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1027 A AVE S.PDF111111111111 9983 1027 A AVE S D�str 1985 : p MAR , i •4EAonds — Water DeP artnXint U1, Reading: 000 No. Meter Si; Mfgrs. No: Purchaser:_ Serv. Add. TAP CARD Date I No. T� r, Lot No. Blk. No. Add. Residential: Other: Meter Location o r J>ik :p- hm °F Z Service Material: �� �a� �•wf wf �� Pressure lbs. Test Date of Work 2-0 — fs i Foreman uar. Voucher No. $ Proj . No: Remarks: RrmizpaD nmy-w- SHOP OUTGOING Index Reg. Route Bk. Stencil Card INCOMING Index Reg. Route Bk. Stencil Card ROUTING SLIP NEW SERVICE INSTALLATIO4 ADDRESS: - DATE: 3—f 3— ,G= DIAL A DIG # P.U.D. TELEPHONE CABLE T.V. lk COVED 9L ft's w- a SO FOREMAN GAS INK (00 STORM SEWER FILE OTHER FUTURE SERVICE INSTL: YES NO BORE: CUT: LOCK CREW DATE: INITIAL: UNLOCK DATE:3 20 ,FJ— INITIAL• -�• METER SHOP ACCOUNT NUMBER: /O ei - SUPPLIER: SSA TREATMENT PLANT FOREMAN B L T FOREMAN INITIAL: DATE: TAP CARD METER SHEET APPLICATION / UTILITY DISPATCH BILLING 7/76 0 ADDRESS: 102 T µOM TAX ACCOUNT/PARCEL NUMBER: W 6 lot q OD S O O'So BUILDING PERMIT (NEW STRUCTURE): I ckO4 , ota O l /M910 COVENANTS (RECORDED) • CRITICAL AREAS: C' 1 1M • 014 T DETERMINATION: []Conditional Waiver Restudy Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: ( Vr I I M PARKING AGREEMENTS DATED. EASEMENT(S) RECORDED FOR: �ilililll!;211111111�L R.wfj R4 & Lek' PLANNING DATA CHECKLIST DATED: 7t' b ` ` SCALED PLOT PLAN DATED: b7 SEWER LID FEE $: LID #: Zt O SHORT PLAT FILE: S 2Z 83 LOT: BLOCK: f SIDE SEWER AS BUILT DATED: ID- 2-to • 1A SIDE SEWER PERMITS) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: Su* I Q WATER METER TAP CARD DATED: OTHER: F1 • D•W gg .�kA5(,b (iVJA�I J L:\TEMP\DSTs\Forms\Street File Checklist.doc 43 I <Z�) K p -.:,- I __: LOT LINE STAKES MUST BE HN! PROPERTY-L.INE 155 ACK LINE(15'f5C' DJ 1 of 3 -0" 1 g• i r- 3" 33* 01, ROPOSE0 EXISTING RE510ENCE ' Ei II T)l PLOT PLAN SCALE: I' - 20'0" 6000 .4 4,,'ENUE APP OVED BY PLANNING PROJEC Single car detached garage with rooftop deck (�- -151115 C--AV--fCV-T -2�" TOTAL PROJECT 34,6sq.ft. I-laae^o lf^4-mrinh '7 cam REVISIONS: 55 z Lu Q Q z 0 DATE: Yl� Ell CN x ILL m to C14 T— C14 -1 w I -- PLANNING DATA -)-/ hWz �5 DATE: kh SITE ADDRESS:-1927-04 .� PROJECT DESCRIPTION: CORNER LOT LJ (Yes/No) FLAG LOT A (Yes/No) �s May-18-98 12:31P WRE/Shaveline 05/18 12:33 1998 FROM: ;;� 4257710221 'SENT 206 546 5741 P.03 TO: 1234567 PAGE: 3 BY: W; 5-18-98 ►12:03pM CITY OF EUAW-;+ 1234587 i 9 Crld cal Are . Chi %list ----------------------- - .-_ -;.------------.-------�------ Site In%rmation (soilsltopfl�rapi� +/hydrology/Vegetati.on) 1. Site Address/Locatian: / 0�3. . _ i�E • S 2. 3. 4. 5. Property Tax Account Number; 1' q •.4,BQ 1 o.3 -- Approximate Site Sin (acres or square febt); 7 5ob 5[3 • Pf'• I Is this sic-6z s •c==tly developed? ; ,,,_,-.>;o. i If yes; bow is site developed? :Sj4j a.E7�+'� r+L� Describ the general site topography. Chk: all•tbat apply. Flat: ICSS than 3-feat el0v4t1cm 4iiaage over entire site. Rolling: slopes on site generally less titan 15% (s vertical rise of 10i t 14orizania3 distance of 66•fieet). Hilly: slopes present an sit4 of mare ftaA 15% and less than 309/4,!( a vertica4 rise of 10-faet over s horizonUl duce of 33 to 664eet), i Steep: grades of greater then 3* pmFern on rite (a vertical rise of I 0-feat over a horizontal distance of k thae:33-feet). i tither (plcaee descinbe): t Site contains area of year-round unding.watar:.. N° ; Approx. Depttl;_ Site contains areas of seasonal standing water, N2 ; Appt'ax. Depth: � What season(s) of the year? Site is in 'ths floodwtsy ivu floodplain of a water course, SIte contol s creek or as area where Warr flows across the grounds surface? Flows are year- rh•und? VleS Flows are saasoual?. Ohattima of year? }, Site is primarily: forested meadow ' : shrubs ; mixed urban landscaped Oavvwhrubs ate) Obvious wedud is present oa site; �,tikwa-�v ' Y�„ • �:""L'!?NY'.;R*f'i'. • ,.j •.,,',,',''"�";,•�„ :.i ...AW �A1�F�JIT� ' y.. sF.rt: i �: afi::.. ..:?ltAI�AP,���+1 is 1t+� .S a `�. - �. I .� ...t. �� `• 't,'' •'t: •v ;�i'�1 ' si: t =' it ql• �t°7tdJt'Y i;i P i':S:r t �' �tb "t .:'tl ' 6,".•.♦'A (.,j�i•r. j.t '. •.•'':` , t. .hI—. y� t.,byl >�p,.,,.-.: :I'i'mt})'t •� f���r� � et F.,.���it R;a• �t�•�•. '�. `" 4�Ilrl9u�'.ui�l�r97«d1•!'lv�f'}.i�'�fiY�4tl� . •. i.; ,. t �r� i.•.. .� r' tj!' ,�•:•�:;,� yr .:;;q• .' t b.'i'irt a.. t+ .... ,. '��?'`��x�'$,k�' �,' �'larj': e•; �e+' � ''F:• �t�� 1 1+ PMli.�fyN!;ie. r�i�._••iit— t '! t4. -+•'Y i.., - is •u.•b,: L: ( tr0.':Er'..�, Sr : s•i::. s: �'t't,�;. �L•ii1,. }r:F! �' i.�jta :jai• r'i.'�;. �,t4+�t ' k �. t '}�s;�{6t`•.f«iYh�,'•>, . �'.f.. a :•3�:�.. ., a .. , , :p M; i:SS:: a i�9.'eiY fl' .Vf � t..:� s-�.t. u.:;ii i:.• '!�� i 1... ni _�.. __..!M �AM.i1KLtr,ISroUR7 M2�y- 18-98 05118 12:32 SENT BY: 12:30P WRE/Shoreline 1998 FROM: 4257710221 • 5-10-se ;12:03PM.+ Cie► of Edn 206 546 TO: 1234557 CITY OF E08- 5741 P.02 PAGE: 2 1234557 r- ;# 2. RFCF . MAY 211998 KANN1146 DEP" CRITICAL ARE.As CHEC isr. 'Me Critical Areas Checklist coutaiaed on this forxz is An applicant, or his/.'tcr reipresentative, must fill out to be filled out by arty person preparing d tilt obecklist, sign and doc it, arW submit it to the Development Permit Application for the City of . City. The City will revilw the €cheekHst, make a Edmonds prior to his/her submittal of a developrdent precursory site visit, and make a di termination of the permit to the City. aubsequont steps necessary !a co etc a devaloprnczt permit application. The purpose of the Checklist is to enable City staff to, .Please submit a vicinity �]4.. aloro vdth the signed determine whether any potential Critical Areas are, or copy of this form to assist. City s�' in finding and may be, present on the subject property. 