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REQUEST FOR PROJECT ✓t Prelim. Plat (PP/I )
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To: Technical Services Date % /�/ld'� 1¢�'W, /ON b7� (a Grceng
From: Plan Review/Project Manager
Project Name
(70 dwaticss nua)
Description of Project:
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Circle Size of Waterline: 8" 10" 12" Circle One: New or Extension '
Circle Size of Sewerline: 8" 10" 12" Circle One: New or Extension
Circle Size of Stomtline: 12" 15" 18r, 24" Circle One:e New or Extension
Address or Street Name(s)
Dvlpr/Contractor/Owner/Cnslt:
(70 cbanaas max)
Check each discipline involved in Project Ltr Drwg 4 of sheets per discipline
(3 l7ans-Storm a"Al
(Roadway/Drainage) (off,ite 4fiffuvenscrnsXinciudc basin narne) - - (usdude TESL altects)
❑ Transportation (Sign.lizzt a Clwuseliza6ory lighting)
❑ Wastewater
(Sanitaty Scw Main)(include basin none)
❑ Water (Mains,Valves,Hydrants)
(Include composite&Horizontal Curl Sheets)
TS Use Only 40 —
SW P
Approved by TSM Date:
rorms/misc02-090.130C/CDrbh