ENG2024-0118_Utility_Application_3.21.2024_8.35.54_AM_4148050RECEIVED
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SECTION A
SEWER AVAILABILITY APPLICATION
Mar 21 2024
CITY OF EDMONDS
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 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 sewer service? �✓ Yes (City of Edmonds sewer) ❑ 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
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:
11 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 Digrt lly signed by Mac Plog
APPLICANT SIGNATURE' 9 Dat82U4032108300207'09 DATE' 3/21/2024
APPLICANT PRINTED NAME: Mark X. Plog
Form Updated 3/28/2023