Side_Sewer_Application.6.15.20_UPDATE_SIDE SEWER
PERMIT APPLICATION
CONTRACTOR INFORMATION:
Company Name: Eakman Construction Site Contact: Dan Gillison
Company Address: 9226 Roosevelt Way NE Phone #: 206-972-2275
City: Seattle Zip: 98115 Email #: dan@eakmanconstruction.com
State License # EAKMACC851DL City Business License #
Expiration Date: 3/13/2021
PROPERTY INFORMATION:
Address: 20018 83rd Ave. W., Edmonds WA 98026
Owner's Name: Simon J. Evans
Phone #: 734-846-6181
® FULL LINE REPLACEMENT ❑ SPOT REPAIR ❑ PIPE BURST ❑ RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific):
The work is for a subplat for a new home. The site work for the subplat is complete and has been recorded with the county.
Th is review pertains, to the. new home. Ass part. of thesuhplatsite. work. the. sewer line. to the. existing home.. which will
remain, was completely replaced and moved to a utility easement on the south side of the new lot and a Y has been added
"Y
0
ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE PERMISSION TO WORK ON ANY PROPERTY OTHER
THAN THAT OWNED BY THE SUBJECT PROPERTY OWNER.
CERTIFICATIONS NECESSARY FOR INSTALLATION METHODS ARE THE RESPONSIBILITY OF THE
CONTRACTOR PERFORMING SAID WORK.
I REPRESENT AND WARRANT TO THE CITY OF EDMONDS, IF REPAIR OF EXISTING SEWER EXTENDS TO AN
ADJACENT PROPERTY, I HAVE OWNERS EXPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY.
SIGNATURE DATE 6/12/2020
Contra..*^ or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE