ENG20170048-SIDE SEWER.pdfCITY OFEDMONDS121 5TH AVENUENORTH -EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20170048
S ID E SEWER PERM IT (I -Single Family)
Permit Number: ENG20170048 Expiration Date:
Job Address: 18626 94TH AVE W, EDMONDS
,APPLICANT CONTRACTOR
PLATINUM CSTM HMS &'RMDLNGLLC
17713 15TH AVE NE`# 102 6305 252ND PL NE
SHORELINE WA 98115 REDMOND, WA .98053
(425) 481°-1211
LICENSE # PLATICH917K1 EXP 08/24/2017
JOB DLS(,'R[PTION
Y' REPAIR Y PROPOSE TO REUSE LATERAL' LID NUMBER:
N' GRINDER PUMP Y PROPOSE TO REUSE SIDE SEWER N DRAINAGE
INSTALL CLEANOUT AT EASEMENT EDGE AND AT HOUSE.
SEE PLANS FOR INFORMATION RE: HOW TO CONFIRM EXISTING LATERAL AND SIDE SEWER ARE APPROVED FOR REUSE.
EASEMENTMFORMATION
N PROJECT CROSSES OTHER PRIVATE PROPERTY
N °VERIFICATION OF RECORDED EASEMENTS COMPLETE
1NDEMMTY The Applicant has signed an application which states he/she holds the City of Edmonds harmless from injuries,
damages or claims ofany kind or description whatsoever, foreseen or unforeseen, that maybe 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 ofgranling this permit.
CALL DIAL A -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
THIS APPLICATION IS NOTA PERMT UNTIL STGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY. AND FEES ARE PAID, AND RECEIPT T ACKNOWLEDGED TN
SPACEPROVIDED,
Printed: Thursdtl ,Febrltai' 2,3t 2017
<717 5, >) C'_)
RELEASE Y V VDATE
FILE COPY INSPECTOR COPY ❑ APPLICANT COPY