City Council Item Report

City of Surprise — City Council (2026-03-03)

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gQinm PROJECT SIGN OFF FORM

SURPRISE PUBLIC WORKS - ENGINEERING SERVICES, INSPECTIONS
ARIZONA
Date Submitted: June 30, 2021 Commercial Commercial w/Offsite **_ Residential
XX COMPLETION ACCEPTANCE (End of Construction) FINAL ACCEPTANCE (End of Warranty)
10/20/2020 Date of Punch-List Walk 4/28/2021 Date Punch-List Completed
FS Number: FS18-093 Permit Number(s): E18P-0748,£18P-0749,E18P-0751,E18P-0752,E18P-0753,E18P-0754

Project Name: Rancho Mercado Parcel A19

Project Developer/Builder: (Name, Address, and Phone #)
William Lyon Homes, 8840 E Chaparral Rd, Suite 200, Scottsdale, Arizona 85250 480-850-3724

Sheet 1 of 3
MAG TIP Reporting:
Street Name Classification Begin Limits End Limits # Lanes Length to Features
nearest % mi.
Crabapple Dr Local 142nd Ave 140th Dr 2 1/4
Buckskin Trl Local Cul De Sac 140th Dr 2 1/4
Hackamore Dr Local Cul De Sac 140th Dr 2 1/4
Desert Hollow Dr Local 140th Ln 140th Dr 2 1/4
Bronco Trl Local 140th Ln Cul De Sac 2 1/4
MATERIALS:
Asphalt: MR Tanner Supplier §5 Total Lane Miles 24192 Total Square Yards
Water: 8"C-900 size/Type 7776 Total Linear Feet 12"DIP__Size/Type 747 Total Linear Feet
S'DIP__ Size/Type _18° Total Linear Feet 16"DIP_ size/Type 772 Total Linear Feet
Sewer: 8"PVC_ Size/Type 5359 Total Linear Feet o"PVC Size/Type 1-794 Total Linear Feet
1s"PVC Size/Type 179 Total Linear Feet 18" PVC Size/Type 580 Total Linear Feet
Storm: ‘@FSRCP Size/Type 418 Total Linear Feet Size/Type Total Linear Feet
2a RGRCP Size/Type 391 Total Linear Feet Size/Type Total Linear Feet
FireLn: NA Size/Type Total Linear Feet Size/Type Total Linear Feet

Additional Comments:

SUPPORTING DOCUMENTATION REQUIRED:
XX ___ Copy of Punch List

NA_ Final Certification Letter from Engineer of Record XX AOC

XX Complete Geotechnical Testing Packet XX__ Asphalt Concrete Ticket w/ Name of Contractor
XX Sewer Pressure Testing Results Way Rtreetlight Energize Letter

XX Sewer Manhole Vacuum Testing Certification 2X__ As built Documents (PDF copy on CD)

XX Sewer Manhole Insecticide Certification 2X __ As Built Documents in PDF format (copy on CD)

— oy ; :

XX Sewer Videos with Operators Notes (inc. re-videos) MA Updated asbuilt CAD base files (copy on CD)
(Specify)

Other

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APPROVAL: | alt

Civil Inspector: William Valdez

Civil Engineering Supervisor: Arist bles Date: _ 6/30/2021

Date: June 30, 2021

aS
SURPRISE

ARIZONA

Date Submitted: June 30, 2021

PROJECT SIGN OFF FORM

PUBLIC WORKS - ENGINEERING SERVICES, INSPECTIONS

XX COMPLETION ACCEPTANCE (End of Construction)

See Sheet 1

Date of Punch-List Walk

Commercial Commercial w/Offsite **_ Residential

FINAL ACCEPTANCE (End of Warranty)

Date Punch-List Completed

FS Number: FS18-093
Project Name: See Sheet!

