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21123 SHELL VALLEY RD
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TAX ACCOLINT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
DETERMINATION: [] Conditional Waiver 0 Study Required E] Waiver
LID #:
LOT: BLOCK:
LATEMPOSTsTomiAStreet File Chccklist.doc
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PUBLIC UORKS DEPARI= CHEamm
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011VITIEW DIV41406-0-ALTARROA-9.
211 L3 - -56 0 11& lit C3-10-11 C5
(address)- - - (date)
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Street Right -of -Way Existing______5,:) REQD
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Access Easenimts Exist
Utility Easement Exist'
Lot Per Subdivisionj!:-�-��Plat Assessor Map_
Site Plan Checked for Accuracy_!g������.��
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Underground Wiring Reqd.
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Check Accuracy of Legal Description
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Review b DAte
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Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existing _
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Hydrant Reqd Per Fire Code Size
Detector Check Itter Reqd. �11A
Cross Connection Inspection_
Fire Department Conments
Water Meter Reqd.
Review by.
Septic Tank Design Approved Date
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Availability -Proi
Drawing No. ez--2_1 File No.
P4
Side Sewer Availability
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Sanitary Sewer Connection Fee Reqd.
:3:
Review by. AdN&M ed Date 2/.
Open Ditch Exist' __Peqd.
Culvert Reqd. 6,. ;r
- - W0f6/"dW —Size
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C4
Catch Basin Reqd. 4 A, Indicate on Site Plan
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Shoulder drainage maintain collection on swale open runoff
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Manhole reqd. &Cke Indicate on Site Plan
Soil Conditions and Ground Water Field Checked L"/,
Review by. :5
Datep, &&�
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02
PM
Revised: 1vlO-1977
Page 2
610
00
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Street Paving Reqd. 4V.
Curb and Gutter Reqd.
Sidewalk Reqd.
Re
Curb Cut for Driveway q
c4 Right -of -Way Construction Permit Reqd.
Bond Reqd. for Public Inprovements
Street Narm Sign Reqd. X10
Other Signing Reqd. S09,
P, * Pre Permit Site Inspection made on
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P-4 F4 BY: SE1,1ER
WATER
H z STREET
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rx-4 ENGINEERING
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Special Requirements listed ixi mem to Comn-mity Development Department,
Building Division
BY Date
items filled in on Building Permit Application
BY Date
Draw-ings Stamped and Notations Made
BY Date
by Public Works Department
F,evised: lv 10-1977
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1 00
DATE: I - 7171)
IIE11,10 TO: Building Division
Community Development Department
FROM; Engineering Division
Public Works Department
SUBJECT: -
—7'117—
After review of the subject building permit application, .,ie have
the following comments:
NO a -10.1
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