'ne locating the specife piece ,of pro?arty described on information needed to complete the Chooldist should, this form, In aatioa, i- a applicant shall lztlude be easily available from observations of the site or' other pertinent idormalion :e.g., si plan, topography data available at City Hall (Critical Areas inventories;, 'map, etc.) or studies in coriaumction d at Checklist maps, or soil ni veys). to assist stO in Completing preliminary .Assessment of the site 1 bave completed the attached Critical Arenas Checklist and attest that the answers best of my knowledgc (fill out the appropriate column below). Owner/Applicautt Name Street Address City State . Zip Telephone Sigr:ature Date o:teoeptlonU nnnlnacLdao Applicant Representative; . -gam•. 1�.5 -fi+ Arvet Address tt9x�l.I�tE ova City State fectual, to the B133 Zip • 51/1. •spy/ Crtx� . 610ph,one ;sig:snzure � I Date (over) I rMI i_DER NO. ar ESCROW NO. MORTGAGOR PLAT MAP Vol _� PG • �- � Sao ��- P1 a�- � �+ 0 3 0 � o ao � �o I' E OF PINE ST ACC TO PLAT OF v05T5 1s1 A00. PIS SB9'21'aS"E EXIST.25' I� i S69°21'a5•E 1633.71' Ex15T. Su CASING 1/16 CCR. 1 SET VON, IN CASIPINE 6TREET 1/16 COR. I NG 'N NORTH OF CURB c � �f �a• I I I I`.aY 90' A o I " s-4 7.9 I' EASE.M_.V7 FOR INGRESS, EGRESS ANO MAINTENANCE OF STORM SEWER Uj /'HGL V 30 C SK 14 RcG L J L; z , ...: Q I A i 7/ Z S SO. FT. r, v {1 }efCfSK /15 • yw �SfrQf3s2�- ••y25• AnaJ This map does not purport to show all highways, roads or easements affecting said property; no liability is assumed for variations in dimensions and location. 4• �•'IMPO 'l! . Presi Iirmly!Whrlr ,ltfriliag �1�ih%c'alro g'•. ` 1 I �:• x, . App 'sI1t T'i�l I '��li'� • >:rtAtj a ,(l i ' BQ■� pp� •¢ tli�di 9° Re1oc®EI® ' ���„`e■ 1<n81dCCSVjt 1a�1CF I NEW SITE A1',UF' Iiti5 I . OWNER'S ARSE •y - - _ .- �, 1•- ,-,. t � •" ti , I j I 1 •,, � �' 1� 1 � �� i � � " it , /, i �L_ � I.MAILIN ,ADDRESSI . '-' i \i } I>�t `vD� YRF-MOVE 1- i' .-: ••�� j'j i \ - . JI INS YF CT10N' Q � n ✓1: (11�J, t i ZONE r W RI.DG. PERMIT NO. /! �7 ry �. _ -I,r FI1tH 1 'l. 7 - FOR WC110C 1 I �q�Mc+.r✓d5 y6o I43 7;f i ,1 lON1; AT.NE1t1 SITE MOVING.CONTRACTOK ` MOVE CONTRACTOR' INSU$ANCE't COVERAGE i. �l I -------ram -, NAME OF SURETY `STREET•AUllRESS 1 - �. ! ' +. PROVIDING, P.L. & /�,r•t t • ' 1 ` j ;` ' P.D. COVERAGE ° iCGI� fY S ;_— ;STREET ADUIor, '; ? ,�4, f•; t a CITY &, ZONE Q j' \ I T7E�LJ. j :O. / � �j `��j I I O 1 i✓� j �' � I'T � r /7_1:3 T'-'l.U`�,.y\i. � i,•C1TT. ZOI21;.�,i, ,bDNTRA'CTOR'S. i' a I CITY. BUSINESS ` �1 Mtn 4' 'I •%j STAE i ^�/ n I LICENSE, NO.' `;'! C t �• �' ENTBENO.,p ,, O, tV /(O'P/�i VALID. INSUtt.ANCE 'POLICY C11E KEll 13Y: DATE a r ' SITE, ESCR'IPTION 1 , ADDRESS16F.PiESENTSUILING,:SITE BUI 'DWG "DES' RTO N /� ll . I n I• Lego! Descriptlun W! Prevent Rldg'1 Sltr — (S•'w w' ucl� A°ts.ch tour coptea) DF: `l.ltl B1E,2iA S1C CON'rRUCTION &. PRF.SF;Iv'T 118E'OF BUILDING , , OVERALL LEVGTIt 01.1TL11LD11! .._/f'D'. 1 FP. S. l .. .f# C I `• i •' - t.OA ED . I3LDG. 'AREA ' 1, kiE1GH�'r.AS LOAT)b:l) }VIplli A.y • �• ADDss of NEW sWu Disc;11'r I a' I I FT 1 tLe6d-IDeeedDtton.ul�Vrw- Bldg. �Ite ^ IShou I r, or aun.eh f.uur cnptes) •- p.•j•, PPRO SAL OF 1`SOVINC. ROUT _ -DATE `t :POLICE' �rV By •! .� .. •III. • �, \ - I• ll1 � ' Tlma• to11lCommencr 'lsa.•rnh_ . C� Q� .•A.� ./ a .MOVING ROUTE - '1 `.' 'Timt ni �lntah'Vol•tnr;. //OL "1.11RE DEPARTMENT Cl..},ARANCE.OF . ROLTTI:WG..', DATE: .. .', 1 'NG1N 'Eti1NC •tJLEAF:A- }: '7, ,�DAT.E x 7_ OLhA1tEV F3Y:: .. .nELO0ATIQN '-.. i ! RF:Ci:1PT NO N %'. ,t^ Paacer .Wmpan.•, r '� _ PERMIT' _ ' •" .�O'� ' I +�. .-, - Tblephutie CVtr]I1llR1' ❑ ... ... _ I 1 .. I, NAME OF,OWNEK OF',i't-:Ft .i:X''t'10\r EU11•iJl ',I. PERMIT.�AcPPROVAL �. :''L CE `hw' k C--_---- -------- - THIS I'I Fi\fl� ,' 1'.I IS .I'F 1:AIIT DOES' NQT -ECOMI✓. ' .,,MAIL OR HO]f E.ADDitEj,•.T-Y'F - , :1U'i'FiCjlti�{F: S' • I \'. I.I13 UNTIL ,SIGNF. iILUING 'OFF•ICIAL OIi=1Psi DEP.iT O� LI T[IL 1 IH1.. FEES'AItE P,AID,`ANI�' R, , RIs1:OC:1'CIO\ I I hereby.ackriowledge tliaL' havo read this a;�alication:'tha. (F:1I'I .tS•:\CI:NOiVLEDGED.Ii/3' THh the'information. giVen is,cori,ct:_:nd Lh:+t I aril al:c owner. ':I f)1' 'I';ii: j f' f'f 1'I:_'\'i171a g con,rae: ic' o:. t`I: aiithprized anent of one duly licensed rrrovin of the§e: I agree..to cOPIPI�• >Fith cit)' . 7,d state lames, re aatilin Nbuilding relocation: and in'do 'clis .cork, r.,j_ persnn gill be, - . -- — '� h. J, �n,i`1` t'�1 tI employed .in violation of the. Labor. Code. State o \Cashir�ton _ . relating to 1Forkmen's Compensation Insurance. < - � I• _ ii:nrtor'• S:Knaturr '� d. Signature of Owner, fit'u.nfxt;,. Contractor, or 4 (� ` — Authorized Agi:nt .... ,. t C11.1' (L` `l 1 /Add,tes� ./',_ ._... s., �. N[i1Ui`IiS" I- I)IS'1'I:IBL.J'1'lON .OF COPIES �.�.trr.id.� / _ I. .1� .\i1 - File (13ldg. Dept.) WHITE-- City:` :l-1 C}i�. 1-E:I,,LO14. - Move.Inspector t� 4, r °: (:Ili1:I ly �fi.esSt71 :' \I AI .' /o f - 9 77 Date...._...... �... - CULI)F\1'OF) 'Police +helit.. Collt[`8l'LOr .L a \' 7 �1, -- ': .• `. .. r� USE � PC NLt,l ... r. �,r, .Ck'OF '.ED $ ZONE ITYk �s-lo l�OI: :'CO k.CTIpN PERM0 PPLICATION ]Ob r N♦uE F N�uE A Bu.rt.F <. - AULMC.) O . •• :,.��.•� ILGAL rToo a Alllit G •Dt'u(eY ..rr - _ f/ ,^7%L `' li. 'TELLPNONE NUMtlLH '. 'F Uk�Ht.rit,�y� ♦ PEI �FE�I;iAt :.7 NC CT�MAr - .f PNCNg15LD - DbE P111N 1 Fr U'f !U I •• P � � 'CJ �` �� :+• + SLt• LNGI:+E NiI r:G �' O 4?'k�r � .. .. _ _ - �� .. c,• < Q TELL flm,F••+ILvF 'k .Iti. a •eD _� - - Si. s •.aM. � `(, t ® . ,.. ./Z 1 't RriA 1. iEk Y \ :].��+^ •�_l ..�. /' MEI t,•.DI<E ILJ .. E k rJi,y U'. Y :. j111. • r• a LI,J, :+�•. I �!'' J r wUMu! . I r % I- - .. � lluc r,a'`edoc t ��— � I � \ / 1•.: ''..I.c I, to �( I ILI i ;a' � � � _, z Lam• T _' � _ 04 LA •'y 1.,�,�1r�+�C` t�C�—_k�C-.A �\_w�..1.:_ ���n'I'�`' .- , ` i ,�, �'k I 4051 oil, Von I ' -, •� � ' Via- ; , ..,. er � �. I. � `3 .. r_. r1PF;d�IvAiLc)t4 'APPf�'%i. L F `' • �� ? ,. '-t S }7 is J rb�i 7 • L .:r � -+i . ' r I� :) e .5 \ '. '4. ��,-,, r v{':�•. .. J/� � lc!u1P: I — FdP A�LI_t nl': � Ins1:r,�t.i� - '. 01 .,_...., a 'WIT I Ra+IT['� ::a'. '4: C'•AFTE''`� IJU`a cv{•(� (ur Gk?Ll, o}usenl. ... UPPER C ATC-H BNSIN DETENTION PIPE LENGTH CONTROL CATCH (VstvT )` DAs t N � I' MIN , 2' MAX COVER 1% SLOPE-► SYSTEM CROSS SECTION aSEE PAGE 3 FOR OUTLET CONTROL. DETAIL. OVTLGT CONTROL .z 4" TO OUTLET (RI P RAP OR RUNOFF SPREADER ... 2' s 2' a % DEEP, 4t 6." SPALLS (OR WOUAL) 2' Y 3" DEEP, VA'— CRUSHED ROCK FROM 1 OUTLET ,� yy CONTROL RIPRAP OUTLET VVA3HED GRAVEL OUTFLOW TRENCH, MIN 10' LONG, 1 'TOP 4 PERF PIPE TO BE ' EVEL FROM 0Lrr6E►- CON-rRDL 4" PERF PIPE WITH CAPS RUNOFF SPREADER OUTLET STANDARD DRAINAGE PLAN DETENTION SYSTEM PAGE I OF 3- for 4A c)LA: location -!« A Llm plan by phone S,�o33 date- DESIGN DATA System Imperm Pipe Pipe Orifice Number Area Diam Length 'Diameter NOTES 1. Call Engineering Division (771-3202) for prebackfill and final inspections. 2. Responsibility for operation and maintenance of drainage systems on private property is the responsibility of the property owner(s). Material accumulated in the storage pipe must be flushed out and removed from catch basins to allow proper operation. The outlet control orifice must be kept open at all times. -Ta — OCT 11984 CITY OF EDMQMDS GD-OD ---- ,PL AN / 74 O v DEC K cz �Bf /D GE SITE PLAN, SCALE: II=ao -o1 NOTE: DO NOT USE RUNOFF SPREADER ON SLOPES OVER 15 PERCENT ( WITHOUT SPECIAL DESIGN ) o cP�1�c- OCT 11984 STANDARD DRAINAGE PLAN DETENTION SYSTEM PAGE 2 OF 3 e CITY of EDMJIDS For Inspection Call 771-3202 STREEFIL#ESEWER PERMIT T PERMIT NO. , 72' ". Address of Construction: leg % ` 's77 , Property Legal Description (Include all easements): PUBLIC IA/Anliw Owner and/or Builder: ,Ifi /te (:�f 0- Z 43rgoc 600 "1• � EDMONDS Contractor & License No: - Mi cr KE /17 & 14 L ITREATMENT PLANT Single Family Residence Multi -Family (No. of Units ) Commercial (No. of fixture Units ) Invasion into City Right -of -Way: No ✓ Yes (If Yes, Right -of -Way Construction Permit required. Call One -Call -Center (1-800-424-5555) before any excavation.) Cross other Private Property: No L-�'" Yes (If -Yes, easement required, attach legal description and county easement number.) PLEASE READ THE ITEMS LISTED ON THE BACK oI certify that I have read and shall comply with the items listed on the back. Permit Fee: _;p,0C) Trunk Charge: ..Y,0 0 Assessment Fee: Issued By: (11 VfW C-1ola Date Issued: /DAq��� Receipt No.: v 0 to,c' Date Partial Inspection: Comments Date Initial Final Inspection Approved: /p-26 4 YFAII 1u51' (i R. I464LtAND Date I n i V al 00 Rejected: CD Reason Date Initial m ** PERMIT MUST BE POSTED ON JOB SITE ** m White Copy - File Green Copy - Inspector Buff Copy - Applicant ;1• The City of Edmonds Side Sewer Drawing Goa►N - NEW CONSTRUCTION ❑ REPAIRS OWNER- ------------------------- ------- ------------- --------- .... CONTRACTOR ................... .............. ... EASEMENT NO. ..... ...... LID NO.. 10 .... ASMT. NO ----- ------------ ---- PERXTIT NO . . ............ .... LEGAL DESCRIPTION: LOT NO. ...... --- -------- -------- ..... BLOCK NO.. . .. .... ------------------------- -------------------------------------------------------------------------------------- NAME OF ADDITION ------------------ -------- ----- ------------------------ Approved: PWW-0001 -11/75 (REV. 11/78) DATE ...... ------ --------- -------------------- By,--------- ---------------- ---------- --- ------------------ , I 60- 00 LLJ I LL_ I­ LU U.j cr CF_/) 0 PL 0'-T Pi -AAA ILI 6 1: L q ,VD /—/ 00 Z S IAl C' SC AL a E / " 20 ,76 B 790 SILIOeT _9161BDIVISMAI f-09 r--r7-,q -7, MoAEx10z1_cF_ A/ Fa R -rl a Al of s. W. Y4 NW.- ;Iel or -54 c. 2.51 'CITY Or rD0dAJPS., SA161-16MISP CLIVAITV, WR. ZONE SETA A CV OTHER -HEIGHT 2,�- / P S E: L L E)� //,'-7 s z: k, PUR CAIA SE lg� LE P Tele-Vue Systems, Inc. aka AT&T Broadband Replace Drop @ 1027 A AVE S 1. Open Trench and hog bore driveway for approximately 107 total feet m/1 in the shoulder of the ROW to replace the damaged direct buried CATV service drop (no hard surface trenching). 2. Install new conduit @ 36". 3. Backfill: Native material, if allowed by jurisdiction and compacts to 95%. If not: Import materials compacted to 95%. 4. All disturbed areas will be restored to existing or better condition. 5. Clean and sweep job site during and after completion of project. C CA Open feet G ......sear, 11 f ai lroad Existing ties pedestal Open • trench 90 ' o feet Hog bore : driveway 11 feet Driveway ... sees... Fence lr Not to scale ATI&T Broadband . AT&T Broadband Trenching and Restoration • Install conduit at 36-inch minimum depth. • Backfill: Native materials if it compacts to the City Standards. If not, use import materials compacted to 95%. • Restore all disturbed areas to existing or better conditions. • Clean and sweep project areas during and after construction. • Erosion Control: Please see attached details if drainage ditches and/or curbs and gutters are in the project areas. ? Y+ 6 t 0.�t f • a ; . renchhr Depth = W 36-inch minimum W Compatible w/ other utilities W Shoring required at 4-ft + Pavement Cuts = 0- T-cut 1-ft wider than trench w Neat -line saw -cut or j ackhammered edge �i_lillilrr-iili III-!1 Traffic Control Plan 1. The standards and guides of the latest version of the MUTCD or the set-up as per the City of Redmond Code shall be followed at all times. 2. A copy of the Permit and Traffic Control Plan shall be on -site with all contractors during the project. 3. All contractors will avoid parking on sidewalks and shoulders and will take the lane and follow the proper traffic control set-up for the given situation. 4. Pedestrian access shall be maintained through or detoured around all worksites. 5. Please find attached the traffic control plan for the various types of work sites that will be encountered during the project. 6. Flaggers will be used only when all other methods of traffic control are inadequate to warn and direct drivers. Only licensed flaggers will be used on the project. 7. If situations occur when questions arise about proper traffic control set-up the solution will be determined in the field with the AT&T Construction Rep. and the City Inspector. Work along the road with minor encroachment: cone -off vehicle with taper and place MEN WORKING OR MAN WITH SHOVEL signs before and after work zone. 200-ft m/1 -M 60-ft m/1 200-ft m/1 = .r r � y of E n,yo�Q CITY OF EDMONDS 121 STH AVENUE NORTH - EDMONDS, WA 9VREET PHONE: (425) 771-0220 - FAX: (425) 771-022FILE o STATUS: APPROVED ENG20130184 EncroachmentPermit Permit Number: ENG20130184 Address of Public Use/Encroachment: 1027 A AVE S, EDMONDS 1027 A AVE S EDMONDS, WA 98020 USE/ENCROACHMENTSTREET fence along alley and fence along property frontage (originally permitted in 1990) STREET USE. Placement of any temporary or movable objects in any portion of public space or City right-of-way shall meet all code requirements as set forth in the following chapters of the Edmonds Community Development Code. ENCROACHMENT. Permanent structures encroaching upon any portion of public space, City right-of-way or easement area. shall meet all Code Requirements as set forth in the following chapter of the Edmonds Community Development Code. CODE APPLICA TION.- Chapter 18.70, 17.65, and 17.70.040 of the Edmonds Community Development Code. All terms of the adopted ordinance are incorporated herein as if set forth in full and this permit therefore is subject to the terms of those chapters. FOR THE TERM IN WHICH THIS PUBLIC USE/ENCROACHMENT IS IN EFFECT, THE OWNER SHALL COMPLY WITH THE PERMIT CONDITIONS SET FORTH BY THIS PERMIT NOTE. The issuance of this permit is understood by the owner to be of a temporary nature, shall vest no permanent right and shall be issued and may in any case be revoked at the sole discretion of the City per ECDC 18.70.040. Applicant is responsible to provide a copy of the insurance certificate to the City at the beginning of each calendar year, no later than the 21st day of January. INDEMNITY. The Applicant understands and 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 applicant or the City of Edmonds, or any of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs, court cost, and attorney fees by reason of granting this permit. In addition, the applicant understands that he/she shall provide and continually maintain during the term of the permit a certtfficate of insurance naming the city as an additional insured, with respect to -liability, and providing that it shall be primary as to any other policy of insurance. A PERMIT UNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN SPACE PROVIDED. Printed:.Thursday. Anril 11.2013 ❑ FILE COPY ❑ INSPECTOR COPY ❑ APPLICANT COPY STATUS: APPROVED ENG20130184 CONDITIONS • The proposal will not adversely impact public space open to vehicular or pedestrian travel. • Architectural Design Board Approval has been granted or the process has been administratively approved. • The proposal will not unreasonably interfere with the rights of the public. • The proposal either benefits the public interest, safety or convenience (e.g., supports or protects the city street) or is an accessory structure such as fence normally associated with residential use of the property as fully complies with the requirements of criteria above. • Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per City standards that is caused by or occurs during the permitted project. • Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits of ECC Chapter 5.30 only during the hours of 7:OOam to 6:OOpm on weekdays and 10:00am and 6:OOpm on Saturdays, excluding Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120. • Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold harmless the City of Edmonds, Washington, its officials, employees, and agents from _ any and all claims for damages of whatever nature, arising directly or indirectly from the issuance fa this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any requirements of any City ordinance not limit in any way the City's ability to enforce any ordinance provision. INSPECTIONS • None Q ITY OF EDMONDS 121 5TH AVENUE NORTH, EDMONDS, WA 98020 (425) 771-0220 RCW 197-11-970 Determination of Nonsignificance (DNS) DETERMINATION OF NONSIGNIFICANCE Description of proposal: Construction of a 315 sq. ft. detached garage and roof top deck on property designated as Environmentally Sensitive due to the presence of a Class 2b stream (Shellegarger Creek). Site address is 1027 A Avenue South (City of Edmonds Plan Check No. 99-209). Proponent: Robert Groeschell and Martha Haring 1027 A Avenue South Edmonds, WA 98020 Location of proposal, including street address if any: 1027 A Avenue South, Edmonds Lead agency: CITY OF EDMONDS 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 is not required under RCW 43.21.030(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. XX 