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PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 8/24/2016 <br /> Permit#: PW1608-046 <br /> PROJECT ADDRESS: 4405 29TH DR SE LOT 18 <br /> DESCRIPTION OF WORK: SITE WORK AND TRAFFIC MITIGATION FOR NEW SFR <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: POLYGON WLH LLC NAME: PANI ALAN/POLYGON <br /> ADDRESS: 4695 MACARTHUR CT 8TH FLR ADDRESS: <br /> NEWPORT BEACH,CA,92660 <br /> PHONE: PHONE: 4255867700 <br /> EMAIL: EMAIL: <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: PANI ALAN <br /> PHONE: 4255867700 <br /> EMAIL: ALAN.PANI@POLYGONHOMES.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?k(YES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: C /6o6 <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> 0 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: 2 <br /> 0 FIRE SERVICE: <br /> o YS—Amount$ x{80 3 `� ❑YES—Amount$ <br /> joi Meter Only, 0 Complete Service, Size - 4 0 3A"Detect Meter Only, 0 Fire Service Size <br /> ❑ NO ArNO <br /> Explanation: Explanation: <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? 00 <br /> %YES—Amount$ 70 Xl New Connection, 0 Alteration/Repair, ❑ Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? 4 $� <br /> , <br /> xYES—Amount$ 79 Z 0 See Attached Spreadsheet / <br /> ❑ NO—No Change of Use/Other <br /> Explanation: <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> 'YES—Amount$ 5)54-`25 ❑ See Attached Spreadsheet <br /> ❑ NO {fie,,, 9 -29 _L4 SlNra <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> OYES—TYPE SFR 0 See Attached Letter <br /> ❑ NO <br /> 7<--29 8- 24-16 <br /> Public Works Reviewer Signature Date <br /> REVISED 2124/2016 <br />