HomeMy WebLinkAboutIssued Utility Availability Certificate WATER AND SEWER AVAILABILITY REQUEST
Community and Economic Development
City of Arlington• 18204 S91h Avenue NE•Arlington,WA 98223•Phone(360)403-3SS1
Submittal Requirements:
1 Complete Application
2. 8-1/2"x 11"Site Plan/Sketch of the Proposal
Type of Request: Water Only ❑ Seewye�r Only ❑ Water and Sewer
LC
Location/Legal Property Address: ��� {<U ic./v /2—&
Lot#: _ _ Parcel ID No(s):13/_Q l { 1-y�j�� ( Subdivision:
Project Scope of Work:I V1 0PV 0_/ l� S�i2�C
Owner Name: f/bj2Z LtJ &u �rJ Office No.:
Email Address: & ) - ' Cuti_ 7 1 CNy y/`��� �'6`l Cell No.:
Mailing Address:/I U: �(, �l_ Cit :/1)'0 -ell)l f State:" Zip: 70
Owners Agent: /! >�(� Ste/ Office No.:
Email Address: ��� G.% Si/� .Y7CPL G/�/f/` •(UfjCell No.: <?S= E
Mailin Address: 121 City: lL State: tz, • Zi :)i_�270
RESIDENTIAL INFORMATION
0
Proposed Single Family Residence Existing Single Family Residence Accessory Dwelling Unit
❑Proposed Multi-Family Residence:#of Units #of Buildings ❑Residential Plat:#of Lots
COMMERCIAL INFORMATION L/A :1
❑Binding Site Plan/Plat:#of Lots #of Phases #of Buildings Total Square Footage
TYPE OF COMMERCIAL USE
❑Hotel/Motel ❑ Food Service ❑ Medical/Dental ❑Office ❑Retail
❑Vehicle Service ❑Warehouse/Storage ❑Industrial ❑ Other(specify):
Commercial Water Usage:Monthly Estimation: Gallons
WATER,SEPTIC SYSTEM AND FIRE
Is there an existing Well on the property? Yes F_jNo Is there an existing Septic System on-site? Yes❑No
Water Meter Size Requested? 5/8" ❑1" ❑1.5" ❑2" ❑3" ❑4" ❑6"
Type of Fire Protection Requested? ❑ Fire Sprinkler System ❑ Fire Hydrant ❑Unknown
I,the undersigned,request City of Arlington Utilities Division to certify willingness to provide water and/orsewer as indicated.
The above information is complete and accurate to the best of my knowledge. I understand that any changes to the above
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City of Arlington Utilities Division as a condition of Utility Availability approval.
*U,,�_ Z 3 -10-2-6—
ignature(owner/agent) Print Name Date
Pagel oF2 REV02.2022
TO BE COMPLETED BY THE CITY OF ARLINGTON
CITY OF ARLINGTON UTILITIES DIVISION - PRELIMINARY INFORMATION / CERTIFICATION
This non-binding preliminary commitment is only valid for the above referenced property in accordance
with City of Arlington policies and for only 18 months.
NO A water main or other capital facility improvement ❑ is required; ® is not required
(If required, refer to below conditions)
Water is presently available from City of Arlington to service the above referenced property and
YES specified number of connections per the below conditions and upon payment of applicable
connection fees and charges.
Fire Flow Estimate. STATIC PRESSURE 78 PSI RESIDUAL PRESSURE 76 PSI FLOW 936 GPM
NO A sanitary sewer main or other capital facility improvement ❑ is required; ® is not required
(If required, refer to attached conditions)
Sanitary sewer is presently available from City of Arlington to service the above referenced
N/A property and specified number of connections per the below conditions and upon payment of
applicable connection fees and charges.
Other: Water service is available at this location per the below conditions.
Approved By: Date: D OZ i
EXPIRES 18 MO HS FROM DATE OF ISSUE
COMMENTS:
1. Water service is available for this project. Please coordinate with the Arlington City Engineer
for water service line connection, meter locations, backflow protection, utility easements, on-
site water main alignment, and any other City of Arlington water supply requirements.
2. Any wells on the development property are to be abandoned per Arlington Municipal Codes
13.04.140 and 13.08.160 as a condition of service.
3. Water and Sewer system improvements shall be designed and constructed in accordance with
City of Arlington Design and Construction Standards.
4. Fire flow data is from water model node 2025-J-594 located at the intersection of Burn Rd and
107th Ave (near the NW corner of the property development site).
Applicant will be required to complete (2) 1" service taps of the watermain with at least 2 feet of
separation.The applicant will be required to pay the full water connection fees for the first service prior
to the water meter being installed.When the applicant provides an approved Snohomish County
building permit for the new SFR,the water connection fees for that residential permit will be 50%of the
connection fees that are in place at the time of building permit submittal.These fees must be paid prior
to water meter installation.When there is an ADU on the property, one connection is considered full
fees, and the other is considered at 50% percent per code.