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STREET FILE
Mr. Addison L. Chrisman
Engineering Inspector
City of Edmonds
Dear Mr..Chrisman
931 Viewmoor Place
Edmonds WA 98020
Jan. 31, 1992
RECEIVE®
FEB 3 1992
ENGINEERING
This letter is in response to your letter of Sept. 20, 1991
regarding two unresolved items related to our short plat
(s-12-88). As you have subsequently indicated to me by
telephone, the as -built utility drawings have been sub-
mitted and are acceptable to the City. The remaining item
then is the provision of water service to the lots. Our
intention is to provide such service at the time when
dwellings are constructed on the lots. No schedule for
construction has been established at this time. We believe
that this -,.approach is legitimate -based on the following
considerations:
1.The final engineering requirements for this short plat,
dated May 19, 1988, did not include installation of water
service.
2. The water lines were added to the Grading, Sewer and
TESC Plan in response to a last-minute request from the
City prior to plan approval.
3. In discussions with the City Water Dept.my engineer, Max
Meyring, was told that water meters would be required to
terminate the water lines and, that, per a new policy, we
would be required to purchase said meters at a cost of
about $750.00 each.
4. Since there is no plan to build on these lots in the
near future, these expensive meters would be unused and
su"bject to damage for an extended period of time.
5. The City authorized the final paving of streets without
installation:.>of water service.
6. At this point there is no practical justification for
tearing up the new paving just to install water lines.
The paving will have to be torn up again during constrction
of dwellings to allow installation of other utilities such
as natural gas.
Please note that this letter is co -signed by Einar H. Pedersen,
who owns lots 3 and 4, to indicate his concurrence with this
intention.
Sincerely,
v
John E. Osterhaug
wye&e"
Einar
H. Pedersen
J.
.. �'..
CITY OF EDMONDS
USE ' PERMIT
ZONE %a 9 NUMBER
CONSTRUCTION PERMIT APPLICATION
ADDRESS E/APT#
OWNER NAME/NAME OF BUSINESSG
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LEGAL DESCRIPTION CHECK
SUBDIVISION NO.
LID NO.
w
0
MAILING ADDRESS J+�1
I OO� r I l/
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
TESCP Approved ❑
RW Permit Required ❑
Street Use Permit Rap'd ❑
CITY ZIP
UDMG Nn S w j� -i$I r177
1� /
TELEPHONE NUMBER
,7 g 2-8 0 a I
L CJ
i"X
vgOPOSED
Inspection Required ❑
Sidewalk Required ❑ Q
NAME
C312Q W N 'fE✓/S� A '�1 i( l'TrE
REMARKS
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ADDRESS
01 /
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CITYO I I � O�O �
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TELEPHONE Nl(MBZI�
/lf.�CGJ12
NAMED//
ENGINEERING MEMO DATED REVIEW BY
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ADDRESS
SIZE
BUILDING SUPPLY SIZE NO.
OF FIXTURES
UMETER
-
m
w
CITY ZIP
TELEPHONE NUMBER
OZ
O
REMARKS
;
STATE LICENSE NUMBER_
..
SIGN AREA
ALLOWED PROPOSED
SEPA REVIEW
.
COMPLETEEXEMPT
EXP
Ap8 NO.
.SHORELINE#' "
Z
Legal Description of Property -include all easements
a
VARIANCE OR CU
P NINi:KVIEW BY
�
ate/
SETBACKS—FE T
�1 ZC
FRONT G SIDE �U REARJ
HEIGHT
�'sl
LOT COVERAGE z
—m z
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v dV �Qj2� I
Tax Account Parcel No. �
REMARKS o
F-1 NEW RESIDENTIAL PLUMBING
LJ ADDIALTER COMMERCIAL MECHANICAL
REPAIR APT.BLDG. SIGN
CHECKED BY T"OFNN CODE
REQUIRED SPECIAL SPECT DRGROUPANCY
10 YE
HEIGHTDEMOLISH
LOOCADUPANT
GRADING Ej FENCE
Cv05. I X_FT)REMODEL GARAGET SpOpL
OD
[:]WOWOOD STOVE( RETAINING WALL/
INSERT ROCKERY RENEWAL
TYP��,,gqFUSE.BUSINES oRA TIVITY Ex PLAIN:
.. K( CSMeN�iC6, I �I��al�
EMARKS -
PROGRESS INSPECTIONS PER USC 305 9
TItexi m- lom 1q91 wuuz m
a
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-'
NUMBER OF STORIES
NUMBER OF
DWELLING I
UNITS
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
C,0WER"'FiINC— 5XV55M N19
FINAL INSPECTION REQUIRED
1�
EKP,&,VD �XiZFrI toy DINII INC4
VALUATION
FEE
bo �' FT
PLAN CHECK FEE
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BUILDINGz6A"
O
PLUMBING
Plan Check No. ��/
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
STATE SURCHARGE
i,. —
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
'i
Permit Limit: 1 Year - Provided Work Is Started Wi l 180 Days .
