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PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 4/11/2016 <br /> Permit#: C1604-012 <br /> PROJECT ADDRESS: 1903 78TH PL SE LOT 18 <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 [ApoCi], [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?El YES 0 NO W.O.#: ggL,� <br /> Notes: Associated Bldg./PW Permit#: FW)'60'(—1)274 <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> S'ES—Type )?)D (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> ❑ NO cS / FJt.E i, <br /> Explanation: <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: cup FIRE SERVICE: <br /> DYES—Amount$ 560•" ❑YES—Amount$ <br /> igl-Meter Only, 0 Complete Service, Size 0 3/"Detect Meter Only, 0 Fire Service Size <br /> ❑ NO g'NO <br /> Explanation: Explanation: <br /> ❑Water Department Cost Estimate Needed-(If yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? <br /> EYES—Amount$ °- $(New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> 0N <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> ErYES—Amount$ -4-16p °o ❑ See Attached Spreadsheet <br /> ❑ NO—No Change of Use/Other <br /> Explanation: )8/6 SP SFr— <br /> (Note: <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 /> 1 NO AtrEet,fits, pcba W/PIaf <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> 1E'YES—TYPE Sr—IZ— S I fYEN71/9L' -See Attached Letter <br /> ❑ NO <br /> Itm/r)4( .5;44/t- 9'7/: <br /> Public Works Reviewer Signature Dafe <br /> ub c g <br /> REVISED 2/24/2016 <br />