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477- PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 9/14/2017 <br /> Permit#: PW1709-028 <br /> PROJECT ADDRESS: 5034 OCEAN DR <br /> DESCRIPTION OF WORK: SITE WORK FOR NEW SFR DETACHED <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: BUSTARD CUSTOM CONSTRUCTION NAME: BUSTARD CUSTOM CONST INC <br /> INC ADDRESS: ADDRESS: PO BOX 1243 <br /> PO BOX 1243 MARYSVILLE,WA,98270 <br /> MARYSVILLE,WA, 98270 PHONE: 4258766551 <br /> PHONE: EMAIL: amkhomes@gmail.com <br /> EMAIL: <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.#: <br /> Notes: Associated Bldg./PW Permit#: Co g mak <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> YES—Type t t V (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> NO <br /> Explanation: <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: FIRE SERVICE: <br /> OYES—Amount$ .32 _a 14 1' 0 YES—Amount$ <br /> 0 Meter Only, a-Complete Service, Size / 0 W Detect Meter Only, 0 Fire Service Size <br /> ❑ NO ❑ NO <br /> Explanation: 1064— L4i0 (A dr0,44.'' Explanation: <br /> ❑ RPBA Needed at premise?-(Plumbing permit for backflow device needed due to High-Hazard Site per Tim Markham's review) <br /> ❑Water Department Cost Estimate Needed-(If yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? <br /> DA YES—Amount$ 2—'0 '-i-Cy l:'New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> 0N <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> DYES—Amount$ /1 ) .S1 JSee Attached Spreadsheet <br /> ❑ NO—No Change of .2(1 Y. <br /> e/Other <br /> Explanation: <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> J WYES—Amount$ 27 -oo S—[ 0 See Attached Spreadsheet <br /> ❑ NO <br /> A DRESS LETTER QUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> YES—TYPE <br /> 0 See Attached Letter <br /> NO <br /> /20 <br /> PW Reviewer: —_; —pi7zn c114—J� .) Date: // l <br /> REVISED 10/11/2016 <br />