STORM DRAINAGE FEE
1
y
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"Applicant, on behalf of his yr her spouse;'hOIrS, assigns and
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
ENG. INSPECTION FEE
,
m
employees, and agents from any and all claims for damages of
PLAN CHECK DEPOSIT
m.
whatever nature, arising directly or Indirectly from the Issuance
of this permit. Issuance of this permit shall not be deemed to
dify, waive or reduce any requirement of any city ordinance
limit in any way the City's ability to enforce any ordinance vision."TOTAL
AMOUNT DUEj
163
reby acknowledge that I have read this application; that theATTENTION APPLICATION AP,PROVAL"ation given is correct; and that I am the owner, or the dulyrized
agent of the owner. I agree to comply with city, andTHIS PERMIT
laws regulating construction; and in doing the wgrk authoriz- AUTHogizes This application is' not a permit until
ereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his/her
Led
of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are aid,and receipt is
sur nce. INSPECTION-"i ace providedURE (OWNER OR AGENT( SIGNED DEPARTMENTCITY 0ICI�DATE
EDMO S
CALL FOR RELEA DATE
ATTENTION INSPECTION.�� DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A/FINAL INSPECTION HAS BEEN MADE AND: APPROVAL OR 771-32U2 ORIGINAL —File YELLOW —Inspector
A CERJIFICATE OF OCCUPANCY HAS BEEN RANTED. .UBC
CHAPT R 3. PINK — Owner GOLD — Assessor
102s7
171
( STREET FIL
STREET FILE
FILE# N/A
DETERMINATION OF NONSIGNIFICANCE
Description of proposal
Addition to an existing single family residence
Proponent Kjell Gjerde
1008 loth Ave. N. Edmonds, WA 98026
Location of proposal, including street address, if any
1008 10th Ave. N. Edmonds, WA 98026
Lead Agency Edmonds Planning Division
The lead agency for this proposal has determined that it does not have
a probable significant adverse impact on the environment. An
environmental impact statement (EIS) is not required under RCW
43.21C.030(2)(c). This decision was made after review of a completed
environmental checklist and other information on file with the lead
agency. This information is available to the public on request.
X There is no comment period for this DNS.
_ This DNS is issued under 197-11-340(2); the lead agency will not
act on this proposal for 15 days from the date below. Comments
must be submitted by
Responsible Official Jeffrey S. Wilson
Position/Title Current Planning Supervisor Phone 771-3202
Address 250 5th Ave. N., Edmonds WA 98020
Date 4bV&( Signature
X You may appeal this determination of nonsignificance
to Hearing Examiner
at 250 5th Ave. North, Edmonds, WA 98020
no later than October 8, 1991
by filing a written appeal citing reasons.
You should be prepared to make specific factual objections. Contact
John Bissell to read or ask about the procedures for
SEPA appeals.
There is no agency appeal.
city of edmonds
development information
Environmental Checklist
Purpose of Checklist:
The State Environmental Policy Act (SEPA), chapter 43.21C RCW, requires all
governmental agencies to consider the environmental impacts of a proposal before
making decisions. An environmental impact statement (EIS) must be prepared for
all proposals with probable significant adverse impacts on the quality of the
environment. The purposes of this checklist is to provide information to help you
and the agency identify impacts from your proposal (and to reduce or avoid impacts
from the proposal, if it can be done) and to help the agency decide whether an EIS
is required.
Instructions for Applicants:
This environmental checklist asks you to describe some basic information about your
proposal. Governmental agencies use this checklist to determine whether the
environmental impacts of your proposal are significant, requiring preparation of an
EIS. Answer the questions briefly, with the most precise information known, or give
the best description you can.
You must answer each question accurately and carefully, to the best of your
knowledge. In most cases, you should be able to answer the questions from your own
observations or project plans without the need to hire expert. If you really do not
know the answer, or if a question does not apply to your proposal, write "do not
know" or "does not apply". Complete answers to the questions now may avoid
unnecessary delays later.
Some questions ask about governmental regulations, such as zoning, shoreline, and
landmark designations. Answer these questions if you can. If you have problems,
the governmental agencies can assist you.
The checklist questions apply to all parts of your proposal, even if you plan to do
them over a period of time or on different parcels of land. Attach any additional
information that will help describe your proposal or its environmental effects. The
agency to which you submit this checklist may ask you to explain your answers or
provide additional information -reasonably related to determining if there may be
significant adverse impact.
Complete this checklist for nonproject proposals, even though questions may be answered "does
not apply". IN ADDITION, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D).
For nonproject actions, the references in the checklist to the words "project," "applicant,"
and "property or site" should be read as "proposal," "proposer," and "affected geographic
area." respectively.
A. BACKGROUND
1. Name of proposed project, if applicable:
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2. Name of applicant:
BRcW N C FnR KJ 5LJ' (:aj eI- )
3. Address and phone number of applicant and contact person: GJ
1219, wE,;�KG 7&\Ve' N- SUI TC; 2,00 ,S(5;°\17T
GoWT;�,,V7 ►21eK 8ROWN OR
4. Date checklist prepared:
/,\uc42.7, 1,:-1 11
5. Agency requesting checklist:
(- (i`loh)L�5
6. Proposed timing or schedule (including phasing, if applicable):
3uMMeOKI r--A4-k- 1 �9 (
7. Do you.have any plans for future additions, expansion, or further activity related
to or connected with this proposal? If yes, explain.
NO
8. List any environmental information you know about that has been prepared, or
will be prepared, directly related to this proposal.
No(\iC
9. Do you know whether applications are pending for governmental approvals of
other proposals directly affecting the property covered by your proposal? If yes,
explain.
10. List any government approvals or permits that will be needed for your
proposal, if known.
N o N c�"i �;- +� 'T, �N I��(� f 611'1 9��Gtu l (' D FO V,
11. Give brief, complete description of your proposal, including the proposed uses
and the size of the project and site. There are several questions later in this
checklist that ask you to describe certain aspects of your proposal. You*do not
need to repeat those answers on this page. (Lead agencies may modify this form
to include additional specific information on project description.)
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� l i°l1)a�LS c� l� New I I`!sU c.A�'tj c� l i�ac.�s• :.
12. Location of the proposal. Give sufficient information for a person to
understand the precise location of your proposed project, including a street
address, if any, and section, township, and range, if known. If a proposal
would occur over a range of area, provide the range or boundaries of the
site(s). Provide a legal description, site plan, vicinity map, and topographic
map, if reasonably available. While you should submit any plans required by the
agency, you are not required to duplicate maps or detailed plans submitted with
any permit applications related to this checklist.
