21125_SHELL_VALLEY_RD.PDFIIIIIIIIIIIIII
14410
21125 SHELL VALLEY RD
-.011, 0 0 �% e& "t-,
ADDRESS:
TAX ACCOUNT/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:
OTHER:
DETERMINATION: [] Conditional Waiver [] Study Required E] Waiver
LOT:
LID #:
BLOCK:
LATEMP\DSTs\Fomis\Street File Checklist.doc
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STREET FILE DATE:
14EMO TO: Building Division
Community Development Department
FROM; Engineering Division
Public Works Department
SUBJECT: V I ? ---? -
After review of the subject building permit application, we have
the following comments:
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PUBLIC WORKS DEPARMInT CHEacLisT
BUIIDING PER�11T REVIEW
(address) (date)
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Street Right -of -Way Existing_.�i-...�REQD
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Access Easenmts Existing D
L,02�� REQ
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Utility Easement Existi
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Lot Per Subdivision Plat // &� Assessor Map_
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Site Plan Checked for Accuracy—_., q'�'70
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Underground 14iring Reqd.___ V_e�
Check Accuracy of Legal Descriptim'L_
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Review b te 1�1_ -57 _71:�i
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Existing Water Main Size
Water Main Required L—S c:,>LJF_
Service Line Required
Hydrant Size Existing MOW/-\
Hydrant Reqd Per Fire Code Size
Detector Check Itter Reqd.
Cross Connection Inspection
Fire Department ConTnents
'dater Meter ge- Reqd.
Review by. Date
Septic Tank Design Approved. Date
Septic Tank Permit Reqd. ,A 21AC Permit No. V/,a
Sanitary Sewer Availability Pro* /_ 0
3 Ae:�� AR
Drawing No. File No.
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Side Sewer Avai1ability_--I;-.,..
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Sanitary Sewer Connection Fee Reqd.
Review by Date
En
Open Ditch Exist aws&
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__�eqd.
Culvert Reqd. 44!A&ft
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Catch Basin Reqd. e
indicate on Sit'Plan
Shoulder drainage maintain collection on swale open runoff
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Manhole reqd. .feg
--Indicate on Site Plan
Soil Conditions and Ground Water Field Checke ."l-aA.
Review by 4aog&&01!� �, �a t e
Revised: lvlO-1977
Page 2
00
Street Paving Reqd._ Amig JVAV _e%g
Curb and Gutter Reqd.
S III
&i4t*7'Reqd. Ile
Curb Cut . for Driveway Reqd. 4f
rd Right -of -Way Construction Permit Reqd.-
Bond Reqd. for Public Improvements
Street Name Sign Reqd.
Other Signing Reqd.
' Pre Permit Site Inspection made an
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BY: Sam
WATER
z
F4 SMEET
ENGINEERING
Special Requirements listed in memo to Commmity Development Department,
Building Division
BY - Date
o All items filled in an Building Permit Application
Pd BY Date
P4 Drawiqg
,s Stamped and Notations Made
P4 BY Date
Approved by Public Works Department
Revised: 1v 10-1977