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1030 GRANDVIEW ST.PDF1111111111111111444 1030 GRANDVIEW ST 0 0 ADDRESS: /03O dr n(/IeL() ,S' TAX ACCOUNT/PARCEL #&j �f,S1j0D000 U BUILDING PERMIT (NEW STRUCTURE) #: COVENANTS(RECORDED)FOR: CRITICAL AREAS #: 9 — DETERMINATION: ❑ Conditional Waiver ElStudy Required Waiver CRITICAL AREAS #: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORD FOR: PERMITS (OTHER — list permit #'s): 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) #: GEOTECH REPORT DATED: STREET USE/ENCROACHMENT PERMIT #: FOR: WATER METER TAP CARD DATED: OTHER: rut L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc CA F* NO. `Critical .Areas Checklist by to r,y�t ti`ti- 3"4" Information "(soils/topography/hydrology/vegetation) 1 'Site d ress%L.ocation: f 036 CA11 U)Vl 6 -J U / 7 jE...%O iVV s t► r r> / . Y `2irort►R�aic Account Number: `5`9S/ — OU - c>O Y - Ov t� 3. Approximate Site Size (acres or square feet): egeRG 4. Is this site currently developed? eyes; no. If yes; ow h holy/ d'g6 CU,t>,ve c° � ,. > is site developed? • / 5. Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance of 66-feet). Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of 10-feet over a horizontal distance of 33 to 66-feet). Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance of less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing water: ; Approx. Depth: 7. ` Site contains areas of seasonal standing water: _/--�_Q Approx. Depth: �..L What seasons) of the year? S. Site is in the floodway WO floodplain of a water course., 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year- round? o Flows are seasonal? (What time of year? ). 10. Site is primarily: forested ; meadow ; shrubs ; mixed urban landscaped (lawn,shrubs etc) _j,,1 . 11. Obvious wetland is present on site: —A,) 0 . RM004W R. i.� y' .^s sbZ." �d♦ ter. 1 r � � . •�in%.�cL.{ .4 .F - � - `i.w�•Pd��`�t ll�xly�^'i'?'g V Q ^ {� , it^�!Fli f.Q��e,2 , r-,�� y ,• „Cf ' es ,G,�i.n. +r"�: �'�, ..a' \ w -���,� X ��i „ �;FEB �:2 ? 4997 , �ui t*- C+• v ry1�n.�•y� '>i°'l�s"�. M r•o /►flUM��N'I f_t ...' .�r �.wa�.wM `z++". :� •ww •s 3+'. awi+we:. . NM1� ^• : �:..,_ � � �. � � � �• • City of Edm:onds ,..�. � ... � s Small, c''IAea sJ�ZrithrCeci , ' Via, -, rrta� t'`r .�`t ���i' s:C�{ � �'• .�� i The Critical.Areas Checklist contained on P� .'-��2and submit it to the City. The City will this form is to be filled out by any person,;+ f, = : t- , review the checklist, make a precursory site preparing a Development Permit visit, and make a determination of the Application for the City of Edmondsprior subsequent steps necessary to complete a to his/her submittal of a development r.,., .,.., r. development permit application. permit to the City. _'With a signed copy of this form, the The purpose of the Checklist is to` enable"" "" "`' applicant should also submit a vicinity map City staff to determine. whether any ... _ �.. _ or plot plan for individual lots of the parcel .potential Critical Areas are or.may be.....�_.....: -... with enough detail that City staff can find present on the subject property. The:. ;.:;F. and identify the subject parcel(s). - In information needed to complete the ; . „;;;t'4. addition, the applicant shall include r Checklist should be easily available from ``` ' other pertinentinformation (e.g, site observations of the site or data available at ::�., .:.....plan, topography map, etc.) or studies in City Hall (Critical Areas inventories, maps, , :" : cogjunction with this Checklist to assist or soil surveys)• staff in completing their preliminary assessment of the site. An applicant, or his/her representative, must fill out the checklist, sign and date it, I have completed the attached Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). -a Owner / Applicant: s &J sine Applicant Representative: Name UO. cgd2�sJDVl1-CJ ST. Street Address Street Address City, S IAA. 9 �o �o ZIP : --Phc The City of Edmonds Side Sewer Drawing EASEMENT NO- . . ........................... ----------- 217-04300 NEW CONSTRUCTION 0 REPAIRS E LID NO----------------_. ASMT. NO. . ------------- - - OWNER ------ FiL&N-C-1S. --- GUNNINGIUU1 ...................................... CONTRACTOR ------------------------------------------------------------------ ---------------- PERMIT NO. ...... ----------- JOB ADDRESS ----- l-Q3D ... GRANDVIEW ... STREET ------------ -------- LEGAL DESCRIPTION: LOT NO. -------------------------------------- BLOCK NO. -- ......... ------------------ - 11 IF f --------------------------------------------------------------------------------------------------- I .............................................................. NAMEOF ADDITION ----------------------------------- ----------------------------------------------- ................................... DYE TESTED ON SEWER Approved: PWW-0001-1 1/75 (REVA 1/78) DATE ................................. ---------- By - --------------------------------------------------