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ENG2024-0291_Utility_Application_6.12.2024_10.52.17_AM_4316867RECEIVED of EDAgDNO� SECTION A Jun 12 2024 SEWER AVAILABILITY APPLICATION CITY E DEVELOPMM ENTT SSERVI ERVICES 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 Matthew Radach (Designs Northwest Architects) Phone Number 360-629-3441 Email matt@designsnw.com Address26915 102nd Dr. NW Suite 201 City Stanwood State WA Zip 98292 Property• • Project Name Feasey-Bryant Residence Address 1041 B Ave S. City Edmonds State WA Zip 98020 Parcel No. 00619400300702 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): Demo of existing SFR Construction of new SFR .1.0nriPc In what phase is the project? ❑ Design Review ❑ Preliminary Plat NJ Building Permit ❑ Rezone or Other Associated permit application number(s), if applicable: BLD2024-0323 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: W'141� /eza�l DATE: 6-12-24 APPLICANT PRINTED NAME: Matthew Radach Form Updated 3/28/2023