PLN2021-0077_Sewer Availability Application_6.24.2022_2.35.22_PM_2953669l/0 of ELP1,1()4/
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SECTION A
RECEIVED
SEWER AVAILABILITY APPLICATION J U N 24 2022
Complete and submit this form through www.MyBuildingPerm:t.com.
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
Applicant Information
Contact/Applicant Name Fedje Properties LLC
Phone Number (206) 240-0236
Email Iferkingstad@hotmail.com
Address 11404 239th PI SW
City Woodway
State WA
zip 98020
Property • •
Project Name Fedje Short Plat
Associated Permit Number PLN2021-0077
Address 157xx 72nd Ave W
City Edmonds
State WA
zip 98020
Parcel No. 00513300002217
Does the property currently have sewer service? ❑ Yes (City of Edmonds sewer) 91 No
Describe project (number of buildings, number of units, number of stories per building):
Three, two-story, single-family homes.
In what phase is the project?
❑ Design Review
VPreliminary Plat
❑ Building Permit
❑ Rezone or Other
Associated permit application number(s), if applicable: PLN2021-0077
SECTION B
VApplicant certifies that this project is a single-family residence, multi -family project of four units or
less, or short plat subdivision (four single-family lots or less), in which case completion of a full utility
availability study shall not be required. Please sign below and submit this form through
www.MyBuildingPermit.com.
❑ For all other permit types, a utility availability study is required and associated fees will be due. Please
submit the complete application through www.MyBuildingPermit.com.
APPLICANT SIGNATURE:DATE: 6/1 /22
APPLICANT PRINTED NAME: Linda Ferkingstad
Form Updated 12/9/2021