HomeMy WebLinkAboutSWP272065 S� ort Plat (S1IPL # )
REQUEST FOR PROJECT # Prelim. Plat (PP#
CAG#
To: Technical Services Date O# Green#
From.- Plan Review/Project Manager
Project Name
z' 0 characters max)
Description of Project- `
Circle Size of Waterline: 8" 10" 12" Circle One: New or Extension
Circle Size of Sewerline: 8" 10" 12" Circle One: e or Extension
Circle Size of Stormline: 12" 15" 18" 24" Circle One: New or Extension
Address or Street Name(s)
Dvlpr/Contractor/Owner/Cnslt: P-
(70 characters max)
Check each discipline involved in Project Ltr Drwg # of sheets per discipline
O Trans-Storm
(Roadway/Drainage) (Off site imp entsxinclude basin name) include TESC sheets)
)
Transportation (Signatization,Channels "on,Ugh' 91 v
Wastewater -__�
—/ (Sam m
tary Sewer Main)(include basin nae)
dl Water (Mains,Valves,Hydran :2 —
(Include composite&Horizontal Ctrl Sheets)
TS Use Only r 41 _ lo6,5 _ 65
6 5
Approved by TSM Date.-
forms/misc/92-090.DOC/CD/bh