HomeMy WebLinkAboutSWP273330 PROJECT REQUEST FORM
PLANNINGBUILDING/PUBLIC WORKS
DATE: 9- 1/-p G CONTACT:XO L(AI}A EXT. }
FILE STATUS W_NEW OR ❑ EXISTING: FILE CODE(PRl-xx-xxxx):
LOCATION ❑ My Work Space: D File Bay Shelf#: ❑ Other:
PROJECT NAME/FILE TITLE: -i6 Ai�--6eeF t--h t _ -PL-�
(70 characters max)
DESCRIPTION OF PROJECT:
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SE'��e'a2 tit A I tit,• 57 DR-M 2 5Y51� .Z7-7Gi2�tlG-�MFnIT4
c�l-Pis�/6-
UTILITY PERMIT# Q 06 CC 6 O LUA# WO#
ADDRESS/STREET NAME(S): 4AC1 LAV-49 t JIB-6H C,7' 0/V 8C-PJ
DEV: Chin A1e9e- ft. ;CNTR: ; OWN:COn)A)Ell- ; CNSLT/ENG: CrA-tC
OTHER ALIASES:
Circle Size of Waterline: 8" 12" Circle One: New/Replace/Extension
Circle Size of Sewerline: !r'— 10" 12" Circle One: New/Replace/Extension
Circle Size of Stormline: Cf2" 18" 24" Circle One New/Replace/Extension
CHECK EACH DISCIPLINE INVOLVED IN PROJECT Ltr Drwg #of sheets
,s� TED ❑ ❑
(off site improvements) (include TESC)
.1 TRO ❑ ❑
(Signalization,Channelization,Lighting)
WWP ❑ ❑
(sanitary sewer main,include basin name)
l� WTR ❑ ❑
(Mains,Valves,Hydrants) (inc.composite&HorizontalCtrl)
SVVP ❑ ❑
(CIP onlyxinc]ude basin name)
PLR (For Developer Files Only) ❑ (letter only)
PLEASE CIRCLE THE DISCIPLINES WHICH NEED TO SIGN MYLARS
WATER WASTEWATER SURFACE WATER TRANSPORTATION FIRE
7=
FOR FILE MAINTAINANCE USE ONLY
File Codes File Alias Date Entered and Labels Made
— — :3V yy
- 4 ! _ '
z 1,g
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