4312 RIVERFRONT BLVD 2019-03-14 - Laserfiche WebLink

gn" PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 7/30/2016 Permit#: PW1607-060 PROJECT ADDRESS: 4323 29TH DR SE LOT 109 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' /a o 7 -O FIRE SPRINKLER REQUIRED?(by Fire Department/Code) 0 YES—Type (If yes, add to TRAKiT under Reviewer Comments-on Bldg Permit and Stamp Drawings) %NO Explanation: (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: 3000 FIRE SERVICE: ❑YES—Amount$ '7 3/ 0 YES—Amount$ 4 Meter Only, 0 Complete Service, Size /�- 0 3/" Detect Meter Only, 0 Fire Service Size ❑ NO NO Explanation: xplanation: ❑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? `] pp Ar YES—Amount$ /e KNew Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect ❑ NO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENT FEE? "YES—Amount$ 7%Z. ❑ See Attached Spreadsheet f?/Q ❑ 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$ 900°- 0 See Attached Spreadsheet ❑ NO &, tr Mr7C-e g,;c.4 �- �1-IC ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) "YES—TYPE S'F/Z 0 See Attached Letter ❑ NO /<3 7. 30-1 Public Works Reviewer Signature Date REVISED 2/24/2016