ENP2021-0054 Sewer Availability CertificatePFRMITTING & DE` rl OPMI-NT
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ITEMS IN THIS BOX TO BE FILLED IN BY APPLICANT
M/Building Permit ❑ Preliminary Plat or PUD
O Subdivision Rezone or Other
Applicant's name: 6 B� � zz_ l n S�-
Proposed Use: G( 0— a, q 7 L ��12
Location (attach map and legal description if necessary):
2,� v - aoo6
SECTION C
1. a. Sewer service will be provided by side sewer connection only to an existing 8" Clay
size sewer main that is 10 feet from the site.
OR
❑ b. Sewer service will require an improvement to the sewer system of:
❑ W.
feet of sewer main to reach the site; and/or
❑ (2). The construction of a collection system on the site; and/or
❑ (3). Other (describe)
2. a. The sewer system is in conformance with a City approved sewer comprehensive plan.
OR
❑ b. The sewer system improvement will require a sewer comprehensive plan amendment.
(This will cause a delay in permit issuance and approval.)
3. V a. The proposed project is within the corporate limits of the City, or has been granted
Boundary Review board approval for extension of service outside the City, or is within the City approved
service area of a private water purveyor.
OR
❑ b. Annexation or Boundary Review Board approval will be necessary to provide service.
AgencySewer
Comments/Conditions:
I hereby certify that the above information is true. This certification shall be valid for one year from the date of signature.
City of Edmonds
(Agency Name)
Russell Lynch
(Signatory Printed Name)
Associate Engineer
(Title)
( re Date)
Form Updated 09/02/2021