1003 SPRUCE ST.PDFiiiiiiiiiiiiii
15661
1003 SPRUCE ST
` CA FILE NO.
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: %OG S rJ �ic�.UC f— eBr
2. Property Tax Account Number: 9D/ C3 / 3 /)0
3. Approximate Site Size (acres or square feet): SOD --,0-
4. Is this site currently developed? cues; no.
If yes; how is site developed? Mo us r a C--7?Deej6 E
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: Approx. Depth:
7. Site contains areas of seasonal standing water: �� ; Approx. Depth:
What season(s) of the"year?
8. Site is in the floodway _ A( floodplain— of a water course.
9. Site contains a reek 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 )TV shrubs ; mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
^ca chk.doc; Rev 10/03/97
RECEIVED
APR 131999
Y City ®f Edmonds PERMIT COUNTER
CRITICAL AREAS CHECKLIST
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 a development
permit 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).
An applicant, or his/her 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 assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
Lis I_-i L `! ?-L7—
Name
1 bU-1 S? R Ld C F_.
Street Address
P tic'�S LO f�; 980Q0
City State Zip
4� `77 4 5--t7
Telephone
Signature
-4/13/i�
Date
Applicant Representative:
Name
Street Address
City State Zip
Telephone
Signature
Date
(over)
n ... mi—\'.ana\rnr1.dnc
IPC. 189 0
April 16, 1999
Leslie Belz
1003 Spruce
Edmonds, WA 98020
CITY OF EDMONDS
121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning • Building • Engineering
Subject: Determination regarding Critical Areas Checklist # 99-102
Dear Applicant:
BARBARAFAHEY
MAYOR
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
IMPORTANT INFORMATION TO BE NOTED:
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIST OR CRIT/CAL AREAS STUDY,
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
y You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED. 40
Permit applications include the following:
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Enc: Critical Areas Determination
* Architectural Design Board
C: ReceptionUana\C R LTR.doc
Thank you.
Sharla Graham
Planning Secretary
• Incorporated August 11, 1890 •
Sister City - Hekinan, Japan
NOTICE:
No warranty of accuracy.
The information shown on the attached map(s)
was compiled for use by the City of Edmonds,
its Employees and Consultants. The City of
Edmonds does not warrant the accuracy of
anything set forth on these map(s). Any person
or entity requesting a copy should conduct an
independent inquiry regarding the information
shown on the map(s), including, but not limited
to, the location of any sewer stub shown. Such
sewer stubs may or may not exist and may or
may not exist at the location shown. Neither
the City of Edmonds nor its employees or
officers shall be liable for the information given
on map(s), nor for any one representation
provided based upon said map(s).
Water Service Drawing
The City of Edmonds EASEMENT NO . ............................................
NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO ................... .ASMT. NO...................
OWNFR........................."........C.................. ..........................................
JOB ADDRESS .I.do 3..... S.PRuCE.....` 77....:......................
CONTRACTOR.................................................................................... PERMIT NO. ....................
LEGAL DESCRIPTION• LOT NO ....................................... BLOCK NO. ....................................
NAMEOF ADDITION ..:............................................................................................................
1003 SIr"-tucE ST.
Appro- zd:
T 9a
COPPER
(ALL- F i Tf l r1U5 srjeAteD)
PVA v'-0001.11175 (REV.11178)
DA'I E .~.............. By 5y........ .a...........................
APPLICATION
The Cityof Edmonds for
SIDE SEWER PERMIT
OUTSIDE ❑ INSIDE ❑ REPAIRS ❑
em.................. ...... CONTRACTOR.............................................................. CC .
STREET
HOUSE No. ...... �.!,m.--------*-t.sf:�z.................. -_ - ----.) AVENUE LOT No.
NAMEADD...................................................................
0
I
Date
BACKFILL WORK ORDER ISSUED ...................................
SEWER WORK ORDER ISSUED ..........................................
CARD No . ..................
EASEMENT No . ..................
............................ PERMIT No.
....... BLOCK No . ....................
......................................................
Eq
Q �. \%a
A IV-
- Approved: - - - - - ---- - - --- - - - . �.
DEPOSIT, $ .............................................
DATEIl..= C. BY �-----19Z
............................
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
1003 Spruce St 164-066,003
• Owner: Washington Natural Gas
Name
805 156 Av NE
Mailing Address
Bellevue, Wa. 98007
City, State, Zip Code
• Contractor: Same as Above
Name
it it it
PWt No. A D -- /S Z
Issue Date ,7��80
• Permit Issued To:
• Type of Work to be Done:
Install.New service
• Work in Connection With:
❑ Sub or Plat L94-5ingle Family
❑ Comml. / Ind. ❑ Apt. Condo.
• Pavement Cut: ❑ Yes ❑ No
Mailing Address State License Number
UCity,
State, Zip Code Telephone Number
w
a yt * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
Q INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
O
wUpon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
O
E�
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permi must be availab. leAat
Signature:' �►//
site for inspection purposes at all times.
�r THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By.
Time Authorized: Void after days
Special Conditions:
Ammendments:
Permit Fee:
Securi Mf o
..�
Receipt
Fund I11 Fee:
Street Cut Dimensions
X =
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * tit
Eng. Div. December 1978