HomeMy WebLinkAboutSWP273556 PROJECT REQUEST FORM
PLANNINGBUILDING/PUBLIC WORKS
DATE: v/ CONTACT: EXT.
FILE STATUS ❑ NEW OR ❑ EXISTING: FILE CODE(Pltt-XX-X)M'):
LOCATION ❑ My Work Space: ❑ File Bay Shelf#: O Other:
PROJECT NAME/FILE TITLE: .v
(70 characters max)
DESCRIPTION OF JE
SadIle
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UTILITYP Mu# LUA# U -� WO#
ADDRESS/STREET NAME(S):
DEV: ; CNTR: ; OWN: ; CNSLT/ENG:4 LTA
OTHER ALIASES: CASC �
Circle Size of Waterline: 8" 10" 12" Circle One: New/Replace/Extension
Circle Size of Sewerline: 8" 10" 12" Circle One: New/Replace/Extension
Circle Size of Stormline: 1 1.8" 24" Circle One New/Replace/Extension
CHECK EACH DISCIPLINE INVOLVED IN PROJECT Ltr Drwg #of sheets
❑ TED
(off site improvements) (include TESC)
❑ TRO ❑ 0
(Signalization,Channelization,Lighting)
❑ WWP So 0
(sanitary sewer main,include basin name)
❑ WTR ❑
(Mains,Valves,Hydrants) (inc.composite&HorizontalCtrl)
SWP a ❑
(CIP onlyxinclude basin name)
PLR (For Developer Files Only) 0 (letter only)
PLEASE CIRCLE THE DISCIPLINES WHICH NEED TO SIGN MYLARS
WATER WASTEWATER SURFACE WATER TRANSPORTATION FIRE
u
FOR FILE MAINTA7NANCE USE ONLY J<
File Codes File Alias Date Entered and Labels Made
_ / � ✓
7. '" _ ..