HomeMy WebLinkAboutSWP272960(4) 1�)AA-T
PROJECT REQUE T FORM
PLANNINGBUILDING/PUBLIC WORKS
DATE_ 7 29 07, CONTACT: -,�AY1 ri�jct In EXT• Ile
FILE STATUS ❑NEW OR (EXISTING: FILE CODE(rxl- - ): a9 (oC)
LOCATION 0 My Work Space: 0 File Bay Shelf#: 0 Other:
PROJECT NAME/FILE TITLE:611 Wt y) GOIS �� �► ' �r0
(70 characters max)
DESCR_IPTI N OF PROJECT:
>7m t�G i pro, ed-+ 6 1 4" la" rrh
we e- C
�ASw W S I An K Co U 610 Co(rck 1) y o yt(N
1 i C , n see, QASb So1r.h
>b t a rp A-\V-V\ Q uA n—n 0-VA A 6 oo� (la-6u l -C b,r a:&SOCILM-kcd Lx4a l
UTILITY PERMIT# LUA# £fib-'1 1-4- . Wo# (D 5 3 g o
ADDRESS I STREET NAME(S): Mtrrrts N e S 4;
DEV: ;CNTR: �bjjU.C,10 OWN: l P ; CNSLT/ENG:
OTHER ALIASES: Moy,"6 M, S-brm 1"rby1trncvl,-t-; �SZ , Eo lsl�e lvr�erz asp ty
Circle Size of Waterline: 8" IV 2' Circle One: vew
Replace'(.Extension
Circle Size of Sewerline: 8". 10" 1291 Circle One: /Replace 7 Extension
Circle Size of Stormline: 12 18 4' Circle One e /Replace/Extension
CHECK EACH DISCIPLINE INVOLVED IN PROJECT Ltr Drwg #of sheets
❑ TED ❑ ❑
(off site improvements) (include MC)
❑ TRO ❑ ❑
(Signalization,Channelization,Lighting)
WWP
(sanitary sewer main,include basin name)
(Mains,Valves,Hydrants) (inc.composite&HorizontalCtrl)
SWP C
(CIP onlyxinclude basin nine)
❑ PLR (For Developer Files Only) ❑ (letter only)
PLEASE CIRCLE THE DISCIPLINES WHICH NEED TO SIGN MYLARS
WATER WASTEWATER SURFACE WATER TRANSPORTATION FIRE
FOR FILE MAINTAINANCE USE ONLY
File Codes Fite Alias Date Entered and Labels Made
v�P- ate,agt>zOCl-a.quo -7-a-1-03 added
w-a g ke o "1045XAA
sw� - a7 '-C>q'U(D too prnm&V