HomeMy WebLinkAboutSWP273287 PROJECT REQUEST FORM
.�---" PLANNINGBUILDING/PUBLIC WORKS
DATE: Z-/0 -o e-'p CONTACT:,p rGe� At 4e-&c10 EXT. -7-3e
FILE STATUS W OR ❑ EXISTING: FILE CODE(PIu-xx-xxxx):
LOCATION My Work Space: 0 File Bay Shelf#: ❑ Other:
PROJECT NAME/FILE TITLE: ZQXo
A/ 3 S' ST !V 3 3 rd Z q4 k S 1' (70 characters max)
DESCRIPTION OF PROJECT:
'2i �.� a 4 G 7.
Y6 ZO O bplelr- Ge r.J NGtJ c S �• H.�S 2Lt
ajY �� ,S�v,c e�. �f o ad` G�►t., >2�� M a�tv+o C r P Pam/z=�T
UTILITY PERMIT# LUA# WO#
ADDRESS/STREET NAME(S):
DEV: ; CNTR: ; OWN: ; CNSLT/ENG:
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 TFSC)
❑ TRO ❑ ❑
(Signalization,Channelization,Lighting)
❑ WWP ❑ ❑
(sanitary sewer/main,include basin name) •�j
WTR %�!,�✓1 S1 UG(1�Q4� FY)l,�1rx.1�� T
(Mains,Valves,Hydrants) (inc.composite&HorizontalCtrl)
❑ SWP ❑ ❑
(CIP onlyxinclude basin name)
❑ PLR (For Developer Files Only) ❑ (letter only)
E LINES ED O SIGN
WATER WASTEWATER SURFACE WATER TRANSPORTATION FIRE
FOR F AINANCE USE ONLY
File Codes File Alias Date Entered and Labels Made
t