ENG2023-0597_Utility_Application_11.21.2023_9.35.59_PM_3914471RECEIVED
Nov 22 2023
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SECTION A
CITY OF EDMONDS
DEVELOPMENT SERVICES
SEWER AVAILABILITY APPLICATION DEPARTMENT
Complete and submit this form through www.MyBuildingPermit.com. Submit as a
new application using the following prompts: Application Type — Utilities, Activity
Type — Utility Availability, Scope of Work — Sanitary Sewer Main.
Applicant Information
Contact/Applicant Name Christopher Kiel
Phone Number 425-923-5414
Email chrisklphomes@gmail.com
Address 14019 52nd Ave W #A
City Edmonds
state Wa
zip 98026
Property • •
Project Name Maplewood Estates Lot B
Address 8817 194th St Sw
City Edmonds
state Wa
zip 98026
Parcel No. 27041800313900
Does the property currently have sewer service? Q Yes (City of Edmonds sewer) ❑ No
Describe project (number of buildings, number of units, number of stories per building):
Build 1 new construction sfr 2 story home
In what phase is the project?
❑ Design Review
❑ Preliminary Plat
)!� Building Permit
❑ Rezone or Other
Associated permit application number(s), if applicable:
BLD2023-1474
SECTION B
Applicability
Exemptions from Utility Availability Study: 1) Single-family residence; 2) Multi -family project of four
units or less; 3) Short plat subdivision (four single-family lots or less). Please check one of the following:
N 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 www.MyBuildingPermit.com.
❑ A utility availability study IS requested/required for the project, and associated fees will be
due. Please submit the complete application through www.MyBuildingPermit.com.
APPLICANT SIGNATURE. CJ/_ DATE: 11 /21 /23
APPLICANT PRINTED NAME: Christopher Kiel
Form Updated 3/28/2023