ENG2022-0231+City_Application+5.17.2022_8.19.57_AM+2874309SIDE SEWER
PERMIT APPLICATION
CONTRACTOR INFORMATION:
Company Name: Complete Excavating, LLC Site Contact: Justin Spears
Company Address: P.O. Box 1235 Phone #: (425) 330-1580
P.O. Box 1235
City: Lake Stevens zip: 98258 Email #: stevens1043@comcast.net
State License # COMPLEL82205 City Business License #
Expiration Date: 10/10/2022
PROPERTY INFORMATION:
Address: 633 Walnut St
Owner's Name:
Barbara Tollefson
Phone #:
✓FULL LINE REPLACEMENT SPOT REPAIR []PIPE BURST RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific): Installation of an eOne DH071 grinder pump package system for the
Tollefson ADU
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 May 16, 2022
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE