HomeMy WebLinkAboutSWP273606 PROJECT REQUEST FORM
PLANNINGBUILDING/PUBLIC WORKS
DATE: J(J IG 11 CONTACT: kV\ EXT_ 77 t
FILE STATUS 10 NEW OR 0 EXISTING: FILE CODE(Pxl-xx-xxxx):
LOCATION 0 My Work Space: 0 File Bay Shelf#: O Other:
PROTECT NAME/FILE TITLEI ep n u)oo ► _FO W n 1 10-1 e__�, _
(70 characters max)
DESCRIPTION OF PROJECT-
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UTILITY PERf16T# �_�� Q��q LUA# J WO# d.3
ADDRESS /STREET NAME(S): —1— fmnn (_
DE&Cmlr;�ilti r; S: OWN tQ vL}��' G.
OTHER ALIASES: �} Rta�Am 45,(to Li�� J '
Circle Size of Waterline: 8" 10" !I Circle One: New/Replace/Extension
Circle Size of Sewerline: 8" 10" 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
IIY TED ❑ ❑
(off site improvements) (include TESC)
O ❑ ❑
(Signalization,Channelization,Lighting)
/WWP ❑ ❑
(sanitary sewer main,include basin name)
VWTR - ❑ ❑
/ (Mains,Valves,Hydrants) (inc.composite&HorizontalCtrl)
1 SWP ❑ ❑
(CIP onlyxinclude basin name)
VV PLR (For Developer Files Only) 0 (letter only)
l/ 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
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