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10518 242ND PL SW.PDFiiiiii iiiiii 4509 10518 242ND PL SW �o,�s�19��r' aUa"� r� �Su� � TAX ACCOUNT/PARCEL NUMBER: BUILDING PERMIT (NEW STRUCTURE): COVENANTS(RECORDED) DETERMINATION: ❑ Conditional Waiver ❑ Study Required ,p�J Waiver CRITICAL AREAS: DISCRETIONARY PERMIT #'S DRAINAGE PLAN DA PARKING AGREEMENTS DATED EASEMENT(S) RECORDED PERMITS (OTHER): 'W3- 15 V PLANNING DATA CHECKLIST DATED: V �O- SCALED PLOT PLAN DATED SEWER LID FEE $: LID mP Paihb SHORT PLAT FILER K� �T � \Q n LOT: BLOCK: Vo4 U SIDE SEWER AS BUILT DATED: SOILS REPORT DATED: STREET USE / ENCROACHMENT PERMIT # WATER METER TAP CARD DATED SIDE SEWER PERMITS) #: LATEMP\DSTs\Forms\Street File Checklist.doc • • PLANNING DATA NAME: 1-J: C¢ m,) tf-f - DATE:_ 10130103 SITE ADDRESS:_ 1 a5 1 S - 2-4 Z" P+. Sw PLAN CHK#: 03-qS3 PROJECT DESCRIPTION:_ A -A 5, ram, w A e„^&Y,rc RAkt REDUCED SITE PLAN PROVIDED?: es / No MAP PAGE: 003 CORNER LOT: Yes / o FLAG LOT: Yes / No ZONING: 0- S - $ CRITICAL AREAS DETERMINATION #: 03, 1 Sa ❑ Rh+riv Rnnidrad- QJ Waiver ❑ Conditional Waiver SEPA DETERMINATION: — ❑ Fee ❑ Checklist ❑ APO list w/ notarized form ❑ (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger) UExempt SETBACKS: Reciuired Setbacks: Street: S • Left Side: Right Side: '• Rear: ! S Actual Setbacks: 6 aOt� F..• Street: 534' Left Side: /5 , Right Side: 3-2' Rear: 4o Street map checked for additional setback required? (Yes / No / DNA) DETACHED STRUCTURES: ❑ ROCKERIES: ❑ FENCES/TRELLISES: ❑ BAY WINDOWS / PROJECTING MODULATION: STAIRS / DECKS: P44, "D r ZM PARKING: Required: 2 Actual: 1 t 1 LOT AREA: O, Z i A -cry- x 4 3: ito 0'/r,� . _ 9 1 4g o LOT COVE Calculations: BUILDING HEIGHT: 19' Datum Point: Datum Elevation: Maximum Allowed: Actual Height: A.D.U. CREATED?: o Yes) SUBDIVISION: -- LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: Yes / o OTHER: Plan Review NewBPP IanningDataForm.DOC of EDP O City of Edmonds p. O Q -5 Development Services Department Planning Division Phone: 425.771.0220 �0c t gqo Fax: 425.771.0221 The Critical Areas Checklist contained on this form is to be filled out by any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of the application to the City. The purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas are, or may be, present on the subject property. The information needed to complete the Checklist should be easily available from observations of the site or data available at City Hall (Critical areas inventories, maps, or soil surveys). Date Receivecl:YIF City Receipt #: Critical Areas File #: Critical Areas Checklist Fee: $135.00 Date Mailed to Applicant: A property owner, or his/her authorized representative, must fill out the checklist, sign and date it, and submit it to the City. The City will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. Please submit a vicinity map, along with the signed copy of this form to assist City staff in finding and locating the specific piece of property described on this form. In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) or studies in conjunction with this Checklist to assistant staff in completing their preliminary assessment of the site. . The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or incomplete information fumished by the applicant, his/her/its agents or employees. By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge and that I am authorized to fil s application on the behalf of the owner as listed below. SIGNATURE OF APPLICANT/AGENT "* DATE Property Owner's Author*/ation By my signature, I certify thatUlve auth ' ed the above