ENG2022-0539+Water Availbility+11.3.2022_9.13.15_AM+3200948WATER AVAILABILITY APPLICATION
Complete and submit this form through www.MyBuildingPermit.com.
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SECTION A
Applicant Information
Contact/Applicant Name
Phone Number
Email
Address
City
State
Zip
Property Inf• •
Project Name
Associated Permit Number
Address
City
State
Zip
Parcel No.
Does the property currently have water service? ❑ Yes (City of Edmonds water) ❑ No
Describe project (number of buildings, number of units, number of stories per building):
In what phase is the project?
❑ Design Review ❑ Building Permit
❑ Preliminary Plat ❑ Rezone or Other
Associated permit application number(s), if applicable:
SECTION B
❑ 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: !�� %-`� DATE:
APPLICANT PRINTED NAME:
Form Updated 12/9/2021