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4ETT PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/9/2017 <br /> Permit#: PW1703-017 <br /> PROJECT ADDRESS: 3340 31ST DR LOT 100 <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: ❑ Owner ❑ 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? LA YES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: C/404/—07, <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 /> R'NO <br /> Explanation: <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: d,, FIRE SERVICE: <br /> I'(YES—Amount$ 4 2O I� ❑YES—Amount$ <br /> *Meter Only, 0 Complete Service, Size yo <br /> 0%" Detect Meter Only, 0 Fire Service Size <br /> ❑ NO Pr NO <br /> Explanation: Explanation: <br /> ❑ RPBA Needed at premise?-(Plumbing permit for backflow device needed due to High-Hazard Site per Tim Markham's review) <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 /> la YES—Amount$ 4i40.- I New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> OYES—Amount$ '6 0 See Attached Spreadsheet ,A/I{' Urh <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 /> qg YES <br /> Amount$ 35"/'p°�,' ❑ See Attached Spreadsheet p.„ pp <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> Y](S'ES—TYPE L9F -- 0 See Attached Letter <br /> ❑ NO <br /> PW Reviewer: Date: <br /> 1,A-114 jig141,‘Lia5 -9)•t /717 <br /> REVISED 10/11/2016 <br />