Applicant/Agent to apply for the subject land use application, and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the purposes of inspection and,posting attnt Xo this applicatioy0,1 DATE �y — Owner/Applicant: Applicant Representative: A -?,- Name Name Street Address City State Zip Telephone: c "be', —, :53�6 — 4g< y Email address (optional): Street Address City State Zip Telephone: gp-�- 7iy- 581U% Email Address (optional): Critical Areas Checklist.doc/4.22.2003 Critical Areas Checklist CAFileNo: D3-'�V Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: 2. Property Tax Account Number: 3. Approximate Site Size (acres or square feet): �, .2/ . 4. Is this site currently developed? kyes; no. If yes; how is site developed? �i�/ ti f ��q�,��� ��S1Dfi4Cf 5. Describe the general site topography. Check all that apply. " Flat: - less than 5-feet elevation change over entire site. Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance of 66-feet). Hilly: slopes present on site of more than 15% and less than 30% (a vertical rise of 10-feet over a horizontal distance of 33 to 66-feet). Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance of less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing water: _&6 ; Approx. Depth: 7. Site contains areas of seasonal standing water: AO ; Approx. Depth: What season(s) of the year? 't" 8. Site is in the floodway �A(O floodplain ,.(1/� of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round? Flows are seasonal? ~` (What time of year? ). 10. Site is primarily: forested meadow shrubs s03ft- mixed urban landscaped (lawn, shru s etc) 11. Obvious wetland is present on site: For City Staff Use Only Plan Check Number, if applicable? 2. Site is Zoned? 3. SCS mapped soil type(s)? 4. Critical Areas inventory or C.A. map indicates Critical Area on site? Njc . 5. Site within designated earth subsidence landslide hazard area? _1,,)n+ ,, , A ht k DETERMINATION STUDY REQUIRED Reviewed WAIVER Critical Areas Checklist.doc/4.22.2003 A.lE�,. tfi• J .. Tµ'.'f^^^i`�i°p�{tT • 5y� rb: F' I 23505 I iCj ommonsi iAWS.,ema 10723 0 l o c o o o o Wood rayl I43-60L JI —1722 i I 23624 N g o 0 0 0 23\511 ROBBERS R 35TH PL S High' —. 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SYST. Main &ftnce si.0' —� Rear ACCeSS —1 16 I 19.0'-1----� I �I APPROVED AS NOTED BY ENGINEERING ./ Date: ze —r 150 N � 0 APPROVED-1%BY PLANNING d Impervious Surface Calcs. Exist. Building: 1272 sq.ft. Exist. Driveway 384 sq.ft. Exist. Patio 170 sq.ft. Proposed addition 212 sq.ft. Proposed patio 180 sa.ft. Lot coverage 28.6% Lot area 0.21 AC Lpt slope flat OWNG RESIDENCE APPROX 1.272 SQ R PROPOSED ADDITIONS 212 SO Fr 01 _ _ _--- -----�� ZONE � s-g PLAN *jT*-Lr- SETBACKS: FRONT SIDE 7 S WISEMILLER ADDITION REAR ► s' G r c E R V r--_ Fa =#Ls AS SHOWN SITE PLAN /VICINITY MAP f- OT OCT I 2G33 �� a1m --- H HEIGHT Zy K SCHROWERS REPLAT OF FORM GLENN BLK 004� DEVELOPMENT! �- IV'r- '' OTC n n'V np 'i1P,.i;f. a 10518242nd Place Ski+, EDMONDS WA 98020 oraAwu 1 - LOT 1 iI .10 0 65.0' �`-- - -- --T RearACcess3 --- --- Impervious Surface Calcs. Exist. Building: 2272 sq.ft. Exist. Driveway 384 sq.ft. Exist. Patio 170 sq.ft. Proposed addition 212 sq.ft. Proposed patio 180 sq.ft. Lot coverage 28.676 Lot area 0.21 AC Lqt slope Flat 19.0' I 1 I I I o I y(o�� 100.0' ---- SITE PLAN SCAM 1" = 1a-W �5 ZONE SETBACKS:. ........ __ FRONT_?, SIDE . REAR.--_. OTHER HEIGHT I? .APPOO bit,s�w�, rs +- a wq-Vc L�?jw cctcr a 0 Y�- EXISTING RESIDENCE APPROX I X2 SQ FT PROPOSED ADDMONS 212 SQ FT 9V " CIT WISEMILLER our:�i=:S(rE PLAN / ViC AID H K SCIMMM RMAT OF FOpj 10518 20id R�ooe %