10412 LITTLE JOHN CT.PDF11111111111111
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10412 LITTLE JOHN
CT
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City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT, Permit xumnei: •�
;, ..
A. Address or Vicinity of Construction:
B. Type of Work (be specific):
nc. lg9
Cul da Sac of Littl
Issue Date: W10 9/
.le John Court
of 2" MPE IP Ma3n @ 29111 in
nm 1R61E wrap around 51' east
C. Contractor: PugAt Sound Energy Contact: Mariamne Kingsbury
Mailing Address: I t 22 75 St SW Everett Phone: 356-7500 X7596
State License #: 98203 Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit tl (if applicable):
E. ❑ - Commercial ❑ Subdivision ❑ City Project [:4 Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: a. INSPECTOR:
F. Pavement or Concrete Cut : ❑ Yes ®No G. Size of Cut: x H. Charge $
APPLICANT TO READ A . SIGN
INDEMNITY: Applicant understands and by his signature to this application to hold 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 of its departments or
.employees, including or not limited to the defense of any legal proceedings including defense costs and attorney fees by re asontof granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC
TION AND ACCEPTANCE OFYHE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED
BY CITY FORCES, AT WH%CH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Two.sets of construction drawings of proposed work required with permit application.
A 24 hour notice is required for inspection. Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
'Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut trench work shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
1 have read the above. statements and understand the permit requirements and the pink copy of the permit will be
available on site at all ti es for ins ection purposes.
Signature: 6/��Date: 9-19-97
(Con actor or Ag(nt)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: RZW
TIME AUTHORIZED: VOID AFTER I Zip DAYS
SPECIAL CONDITIONS:
RIGHT OF WAY FEE:
DISRUPTION FEE/FUND I 1 I:
RESTORATION FEE:
T OTAL FEE:
RECEIPT NO.:
ISSUED BY
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments•
I� Dia¢ram • •
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
CA FILE NO.
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: /O!Z42. L
2. Property Tax Account Number: 57l 3 —0601—'b0(o-0&0 3
fQ
3. Approximate Site Size (acres or square feet): 2 3 ES��
4. Is this site currently developed? �yes; no. PERMIr CO( f
If yes; how is site developed? DNS&
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. 4ZO _; Approx. Depth:
7. Site contains areas of seasonal standing water: &0 ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway_ O floodplam _&d of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? &j ? Flows are seasonal? (What time of year? ).
10
Site is primarily: forested
urban landscaped (lawn,shrubs etc)
; meadow ; shrubs ; mixed _Z ;
I L. Obvious wetland is present on site:
For City Staff Use Only
<1: Site is Zoned?
2. SCS mapped soil type(s)?
3::: ;< Wetland inventory or C.A. map indicates wetland present on site?.
4:;:;Critical Areas inventory or C.A. map indicates Critical Area on site?
5 ;: ` ..Site within designated earth subsidence landslide hazard area?
6:;: 'Site designated on the Environmentally Sensitive Areas Map?�
DETERNfINATWN
STUDY REQUIRED CONDITIONAL WAIVER
. WAIVE
Reviewed by: �`�/ 1.�
Planner Dat
Rcv 0IroN9<
ego . 19°1-
City of Edmonds
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.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). 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 Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
�✓I�'�9« S. �r',ea��Fae
Name
Street Address
o�7y
City, State, ZIP Phone
10b,,'
v
Signature Date
Applicant Representative:
Name
Street Address
City, State, ZIP
Signature
;:Phone
Date
PLANNING DATA
SITE ADDRESS: Z- L;4 cT DATE: L
ZONING: /C S " b PLAN CHK#: q� 2Z
PROJECT DESCRIPTION:
SETBACKS:
Required Setbacks:
Front: Z.' Left Side: 7 ) Right Side: 7 ' Rear:
Actual Setbacks: ,
Front: 3 o Left Side: 2 Right Side: ! o Rear: 160
CORNER LOT A.16 (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE: ;
Maximum Allowed: Sl o Actual: !a?
