HomeMy WebLinkAboutSWP273366 PROJECT REQUEST FORM
PLANNINGBUILDING/PUBLIC WORKS
(SOME SECTIONS APPLY TO CIP AND SOME APPLY TO DEVELOPER PROJECTS
DATE: CONTACT: = / o WO#
FILE STATUS ❑ EXISTING OR NEW FILE CODE(PRI XX-XXXX)(if applicable)
LOCATION My Work Space: I ❑ File Bay Shelf#: I ❑ Other:
PROJECT NAME:(TERTIARY) (label line one)
(250 characters max)
Allowable Folder Title: (SECONDAY): (CIP Only)(enter or open pick list below) (label line two)
(WORKING FILE)
Go to Utilities Pick List
DESCRIPTION OF PROJECT: ' ` S�r.�• Cc-` /7 ` ,`
ADDRESS/STREET NAME(S): S
DEV/CNTR/OWN/CNSLT: V•^���� �^s� �(,�- S
OTHER ALIASES:
Size of Waterline: (--Nl- New & N/A New
Size of Sewerline: N/A New & N/A <--f�e— $-
Size of Stormline: N/A New & N/A ew 2--t n c�
CHECK EACH DISCIPLINE INVOLVED IN PROJECT Ltr Drwg #of sheets
TED(roadway/drainage) IL
(off site improvements) (include TESL)
❑ TRO (Signalization, Channelization, Lighting) ❑ ❑
WWP (wastewater)
(sanitary sewer main)
WTR(water) (Mains,Valves,Hydrants) ❑ ❑
(inc.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:
ProjectRequestForm.doc