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HomeMy WebLinkAboutSWP272257(3) r� Short Plat (SHPL# ) J Prelim.Plat P# REQUEST FOR PROJECT# � ) CAG# ) To: Technical Services Date — — q WO# �7:7 13 Green# T From: Plan Review/Project Manager 'q k=l j TT P—J c Project Name -Dwj 0 x) S U 01JE-/'14 � ' (70 characters max) Description of Project: S U h 4:--X re/US 1i9 A I -c* Jll.l�20rJF�/e � � tiE 3 K--ep S7- Circle Size of Waterline: 8" 101, 12' Circle One: New or Extension Circle Size of Sewerline: 8" 10" 12" Circle One: New or Extension Circle Size of Stormline: 12" 15" 18" 24" Circle One: New or Extension Address or Street Name(s) A;bm p Lib R-t) L L c�- Q 67 O S T Dvlpr/Contractor/Owner/Cnslt:: 13&7(2 ,,4e 7 (2 '—.D�q p� 2CST T)21 - (70 characters max) Check each discipline involved in Project Ltr Drwg #of sheets per discipline ✓ ✓ L�- Trans-Storm ❑ ❑ (Roadway/Drainage) (Off site improvements)(include basin name) (include TESC sheets) L7 Transportation (Signalization,Channelization,lighting) ❑ 3,� 2 Cl Wastewater ❑ Sanitary Sewer Main(include basin name) Water (Mains,valves,Hydrants) ❑ ❑ (Include composite&Horizontal Ctrl Sheets) ❑ Suface Water ❑ ❑ Improvements (CIP ONLY)(include basin name) TS Use Only f�b j�U .� �— �o, J7 TP rcr T Approved by TSM Date: H•fnr -hitility/92-MO r)OC/CD/hh