ENG2022-0556+City_Application+11.15.2022_4.30.12_PM+3221907r
SIDESEWER
C. 1890
PERMIT APPLICATION
ION:
Homes LLC Sit
Contact: Balwant Aulck
CONTRACTOR INFORM
Company Name: QuantU
Company Address: 12 66 1
9th PI SW Phone
#:206-571-7777
#: balwantaulck@gmail.com
Business License #
1226 169th PI SW
City: Lynnwood
Zip:98037 Email
State License # QUANTHI.,806BW
City
Expiration Date: 02-05-2C.24
PROPERTY INFORMATI
Sr S(,J
Address: 7903 240th
owners Name: Twin Pi6i,
LLC - Balwant Aulck
Phone #:
DULL LINE REPLACE
ENT SPOT REPAIR DIPF
BURST RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED
WORK (Be Specific):
New connection to City
'ystem
ISSUANCE OF THIS PERMI
DOES NOT CONSTITUTE PER -MISSION
TO WORK ON ANY PROPERTY OTHER
THAN THAT OWNED BY T
E SUBJECT PROPERTY OWNER.
CERTIFICATIONS NECESSA
RY FOR INSTALLATION METHODS
ARE THE RESPONSIBILITY OF THE
CONTRACTOR PERFORMPIG
SAID WORK.
I REPRESENT AND WARR4f
T TO THE CITY OF EDMONDS, IF
REPAIR OF EXISTING SEWER EXTENDS TO AN
ADJACENT PROPERTY
VE OW S EXPRESS ISSION
TO PERFORM WORK ON THAT ADJACENT
PROPERTY.
SIGNATURE
DATE
ractor o ge
Co
i
O WORK SHALL BEGIN PRIOR TO
PERMIT ISSUANCE