1058 SPRAGUE ST.PDFIiiiiiiiiiiii
13240
1058 S P RAG U E ST
ADDRESS:
TAX ACCC
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS(RECORDED)FOR:
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR: .
PERMITS (OTE
1A ---
DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DA'
LATEMP\DSTs\Forms\Street File Checklist.doc
OJC- WDRKS DEPARIT CHECKLIG"
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BUILDING PERMIT REVIEW
Date
c.?Address
Street Right -of -Way -Existing 5-� REQD
Access Easements Existing REQD
Utility Easement Existing REQD
Lot per Subdivision' Plat Assessor Map --, Zq
2 Site Plan Checked for Accuracy S/cg 1�9,
Undergrourid . Wiring .Regd .
a Check Accuracy of Legal Description
w Environmentally Sensitive Area
w Environmental Checklist Reqd. —
Z,
Flood Hazard Zone
U Shoreline Management Area �-
z Slope, Soil, Vegetation
w Stream, Creek, Drainage.Basin
Existing Zoning Per .Code S
Amenities Design Board Approval Reqd. ADB Approval
Board of Adjustment Approval.Regd.
Review By: Date:
Existing Water Main Size
Water Main Reqd.
P4 Service Line Reqd. -
w Hydrant Size Existing
F'` ` Hydrant Reqd. Per Fire Code
d Detector Check Meter Reqd.
Cross Connection Inspection
Fire Department Comments
Water Meter Charge Reqd.
Review by: — Date:
Septic Tank Design Approved- Date:
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Availability Proj.
Drawing No. File No.
IT,
Side Sewer Availability
w Sanitary Sewer Connection Fee Reqd.
Review By: Date:
.AJ
OE)cn Ditch Existing
Regd.
Culvert Reqd.
Size
Catch Basin Reqd:
Indicate on Site, Plan
o
Shoulder drainage ntiii.ntain collection
an swale open runoff
"'
l,t-u-iiole regd.
Indicate on Site Plan
Soil Conditions and Ground Water Field Checked
Review by
Date
r
Street Paying Reqd.
Curb and Gutter Reqd.
w
Sidewalk Reqd.
w
Curb Cut for Driveway Reqd.
o�
Right -of -Way Construction Permit Regd.,.
H
Bond Reqd. for Public LTprovements
Street Name Sign Reqd.
Other Siding Reqd.
Q.
Pre: Permit Site Inspection made on.
z
HBY:
SEWER
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WATER.
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H
STREET
ENGINEERING
rM'
11� INK
Special Requirements listed in menb to
ConT=ity Development Department,
Building Division
BY
Date
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All items filled in on Building Permit
Application ,
BY
Date
Drawings Stamped and Notations Made
A4
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BY
Date
Approved by Public itTorks DeparLiTK'nt
Revised: Iv 10-1977