Fillable Engineering Request Formaf (City of Milwaukie (OR))

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Engineering Request Formaf (City of Milwaukie (OR))

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File type: PDF

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Engineering Request Form.docx—Rev. 3/25/14
MILWAUKIE ENGINEERING
6101 SE Johnson Creek Blvd
Milwaukie OR 97206
503-786-7630
planning@milwaukieoregon.gov
Engineering
Request
CONTACT INFORMATION:
PLEASE RESPOND BY (date):
Name:
Mailing address:
Zip:
Phone(s):
Email:
SITE INFORMATION (if different from above):
Address/Location:
QUESTION(S) (use reverse side, if needed, to provide drawing or further details):
Wastewater (Sewer)
Connected (or if/when)?
Need drawing/records
Cost to connect?
Other/specifics:
Location of property line, right-of-way, and/or easement:
Please provide map
Please make site visit
Other/specifics:
Other maps needed:
Topographic site map
Aerial site map
Flood plain/FEMA map
Utility as-builts
Other/specifics:
Fence information (specify):
Sidewalks, curbs, or streetlights: For Traffic Signal requests, please use Traffic Control Device Request form.
Request for new
Repair/replacement of existing
Other/specifics:
Clear vision obstruction (describe):
Other (examples might include questions about surveyors, street markings, construction projects,
upcoming hearings, school trip safety, etc.) (please specify):
OFFICE PROCESSING:
Received by:
Date:
Response by:
Reference:
Date:
#
SUBMIT
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Engineering Request Formaf (City of Milwaukie (OR))

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Completed 13 July 2020

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