ENG2023-0155 SEWER AVAILABILITY CERTIFICATERECEIVED
SEWER AVAILABILITY APPLICATION MAR 24 2023
Complete and submit this form through www.MyBuildingPermit,enm,
CITY OF EDMONDS
C a DEVELOPMENT
SERVICES DEPARTMENT
SECTION A
Applicant Information
Contact/Applicant Name Glenn Safadago
Phone Number 360.321.7090
Email GlennHCI@msn.com
Address PO Box 1389
City Edmonds
State WA
Zip 98020
Property Inf• •
Project Name 627 Dayton Apartments
Associated Permit Number N/A
Address 627 Dayton Street
City Edmonds
State WA
Zip 98020
Parcel No. 00434209703100
Does the property currently have sewer service? x Yes (City of Edmonds sewer) ❑ No
Describe project (number of buildings, number of units, number of stories per building):
3-story,18-unit apartment building with 18 parking spaces
In what phase is the project?
n Design Review
❑ Preliminary Plat
N Building Permit
❑ Rezone or Other
Associated permit application number(s), if applicable: PLN2022-0089 & BLD2022-1540
SECTION B
❑ 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.
I xl 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: 9efm S4006W DATE: 03/13/23
APPLICANT PRINTED NAME: Glenn Safadag0
Form Updated 12/9/2021
SECTION C
1. 1 a. Sewer service will be provided by side sewer connection only to an existing 8" clay gravity
size sewer main that is 10 feet from the site.
OR
❑ b. Sewer service will require an improvement to the sewer system of:
❑ (1).
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.
SewurN-ency Certification
Comments/Conditions:
Service connection shall be made to existing 8" clay gravity main in alley directly north
of property.
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 - Engineering
(Agency Name)
Russell Lynch
(Signatory Printed Name)
Associate Engineer
(Title)
(Signature/Date)
Form Updated 3/28/2023