ENG2023-0128_Utility_Application_3.6.2023_3.13.35_PM_3404466RECEIVED
A FMCI- pillyA91
CITY OF EDMONDS
SEWER AVAILABILITY APPLICATION DEVELOPMENT P SERVICES
Complete and submit this form through www.MyBuildingPermit.com.
SECTION A
Applicant Information
Contact/ApphcantName Joseph Rowett for Landsverk Quality Homes, Inc.
Phone Number 425-760-9218
Email joseph@lqh-inc.com
Address 24113 56th Ave W
city Mountlake Terrace
state WA
zip 98043
Property • •
Project Name Iron Vista Lot A
Associated Permit Number BLD2022-0926
Address 19xxx 94th Ave W 19128 94TH AVE W
city Edmonds
state WA
zip 98020
Parcel No. 00434600006102
Does the property currently have sewer service? ❑ Yes (City of Edmonds sewer) X No
Describe project (number of buildings, number of units, number of stories per building):
1 single family residence. 1 story above grade with 2 basements below
In what phase is the project?
❑ Design Review
❑ Preliminary Plat
E Building Permit
❑ Rezone or Other
Associated permit application number(s), if applicable:
SECTION B
BLD2022-0926 & BLD2022-1035
® Applicant 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 SIGNA
APPLICANT PRINTED N
Joseph Rowettro;;;�^_�
Joseph Rowett
DATE: 8-29-22
Form Updated 12/9/2021