ENG20170025.pdfO � 11 3 plt
CITY OF EDMONDS
121 5TH AVENUE NORTH -EDMONDS WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBS .: *
STATUS: ISSUED ENG20170025
SIDE SEWER PERMIT (1 -Single Family)
Permit Number: ENG20170025 Expiration Date: 03/24/2017
Job Address: 9615 220TH ST SW, EDMONDS
APPL1(",ANT CONTRACTOR
Mikes Plumbing & Drain Cleaning Mikes Plumbing & Drain Cleaning
22219 97TH AVE W 22219 97TH AVE W
Edmonds, WA 98020 ` Edmonds, WA 98020'
(206) 249-2532 EXT: 20642
LICENSE #: MIKESPC99OKM EXP: 05/11/2017
rEPAIR N PROPOSE TO REUSE LATERAL LID NUMBER:
RINDERPUMPN PROPOSE TO REUSE SIDE SEWER N DRAINAGE
Removing 6' section of concrete sewer and repairing with new PVC and outside cleanout access
PROJECT CROSSES' OTHER PRIVATE PROPERTY
VERIFICATION OF RECORDED EASEMENTS COMPLETE
IADEMATTY The Applicant has signed an application' which stales he/she'holds the City of Edmonds harmless from injuries,
damages or claims ofany kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any ofils departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
attorney fees by reason ofgranting this permil.
THIS APPLICATION IS
CALL DIA1rA-DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
APPLICATION APPROVAL,
ITL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACEPROVIDED,
Printed: Tmisd 1arlalar 4 2017
1) BY V DATE
D FILE COPY ❑ INSPECTOR COPY ❑ APPLICANT COPY