VFZzU�cl- A" .ess : 100�3, Ivor N • 45DMO NDS
WA • 1I 8 1 '77- t�ETCS`k� 5G�3ScQ4 Fr7T0N GV"
TO BE COMPLETED BY APPLICANT EVALUATION FOR
AGENCY USE ONLY
B. ENVIRONMENTAL ELEMENTS
1. Earth
a. General description of the.site (circle one): Flag rolling, hilly, steep
slopes, mountainous, other S{. lC�,{T S Wt'17—, .
b. What is the steepest slope on the site (approximate percent slope)?
c. What general types of soils are found on the site (for example, clay, sand;
gravel, peat, muck? If you know the classification of agricultural soils, specify
them and note any prime farmland.
No N� -O'O I U AfiN AN ,`(S15 FE-;i 2m6D
d. Are there surface indications or history of unstable soils in the immediate
vicinity? If so, describe.
No
e. Describe the purpose, type, and approximate quantities of any filling or
grading proposed. Indicate source of fill.
r}Q,OQ CT i N Vo !_VeS N
P05T z-n N (2� u) (Tl-t
INVO�-VOS fa`1f NI MAL, I
f. Could erosion occur as a result of clearing, construction, or use? If so,
generally describe.
No
g. About what percent of the site will be covered with impervious surfaces after
project construction (for example, asphalt or buildings)?
No CHANAE5 73 &XJ311 N�
h. Proposed measures to reduce or control erosion, or other impacts to the earth,
if any:
N ohs
2. Air
a. What types of emissions to the air would result from the proposal (i.e., dust.
automobile, odors, industrial wood smoke) during construction and when the project
is completed? If any, generally describe and give approximate quantities if known.
NO Cq/Y- l O.:;
b. Are there any off -site sources of emissions or odor that may affect your
proposal? If so, generally describe.
NO
c. Proposed measures to reduce or control emissions or other impacts to air, if
any:
3. Water
a. Surface:
1) Is there any surface water body on or in the immediate vicinity of the site
(including year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If
yes, describe type and provide names. If appropriate, state what stream or river it
flows into.
IS AN eXlizMNO .5'►F2EN-Yi 8e-YoND exZ n N (�i
FAST FS01 5IeT`( L I N e , A%DJAiQe T TU -IE rt OFEiQ-'`i
2) Will the project require any work over. in or adjacent to (within 200 feet) the
described waters? If yes, please describe and attach available plans.
ON& EXJe'T1NCi rc5r ' �o'rlN�a ( f f�c drC � �IT1i
LA PCI GK F0 0 71 N G-e ^N b ? fir- cv �L r� e A�oj)" Tb EXISTi N (4
3) Estimate the amount of fill and dredge material that would be placed in or removed
from surface water or wetlands and indicate the area of the site that would be
affected. Indicate the source of fill material.
NoN�
4) Will the proposal require surface water withdrawals or diversions? Give general
description, purpose, and approximate quantities if known.
No
5) Does the proposal lie within a 100-year floodplain? If so, note location on the
site plan.
6) Does the proposal involve any discharges of waste materials to surface waters? If
so, describe the type of waste and anticipated volume of discharge.
NO
b. Ground:
1) Will ground water be withdrawn, or will water be discharged to ground water? Give
general description, purpose, and approximate quantities if known.
NO
2) Describe waste material that will be discharged into the ground from septic tanks
or other sources, if any (for example: Domestic sewage; industrial, containing the
following chemicals:..; agricultural; etc.). Describe the general size of the system,
the number of such systems, the number of houses to be served (if applicable), or the
number of animals or humans the system(s) are expected to serve.
c. Water Runoff (including storm water):
1) Describe the source of runoff (including storm water) and method of collection and
disposal, if any (include quantities, if known). Where will this water flow? Will
this water flow into other waters? If so, describe.
No 'TD 5X(5?IN�q.
2) Could waste materials enter ground or surface waters? If so, generally describe.
No
d. Proposed measures to reduce or control surface, ground, and runoff water
impacts, if any:
N OW19
4. Plants
a. Check or circle types of vegetation found on the site:
_ deciduous tree: alder, maple, aspen, other
evergreen tree: fir, cedar, pine, other
Ptshrubs SvFTs�tdrr°� r�
ygrass v O
_ pasture
_ crop or grain
wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other
water plants: water lily, eelgrass, milfoil, other
other types of vegetation
b. What kind and amount of vegetation will be removed or altered?
N o N�rTj �. �� � ^r��t to N w l � �, 8:6
ale z4LT�R� D
c. List threatened or endangered species known to be on or near the site.
NoNt KNOCON
d. Proposed landscaping, use of native plants, or other measures to preserve or
enhance vegetation on the site, if any:
OFF
AS NEc. SSA%R--r.
5. Animals
a. Circle any birds and an-imals which have been observed on or near the site or
are known to be on or near the site:
birds: hawk, heron, eagle, songbirds, other: ....NkC)Ne lcN U � N
mammals: deer, bear, elk, beaver, other: .•....0..................
fish: bass, salmon, trout, herring, shellfish, other: ....................
b. List any threatened or endangered species known to be on or near the site.
NcNe
c. Is the site part of a migration route? If so, explain.
N ON C5 'Tb, OU R KN OU) � 6
d. Proposed measures to preserve or enhance wildlife, if any:
NONE
6. Energy and'Natural Resources
a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used
to meet the completed project's energy needs? Describe whether it will be used for
heating, manufacturing, etc.
b. Would your project affect the potential use of solar energy by adjacent
properties? If so, generally describe.
No
c. What kinds of energy conservation features are included in the plans of this
proposal? List other proposed measures to reduce or control energy impacts, if
any: }RFal•t42e7 A'U., rGLANZE-T)
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7. Environmental Health
a. Are there any environmental health hazards, including exposure to toxic
chemicals, risk of fire and explosion, spill, or hazardous waste, that could occur
as a result of this proposal? If so, describe.
NON 6
1) Describe special emergency services that might be required.
Nc )os
2) Proposed measures to reduce or control environmental health hazards, if any:
NoN6
b. Noise
1) What types of noise exist in the area which may affect your project (for example:
traffic, equipment, operation, other)?
No '�XI SAS .
2) What types and levels of noise would be created by or associated with the project
on a short-term or a long-term basis (for example: traffic, construction, operation,
other)? Indicate what hours noise would come from the site.
NO 1 Z 6Xr5CT' b .
G2"-
3) Proposed -measures to reduce or control noise impacts, if any:
N ONE5
8. Land and Shoreline Use
a. What is the current use of the site and adjacent properties?
I N'`cl, c. , S I N C411 & F�m �Y
b. Has the site been used for agriculture? If so, describe.
NO
c. Describe any structures on the site.
d. Will any structures be demolished? If so, what?
7H15 (rDON 3D067S NOT IRG�)1�0
12) eFm Ou ^10N. _FK1 STc N Ca ROOF
OVtrl2 AP,GA, wIl, Ise
e. What is the current comprehensive plan designation of the site?
F\-8- 12ao0
h. Has any part of the site been classified as an "environmentally sensitive"
area? If so, specify.
N0N6 TO 009 �; OcId DCq�_V
i. Approximately how many people would reside or work in the completed project?
4
j. Approximately, how many people would the completed project displace?
NONG
k. Proposed measures to avoid or reduce displacement impacts, if any:
1. Proposed measures to ensure the proposal is compatible with existing and
projected land uses and plans. if any:
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9. Housing
a. Approximately how many units would be provided, if any? Indicate whether high,
middle, or low-income housing.
70 CNe 15KISr1;NCa
b. Approximately how many units, if any, would be eliminated? Indicate whether
high, middle, or low-income housing:
NONE .
c. Proposed measures to reduce or control housing impacts, if any:
Nai�� C
10•.. Aesthetics
a. What is the tallest height of any proposed structure(s), not including
antennas; what is the principal exterior building material(s) proposed?
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b. What views in the immediate vicinity woul be•altered or obstructed?
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c. Proposed measures to reduce or control aesthetic impacts, if any:
NoNa N
11. Light and Glare
a. What type of light or glare will the proposal produce? What time of day would
it -mainly occur?
NO L51CgN(-FP�,,"Y' OH,4,Nc:�6
b. Could light or glare from the finished project be a safety hazard or interfere
with views?
NO
c. What existing off -site sources -of light or glare may affect your proposal?
NoNG
d. Proposed measures to reduce or control light and glare impacts, if any:
No'N6
12. Recreation
a. What designated and informal recreational opportunities are in the immediate
vicinity?
DON tT c�
b. Would the proposed project displace any existing recreational uses? If so,
describe.
No
c. Proposed measures to reduce or control impacts on recreation, including
recreation opportunities to be provided by the project or applicant, if any:
No�.\5
13. Historic and Cultural Preservation
a. Are there any places or objects listed on, or proposed for, national, state, or
local preservation registers known to be on or next to the site? If so, generally
describe.
NO
b. Generally describe any landmarks or evidence of historic, archaeological,
scientific, or cultural importance known to be on or next to the site.
c_ Proposed measures to reduce or control impacts, if any:
N oNe
14. Transportation
a. Identify public streets and highways serving the site, and describe proposed
access to the existing street system. Show on site plans, if any.
b. Is site currently served by public transit? If not, what is the approximate
distance to the nearest transit stop?
�DoN'? K1JoW
c. How'many parking spaces would the completed project have? How many would the
project eliminate? _
'Dot)&e
NONE5
d. Will the proposal require any new roads or streets, or improvements to existing
roads or streets, not including driveways? If so, generally describe (indicate
whether public or private).
N O
e. Will the project use (or occur in the immediate vicinity of) water, rail, or
air transportation? If so, generally describe.
Nn
f. How many vehicular trips per day would be generated by the completed project?
If known, indicate when peak volumes would occur.
NOT f� ',-:"U CABLU
g. Proposed measures to reduce or control transportation impacts, if any:
15. Public Services
a. Would the project result in an increased need for public services (for example:
fire protection, police protection, health care, schools, other)? If so, generally
describe.
NO
b. Proposed measures to reduce or control direct impacts on public services, if
any.
IN
16. Utilities
a. Circle utilities currentl avail ble..a.t_th site:(electricity� natural gas
f_.. _._.._. _ ----- as .
water, refuse service; telephone, anitary�sewer sep%ic system, o
�1__ :.�
b. Describe the utilities that are proposed for the project, the utility providing
the service, and the general construction activities on the site or in the
immediate vicinity which might be needed.
No NeGJ J ril v! it c pobaS
C. SIGNATURE
The above answers are true and complete to the best of my knowledge. I understand
that the lead agency is relying on them to ake its decision.
Signature: ............ o ............... . .............
Date Submitted:......V...................................
D. Supplemental Sheet for Nonproject Actions (Rezones, Code Changes, Annexations, etc.) -- Do
not use this sheet for project actions.
Because these questions are very general, it may be helpful to read them in conjunction with
the list of the elements of the environment.
When answering these questions, be aware of the extent the proposal, or the types of
activities likely to result from the proposal, would affect the item at a greater intensity or
at a faster rate than if the proposal were Pot implemented. Respond briefly and in general
terms.
1. How would the,proposal be likely to increase discharge to water; emissions to
air; production, storage, or release of toxic or hazardous substances; or
production of noise?
No INUe15PnG
Proposed measures to avoid or reduce such increases are:
NeNe
2. How would the proposal be likely to affect plants, animals, fish, or marine
life?
No SIG,NIFICI�N'; I.I1'1�AGrt"
Proposed measures to protect or conserve plants, animals, fish, or marine life are:
NONE
3. How would the proposal be likely to deplete energy or natural resources?
NO S1r�tJIFICP<.�J�'T>���..�:'iio�t
Proposed measures to protect or conserve energy and natural resources are:
N ONv
4. How would the proposal be likely to use or affect environmentally sensitive areas
or areas designated (or eligible or under study) for governmental protection; such
as parks, wilderness, wild and scenic rivers, threatened or endangered species
habitat, historic or cultural sites, wetlands, floodplains, or prime farmlands?
NO ;MJC�NC'T
Proposed measures to protect such resources or to avoid or reduce impacts are:
NoN
5. How would the proposal be likely to affect land and shoreline use, including
whether it would allow or encourage land or shoreline uses incompatible with
existing plans?
NO I m pAGT
Proposed measures to avoid or reduce shoreline and land use impacts are:
6. How would the proposal be likely to increase demands on transportation or public
services and utilities?
No u Ka(,>( i r o AGT
Proposed measures to reduce or respond to such demand(s) are:
NONE
7. Identify, if possible, whether the proposal may conflict with local, state, or
federal laws or requirements for the protection of the environment.
NO i-'NOW N
ENVCHK3/PFORMS
STREET FILE
wt#-Tfllw
qg!
AUG 0 � 1
PERMIT C'UNTER
�aoo�o
I I W .
STREET FILE
FILE# N/A
DETERMINATION OF NONSIGNIFICANCE
Description of proposal
Addition to an existing single family residence
Proponent Kjell Gjerde
1008 loth Ave. N. Edmonds, WA 98026
Location of proposal, including street address, if any
1008 loth Ave. N. Edmonds, WA 98026
Lead Agency Edmonds Planning Division
The lead agency for this proposal has determined that it does not have
a probable significant adverse impact on the environment. An
environmental impact statement (EIS) is not required under RCW
43.21C.030(2)(c). This decision was made after review of a completed
environmental checklist and other information on file with the lead
agency. This information is available to the public on request.
X There is no comment period for this DNS.
_ This DNS is issued under 197-11-340(2); the lead agency will not
act on this proposal for 15 days from the date below. Comments
must be submitted by
Responsible Official Jeffrey S. Wilson
Position/Title Current Planning Supervisor Phone 771-3202
Address 250 5th Ave. N., Edmonds WA 98020
Date g/zx Signatu
-I
X You may appeal this determination of nonsignificance
to Hearing Examiner
at 250 5th Ave. North, Edmonds, WA 98020
no later than October 8, 1991
by filing a written appeal citing reasons.
You should be prepared to make specific factual objections. Contact
John Bissell to read or ask about the procedures for
SEPA appeals.
There is no agency appeal.
city of edmonds
development information
Environmental Checklist
Purpose of Checklist:
The State Environmental Policy Act (SEPA), chapter 43.21C RCW, requires all
governmental agencies to consider the environmental impacts of a proposal before
making decisions. An environmental impact statement (EIS) must be prepared for
all proposals with probable significant adverse impacts on the quality of the
environment. The purposes of this checklist is to provide information to help you
and the agency identify impacts from your proposal (and to reduce or avoid impacts
from the proposal, if it can be done) and to help the agency decide whether an EIS
is required.
Instructions for Applicants:
This environmental checklist asks you to describe some basic information about your
proposal. Governmental agencies use this checklist to determine whether the
environmental impacts of your proposal are significant, requiring preparation of an
EIS. Answer the questions briefly, with the most precise information known, or give
the best description you can.
You must answer each question accurately and carefully, to the best of your
knowledge. In most cases, you should be able to answer the questions from your own
observations or project plans without the need to hire expert. If you really do not
know the answer, or if a question does not apply to your proposal, write "do not
know" or "does not apply". Complete answers to the questions now may avoid
unnecessary delays later.
Some questions ask about governmental regulations, such as zoning, shoreline; and
landmark designations. Answer these questions if you can. If you have problems,
the governmental agencies can assist you.
The checklist questions apply to all parts of your proposal, even if you plan to do
them over a period of time or on different parcels of land. Attach any additional
information that will help describe your proposal or its environmental effects. The
agency to which you submit this checklist may ask you to explain your answers or
provide additional information -reasonably related to determining if there may be
significant adverse impact.
Complete this checklist for nonproject proposals, even though questions may be answered "does
not apply". IN ADDITION, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part 0).
For nonproject actions, the references in the checklist to the words "project," "applicant,"
and "property or site" should be read as "proposal," "proposer," and "affected geographic
area." respectively.
A. BACKGROUND
1. Name of proposed project, if applicable:
2. Name of applicant:
3. Address and phone number of applicant and contact person: a Rio
12191 IAK5�K& 76\Ve' N- SUITC-5 200
C-ONII&,V7 P-1�-K 8ROWN oR
4. Date checklist prepared:
�\ucA 2,7, l 11 1
5. Agency requesting checklist:
�--31711( of (�D,;`) oNDS
P(,A-N N 1 NC�-, Z) �S�T
6. Proposed timing or schedule (including phasing, if applicable):
31JM 1&K/ r--A-Q. 199 (
7. Do you .have any plans for future additions, expansion, or further activity related
to or connected with this proposal? If yes, explain.
NO
8. List any environmental information you know about that has been prepared, or
will be prepared, directly related to this proposal.
N0Nc
9. Do you know whether applications are pending for governmental approvals of
other proposals directly affecting the property covered by your proposal? If yes,
explain.
10. List any government approvals or permits that will be needed for your
proposal, if known.
N oN� 0"1 h� t` -¢�,N Fe-, , zs1173 4R�acsaU (f`�ED FOR
c01v5-tJ'�,(JCrn C.) tN TNe f D OEz OS6p PIP-qJ GC-T
11. Give brief, complete description of your proposal, including the proposed uses
and the size of the project and site. There are several questions later in this
checklist that ask you to describe certain aspects of your proposal. You'do not
need to repeat those answers on this page. (Lead agencies may modify this form
to include additional specific information on project description.)
�(Gt,83 TO FRCP,NKp 'EXIS`nNC-
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12. Location of the proposal. Give sufficient information for a person to
understand the precise location of your proposed project, including a street
address, if any, and section, township, and range, if known. If a proposal
would occur over a range of area, provide the range or boundaries of the
site(s). Provide a legal description, site plan, vicinity map, and topographic
map, if reasonably available. While you should submit any plans required by the
agency, you are not required to duplicate maps or detailed plans submitted with
any permit applications related to this checklist.
1008,107tf N - i5DM Nis
WA • cl S 177 - LETcs�� dRt �io�t '4)
TO BE COMPLETED BY APPLICANT EVALUATION FOR
AGENCY USE ONLY
B. ENVIRONMENTAL ELEMENTS
1. Earth
a. General description of the site (circle one): Flag rolling, hilly, steep
slopes, mountainous, other S{, lUi,}{�'x S 1,0 .
b. What is the steepest slope on the site (approximate percent slope)?
"��%lpqtRsDX • C'0 ' (�' o,
c. What general types of soils are found on the site (for example, clay, sand;
gravel, peat, muck)? If you know the classification of agricultural soils, specify
them and note any prime farmland.
NNEW i� v i U '-�f�J r^�C.`� 1. FeRFE:>fM q�; D
d. Are there surface indications or history of unstable soils in the immediate
vicinity? If so, describe.
Na .
e. Describe the purpose, type, and approximate quantities of any filling or
grading proposed. Indicate source of fill.
I NVU�-VOS raft N1 z1=�t, � p�'�a tLG
f. Could erosion occur as a result of clearing, construction, or use? If so,
generally describe.
No
g. About what percent of the site will be covered with impervious surfaces after
project construction (for example, asphalt or buildings)?
NO Gill <AE5 73
h. Proposed measures to reduce or control erosion, or other impacts to the earth,
if any:
ly oNFa
2. Air
a. What types of emissions to the air would result from the proposal (i.e.. dust.
automobile, odors, industrial wood smoke) during construction and when the project
is completed? If any, generally describe and give approximate quantities if known.
IVO �,l*tt�iG�
b. Are there any off -site sources of emissions or odor that may affect your
proposal? If so, generally describe.
NO:,N:p -_
c. Proposed measures to reduce or control emissions or other impacts to air, if
any:
!N=)NG
3. Water
a. Surface:
1) Is there any surface water body on or in the immediate vicinity of the site
(including year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If
yes, describe type and provide names. If appropriate, state what stream or river it
flows into.
iFi(E5RCT IS /6,,N eXleMx0 5-M&4%M t3GFYoND Xi�`ii N
FAS7 p!'co1-G-feT( L I N e , ADJl5sCG_N •(" MO 7iE PRaF&P-'-lf
2) Will the project require any work over, in or adjacent to (within 200 feet) the
described waters? If yes, please describe and attach available plans.
ON& eXJe71NCi %os'j' F-00 71 N(fa, w ► C' fRetQL^CQib a-)ITH
(A R:� E 1K Fo o °T1 N Ca ^N b ?, � c:km - F r r�E �E� ^j'o E457N(a
SCCj-N -D -TOR'(• C w Iv4 u,' 2v-
3) Estimate the amount of fill and dredge material that would be placed in or removed
from surface water or wetlands and indicate the area of the site that would be
affected. Indicate the source of fill material.
NdNG
4) Will the proposal require surface water withdrawals or diversions? Give general
description, purpose, and approximate quantities if known.
No
5) Does the proposal lie within a 100-year floodplain? If so. note location on the
site plan.
NO
6) Does the proposal involve any discharges of waste materials to surface waters? If
so, describe the type of waste and anticipated volume of discharge.
NO
b. Ground:
1) Will ground water be withdrawn, or will water be discharged to ground water? Give
general description, purpose, and approximate quantities if known.
NO
2) Describe waste material that will be discharged into the ground from septic tanks
or other sources, if any (for example: Domestic sewage; industrial. containing the
following chemicals:..; agricultural; etc.). Describe the general size of the system,
the number of such systems, the number of houses to be served (if applicable). or the
number of animals or humans the system(s) are expected to serve.
NotNe
c. Water Runoff (including storm water):
1) Describe the source of runoff (including storm water) and method of collection and
disposal, if any (include quantities, if known). Where will this water flow? Will
this water flow into other waters? If so, describe.
No G114,�NrqIE To
2) Could waste materials enter ground or surface waters? If so, generally describe.
No
d. Proposed measures to reduce or control surface, ground, and runoff water
impacts, if any:
NONG
4. Plants
a. Check or circle types of vegetation found on the site:
_ deciduous tree: alder, maple, aspen, other
evergreen tree: fir, cedar, pine, other
shrubs 5ca8/e•�1�iJ
yrass
v✓f �IOsc`c�cw��'E—
_ A,1169pasture
_ crop or grain
wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other
—_ water plants: water lily, eelgrass, milfoil, other
other types of vegetation
b. What kind and amount of vegetation will be removed or altered?
