DNS BLD2022-0750+Sewer_Availability_Certificate_+7.7.2022_11.14.39_AM+2975347SEWER AVAILABILITY APPLICATION
Complete and submit this form through www.MvBuildingftrnALcom.
SECTION A
Applicant Information
Contact/Applicant Name M r a n Ahcdail6L
Phone Number q 2- 9 _ ZN y - 0iry
Email (�1Q lei 6l { LO -5 • COM
Address 10q,61 cSF ! t'D fn�l Sf'
City fti lcvu
Stated
Zip G� g f7
Project Name y1Gu
Associated Permit Number
Address -7 g' / 5 2 0 2 vl d pL S 1 //
Ltty yh Dy) CJS
State
Zipqfo'910
Parcel No. 00 D O O
Does the property currently have sewer service? ❑ Yes (City of Edmonds sewer) o No
Describe project (number of buodings, number of units, number of stories per building):
In what phase is the project?
❑ Design Review Building Permit
❑ Preliminary Plat ❑ Rezone or Other
Associated permit application number(s), if applicable:
WDIM011106'
ApplicabihLy
Q� Applicant certifies that this project is a single-family residence, multi -family project of four units or
less, or short plat subdivision (four single-family lots or less), in which case completion of a full utility
availability study shall not be required. Please sign below and submit this form through
www.MyBuildingPermit.com.
q For all other permit types, a utility availability study is required and associated fees will be due. Please
submit the complete application through www.MyBuildiggPermit.com.
/�vtc 4e<e'a 'az 6/22/22
APPLICANT SIGNATURE: DATE:
APPLICANT PRINTED NAME: Niran Abedalla
Form Updated 12/9/2021