HomeMy WebLinkAboutSWP273441 PROJECT REQUEST FORM
PLANNINGBUILDING/PUBLIC WORKS
DATE: d D8 CONTACT:
FILE STATUS ❑ NEW OR ❑ EXISTING: FILE CODE(i'lu-xx-xxxx):
LOCATION ❑ My Work Space: ❑ File Bay Shelf#: ❑ Other:
[PROJE:CT:N:AME/FILE TITLE:
(70 characters max)
DESCRIl'TION OF PROJECT:/ ou
r
UTILITY PERMIT# IL 0 o'0 Z LUA# 0 -7 / 00 WO#
ADDRESS /STREE N E(S):
DEVCju�Q I Lo CO; R: ; OWN: ; CNSLT/ENG:
OTHER ALIASES: �j G�i 7 p
[Circle
cle Size of Waterline: 8" 10" 12" Circle One: New/Replace/Extension
cle Size of Sewerline: 8" 10" 12" Circle One: New/Replace/Extension
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)
e— WWP ❑
(sanitary sewer main,include basin name)
P-- WTR ❑ V
(Mains,Valves,Hydrants) (inc.composite&HorizontalCtrl)
T--S WP ❑ ❑
(CIP onlyxinclude basin name)
P--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 File Alias Date Entered and Labels Made