HomeMy WebLinkAbout2026_PWD4211_Completed Utility Certificate WATER AND SEWER AVAILABILITY REQUEST
12 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: ZZ11 5K53c Wy/1;,,,Z-,- If� 1?X2
Lot#: _ Parcel ID No(s): �j&ogr�a 2s>aGj Subdivision: ti/ /F
Project Scope of Work: 31 05 c gev 2 oz-o
Owner Name: �j f�'t (,j�TL/ L Office No.: 2-51 -
Email Address: ��i�.�CT��/fL[�LS"io��" �/H� Cell No.: AL s�
Mailing Address: 2115 57 E City: 4 e State: Aj A Zi : gZ7(
Owners Agent: _ .+� Office No.:
Email Address: Cell No.:
Mailing Address: CitCv: State: Zip:
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 tNFORMATM,
Binding Site Plan/Plat:#of Lots #of Phases 3 #of Buildings 2 Total Square Footage�D
TM, COMIIt$ 0n USE
❑Hotel/Motel 0 Food Service ❑Medical/Dental X1 Office ❑Retail
❑Vehicle Service ❑Warehouse/Storage ❑Industrial ❑Other(specify):
Commercial Water Usage:Monthly Estimation: 2 ¢-a Gallons
WATER,SEPTIC SYSTEM AND FIRE
Is there an existing Well on the property? Yes 9No is there an existing Septic System on-site? Yes 9No
Water Meter Size Requested? ❑5/8" ❑ 1" ❑ 1.5" 2" ❑3" ❑6"
Type of Fire Protection Requested? NLFire Sprinkler System ❑Fire Hydrant Unknown
1,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, 1 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.
44i,23-k ALG (�. dqG Lila 9 1 I Zo2
Signature(own /agent) Print Name Dale
Page 1 of 2 REV02.2022
TO BE COMPLETED BY THE CITY OF ARLINGTON
CITY OF ARLINGTON UTILITIES DIVISION --PRELIMINARY INFORMATION I 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.
YES 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 124 PSI RESIDUAL PRESSURE 23 PSI FLOW 1,361 GPM
YES 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
YES property and specified number of connections per the below conditions and upon payment of
applicable connection fees and charges.
Other: Water and sewer service is available at this location per the below conditions.
Approved By Date: v�_ Z` ZOZtS
EXPIRES 18 MO HS ROM DATE OF ISSUE
COMMENTS:
1. Water service is available for this project; water main improvements will be required as a
condition of service. The existing 10-inch water main bordering the property frontage will
be replaced with a 12-inch ductile iron water main (approx. 300-ft). Also to be replaced
will be FH-337 and FH-1065. Please coordinate with the Arlington City Engineer for water
main replacement, FH water service line connection, meter locations, backflow protection,
utility easements, and any other City of Arlington water supply requirements.
2. Sewer service is available for this project; a sewer main replacement is required as a
condition of service. The existing 8-inch sewer main from MH1822 to MH1823 will need
to be replaced with a 12-inch sewer main (approx. 360-ft). The side sewer connection
point will be at MH-1822. Please coordinate with the Arlington City Engineer for specifics
pertaining to sewer main replacement, service location, utility easements, required pipe
slope, monitoring manhole location, pretreatment requirements, and any other City of
Arlington sewer requirements.
3. Any wells or septic tanks/systems on the development property are to be abandoned per
Arlington Municipal Codes 13.04.140 and 13.08.160 as a condition of service.
4. Water and Sewer system improvements shall be designed and constructed in accordance with
City of Arlington Design and Construction Standards.
5. Fire flow data is from water model node 2025-J-1155 at 2211 SR-530.