City of Grand Rapids - Engineering Department

Private Development Initiation Form

Proposed Development Name: *

Developer Company Name: *

Development Location: *

Type of Development: *

Single Family Homes

Condominium

Apartments

Other (Describe): Other (Describe):

Developer Contact Information:

Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Engineering Consultant:

Project Engineer Name *

Company Name *

Phone Number *

Email Address *

Select which City utilities that are proposed to be extended as part of this project: *

Sanitary Sewer	Water Main
Storm Sewer (in GR Only)	Other Other

Attach Preliminary Utility Plan (PUP): * 🛈

Attach cover letter from municipality: 🛈

PUP: City utilities must be displayed in color: Sanitary Sewer in RED, Water Main in BLUE and Storm Sewer in GREEN. Existing utilities should be light line weight and proposed heavy. Label utilities accordingly (e.g 8" WAT or PROPOSED 8" WATER MAIN).

NOTE: You will need to drop off or mail the originally signed cover letter and three (3) full-sized, color bond copies of the PUP to the Engineering Office, in addition to submitting this form.

Contact Jack Stegehuis at jstegehuis@grcity.us or (616) 456-3715, with questions concerning this form.

Comments/Questions/Additional Information: