ENG2023-0255_Utility_Application_5.22.2023_2.10.54_PM_3560986RECEIVED
SEWER AVAILABILITY APPLICATION
May 22 2023
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
Complete and submit this form through www.MyBuildingPermit.com.
SECTION A
Applicant Information
Contact/Applicant Name 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 The SLAC
Associated Permit Number BLD2023-xxx
Address 19515 94th PI W
city Edmonds
state WA
zip 98020
Parcel No. 00434600005801
Does the property currently have sewer service? XYes (City of Edmonds sewer) ❑ No
Describe project (number of buildings, number of units, number of stories per building):
Construction of 1 story SFR to replace recently demolished SFR
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
BLD2023-xxx
® 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 Rowett
Joseph Rowett
DATE: 5-19-23
Form Updated 12/9/2021