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PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 7/22/2016 <br /> Permit#: PW1607-041 <br /> PROJECT ADDRESS: 6607 HIGHLAND DR <br /> DESCRIPTION OF WORK: SITE WORK FOR NEW SFR(LOT 2) <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: JACOBS DUANE NAME: BUSTARD CUSTOM CONST INC <br /> ADDRESS: 6601 HIGHLAND DR ADDRESS: PO BOX 1243 <br /> EVERETT,WA, 98203 MARYSVILLE,WA,98270 <br /> PHONE: PHONE: 4258766551 <br /> EMAIL: EMAIL: amkhomes@gmail.com <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: BUSTARD PAUL <br /> PHONE: 4258766551 <br /> EMAIL: amkhomes@gmail.com <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? 0 YES 0 NO W.O.it: s / <br /> Notes: Associated Bldg./PW Permit#: 0.1606—l6O6— OI/ <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 /> bit NO <br /> Explanation: cc,c rt./ 41'C\ 3cAt <br /> (Note:Counter Staff to Create Utility Permit for any Water ewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: FIRE SERVICE: <br /> YES—Amount$ �U.12- <br /> w ❑YES—Amount$ <br /> )S(Meter Only, 0 Complete Service, Size 31411 ❑3/4" Detect Meter Only, 0 Fire Service Size <br /> 0 N t 0 N <br /> Explanation: R - E. Explanation: <br /> ❑Water Department Cost Estimate Needed-(//ryes, PW i ay.; o send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? <br /> X.YES—Amount$ U.) .°9— 0 New Connection, 0 Alteration/Repair, 1i(Cap-o Reconnect <br /> ❑ NO <br /> Explanation: Q <br /> Existing Utility Permit#(if applicable): 6.110-.4 WAS U isoc- 0 <br /> SYSTEM DEVELOPMENT FEE? <br /> ❑YES—Amount$_ p <br /> 0 See Attached Spreadsheet <br /> ❑ NO—No Change seU /Other 14 6 <br /> Explanation: UN SF- R31` $-" ' c _ / ": a' <br /> (Note:Public Works R-viewer to Add Traffic Mitigation to PW hermit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> ❑YES Amount� � $ 0 See Attached Spreadsheet <br /> II NO Pw[U•. tot sho * (kat" <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> /(YES—TYPE I' 'See Attached Letter <br /> ❑ NO <br /> o4nC — — as- aol g_ <br /> ublic Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />