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10127 238TH ST SW.PDF111111111111 4155 10127 238TH ST SW r ADDRESS: TAX ACCOUNT/PARCEL NUMBER: 7D �✓ [�_DiJ i�'Y 7� BUILDING PERMIT (NEW STRUCTURE): eA COVENANTS (RECORDED) FOR: CRITICAL AREAS :/ iM 1 DETERMINATION: ❑ Conditional Waiver ❑ Study Require Waiver DISCRETIONARY PERMIT # S. DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: SOILS REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR: WATER METER TAP CARD DATED: OTHER: LATEMP\DSTs\Fomis\.Street File Checklist.doc CA FI NO. r Cacal Ar J c eas Checklist - .------------------------- --------------------------- Site Information (soils/topography/hydrology/vegetation) b�,Zkop� ?�1 r F� 1. Site Address/Location: / 0 /Z % a3 o� f`ej 2. Property Tax Account Number: D D 3 D Q 040ss C 3. Approximate Site Size (acres or square feet): J/d—" S� ' 4. Is this site currently developed? X yes; no. If yes; how is site developed? �7y W�x- 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: /U ; Approx. Depth: ' 7. Site contains areas of seasonal standings water: ; Approx. Depth: What season(s) of the year? Gc�-C,. 8. Site is in the floodway floodplain 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 mixed urban landscaped (lawn,shrubs etc) ,Z( 11. Obvious wetland is present on site: 2 SCS mapped soil type(s'� ..:;:..:;%�.?t."'' `{ L.i''i> ?w�► �. M., Reviewed City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 Fax: 425.771.0221 Critical Areas File #: — Critical Areas Checklist Fee: $45.00 Date Received by Dev. Serv. Dept Z City Receipt No:_ C 5 Date Mailed to Applicant: 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). PLEASE PRINT CLEARLY Owner/Applicant: /117fcr ci4nne_ CAS. Name %6/-27-C,23�'te-, 5j Street Address City State Zip Telephone Signature ' J Date Applicant Representative: Name Street Address City State Zip Telephone Signature Date d:neceptlongana1CACLHandotAAoc Revised 4110l2000 In $cj0 July 30, 2001 CITY OF EDMONDS 121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771.0221 DEVELOPMENT SERVICES DEPARTMENT Planning • Building • Engineering Maryanne Enslow 10127 238" 5t Sw Edmonds, WA 98026 Re: CHANGE OF ADDRESS GARY HAAKENSON MAYOR This letter is to inform you of your address change. Due to the recent subdivision of your property and the current existing homes address numbers, the following address change is made, effective immediately: 10127 238th St SW has been changed to 10131 238th St SW The City will notify all applicable departments of this address change. It is your responsibility to notify all other interested parties, including the Post Office. Please call me at (425) 771-0220 with any questions. Lara Knaak Permit Coordinator Cc: Fire Police Public Works Utility Billing Address Files Street Files Engineering Building Official ADDRESS.DOC/TEMPBLDG • Incorporated August 11, 1890 • Sister City - Hekinan, Japan