ENG2023-0487_SEWER AVAILABILITY APPLICATION_9.27.2023_2.08.38_PM_3808050of EDAgDNO�
SECTION A
SEWER AVAILABILITY APPLICATION
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
Contact/Applicant Name Nathaniel Brown
Phone Number - -
Email nathanielbrown@gmail.com
Address 16223 48th Ave W, Apt B4
city Edmonds
state WA
zip
Property
Project Name Brown House
Address 15700 75th PL W
city Edmonds
state WA
zip 98026
Parcel No. Nathaniel Brown
Does the property currently have sewer service? ❑ Yes (City of Edmonds sewer) QQ No
Describe project (number of buildings, number of units, number of stories per building):
This is a single familv residence that is approximately 4,900 sf. It has 3 stories.
In what phase is the project? R E S U B
❑ Design Review IN Building Permit
SEP 27 2023
❑ Preliminary Plat ❑ Rezone or Other
CITY OF EDMONDS
Associated permit application number(s), if applicable: DEVELOPMENT
SERVICES DEPARTMENT
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:
® 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: DATE: 9/12/23
APPLICANT PRINTED NAME: Nathaniel Brown
Form Updated 3/28/2023