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 14 days from the date below. Comments must be submitted by: Responsible Official: Jeffrey S. Wilson Position/Title: Planning Supervisor, Department of Development Services - Planning Division Phone: (425) 771-0220 Address: City of Edmonds, 121 5th Avenue North, Edmonds, WA 98020 Date: - 13 149 XX You may appeal this determination to Robert Chave, Planning Manager, at 121 5th Avenue North, Edmonds, WA 98020, no later than '] 2 -7 , 1999, by filing a written appeal citing the reasons. You should be prepared to make specific factual objections. Contact Jeffrey S. Wilson to read or ask about the procedures for SEPA appeals. XX Posted on —2 / 13 , 1999, at the Edmonds Public Library, Edmonds Community Services Building, and the Edmonds Post Office. XX Distribute to "Checked" Agencies on the reverse side of this form, along with a copy of the Checklist. Mailed to the following along with the Environmental Checklist: CU-99-20.DNS.DOC Page 1 of 2 7/12/99.SEPA XX Environmental Review Section Department of Ecology P.O. Box WA 98504-7703 Olympia, WA XX National Marine Fisheries Service Attn.: Steve Landino XX Robert Groeschell and Martha Haring WA. State Habitat Branch Chief 1027 A Avenue South 510 Desmond Drive SE Edmonds, WA 98020 Lacey, WA 98503 Attachments pc: File No.Plan Check-99-209 SEPA Notebook Page 2 of 2 CU-99-20.DNS.DOC 7/12/99.SEPA • c Date: July 12, 1999 To: Plan Check No. 99-209 From: Karissa Kawamoto, Planner Via: Jeffrey S. Wilson, Responsible Official Subject: ENVIRONMENTAL DETERMINATION FOR A PROPOSED DETACHED GARAGE AND ROOFTOP DECK ADDITION. PROPERTY HAS SHELLEBARGER CREEK FLOWING THROUGH IT AND IS IDENTIFIED AS ENVIRONMENTALLY SENSITIVE. SITE ADDRESS IS 1027 A AVENUE SOUTH. I have had the opportunity to field check the site, review the critical area determination, building permit application and environmental checklist which have been provided for the proposal. Shellebarger Creek runs south to north through the site. A driveway currently crosses the creek and the new garage would utilize the same driveway. The new garage would be no closer to the stream than the existing home and would not appear to increase any signigicant impacts to the critical area. Based on my review of all available information and adopted policies of the City, I recommend that a determination of nonsignificance be issued for the project. Review by Responsible Official I concur: c/ I do not concur: Je ey 6wilsor A.I.C.P. Date City of Edmonds c�a Planning Division PLCK 99-209.SEPA.DOC 07/ 12/99. 0 RECEIVED City of Edmonds Critical Areas Determination Applicant: Kathy St. Peter = Determination # Project Name: N/A Permit Number: JUL 0 11999 DEVELOPMENT SERVICES CTR. CITY OF EDMONDS CA-98-147 N/A Site Location: 1027 "A" Avenue South Property Tax Acct #: 6194-005-008-0103 Project Description: Detached garage and rooftop deck Determination: Conditional Waiver Staff has reviewed the proposal to add a detached garage and rooftop deck to the property located at 1027 A Avenue South. The new garage would utilize the existing driveway which crosses the stream. It would also be located the same distance from the stream as the existing home. The critical area will not be further impacted by the proposed development, thereby allowing staff to issue a Critical Area Conditional Waiver. Waiver Criteria (all criteria must be found to apply): X There will be no alteration of the Critical Area or its required buffers pursuant to the requirements of Chapter 20.1513; X The development proposal will not impact the Critical Area in a manner contrary to the goals, purposes, objectives and requirements of the Critical Areas ordinance; X The development proposal meets the minimum standards of the Critical Areas ordinance; X The above findings are based on the following conditions of approval: 1. SEPA is required of any development permit due to the Environmentally Sensitive designation of the property. The environmental checklist and fee must be included with all building permit applications. 2. Any project shall be constructed in compliance with the City of Edmonds approved plans and code requirements. 3. This conditional waiver shall be applied to this specific project proposal only. Any revisions and future permits will be reviewed independently for critical area compliance. Development standards and code requirements in effect at that time will be enforced. Based on the above findings and conditions, the requirement for a Critical Areas Study associated with this development permit is hereby Conditionally Waived, as authorized by Chapter 20.1513.150 (B) of the Edmonds Communit Development Co Karissa Kawamoto 7/1/99 Name Signa re Date • • December 14, 1989 Jeannine L. Graf Permit Coordinator 250 - 5th Avenue N. Edmonds, WA 98020 Dear Ms. Graf: F ILDING Rodney C. Cook, Ph.D. Otc 1 81989 Susan L. Cook 1027 A Avenue Edmonds, WA 98020 206-771-3727 Thank you for your letter of November 15 and the hospitality that you displayed during our phone conversation of December 8. As I expressed, I was quite surprised to find out that I did not own the property fenced in by the previous owner of my home. This leaves me unprepared to react quickly to your requests: I need to seek legal advice before proceeding, and rework my insurance coverage accordingly. Regardless of the civil implications of my situation, I plan to keep the fence, and remain in full compliance with Edmonds statutes on this matter. I request that you grant me 90 days from the first of the year to comply. I also request that you send me a copy of Street Use Permit #86-10 so that I may proceed I will pay the necessa copy fees. ry Thank you for you consideration. Sincerely, Rodney C. Cook, Ph.D. I 1211�I"77 890 199_ CITY OF EDMONDS 250 • 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771.3202 COMMUNITY SERVICES: Public Works • Planning - Parks and Recreation • Engineering November 15, 1989 R. Cooke or S. McLenaghati 1027 'A' Avenue Edmonds, WA 98020 RE: Street Use Permit #86-10 LARRY S. NAUGHTEN MAYOR PETER E. HAHN DIRECTOR According to Utility Billing records, you are the present owner(s) of the subject residence. The previous owner obtained a Street Use Permit to install a fence over a partial City alleyway and that permit is due to.expire. As new owners, if you wish to keep the fence, please complete the enclosed permit application and provide a Certificate of Insurance (see sample) to hold the City harmless against property damage or personal injury caused by the fence. Please submit your insurance certificate, permit application, and a $25 fee to the building division, City of Edmonds. If you choose not to keep the fence, please remove it within 30 days. If you have any questions, please give me a call at 771-3202, extension 257, and refer to Street Use Permit #86-10. Thank you, annine L. Permit Coordinator STREEUSE/TXTJLG52 Y Incorporated August 11, 1890 - Sister Cities International — Hekinan, Japan • r� u CITY OF EDMONDS 250 - 5th AVE N. • EDMONDS. WA 98020 • (206) 771-3202 COMMUNITY SERVICES: Public Works • Planning • Parks and Recreation • Engineering November 15, 1988 Susan Hurley 1027 'A' Ave. Edmonds, WA 98020 RE: Street Use Permit #86-10 Yearly Renewal Fee LARRY S. NAUGHTEN MAYOR PETER E. HAHN DIRECTOR According to building division records, yearly street use permit fees are again due. This payment is for 1988, the renewal fee is $10.00, please make your check payable to the City of Edmonds, Building Division, 250 Fifth Avenue North, Edmonds, Washington, 98020. Please enclose a current certificate of insurance with your payment. If you have any questions please feel free to call me at 771-3202. Thank you, Jeannine L. Graf Permit Coordinator STREEUSE/TXTDMC24 • Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan • • CITY OF EDMONDS 250 5th AVE. N. - EDMONDS, WASHINGTON 98020 - (206) 771.3202 COMMUNITY SERVICES November 13, 1987 Susan Hurley 1027 A Avenue Edmonds, WA 98020 RE: Street Use Permit 86-10 Yearly Renewal Fee LARRY S. NAUGHTEN MAYOR PETER E. HAHN DIRECTOR According to building division records, yearly street use permit fees are again due. For your information, attached is Section 18.70 of the Edmonds Community Development Code on street use permits. This payment is for 1987, the renewal fee is $10.00, please make your check payable to the City of Edmonds, Building Division, 250 5th Avenue North, Edmonds, Washington, 98020. Please enclose a current certificate of insurance with your payment. If you have any questions please feel free to call me at 771-3202. Thank you, I Jeannine L. Graf Permit Coordinator • STREET/TXTJLG52 i PUBLIC WORKS PLANNING • PARKS AND RECREATION • ENGINEERING • 11 .'7 L_J • CITY OF EDMONDS 250 5th AVE. N. • EDMONDS, WASHINGTON 98020 • (206) 771-3202 COMMUNITY SERVICES January 9, 1987 Susan Hurley 1027 A Avenue Edmonds, Washington 98020 RE: Street Use Permit #86-10 Landscaping in City Alley Right -of -[Jay LARRY S. NAUGHTEN MAYOR Your proposal to install landscaping in the City alley has been denied. A review of Engineering records reveals that a sewer main runs the length of the alley and roots from your trees could cause damage to the main. Please immediately remove the trees from the alley and inform the Building Division when the work is complete. If you have any questions please call Dan Smith at 771-3202. Thank you, �eannine L. Graf Permit Coordinator JLG:pmm PETER E. HAHN DIRECTOR PUBLIC WORKS PLANNING PARKS AND RECREATION • ENGINEERING • CITY OF EDMONOS 250 5lh AVE. N. • EDMONDS, WASHINGTON 98020 • (206) 771.3202 COMMUNITY SERVICES December 29, 1986 Susan Hurley 1027 A Avenue Edmonds, Washington 98020 RE: Street Use Permit #86-10 Fence in City Alley Right -of -Way LARRY S. NAUGHTEN MAYOR Please be advised that under street use permit #86-10 issued July 15, 1986, the only approved improvement for the City alley was the construction of a fence. The right=of-way City owned land was to remain in it's natural state; any additional landscaping provided by you in this area is prohibited. If new landscaping has been provided you have two options to resolve this matter: 1) Remove all new landscaping, 2) Submit a plot plan to the Building Division showing all new landscaping,_ list the type and size of all plantings. The City Planning Division will review your proposal for acceptance. If you have any questions please call me at 771-3202. Jeannine L. Graf Permit Coordinator JLG:amm PETER E. HAHN DIRECTOR PUBLIC WORKS PLANNING 0 PARKS AND RECREATION' 0 ENGINEERING • r� U • CITY OF EDMONDS 250 5th AVE. N. • EDMONDS, WASHINGTON 98020 • (206) 771.3202 COMMUNITY SERVICES October 23rd, 1986 Susan Hurley 1027 A Avenue Edmonds, Washington 98020 RE: Proposed Revision To Street Use Permit #86-10 LARRY S. NAUGHTEN MAYOR PETER E. HAHN DIRECTOR All interested City Departments have reviewed your proposed change on Street Use Permit #86-10. No exceptions have been taken and the change is approved. Enclosed is a revised site plan showing the approved fence change. If you have any questions please call on me. Thank you, Jeannine L. Graf Permit Coordinator JLG:pmm cc: Engineering Public Works Vnanning Street Use Permit Files PUBLIC WORKS PLANNING PARKS AND RECREATION • ENGINEERING City. of Edmonds, Communo Services Department • APPLICATION FOR STREET USE PERMIT - - Page 2 • Approval (and Agreement, if applicable) of Abutting Property Owners: SIGNATURE PRINTED NAME ADDRESS DATE DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency) City Council Approval (if applA cable)(Attach Minute Entry): ADB Approval (if applicable)(Attach Minute Entry): /✓Ii4 Signature Date Provision for Indemnity: 4 • law'l !ol/61k Terms and Provision of Performance Bond, if applicable: PERMIT AUTHORIZATION BY: iAS icnatu Date PERMIT NO. 86 lD Date Issued: 7/51& Permit Fee: -4Zs Remarks /Comments : /�ES/,pE�YT REQ[!/RE,o TD InalE --EeYCE ^T C/TYs �E�ll�S7' G�VjVE,Q W11J- IlVeW2 fiLL FE0F.S 13 �1j / e&NIT � Q� �W�t�O Y�RLY ISSttEO ��6�86 40 �ii�r'�/itR�Ey ,/SUBJECT I TER -OFFICE CORRESPO DE CE DATE 4✓A/( 4?V /,✓ � le • le le,u/ - VC) ��•�b/ gym �@ s < � ski ��� `jam ����/�-eD BY TOPSFORM 1232 UIERML MENEM OOO K V OO LITHO IN U.S.A. Nam� f Applicant: Mailing Address: OhiMUNITY SERVICES GEPARTMENTS�EET FILE. . 250 5th Ave N 771-3202 APPLICATION FOR STREET USE PERMIT / v ,kjzzd_ All, Telephone Number: � % Date: Description of Public Place or Portion thereof desired to be used: (exhibit may be attached) r- Type of Use desired to be made of Public Place: I% If applicable, attach plz s and specifications for any utility or structure to ce erected and/or maintained 11 on the Public Place: RycE raA64Ai4e-rj!,O /i✓ ClTy 21bK7�f-6✓/9Y �/gl1EYJ AN�I�'liS�/iy�i9-/i►'c�a! �i�/D[eYi1�2 • iEMPORAR! PER;'iIT: Unless otherwise designated herein, this permit is understood by applicant to be who?ly of a temporary nature, that it vests no permanent right whatsoever. If the permitted use becomes dangerous or such structure shall become insecure or unsafe or shall not be constructed, maintained or used in accordance with the. provisions of this title, the same may be revoked and the structure and obstructions ordered re,noved by order of the City Engineer. If this application is for a specified period of time, the terms of said application is: 1NDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City off Edmonds harmless from any injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the applicant or the City. of Edmonds, or any of its department or employees, including but not limited to the defense or any legal proceedings including defence costs, court costs, and attorney fees by reason of a_ranting this permit. In tands that the City shall be provided a certificate of addition, applicant unders insurance to indemnify and hold the City of Edmonds harmless from all claims and/or Property damage, naming the City of Edmonds as an also insured. APPLICATION OF CHAPTER 18.70 OF THE COMINUNITY DEVELOPMENT CODE: Aoplicant warrants that he has read, or had the opportunity to read, Chapter 18.70 of the Community Development Code, attached 'herewith, and understands that all terms of that Ordinance are incorporated herein as if set forth in full and this application and permit therefore are subject to the terms of that Chapter of the Edmonds City Code. I. STREET FILE ENGINEERING d PUBLIC WORK ,�� Qv4 Cl NI(N �puOwOS. 7D PROJECT R E V I EciTY OF EDMON wAs"wGIDN POOE CMRCAL CHECK LISTSINGLE FAMILY MULTI O PROJECT ADDRESS ��" CONTACT NAMEb TELEPHONE NUMBER ACCESS SLOPE AND VEHICLE ACCESS INITIAL DATE N DRAINAGE PLAN STREET FILE , f LEGAL DESCRIPTION VERIFICATION K— ' ,QUIT CLAIM/DEOICATIONS EASEMENT - PUBLIC/PRIVATE i o = CALCULATE SEWER CONNECTION IF NO LID I 0 3 0 o'Lc ¢ w w z_ STREET PAVING REQUIRED O CURB AND GUTTER REQUIRED 2 w SIDEWALK REQUIRED ,,Y% / �L CURB CUT FOR DRIVEWAY.REQUIRED 91 0-Of-WAY CONSTRUCTION PERMIT REQUIRED - BOND REQUIRED FOR PUBLIC IMPROVEMENTS - ell STREET NAME SIGN REQUIRED OTHER SIGNING REQUIRED (ADDITIONAL COMMENTS ON x w ~I w w co F- z co ir H 00 EXISTING WATER MAIII SIZE WATER WAIN REQUIRED ' SERVICE LINE REQUIRED IIYORAINT SIZE EXISTING s HYDRANT REQUIRED PER FIRE CODE ,y,Q CROSS CONNECTION INSPECTION SIZE WATER IIFTER CHARGE REQUIRED REVIEW BY DATE /% , (ADDITIONMNE AL COHTS rm —�— -- SANITARY SEWER DZAI)ING IIUPBER FILE IWVER _ SIDE SEWER AVAILABILITY SANITARY SEWER COVIIECTIOII FEE REQUIRED OPEN DITCH EXIST111r, �E2 % REWIRED CULVERT REgU1RE0 r (�pR �`� ��� t rJ �,o CATCH BASIN REQUIRED Et —i L , SIZE INDICATED ON SITE PLAN SHOULDER DRAINAGE MAINTAIN COLLECTION ON SHALE OPEN RUIIOfi }WNNOt[ REQUIRED ' 7 INDICATED OM SITE PLAN SOlI CONDlTI D WATER IELD CHECKED REVIEW DY ('ATE IU g (AOOtTtONAI CO►41ENT5 ON DA MEMO TO: FROM: SUBJECT: Building Division Planning Department Engineering Division Public Works Department DATE: /o /Aw. After review of the subject Building Permit application, we have the following comments: 1. Connection to City water system required. 2. Connection to City sanitary sewer system required. 3. Right-of-way permit required for any work on City property. 4. Driveway slope not to exceed 14% 5. Backwater valve required if downstairs plumbing is below elevation of upstream manhole. 6. Water and sewer lines to be separated by 10 foot minimum. BD 6/a2 SADARD DRAINAGE PLAN UPPER C ATCN E'`SIN DETENTION PIPE LENGTH COTrrROL CATCH (YfiNT)\ Wks 1N -� r 1 r— 1' MIN, 2' MAX COvER OUTLGT 10 CONTROL 44 I x SLOPE ~" •, .r _' Z TO OU//TLET �(N P RAP OR RUNOFF 51PREADER) ... SYSTEM CROSS SECTION SEE PAGE 3 FOR OUTLET CONTROL. DETAIL. 2' s 2 a (D" DEEp, •4"- b ° SPALLS (oR cou-.L) �. 2f" 2' .c 3!' DEEP, 7cj"— CRUSHED ROCK FROM 0LrrLET CON"r ROL WASHED GRAVE �i FROM OLrrLET CONTROL RIPRAP OUTLET OUTFLOW TRENCH, MIN 10' LONG, TOP 4 4" PERF PIPE TO BE I EVEL •v 4" PE.RF PIPE WITH CA,] RUNOFF SPREADER OUTLET DETENTION SYSTEM PAGE I OF 3 for location `- 4,Le plan by phone date DESIGN DATA System Imperm Pipe Pipe Orifice Number Area Diam Length Diameter mmm-_ ----_' ----_ NOTES 1. Call Engineering Division (771-3202) for prebackfill and final inspections. 