N ° ` i ( 4 �� ^r�, io (mil wI1 �, d3 tRC O') o V ab
c. List threatened or endangered species known to be on or near the site.
N oN(7E_ KN vwN
d. Proposed landscaping, use of native plants, or other measures to preserve or
enhance vegetation on the site, if any:
��NDs^�(NC� �S NEcbssnt�Y.
5. Animals
a. Circle any birds and animals which have been observed on or near the site or
are known to be on or near the site:
birds: hawk, heron, eagle, songbirds, other: ........................K.. N
.
mammals: deer, bear, elk, beaver, other: .................................
fish: bass, salmon, trout, herring, shellfish, other: ....................
b. list any threatened or endangered species known to be on or near the site.
NcNe
c. Is the site part of a migration route? If so, explain.
NCi 7)- OUR KN caw l� E
d. Proposed measures to preserve or enhance wildlife. if any:
NoNe
6. Energy and'Natural Resources
a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used
to meet the completed project's energy needs? Describe whether it will be used for
heating, manufacturing, etc.
N�rjZJ(�l. (A146
b. Would your project affect the potential use of solar energy by adjacent
properties? If so, generally describe.
No
c. What kinds of energy conservation features are included in the plans of this
proposal? List other proposed measures to reduce or control energy impacts, if
any: PaaLek 7 IN , 4541s91N � S(�j<aC:E rq , a7 GJ (N 00Z6S
1,.) ITH N5W N5Uc,a.751 (ac?kSS W f N.Z)C)wS (M (N •` (J,
7. Environmental Health
a. Are there any environmental health hazards, including exposure to toxic
chemicals, risk of fire and explosion, spill, or hazardous waste, that could occur
as a result of this proposal? If so, describe.
NON b
1) Describe special emergency services that might be required.
Nc)Ns
2) Proposed measures to reduce or control environmental health hazards, if any:
NoNF
b. Noise
1) What types of noise exist in the area which may affect your project (for example:
traffic, equipment, operation, other)?
NO ; 011sa �i srrz
2) What types and levels of noise would be created by or associated with the project
on a short-term or a long-term basis (for example: traffic, construction, operation,
other)? Indicate what hours noise would come from the site.
NO e7XP6C-T`%I�
3) Proposed -measures to reduce or control noise impacts, if any:
N oN6
8. Land and Shoreline Use
a. What is the current use of the site and adjacent properties?
S I N 6!!,I& FAm 1 �Y
b. Has the site been used for agriculture? If so, describe.
No
c. Describe any structures on the site.
eTY45M N (;�\ HOUV5 'a� sw1 ro n,); (`tc,, ¢ oo (,
d. Will any structures be demolished? If so, what?
TH 16 > (MON T) a ES N O T IgG6LU 1 � f�� o to
rl✓Maurit�N FX(1571N(�
�Vbp2 L4V(K(;.�,�DIN INC-A P1P,(5F# WIU., (36 -�Diarnot43t-(E�) � L C C�•
e. What is the current comprehensive plan designation of the site?
f?'-s- Izoo o
h. Has any part of the site been classified as an "environmentally sensitive"
area? If so, specify.
i. Approximately how many people would reside or work in the completed project?
4
j. Approximately how many people would the completed project displace?
NONS
k. Proposed measures to avoid or reduce displacement impacts, if any:
QoG_.: N vT
1. Proposed measures to ensure the proposal is compatible with existing and
projected land uses and plans, if any:
CO(TH pTO,65SNT cf•t,�, �,C'r" t2, Hu
9. Housing
a. Approximately how many units would be provided, if any? Indicate whether high,
middle, or low-income housing.
b. Approximately how many units, if any, would be eliminated? Indicate whether
high, middle, or low-income housing:
NONE
c. Proposed measures to reduce or control housing impacts, if any:
N C�;� E .
10'.. Aesthetics
a. What is the tallest height of any proposed structure(s), not including
antennas; what is the principal exterior building material(s) proposed?
-T'1a.c.G.�=:�v?" . S�.UW`i`u �.�'i i � ` ����►�.� cH (fYl t�lE`(' r? �,--plt �V��C�
waOD I N C�► �}c �iC P���Pa QED EXr
b. What views in the immediate vicinity woul be�altered or obstructerGd?
EXIa'MN(a 1;c)0F OV&R l-AViNC-F a, SIN (NCn, 12> Be" IQ�i��`:cycy
jai sWO)HrF� H1CaHeiK t'OOF COH1P-f H1-5 IPPAUT
c. Proposed measures to reduce or control aesthetic impacts, if any:
N0HE; NG3=—DFD
11. Light and Glare
a. What type of light or glare will the proposal produce? What time of day would
it -mainly occur?
NO cHANI:2�e
b. Could light or glare from the finished project be a safety hazard or interfere
with views?
NO
c. What existing off -site sources -of light or glare may affect your proposal?
NON(5
d. Proposed measures to reduce or control light and glare impacts, if any:
NaN6
12. Recreation
a. What designated and informal recreational opportunities are in the immediate
vicinity?
J)ON4 - �_-vaw
b. Would the proposed project displace any existing recreational uses? If so,
describe.
No
c. Proposed measures to reduce or control impacts on recreation, including
recreation opportunities to be provided by the project or applicant, if any:
�1 n�,�e
13. Historic and Cultural Preservation
a. Are there any places or objects listed on, or proposed for, national, state, or
local preservation registers known to be on or next to the site? If so, generally
describe.
