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ENG2024-0117_Utility_Application_3.21.2024_8.32.51_AM_4148033RECEIVED Mar 21 2024 of EDA40NO� SECTION A CITY OF EDMONDS WATER AVAILABILITY APPLICATION DEVE DOPMENT EPARTMENRVICES 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 Contact/Applicant Name Mark X. Plog Phone Number 206-420-7130 Email mark@plogengineering.com Address P.O. Box 412 City Ravensdale State WA Zip 98051 Property Project Name Garrett Short Plat Address 9014 218th St SW City Edmonds State WA Zip 98026 Parcel No. 00380300100200 Does the property currently have water service? [D Yes (City of Edmonds water) [:]No Describe project (number of buildings, number of units, number of stories per building): 2 lot short plat with existing home to remain on one of the lots. In what phase is the project? ❑ Design Review 4 Preliminary Plat ❑ 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 4 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. Mark Plog Digitally signed by Mark Plog APPLICANT SIGNATURE: g Dete: 2024.03.21082055-07'00' DATE: 3/21/24 APPLICANT PRINTED NAME: Mark X. Plog Form Updated 3/28/2023