ENG2022-0551_Utility_Application_11.15.2022_11.50.02_AM_3220729RECEIVED
Nov 15 2022
O1 EC),tlUCITY OF EDMONDS
1 DEVELOPMENT SERVICESJ, WATER AVAILABILITY APPLICATION DEPARTMENT
Complete and submit this form through www.MyBuildingPermit.com.
SECTION A
Applicant Information
Contact/Applicant Name Fedje Properties LLC
Phone Number (206) 240-0236
Email lferkingstad@hotmail.com
Address 11404 239th PI SW
City Woodway
State WA
Zip 98020
Property Inf
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 water service? ❑ Yes (City of Edmonds water) m 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
iZ Preliminary Plat
❑ Building Permit
❑ Rezone or Other
Associated permit application number(s), if applicable: PLN2021-0077
SECTION B
0 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: ,Z DATE: 6/1 / 2
APPLICANT PRINTED NAME: Linda Ferkingstad
Form Updated 12/9/2021