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ENG2023-0609_Utility_Application_11.28.2023_2.30.21_PM_3921786RECEIVED Nov 28 2023 of EDA40NO� SECTION A CITY OF EDMONDS WATER AVAILABILITY APPLICATION DEVELOPMENT SERVICES 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 — Water 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 water service? ❑ Yes (City of Edmonds water) d 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 V Building Permit ❑ Rezone or Other Associated permit application number(s), if applicable: SECTION B Exemptions from Utility Availabilit units or less with combo water/fire check one of the following: residence; 2) Multi -family project of four 7ision (four single-family lots or less). Please 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: 2F41yaza_�- DATE: 11/28/2023 APPLICANT PRINTED NAME: Brian Kalab Form Updated 3/28/2023