1802 75TH ST SW 2019-01-30 - Laserfiche WebLink

/1111 -4 PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/14/2016 Permit#: PW1603-031 PROJECT ADDRESS: 1802 75th st sw DESCRIPTION OF WORK: DRAINAGE MAINTENANCE FOR THE OPERATION CENTER SITE CONTACT INFORMATION: OWNER: APPLICANT: NAME: SNOHOMISH COUNTY PUD NAME: BEN DAVIS ADDRESS: 2320 CALIFORNIA ST ADDRESS: EVERETT,WA,98201 PHONE: 4257838465 PHONE: 4257838465 EMAIL: EMAIL: CONTACT: 0 Owner 0 Applicant ❑Other. NAME: [ContactName] PHONE: [ContactPhone] EMAIL: [ContactEmail] COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required?RYES 0 NO W.O.#: Notes: Associated Bldg./PW Permit#: FIRE SPRINKLER REQUIRED?(by Fire Department/Code) ❑YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) ,100 Explanation: (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: FIRE SERVICE: ❑YES—Amount$ 0 YES—Amount$ 0 Meter Only, 0 Complete Service, Size ❑3/" Detect Meter Only, 0 Fire Service Size XNO ❑ NO Explanation: Explanation: ❑Water Department Cost Estimate Needed-(/f yes, PW Reviewer to send cost estimate request to Water Department, attach copy) Existing Utility Permit#(if applicable): SEWER FEE? ❑YES—Amount$ 0 New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect XNO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENT FEE? ❑YES—Amount$ 0 See Attached Spreadsheet NO—No Change of Use/Other Explanation: (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? ❑YES—Amount$ 0 See Attached Spreadsheet ,r4NO ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) ❑YES—TYPE 0 See Attached Letter ¢ --/3-/4 Public Works Review ' ignature Date REVISED 2/24/2016