HomeMy WebLinkAboutSWP273470 PROJECT REQUEST FORM
PLANNINGBUILDING/PUBLIC WORKS
DATE: Z( v CONTACT: Ems/ EXT. "?2
FILE STATUS JXNEW OR ❑ EXISTING: FILE CODE(PRI-xx-xxxx):
LOCATION My Work Space: T❑ File Bay Shelf#: ❑ Other:
PROJECT NAME/FILE TITLE: I -7a 1 'rc W46► ('s
(70 characters max)
DESCRIPTION OF PROJECT:
X V e-be ;.-I In FIN S e-we--( In ,v\ '
3 a h'e-.f K-j- c -;X� c:. e. r.nn W A C. 5
UTILITY PERMIT# LUA# WO#
ADDRESS/STREET NAME(S): /411
DEV: ; CNTR: ; OWN: ; CNSLT/ENG:
OTHER ALIASES:
Circle Size of Waterline: 8" 10" 12" Circle One: New/Replace/Extension
Circle Size of Sewerline: 8" 101, 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
/0' TED 0
(off site improvements) (include TESC)
❑ TRO ❑ ❑
(Signalization,Channelization,Lighting)
WWP
(sanitary sewer main,include basin name)
WTR (Mains,Valves,Hydrants) (inc.composite&HorizontalCtrl)
S WP ,dl
(CIP only)(include basin name)
PLR (For Developer Files Only) f (letter only)
=WATER
LE T WHIC O SIGN ARS
ZDATER
SURFACE WATE TRANSPORTA FIRE
FOR FILE MAINTAINANCE USE ONLY
File Codes File Alias Date Entered and Labels Made
7,; t
°` y