Fillable City of Sumner Water Line / Sewer Line (City of Sumner)

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City of Sumner Water Line / Sewer Line (City of Sumner)

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The City of Sumner Water Line / Sewer Line (City of Sumner) form is 1 page long and contains:

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  • 2 check-boxes
  • 34 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Sumner

BROWSE CITY OF SUMNER (WA) FORMS

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City of Sumner
Water Line / Sewer Line Replacement
Application
(Please fill out ALL fields unless otherwise noted)
PLEASE INDICATE IF THE REPLACEMENT IS: ☐COMMERCIAL ☐ RESIDENTIAL
Site/Project Address (if available):
Parcel #:
Owner:
Phone:
Email:
Owner Address:
City:
State:
Zip:
Surveyor/Engineer/Contractor:
Phone:
Contractor License Number:
Address:
Email:
City:
State:
Zip:
Contact Person:
Phone:
Fax:
Contact Address:
Email:
City:
State:
Zip:
Description of Project:
Suppor
ting Materials Required:
Office Applicant - (please check off all applicable “applicant” boxes)
☐ ☐
This Application Form / Checklist
Site Plan (1:40 scale)
☐ Building envelope with building setbacks and full property lines
☐ Environmental constraints delineated
☐ Streets in relationship to the building including sidewalks, curb, alley, driveway
☐ Location of easements (if any)
☐ Stormwater/open space locations
☐ Utility connections from source to the building (water, sewer, storm)
Other Questions:
Will any work be done in right-of-way? (ex: sidewalk cuts)
YES
NO
Will material be replaced like for like?
YES
NO
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT.
___
__________________________________________________ _____________________________________________ DATE: _____/_____/______
SIGNATURE OF OWNER / AUTHORIZED AGENT PRINTED NAME
Community Development
cd@sumnerwa.gov
(253)299-553
0
www.sumnerwa.gov
File Number: __________________________
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City of Sumner Water Line Sewer Line (City of Sumner)

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Completed 16 July 2020

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