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PUBLIC WORKS 1 <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 9/12/2016 <br /> Permit#: PW1609-025 <br /> PROJECT ADDRESS: 3317 31ST DR LOT181 <br /> DESCRIPTION OF WORK: NEW TOWNHOME/TRAFFIC MITIGATION <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: POLYGON WLH LLC NAME: PNW Riverfront LLC <br /> ADDRESS: 11624 SE 5TH ST ADDRESS: 11624 SE 5th Street#200 <br /> BELLEVUE,WA,98005 BELLEVUE,WA,98005 <br /> PHONE: PHONE: 4255867700 <br /> EMAIL: EMAIL: nicka@polygonhomes.com <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: PANI ALAN <br /> PHONE: 4255867700 <br /> EMAIL: ALAN.PANI@POLYGONHOMES.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? OYES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: C/6 0 V b�Q <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> 0 YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> YlfNO <br /> Explanation: <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 /> ❑YES—Amount$ ¢ b h ❑YES—Amount$ <br /> I(Meter Only, 13 Complete Service, Size 3/Y 0 3/" Detect Meter Only, 0 Fire Service Size <br /> ❑ NO y<NO <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 /> -FYES—Amount$ 'New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> PrYES—Amount$ . r Q(,Z 0 See Attached Spreadsheet S / /F3 <br /> ❑ NO—No Change of Use/Other / <br /> Explanation: <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> EYES—Amount$ 3S-7 '7 0 See Attached Spreadsheet �J <br /> ❑ NO , /1/r'eAosta R- P.,.• <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> 1.ES—TYPE Sz-- 0 See Attached Letter <br /> ❑ NO Ii Alre <br /> Pnorks Reviewer Signa ate `^' Y <br /> REVISED 2/24/2016 <br />