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/1j.:4 PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 9/13/2016 <br /> Permit#: PW1609-047 <br /> PROJECT ADDRESS: 3322 31ST DR LOT 92 <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? Fel YES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: /604/-061 <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> ❑YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> DtNO <br /> Explanation: Ft i,& C&b€ <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: FIRE SERVICE: <br /> LYES—Amount$ 4/80.Q1° ❑YES—Amount$ <br /> bir Meter Only, 0 Complete Service, Size 3/1/ ❑3/"Detect Meter Only, 0 Fire Service Size <br /> ❑ NO tit 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 /> MT YES—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 /> Ig YES—Amount$ -7; (7 , go. 0 See Attached Spreadsheet <br /> ❑ NO-No Change of Use/Other <br /> Explanation: /560 <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> EYES—Amount$ 35(. 0 See Attached Spre�et <br /> ❑ NO �e�Z <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> EYES—TYPE cSP _ t$See Attached Letter <br /> ❑ NO <br /> JanAt& 9-13-Z90‘ <br /> Public Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />