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REVIEWED ENG2022-0555_SEWER AVAILABILITY_11.15.2022_4.35.27_PM_3221922
SEWER AVAILABILITY APPLICATION Complete and submit this form through www.MyBuildingPermit.com. SECTION A Applicant Information Contact/Applicant Name Select Homes, Inc. Phone Number 425.778.2144 Email kayla.clark@outlook.com Address 8304 212th St SW City Edmonds State WA Zip 98026 Property • • Project Name 7918 203rd St. SW SFR Associated Permit Number BLD2022-1087 Address 7918 203rd St. SW City Edmonds State WA Zip 98026 Parcel No. 27041900112700 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): One two story single family residence In what phase is the project? ❑ Design Review ❑ Preliminary Plat © Building Permit ❑ Rezone or Other Associated permit application number(s), if applicable: SECTION B E 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 SIGNATURE: &�< A-- DATE: 8/18/22 APPLICANT PRINTED NAME: Kayla Nichols, Select Homes, Inc. Form Updated 12/9/2021