Permit Number(s): See Sheet 1

Project Developer/Builder: (Name, Address, and Phone #)

Sheet 2 of 3
MAG TIP Reporting:
Street Name Classification Begin Limits End Limits # Lanes Length to Features
nearest % mi.
Crabapple Dr Local 142nd Ave 140th Dr 2 1/4
Buckskin Trl Local Cul De Sac 140th Dr 2 1/4
Hackamore Dr Local Cul De Sac 140th Dr 2 1/4
Desert Hollow Dr Local 140th Ln 140th Dr 2 1/4
Bronco Trl Local 140th Ln Cul De Sac 2 1/4
MATERIALS:
Asphalt: See Sheet 1 Supplier Total Lane Miles Total Square Yards
Water: Size/Type Total Linear Feet Size/Type Total Linear Feet
Size/Type Total Linear Feet Size/Type Total Linear Feet
Sewer Size/Type Total Linear Feet Size/Type Total Linear Feet
Size/Type Total Linear Feet Size/Type Total Linear Feet
Storm Size/Type Total Linear Feet Size/Type Total Linear Feet
Size/Type Total Linear Feet Size/Type Total Linear Feet
Fire Ln: Size/Type Total Linear Feet Size/Type Total Linear Feet
Additional Comments:
SUPPORTING DOCUMENTATION REQUIRED:
Copy of Punch List
Final Certification Letter from Engineer of Record AOC

Complete Geotechnical Testing Packet

Sewer Pressure Testing Results

Sewer Manhole Vacuum Testing Certification
Sewer Manhole Insecticide Certification
Sewer Videos with Operators Notes (inc. re-videos)

Other

____ Asphalt Concrete Ticket w/ Name of Contractor
____ Streetlight Energize Letter

____ As built Documents (PDF copy on CD)

_____ As Built Documents in PDF format (copy on CD)
____ Updated asbuilt CAD base files (copy on CD)

(Specify)

APPROVAL:

Civil Inspector: William Valdez

lw

Civil Engineering Supervisor:

Date; June 30, 2021

Date:

ginm

SURPRISE

ARIZONA

Date Submitted: June 90. 2021

PROJECT SIGN OFF FORM

PUBLIC WORKS - ENGINEERING SERVICES, INSPECTIONS

XX COMPLETION ACCEPTANCE (End of Construction)

See Sheet 1

Date of Punch-List Walk

Commercial Commercial w/Offsite **_ Residential

FINAL ACCEPTANCE (End of Warranty)

Date Punch-List Completed

FS Number: FS18-093

Permit Number(s): See Sheet 1

Project Name: See Sheet t

Project Developer/Builder: (Name, Address, and Phone #)

Sheet 3 of 3
MAG TIP Reporting:
Street Name Classification Begin Limits End Limits # Lanes Length to Features
nearest % mi.
Gray Fox Trl Local Sta 31+60.95 140th Dr 2 1/4
Cottontail Ln Local 140th Ln 140th Dr 2 1/4
Honeysuckle Dr Local 140th Ln 140th Dr 2 1/4
MATERIALS:
Asphalt: See Sheet 1 Supplier Total Lane Miles Total Square Yards
Water: Size/Type Total Linear Feet Size/Type Total Linear Feet
Size/Type Total Linear Feet Size/Type Total Linear Feet
Sewer: Size/Type Total Linear Feet Size/Type Total Linear Feet
Size/Type Total Linear Feet Size/Type Total Linear Feet
Storm: Size/Type Total Linear Feet Size/Type Total Linear Feet
Size/Type Total Linear Feet Size/Type Total Linear Feet
Fire Ln: Size/Type Total Linear Feet Size/Type Total Linear Feet
Additional Comments:
SUPPORTING DOCUMENTATION REQUIRED:
Copy of Punch List
Final Certification Letter from Engineer of Record AOC

Complete Geotechnical Testing Packet

Sewer Pressure Testing Results

Sewer Manhole Vacuum Testing Certification
Sewer Manhole Insecticide Certification
Sewer Videos with Operators Notes (inc. re-videos)

Other See Sheet 1

____ Asphalt Concrete Ticket w/ Name of Contractor
___ Streetlight Energize Letter

____ As built Documents (PDF copy on CD)

_____ As Built Documents in PDF format (copy on CD)
_____ Updated asbuilt CAD base files (copy on CD)

(Specify)

APPROVAL:

Civil Inspector: William Valdez

nt

Civil Engineering Supervisor:

Date: June 30, 2021

Date: