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PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 4/11/2016 <br /> Permit#: C1604-010 <br /> PROJECT ADDRESS: 1907 78TH PL SE LOT 16 <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 SN <br /> PHONE: 425 190122DER /- 'V 160 41--0Z3 <br /> EMAIL: STEVE.S@SEAPACHOMES.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?, YES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: ?OJ 16 Q'1_0 a3 <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> rYES-Type /3-/) (If yes,add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> O NO <br /> Explanation: aa_ S7`a ri p <br /> i <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: ' a� FIRE SERVICE: <br /> OYES-Amount$ a ❑YES-Amount$ <br /> J�Meter Only, ❑ Complete Service, Size 0 3/<" Detect Meter Only, 0 Fire Service Size <br /> ❑ NO r'NO <br /> Explanation: Explanation: <br /> ❑Water Department Cost Estimate Needed-Of 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$ 70�^o ,'New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> EYES-Amount$ 919/0 0 See Attached Spreadsheet X9 3 s `011ie <br /> ❑ NO-No Change of Use/Other ,/p/e si O f `?d-se I/a ev <br /> Explanation: /�[ <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 /> %NO r9Gf^&a 5 Pak/. InJ/OLa?' <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> 'YES-TYPE SFK ,'See Attached Letter <br /> NO <br /> Public W s Reviewer Signature Date <br /> REVISED 2/24/2016 <br />