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ENG2023-0566_SEWER AVAILABILITY APPLICATIONRECEIVED Nov 03 2023 of ED%NO� SECTION A CITY OF EDMONDS SEWER 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 — Sanitary Sewer Main. Applicant Information Contact/Applicant Name Christian Gladu Phone Number 541-325-6164 Email christian@gladudesign.com Address 8509 Ferncliff Ave NE Citygainbridge Island State WA Zip 98110 Property • • Project Name Martin O'Leary Address 717 Walnut Street City Edmonds State WA Zip 98020 Parcel No. 00434209103300 Does the property currently have sewer service? es (City of Edmonds sewer) ❑ No Describe project (number of buildings, number of units, number of stories per building): One 2,768 SQ FT SFR to be demolished and a new 2,906 SQ FT single story SFR to replace it 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: 9*1 G DATE: 11-03-2023 APPLICANT PRINTED NAME: Christian Gladu Form Updated 3/28/2023