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ENG2022-0540_Sewer Availbility_11.3.2022_9.08.25_AM_3200908SEWER AVAILABILITY APPLICATION Complete and submit this form through www.MyBuildingPermit.com. SECTION A Applicant Information Contact/Applicant Name Select Homes, Inc. Phone Number (425) 742-6044 Email kayla.clark@outlook.com Address 8304 212th St SW City Edmonds State WA Zip 98026 Property Project Name • • 19510 88th Ave W Lot 2 SFR Associated Permit Number BLD2022-1105 Address 19510 88th Ave W City Edmonds State WA Zip 98028 Parcel No. 27041800303400 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