HomeMy WebLinkAbout20260716_PWD4165_Water Sewer Availability i
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: 0 Water Only ❑ Sewer Only ❑ Water and Sewer
Location/Legal Property Address: XXX 196th Place NE
Lot#: Tract 999 Parcel ID No(s): 01052300099900 Subdivision:Quail Ridge
Project Scope of Work: 2 single-family lots on 13.08 acres
Owner Name: KJR Family LLC Office No.:
Email Address: Cell No.:
Mailing Address: 1831 Colby Avenue city: Everett State: WA zip:98201
Owners Agent: Ry McDuffy - Land Resolutions Office No.: 425-258-4438
Email Address: ry@orcalandsurveying.com Cell No.:
Mailing Address: 3605 Colby Avenue City: Everett State: WA zip: 98201
RESIDENTIAL INFORMATION
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" ❑ 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.
Ry McDuffy 1/3/26
Signature(&nerlagent)�"V 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: