4224 RIVERFRONT BLVD 2019-03-14 - Laserfiche WebLink

PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 6/16/2016 Permit#: PW1606-028 PROJECT ADDRESS; 4307 29TH DR SE LOT 101 DESCRIPTION OF WORK: SITE WORK AND TRAFFIC MITIGATION FOR NEW SFR CONTACT INFORMATION: OWNER: APPLICANT: NAME: POLYGON WLH LLC NAME: PANI ALAN/POLYGON ADDRESS: 4695 MACARTHUR CT 8TH FLR ADDRESS: NEWPORT BEACH,CA, 92660 PHONE: PHONE: 4255867700 EMAIL: EMAIL: CONTACT: 0 Owner 0 Applicant ❑Other NAME: PANI ALAN PHONE: 4255867700 EMAIL: ALAN.PANI@POLYGONHOMES.COM COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required?, YES 0 NO W.O.#: Notes: Associated Bldg./PW Permit#: C /'O _ooc FIRE SPRINKLER REQUIRED?(by Fire Department/Code) 0 YES—Type (If yes,add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) XNO Explanation: (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: — FIRE SERVICE: ❑YES—Amount$ 4 80 -- 3j 0 YES—Amount$ JKMeter Only, 0 Complete Service, Size 4- 0%"Detect Meter Only, 0 Fire Service Size ❑ NO ❑ NO Explanation: Explanation: ❑Water Department Cost Estimate Needed-(If yes, PW Reviewer to send cost estimate request to Water Department, attach copy) Existing Utility Permit#(if applicable): SEWER FEE? > °--.°- %YES—Amount$ /Q- New Connection, ❑Alteration/Repair, 0 Cap-off/Reconnect ❑ NO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENT FEE? // Q Q EYES—Amount$ 7 2_ 0 See Attached Spreadsheet �D 1 ❑ NO—No Change of Use/Other Explanation: (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? EYES—Amount$ 7Q® 0 See Attached Spreadsheet ❑ NO Po., /11 ke er/C f, --14-fl, ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) %YES—TYPE S/CR >$'See Attached Letter ❑ NO Public Works Reviewer Signature Date REVISED 2/24/2016