2. Responsibility for operation and maintenance of drainage systems on private property is the responsibility of the property owner(s). Material accumulated in the storage pipe must be flushed out and removed from catch basins to allow proper operation. The outlet control orifice must be kept open at all times. OCT 11984 CITY OF EDMONDS SNORT 91JBDIV/510N FOR ET TA 5. MOREHOUSE IN A POP TlO,U OF 5 GV. 114 Al W. ✓4 OF SEC. 25, T. 2 7N., R. 3E .) W M. Cl T Y OF E WAID 5) 9NOYOMI51-1 COUNTY, WASHING TON KtIU, MIUULtIUIV at AJJVl.lA1tJ, lNk-. ENGINEERS • SURVEYORS • PLANNERS J&4�) Edmonds, Wnthingfon 98020 206/775-1434 CH.. .�-..._' ;GALE /"•,yD� FILE NO. 02-83-097 S FI EET OF — — City of Edmonds . it No: RIGHT—OF-WAY CONSTRUCTION PERMIT Issue Date: ~ .31— - A. Address or Vicinity of Construction: A B. Type of Work (be specific C. Contractor: Mailin,g� Address: �c�S� 1 c�1-►'� C-i �Q S 4101 Phone: ' y ) 7 — Y OR7 State License #: 6 C.0 Liability Insurance: D. Building Permit # (if applicable): /y ' Side Sewer Permit # (if appl E. ❑ Commercial ❑ Multi -Family INSPECTOR: F. PAVEMENT CUT: CONCRETE CUT: ❑ Subdivision IV Single Family ❑ YES NO ❑ YES NO ❑ City Project ❑ EUC (POD, ❑ Other G. SIZE OF CUT X INDEMNITY. • Applicant understands by h'ts'igna'e to this application he/she holds the',Gity''�o��f Edmonds harmless from injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that ay tfe- a mde''against the City of Edmonds' or any of its departments or employees, including but not limited to the defense of any legal proceedings including defense -costs and attorney fees by reason of granting this permit. K ' ~ " THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND. MATERIALS FOR ArPERIOD'OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. ♦ Traffic control and public safety. shallQ,be in accordance with City regulations as required by the City ,Engineer. Every " �•flagger must be trained as required by (WAC) 296-155-305''and must have certification verifying completion of the required training in their possession. ♦ ` Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City- ' approved material prior to the end-6f`ttie workday — NO EXCEPTIONS. ♦ Three sets of construction drawings of proposed work are required with the permit application. CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK I HAVE READ"THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE THAT I MUST MAKE THE PINK -COPY OF THE PERMIT AVAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS Signature:11 rI i, / i %41,l. I Date: (Contractor or Agent) FOR CITY USE ONLY Approved by: Right-of-way Fee: Time Authorized: Void After +T / ! / Q' Disruption Fee/Fund 111: Special Conditions: - .l-r, (J . 'T© l I Restoration Fee: li(L "Ct JCS- i2i OAQ Total Fee: Receipt No: 1 G Issued by: i 199a, mulm V • UPON COMPLETION OF PERMITTEDVORK, AN'_ENGINEER1N,G RMxL ' INSPECTION IS ,REQUIRED PER CHAPTER 18.00 OF -THE EDMOND.S COMMUNITY DEVELOPMENT CODE (Phone 425-771-0220, EX"t..13 .:� 'FINAL APPROVAL OF PERMITTED WORK: - 1a�;'"-� DATEi I pector's Signature �,'JeG;{II n;Ma For inspection requirements see Engineering Inspection Information handout: DAM Documents�Forms�En nm UtOW ermit .doc Y B B P _ _ .City of Edmonds Permit No: 7 Y' Gco� RIGHT-OF-WAY C:.ONSTRUCTION PERMIT Issue Date: A. Address or Vicinity of Construction: lO Z 7" V 6'. 5 B. Type of Work (be specific)': �/�� ✓EW 14 7� PA �/ r�/� Nkv sTH'���s-ttD C. Contractor:1 C&N �-( IMJ (U iy o Mailing Address: State License _� s D. Building Permit # (if applicable): Contact: Phone: Liability Insurance: Bond: $ Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project ❑ EUC (PUD, GTE, PSE, CHAMBERS, OVWD) . ❑ Multi -Family. [g Single Family ❑ Other t ` INSPECTORI W N i7Ly T�' F. PAVEMENT: ❑ VES ❑ NO G. SIZE OF CUT X H. Charge: $ CONCRETE CUT: ❑ YES ❑ NO A13PLICANT TO READ AND SIGN IDERNITY.• Applicant understands by his/her signature to this application he/she holds the City of Edmonds harmless from injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or any, o`f its departments or employees, including but not limited- to the defense of any legal proceedings including defense costs and aitorney fees by reason ofgranting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. ♦ Traffic control and public safety shall be in accordance with City regulations as required by the City Engineer. Every flagger must be trained as required by (WAC) 296-1557305 and must have certification verifying completion of the required training in their possession. ♦ Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or. City, approved material prior to the end of the• workday — NO EXCEPTIONS. ♦ Three sets of construction drawings of proposed work are required with the permit application. ENTS AND I HA VE THAT I MA S M A E V PIN COP;�'E PERMIT AVAILABLE ON SIT�4A UNDERSTAND THE PERMIT EAT LL TIMES FOR INSPECTIONS ACKNOWLEDGE r 9Signature: — to Date: (Contractor or Agent) 4 CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK Approved _by rTiz ;ime Author,ed oid ;Af 90 ialdConditions P - ter cri -00 `1-4Q 'SE ONLY Right-of-way Fee: 7v� Disruption Fee/Fund 111: Restoration Fee: Total Fee: Receipt No: Issued by: t UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL' INSPECTION IS REQUIRED PER CHAPTER 18:00 OF THE EDMONDS COMMUNITY DEVELOPMENT CODE. FINAL APPROVAL OF PERMITTED WORK: J .> INSPEETOR'SSIGNATURE DATE: i°W603�b�'� For inspection requirements see Engineering Information Handout. its' I .1 NO WORK SI-IAI. , BEGIN PRIOR TO PERMIT ISSUANCE