HomeMy WebLinkAbout20260115_PJA26-0013_App 4DWATER AND SEWER AVAILABILITY REQUEST
Community and Economic Development
City of Arlington• 18204 591h Avenue NE•Arlington,WA 98223 •Phone(360)403-3551
Submittal Requirements:
1. Complete Application
2. 8-1/2"x 11"Site Plan/Sketch of the Proposal
Type of Request: ❑ Water Only ❑✓ Sewer Only ❑ Water and Sewer
Location/Legal Property Address: 6001 192nd St NE Arlington WA 98223
Lot#: Parcel ID No(s): 31051500401215 Subdivision:
Project Scope of Work: Install Sewer Lateral for New Bathroom in Building
Owner Name: 2BRND LLC Office No.: (425)-870-8259
Email Address: Brent@globalmachineworks.com Cell No.: (360)-386-8563
Mailing Address: 19132 59th DR NE City: Arlington State: WA zip:98223
Owners Agent: Office No.:
Email Address: Cell No.:
Mailing Address: City: State: zip:
RESIDENTIAL INFORMATION
❑Proposed Single Family Residence
❑Existing Single Family Residence El Accessory Dwelling Unit
❑Proposed Multi-Family Residence:#of Units #of Buildings ❑Residential Plat:#of Lots
COMMERCIAL INFORMATION
❑Binding Site Plan/Plat:#of Lots #of Phases #of Buildings 1 Total Square Footage 10360
TYPE OF COMMERCIAL USE
❑Hotel/Motel ❑Food Service
❑Medical/Dental El 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 R]No Is there an existing Septic System on-site? ElYesZ 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
1,th nde igned,reques Ty ofArlington Utilities Division to certify willingness to provide water and/or sewer as indicated
e ab e information ' mplete and accurate to the best of my knowledge. 1 understand that any changes to the above
info r ton st be rted immediately to the City ofArlington Utilities Division as a condition of Utility Availability approval.
ignature-(ow er/agent) PrmtName Date
Gv, 1 0,'�c� �� CAAc VA.�i,,,,,
Page 1 of 2
REV02.2022
TO BE COMPLETED BY THE CITY OF ARLINGTON
CITY OF ARLINGTON UTILITIES DIVISION - PRELIMINARY INFORMATION/ CERTIFICATION
A water main or other capital facility improvement: ❑is required; ❑is not required.
(If required, refer to below conditions).
Water is presently available from the City of Arlington to service the above referenced
property and specified number of connections upon payment of applicable connection fees and charges.
Fire Flow Estimation: Static Pressure Residual Pressure Flow
gpm
A sanitary sewer main or other capital facility improvement: Elis required; ❑is not required.
(If required,refer to below conditions).
Sanitary sewer is presently available from the City of Arlington to service the above referenced property
and specified number of connections upon payment of applicable connection fees and charges.
Approved By: Date:
EXPIRES 18 MONTHS FROM DATE OF ISSUANCE
Additional Comments/Conditions:
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