No
b. Generally describe any landmarks or evidence of historic, archaeological,
scientific, or cultural importance known to be on or next to the site.
c_ Proposed measures to reduce or control impacts, if any:
N ONG-
14. Transportation
a. Identify public streets and highways serving the site, and describe proposed
access to the existing street system. Show on site plans. if any.
b. Is site currently served by public transit? If not, what is the approximate
distance to the nearest transit stop?
c. How many parking spaces would the completed project have? How many would the
project eliminate? _
000 e' -
NONO
d. Will the proposal require any new roads or streets. or improvements to existing
roads or streets, not including driveways? If so, generally describe (indicate
whether public or private).
No
e. Will the project use (or occur in the immediate vicinity of) water, rail, or
air transportation? If so, generally describe.
No
f. How many vehicular trips per day would be generated by the completed project?
If known, indicate when peak volumes would occur.
NOT A �U CA13LU
g. Proposed measures to reduce or control transportation impacts, if any:
NONe
15. Public Services
a. Would the project result in an increased need for public services (for example:
fire protection, police protection, health care, schools, other)? If so, generally
describe.
NO
b. Proposed measures to reduce or control direct impacts on public services, if
any.
N O,N G�
16. Utilities
a. Circle utilities currently available -at -the site: (electriciiy�+�natural gas
water, refuse servic telephone,)rnitary sewer septic system, o-Mer:��-`"`"
b. Describe the utilities that are proposed for the project, the utility providing
the service, and the general construction activities on the site or in the
immediate vicinity which might be needed.
Na NU0J
C. SIGNATURE
The above answers are true and complete to the best of my knowledge. I understand
that the lead agency is relying on them to make its decision.
Signature-.
....... ........................................... �
DateSubmitted:..... ...................................
D. Supplemental Sheet for Nonproject Actions (Rezones, Code Changes, Annexations, etc.) -- Do
not use this sheet for project actions.
Because these questions are very general, it may be helpful to read them in conjunction with
the list of the elements of the environment.
When answering these questions, be aware of the extent the proposal, or the types of
activities likely to result from the proposal, would affect the item at a greater intensity or
at a faster rate than if the proposal were not implemented. Respond briefly and in general
terms.
1. How would the proposal be likely to increase discharge to water; emissions to
air; production, storage, or release of toxic or hazardous substances; or
production of noise?
No S1()Wflct"Ni INC-1`Z 6se
Proposed measures to avoid or reduce such increases are:
Nowe
2. How would the proposal be likely to affect plants, animals, fish, or marine
life?
No
Proposed measures to protect or conserve plants, animals, fish, or marine life are:
N ^J
3. How would the proposal be likely to deplete energy or natural resources?
No SieANIFiCf4\1 7- �C TioN
Proposed measures to protect or conserve energy and natural resources are:
N GNP
4. How would the proposal be likely to use or affect environmentally sensitive areas
or areas designated (or eligible or under study) for governmental protection; such
as parks, wilderness, wild and scenic rivers, threatened or endangered species
habitat, historic or cultural sites, wetlands, floodplains, or prime farmlands?
No �-( � f,' I m F�N GT
Proposed measures to protect such resources or to avoid or reduce impacts are:
NoN u
5. How would the proposal be likely to affect land and shoreline use, including
whether it would allow or encourage land or shoreline uses incompatible with
existing plans?
ND 1M
Proposed measures to avoid or reduce shoreline and land use impacts are:
Na f4E
6. How would the proposal be likely to increase demands on transportation or public
services and utilities?
No uK�c�~� I rnQvl�rT
Proposed measures to reduce or respond to such demand(s) are:
NONE
7. Identify. if possible, whether the proposal may conflict with local, state, or
federal laws or requirements for the protection of the environment.
No �NoCJN CON F�JCfr,,
ENVCHK3/PFORMS
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CITY OF EDMONDS Call PRospect 6-1107 when work
CYVIC CENTER — WATER -SEWER DEPARTMENT is ready for Inspection. (NO insPec'
SIDESEWER PERMIT- lions Saturday, Sunday or holidays.) N2 33691
1008 10th Avenue North ---------------- * .......................................
ADDRESS----------------------------- - - - --- -------------------------------------------- - ---------------------
ACTOR .... B & M Contractors ........................
OWNER -A ------------------------------ .................................. CONTp . .................................................
Permission is granted ...... AP.ril --- 3.................. 19.70.., for ------------------------ days to REPAIR or CONNECT a side sewer
-
with pity Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING
I NOTE No. 1—The owners of the Property may obtain . permit to construct sewer inside property line. A licensed Side Sewer Contractor must
be employed to construct side sewer in street area. Do not cover any portion of sewer before it has been inspected.
NOTE No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
N' • F, No. 3—Top of side sewer must have at least 30 inches coverage at property line and 12 inches Inside property line; minimum grade of 2%.
No bends in grade sharper than % will be permitted. N. ---F, No. 4—Trenches in street must be water settled and surface of street restored to original condition.
Contractors shall be responsible for
failure due to improper work which may develop within one year of completion. in sewer or its appur-
NOTE No. 5--It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the ma.
tenances except to Insert the ono the wye.
APPLICATION
for
The City of Ildmonds bVfttT $]ODE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS 0 EASEMENT No. ........................................
1
410 '?r7 k I
OWNER .... ....... CONTRACTOR .... Ak ... ?
... . ................................ ....... 0 .... .............. I .. % .............. PERMIT
ADDRESS ...... ................. ..................... ------- .......% LEGAL DESCRIPTION: LOT ..... BLOCK No . .............................................
NAME OF ADDITION
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APPROVED
APR 3 01970
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Approved:
DATE. ................. BY ............... .....
0
`CITY COPY
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