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may1477-, <br /> PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 2/5/2016 <br /> Permit#: C1602-006 <br /> PROJECT ADDRESS: 2433 W MUKILTEO BLVD <br /> DESCRIPTION OF WORK: NEW SFR �� /�����G�N <br /> CONTACT INFORMATION: Co 1 <br /> OWNER: APPLICANT: <br /> NAME: JUDKINS PATRICK C NAME: [AppName] <br /> ADDRESS: 640 WASHINGTON PL SW ADDRESS: [AppAdd] <br /> MUKILTEO,WA,98275 [AppCi], [AppSt], [AppZip] <br /> PHONE: qaS-3S9 -SSVf PHONE: [AppRierva]20> - 3g--a 9/ <br /> EMAIL: y bo y s lib€c..J y /oo,C.IN EMAIL: [AppEmail] <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: . [ContactName] <br /> PHONE: [ContactPhone] <br /> EMAIL: [ContactEmail] <br /> COMMENTS FROM PUBLIC/WORKS REVIEWER: LAND USE PROJECT#: Ndl`T <br /> PW Permit Required? 66 YES 0 NO W.O.#: OM-- <br /> ��``� / <br /> /�O <br /> Notes: pV v f 60?—037- Associated Bldg./PW Permit#: PW a-037 <br /> FIj2E SPRINKLER REQUIRED?(by Fire Department/Code) >-f ket-14, 356' 475 �yi <br /> so YES-Type /31> (If yes,add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> ❑ NO <br /> Explanation: 6OAii)l11(YN 6 ei2ESSU E Tt iJ 6 RECWIR t, oN m>41N IN W, f►1VKic.TEO BLVD. <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/Systemf � Developmen Fees <br /> WATER FEE? �lJMiu (,/`�7�! Y d i�((rk F( ? ► 1e-tt- - �C�l'l V rS( -\ <br /> ?ES-Amount$ _ _ v Meter Only, 0 Complete Service,'ipe/Size <br /> NO <br /> rxpla ation: _ _. to •,s, ' '0 ill - e 4 —r - /.� T ii_ r _-..- <br /> � L �ai V .1f���7�LlL�IE�� <br /> Pd . ,. . '- -. w .R. Tr1Nk r7„►-gX Al .r-b ,t' 4 RFsuzr <br /> Existing Utility Permit#(if applicable): ' OF Pete V/e€ 7tr ON V71/41M <br /> WER FEE? / <br /> SEWER <br /> -Amount$ 6o.cs ❑ New Connection, 0 Alteration/Repair, ICap-off -econnect <br /> ❑ NO <br /> Explanation: '' M /: <br /> Existing Utility Permit#(if applicable): l/ '�I` p2 it 2i* = OisO'I-1/t -4 p Aelar) <br /> SYSTEM DEVELOPMENT FEE? <br /> ❑YES-Amount$ 0 See Attached Spreadsheet <br /> FN()-No Change of Use/Other 1416111111011110"- <br /> Explanation: WV/l/a e2( /a"-ySF --p1990sei /2%.S'F- no .S'ys cipA '& <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 /> El I NO a(SF/t WT" em-y2 Al07ffiN4 <br /> AARESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ES-TYPE ❑ See Attached Letter <br /> O <br /> ,nii, 3—!O- M <br /> =ublic Works Reviewer Signature Date <br /> REVISED 1/5/2016 <br />