HomeMy WebLinkAboutSWP273233 PROJECT REQUEST FORM
PLANNING/BUILDING/PUBLIC WORKS
(SOME SECTIONS APPLY TO CIP AND SOME APPLY TO DEVELOPER PROJECTS)
DATE: 4/11/2005 CONTACT: Ryan Phut x7372 WO# 25536
FILE STATUS I ❑ EXISTING OR ® NEW FILE CODE
LOCATION I ® My Work Space: F/od! ❑ File Bay Shelf#: I ❑ Other:
PROJECT NAME:(TERTIARY) South 4 h Street and Burnett Ave South (label line one)
(250 characters max)
Allowable,Folder Title: (SECONDAY): Traffic Improvements (label line two)
(WORKING FILE)
Go to Utilities Pick List
DESCRIPTION OF PROJECT: Signal,Illumination and Channelization Improvements
ADDRESS/STREET NAME(S): South 4`h Street,Burnett Avenue South,Houser Way
DEV/CNTR/OWN/CNSLT: CNSLT: Garry Struthers Associates,Inc.
OTHER ALIASES:
Size of Waterline: N/A New & N/A New
Size of Sewerline: N/A New & N/A New
Size of Stormline: N/A New & N/A New
CHECK EACH DISCIPLINE INVOLVED IN PROJECT Ltr Drwg #of sheets
® TED(roadway/drainage) ❑ ® 4
(off site improvements) (include TESL)
TRO (Signalization, Channelization,Lighting) ❑ ® 6
❑ W WP(wastewater) ❑ ❑
(sanitary sewer main)
❑ WTR(water) (Mains,Valves,Hydrants) ❑ ❑
(me.composite&HorizontalCtrl)
❑ SWP(surface water imp.) ❑ ❑
(CIP only)(include basin name)
❑ PLR(plan review) (Neccessary for developer files) ❑ (letter only)
PLEASE CHECK THE DISCIPLINES WHICH NEED TO SIGN MYLARS:
WATER ❑ WASTEWATER ❑ SURFACE WATER ❑ TRANSPORTATION ❑ FIRE
FOR FILE MAINTAINANCE USE ONLY
File Codes: Date Entered and Labels Made:C,o a a�_l2 33
-3 f —`1.
731
CT-
ProjectRequestForm.doc