ENP2022-0002 WATER AVAILABILITY APPLICATIONof Evjq
WATER AVAILABILITY APPLICATION
Complete and submit this form through www.MyBuildingPermit.com.
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SECTION A
Applicant Information
Contact/Applicant Name R
Phone Number q
Email W i
Address
City
State
Zip
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Project Namefto S
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Associated Permit Number U Q
Address
City State Zip �i U�
Parcel No. 16 ` vv
Does the property currently have water service? Yes (City of Edmonds water) ❑ No
Describe project (number.of buildings, number of units, number of stories per building):
In what phase is the project?
❑ Design Review ❑ Building Permit
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❑ Preliminary Plat ❑ Rezone or Other
Associated permit application number(s), if applicable: B L_D - W IOI — i S" 3
SECTION B
Applicant certifies that this project is a single-family residence, multi -family project of four units or
less with combo water/fire lines, 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: //L--� DATE: I
APPLICANT PRINTED NAME:_ 1 ) (W W_ Slr1CA, qO
Form Updated 12/9/2021