3505 UPLAND AVE 2018-03-27 - Laserfiche WebLink

PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 12/23/2015 Permit#: PW1512-022 PROJECT ADDRESS: 3505 UPLAND AVE DESCRIPTION OF WORK: NEW SFR/SITE WORK CONTACT INFORMATION: OWNER: APPLICANT: NAME: ACME HOMES LLC NAME: ACME HOMES LLC ADDRESS: 10211 180TH ST SE ADDRESS: 17408 56TH ST NE SNOHOMISH,WA, SNOHOMISH,WA, 98290 PHONE: 4259030292 PHONE: 4259031786 EMAIL: EMAIL: CONTACT: 0 Owner 0 Applicant ❑Other NAME: ACME HOMES LLC PHONE: 4259031786 EMAIL: COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required? c6 YES 0 NO W.O.#: Notes: Associated Bldg./PW Permit#: FIRE SPRINKLER REQUIRED?(by Fire Department/Code) 0 YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) 4NO Explanation: (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: FIRE SERVICE: feYES—Amount$ g/ /► 0 YES—Amount$ 0 Meter Only, Complete Service, Size ❑'/"Deduct Meter Only, 0 Fire Service Size 0N NO Explanation: Explanation: ❑Water Department Cost Estimate Needed-(/f yes, PW Reviewer to send cost estimate request to Water Department, attach copy) Existing Utility Permit#(if applicable): SEWER FEE? ❑YES—Amount$ ¢",New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect ❑ NO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENT FEE? / YES `Amount$ 5 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? 0 YES—Amount$ 0 See Attached Spreadsheet NO ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) ❑YES— ' ', 0 See Attached Letter NO Pulte orks Reviewer' �g ! a Date REVISED 2/24/2016