HomeMy WebLinkAboutSWP272290 ` Short Plat (SHPL# )
REQUEST FOR PROJECT# Prelim.Plat (PP# )
CAG# )
To: Technical Services Date 1— �6 " 77 WO# 87 '17 Green#
From: Plan Review/Project Manager PA y CL L v m M-<7 —
Project Name P! IQC Le' S,#OIZT' A,4T
(70 characters max)
Description of Project: t C7' sI�OI�T A4 r IrVAI WgrXR.Ai 1,V MmIrWy.?het
CIA/N . SrofAl 179-4/NIA E Stir S"TZam AX IY �mYW If
PAV/N 6 A,< 1*047W 9a0194w,4k.
Circle Size of Waterline: 0 10" 12" Circle One: ew or Extension
Circle Size of Sewerline: O 10" 12" Circle One: New or Extension
Circle Size of Stormline: 12" 15" 18" 24" Circle One: <ZD or Extension
Address or Street Name(s) P/15 X CC 4V4e—,
Dvlpr/Contractor/Owner/Cnslt:: aMAL4f
(70 characters max)
Check each discipline involved in Project Ltr Drwg #of sheets per discipline
✓ ✓
❑ Trans-Storm ❑
(Roadway/Drainage) (Off site improvements)(include basin name) (include TESC sheets)
❑ Transportation (Signalization,Channelization,Lighting) ❑ ❑
❑ Wastewater /1fZM 11/6,#JAN40s O
Sanitary Sewer Main(include basin name)
❑ Water (Mains,Valves,Hydrants) ❑
(Include composite&Horizontal Ctrl Sheets)
❑ Suface Water O ❑
Improvements (CIP ONLY)(include basin name)
TS Use Only 1 0— d ?(? D
OTA- 1� ga R�
7
L
Approved by TSM Date:
H:forms/utility/92-090.DOC/CD/bh