Type (;p (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> O NO <br /> Explanation: S{ FR'-r c- <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: FIRE SERVICE: <br /> EYES—Amount$ 560,`'-12- 0 YES—Amount$ <br /> rI <br /> arMeter Only, 0 Complete Service, Size 1 03/4' Detect Meter Only, 0 Fire Service Size <br /> ❑ NO ANO <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 /> ) (YES—Amount$ � (eNew Connection, 0 Alteration/Repair, ❑ Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE?? <br /> AYES—Amount$ �R(o2•°�' 0 See Attached Spreadsheet <br /> ❑ NO—No Change of Use/Other <br /> Explanation: is p �LD Sf tioaga QhAAoypved4(, ff4141) <br /> (Note:Public Works Reviewer to Add Trac Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> ❑YES—Amount$ 0 See Attached Spreadsheet <br /> LINO Rkr A Y 1�1 Fr/cc/ <br /> ADDRESSLETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> EYES—TYPE SF-12 i 'See Attached Letter <br /> O N /11101‘ <br /> O <br /> Public Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />