Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
PUBLIC WORKS <br />REVIEW WORKSHEET <br />(ATTACH 1 SITE PLAN FOR REVIEW) Date: 7/1812017 <br />AiVer'vo104Bl4 Permit #: PW1708- D11 <br />PROJECT ADDRESS: 44Z4 ^THAVE == Z074-;��� <br />DESCRIPTION OF WORK: SITE WORK FOR A NEW SFR <br />CONTACT INFORMATION: <br />OWNER: <br />APPLICANT: <br />NAME: <br />POLYGON WLH LLC <br />NAME: PANT ALAN / POLYGON <br />ADDRESS: <br />4695 MACARTHUR CT 8TH FLR <br />ADDRESS: <br />NEWPORT BEACH, CA, 92660 <br />PHONE: <br />PHONE: 4255867700 <br />EMAIL: <br />EMAIL: <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 M <br />PW Permit Required?)KYES ❑ NO W.O. M <br />Notes <br />Associated Bldg./PW Permit #: C 170 7—• 0,24 <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 />,WN O <br />Explanation: <br />(Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br />WATER FEES? <br />DOMESTIC SERVICE: rj©® FIRE SERVICE. <br />❑ YES — Amount $ `f 3 s� ❑YES — Amount $ <br />"hAeter Only, ❑Complete Service, Size_ ❑ % Detect Meter Only, ❑ Fire Service Size <br />❑ NO XNO <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-(/f yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br />Existing Utility Permit # (if applicable): <br />SEWER FEE? <br />YES — Amount $ �� ©-- ArNew Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect <br />❑ NO <br />Explanation: <br />Existing Utility Permit # (if applicable): <br />SYSTEM DEVELOPMENT FEE? <br />$'YES — Amount $-- /0 0 94 % ❑ See Attached Spreadsheet 2815-0 <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 />❑ YES = Amount $ ❑ See Attached Spreadsheet <br />WNO <br />ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) <br />Vf YES —TYPE o$'�le ❑ See Attached Letter <br />❑ NO <br />PW Reviewer: <br />Date: 6' —17 <br />RFVNFn 10111/9016 <br />