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WATER 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 0 Water and Sewer
Location/Legal Property Address: 8500 Block of 207th St NE, Arlington, WA 98223
Lot#: Parcel ID No(s): 31051200301000,31051200301400,31051200301500 Subdivision:
Project Scope of Work: 22 single-family homes
Owner Name: Layoy Inc. Office No.: (425) 770-0888
Email Address: jjfrew@thefrontierassociates.com Cell No.:
Mailing Address: 1602 4th St, #4 city: Marysville State: WA zip:98270
Owners Agent: Nicole Larsen Office No.: (425) 303-9363
Email Address: nicole@insightengineering.net Cell No.: (425) 923-9672
Mailing Address: PO Box 1478 City: Everett State: WA zip: 98206
RESIDENTIAL INFORMATION
n 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
❑ 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 ✓❑No Is there an existing Septic System on-site? ❑Yes ✓❑No
Water Meter Size Requested? ❑ 5/8" 0 1" ❑ 1.5" ❑ 2" ❑ 3" ❑4" ❑ 6"
Type of Fire Protection Requested? ❑ Fire Sprinkler System ❑ Fire Hydrant 0 Unknown
I, the undersigned, request City ofArlington Utilities Division to certify willingness to provide water and/or sewer as indicated.
The above information is complete and accurate to the best of my knowledge. I understand that any changes to the above
information must be reported immediately to the City ofArlington Utilities Division as a condition of Utility Availability approval.
lt')2e114Z Z_124� Nicole Larsen 11/24/25
Signature(owner/agent) Print Name Date
Pagel 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: ❑ is 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: