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PUBLIC WORKS REQUEST— <br /> ' 0,4rwe FOR WATER DEPARTMENT COST ESTIMATE <br /> (ATTACH 1 WATER PLAN FOR REFERENCE) Date Request Sent: 8/11/2017 <br /> Associated Permit#: PW1705-029 <br /> PROJECT ADDRESS: 7301 HARDESON RD <br /> DESCRIPTION OF WORK: SITE WORK FOR FED EX DISTRIBUTION FACILITY <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: UNDERWOOD GARTLAND JOHNSON NAME: GARTLAND DAVID <br /> LLC ADDRESS: ADDRESS: <br /> PO BOX 3513 <br /> BELLEVUE,WA,98009 PHONE: <br /> PHONE: 4258812113 ' EMAIL: david@ug-dev.com <br /> EMAIL: david@ug-dev.com <br /> CONTRACTOR: CONTACT: 0 Owner, 0 Applicant, ❑Other <br /> NAME: FOUSHEE&ASSOC NAME: MOLVER JACK(DAVID EVANS& <br /> ADDRESS: PO BOX 3767 ASSOCIATES) <br /> BELLEVUE,WA,98009 PHONE: 4252594099 <br /> PHONE: 4257461000 EMAIL: jnm@deainc.con4 <br /> 5( k)( <br /> EMAIL: ,r� <br /> REQUEST FROM PUBLIC WORKS REVIEWER: c(S/A\I <br /> COST ESTIMATE REQUESTED BY: SOS'' Q. <br /> © `f <br /> COST ESTIMATE REQUESTED FOR: <br /> CITY CREWS TO MAKE NEW CONNECTION TO MAIN C.-9e)'(tk\--- e <br /> • #OF CONNECTIONS NEEDED: <br /> s a411,44ed ski. <br /> • TYPE OF CONNECTION: <br /> l on Siena DUECYa 8.'6/wt./fon w2 4 1 9:44/iPAPrelr4te.8/Cof <br /> nn, <br /> • <br /> SIZE OF CONNECTION:41 oVscYE&Du6CY 't 42 ineas£m '@S®uf�+thee''l9' ::= <br /> • SIZE OF MAIN: g >ylA�►'t ) <br /> ❑ CITY CREWS TO INSTALL PIPE FROM MAIN TO BACK SIDE OF METER <br /> • EXCAVATE,SHORE,AND RESTORE BY: 0 CONTRACTOR, 0 CITY CREWS <br /> • TRAFFIC CONTROL BY: 0 CONTRACTOR, 0 CITY CREWS <br /> • INSTALLATION AND PIPE THROUGH VAULT BY: 0 CONTRACTOR, 0 CITY CREWS <br /> OTHER DESCRIPTION OR REQUEST: <br /> T <br /> jAvihi\ <br /> O <br /> Q Public Works Reviewer Signature Dalhh /201 <br /> e <br /> REVISED 2/24/2016 <br />