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ENG2023-0608_Utility_Application_11.28.2023_2.28.26_PM_3921767RECEIVED Nov 28 2023 of EDAgDNO� SECTION A CITY OF EDMONDS SEWER AVAILABILITY APPLICATION DEVELOPMENTEPARTMENRVICES 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 Brian Kalab / Insight Engineering Co. Phone Number (425) 303-9363 Email brian@insightengineering.net Address PO Box 1478 City Everett State WA Zip 98206 Property • • Project Name Sprague Edmonds Address 738 Sprague St City Edmonds State WA Zip 98020 Parcel No. 00434208501400 Does the property currently have sewer service? ❑ Yes (City of Edmonds sewer) it No Describe project (number of buildings, number of units, number of stories per building): The proposal is to construct a single-family home. The exsiting garage is to be removed. In what phase is the project? ❑ Design Review ❑ Preliminary Plat NJ Building Permit ❑ Rezone or Other Associated permit application number(s), if applicable: 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: NJ 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: Aak. DATE: 11/28/2023 APPLICANT PRINTED NAME: Brian Kalab Form Updated 3/28/2023