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0477- PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/21/2017 <br /> Permit#: PW1703.641_3 <br /> PROJECT ADDRESS: 3353 31th Dr LOT l 44/ <br /> DESCRIPTION OF WORK: SITE WORK FOR 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 ❑ 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?RYES ❑ NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#:C /603-634- <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 /> NO <br /> Explanation: <br /> (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: 0 ,1 FIRE SERVICE: <br /> OYES—Amount$ 4,' P} 3 ❑YES—Amount$ <br /> 0 Meter Only, 0 Complete Service, Size ❑3/4' Detect Meter Only, 0 Fire Service Size <br /> ❑ NO MNO <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-(lf yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit# (if applicable): <br /> SEWER FEE? D� <br /> , YES-Amount$ --7Z) ;Ii 'New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? vC <br /> YES—Amount$ 10, 9+7-- 0 See Attached Spreadsheet qLL to Cd,,6 /4ed':Si Z e <br /> ❑ NO—No Change of Us /Other <br /> Explanation: <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> 0 <br /> JWYES—Amount$ 3 / d 0 See Attached Spreadsheet <br /> ❑ NO - r /l;ke h-, c.,� e/4,7 i C <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ,OYES—TYPE %See Attached Letter <br /> ❑ NO <br /> PW Reviewer: <br /> (-7(/(5' <br /> f- (/ Date: <br /> /T 3-23-'17 <br /> REVISED 10/11/2016 <br />