Reviewed Grey Sea_SIDE SEWER APPof EDry041,
r&C. 1890
CONTRACTOR INFORMATION:
SIDE SEWER
PERMIT APPLICATION
Company Name: LZL Construction Site Contact: Dennis Lehtinen
Company Address: 10604 E. Riverside Drive Phone #: 425.485.3877
City: Bothell Zip: 98011 Email #: dennis@lzlconstruction.com
State License # LZLCOM85BA City Business License # #NR-026335
Expiration Date: 4.22.2023
PROPERTY INFORMATION:
Address: 729 Laurel St.
Owner's Name: Grey Sea LLC
Phone #: 206.498.3299
❑ FULL LINE REPLACEMENT ❑ SPOT REPAIR ❑ PIPE BURST ❑ RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific):
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 Meredith Kelly I DeForest Architects DATE 8.19.2021
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE