HomeMy WebLinkAboutSWP273285 PROJECT REQUEST FORM
PLANNINGBUILDING/PUBLIC WORKS
DATE: jal at 105 CONTACT: :J—Cjn THIQAEXT.
FILE STATUS ❑ NEW OR ❑ EXISTING: FILE CODE(PRI-xx-xxxx):
LOCATION ❑ My Work Space: ❑ File Bay Shelf#: ❑ Other:
PROJECT NAME/FILE TITLE: Foj g 1^ 1 6e per vo— lQ o K
(70 characters max)
DESCRIPTION OF PROJ�:
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UTILITY PERMIT# U ()50 ILI--] LUA# 0(I--/ q S WO#
ADDRESS/STREET NAME(S): La O I — '!5W (E� c'E
DEV: ( CrNTR: ; OWN: ; CNSLT/ENG:Onor GL 0)1
OTHER ALIASES:
Circle Size of Waterline: 8" 10" 12" Circle One: New/Replace/Extension
Circle Size of Sewerline: 8" 10" 12" Circle One: New/Replace/Extension
Circle Size of Stormline: 12" 18" 24" Circle One New/Replace/Extension
CHECK EACH DISCIPLINE INVOLVED IN PROJECT Ltr Drwg #of sheets
TED ❑ ❑
(off site improvements) (include TESC)
❑ TRO ❑ ❑
(Signalization,Channelization,Lighting)
�. WWP ❑ ❑
(sanitary sewer main,include basin name)
WTR ❑ ❑
(Mains,Valves,Hydrants) (inc.composite&HorizontalCtrl)
sWP ❑ ❑
(CIP onlyxinclude basin name)
PLR (For Developer Files Only) ❑ getter only)
PLEASE CIRCLE THE DISCIPLINES WHICH NEED TO SIGN MYLARS
WATER WASTEWATER SURFACE WATER TRANSPORTATION FIRE
FOR FII.E MAINTAINANCE USE ONLY
File Codes File Alias Date Entered and Labels Made
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