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ENG2023-0496_Utility_Application_9.29.2023_12.59.43_PM_3812838of EL410 RECEIVED SECTION A WATER AVAILABILITY APPLICATION SEP 29 2023 Complete and submit this form through 'erzriit.coin. Submit as a new application using the following prompts: Application Type — Utilities, Actilu ti, Type — Utility Availability, Scope of Work — Water Main. CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Contact/Applicant Name J- Y F U LTpN Phone Number 2 - Z-) - f 470 Email S y. FU L?DN I @ 6 MAt L , CAM Address 6.6 30 Z iy L/ v /v E- Ciry R K L% /f I State WA I Zip Project Name F u LTD" A45—`il FAle:4� � — � Address 654 77-f City 0N&C State Zip © (' _ Parcel No Does the property currently have water service? )(Yes (City of Edmonds water) ❑ No Describe roject (number of buildi s number : ber of units, number of stories per building) PJF' t�F�i1 D� VV �,f1RTl hL S,�GDNL7 �TDIz �/ -f- ft-TTftG In what phase is the project? ❑ Design Review N Building Permit ❑ Preliminary Plat ❑ Rezone or Other Associated permit application number(s), if applicable: SECTION B P HP6L Exemptions from Utility Availability Study. i) Single-family residence; 2) Multi-famil units or less with combo water/fire lines; 3) Short plat subdivision (four single-family check one of the following: project of four )ts or less). Please A utility availability study IS NOT requested/required. The applicant certifies that this project is exempt from needing a study as described above and is not requesting a full utility availability study at this time. Please sign below and submit this form through `N, %,-Nv.'\1vBtiildiii Peririit.coiii. ❑ A utility availability study IS requested/required for the project, and associated fees will be due. Please submit the complete application through 1v� v_ v..-Jli_tildiiig Permit.coiii. APPLICANT SIGNATURE: JDATE: 7�� Z 923 APPLICANT PRINTED NAME: Form Updated 3/28/2023