BUILDING HEIGHT: e
Maximum Allowed: Z Actual Height: Q
Datum Point: WItt Datum Elevation:
SUBDIVISION:
CRITICAL AREAS #:
SEPA DETERMINATION: NI,4
LOT AREA: Z6 5-ZY r&
OTHER:
Plan Review By:
CA FILE NO.
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: /04/42 L/7'77k6:- 7014V CCU it % 0
2. Property Tax Account Number: S%/ 3 —000 D (v - 60 O 3
JQ f
3. Approximate Site Size (acres or square feet): �g � 2 3 'S�u
4. Is this site currently developed? yes; no. PEn+rlII CO� fIVT
If yes; how is site developed? %%DN S&
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: 4ZO ; Approx. Depth:
7. Site contains areas of seasonal standing water: Ald ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway_ ZO floodplain &d of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? &a Flows are seasonal? (What time of year? ).
10. Site is primarily: forested ; meadow ; shrubs ; mixed
urban landscaped (lawn,shrubs etc) _
11. Obvious wetland is present on site: Alt)
For City Staff' Use Only
1. Site is Zoned?
2. SCS mapped soil type(s)?
3. Wetland inventory or C.A. map indicates wetland present on site?.
4 :-; =:;:Critical Areas inventory or C.A. map indicates Critical Area on site? { `
5::: ::Site within designated earth subsidence landslide hazard area? -sue
Site designated on the Environmentally Sensitive Areas Map?�
DETERI%fINATION
STUDY REQUIRED CONDITIONAL WAIVER
WAIVE
Reviewed by: T AA1U0 ' 6
Planner Dat
Rev 01/OW94
e9o.j99-
City of Edmonds
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.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). 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 Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
Name
L/77&(-- Y0i11k)604Rj,
Street Address
qg�)) O .79
City, State, ZIP Phone
- 34&—' 12 J A,'
Signature Date
Applicant Representative:
Name
Street Address
City, State, ZIP.
Signature
,Phone
Date
T I E= I IQ
1840' E 29' IJ
I
PROP. 1 !4'MRe IP MAI"
29' >�
1
Notes: The City of Edmonds
1)
Field locate all utilities.
Call 1-800-424-5555
24 hours before digging.
2)
Survey is not required
3)
Maintain a minimum of 5'
horizontal and 3' vertical
clearance from all city
utilities and appurtenances.
4)
Cuts in paving are shown as o
5)
0 cuts in paving anticipated.
I --
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M PE P I Ft---
iTEm QUANT. DESCRIPTION STOCK NO.
�j BILL OF MATERIAL
PERMIT TAX CODE
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PERMIT D.G.R. 9-2Ca-9�
PERMIT 1!4 SEC. 2-7 - 3
PERMIT PLAT I • ��
234,OP MAP ICP4 �Z
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PROP. I *'M
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Notes: The City of Edmonds
1) Field locate all utilities.
Call 1-SOG-424-5555
24 hours before digging.
2) Survey is not required
3) Maintain a minimum of 5'
horizontal and 3' vertical
clearance from all city
utilities and appurtenances.
4) Cuts in paving are shown as o
5) 0 cuts in paving anticipated.
I IAP� PI
/O J� ITE AQUANT. DESCRIPTION STOCK NO.
BILL OF MATERIAL
PERMIT EEZD., (ON-10c;= TAX CODE
PERMIT D.G.R. 9-ZCfl-9�
PERMIT 1!4 SEC.
f�rt15.11] �t`(D PERMIT PLAT I Cc, Co•(a,(2o
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4. NO. DESCRIPTION DATTiy APPD. CHKD. DRAWING
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REVISIONS SCALE APP. 9To-�Je I t
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Notes: The City of Edmonds
__,..
: ; 1) Field locate all utilities.
i Call 1-800-424-5555
24 hours before digging.
T 1 I l-1 2) Survey is not required
3) Maintain a minim--
um of 5'
-
horizontal and 3! vertical
1
clearance from all city
utilities and appurtenances.
i
4) Cuts in paving ate.shown asp
10.425 PROP. i Y4" M PE i P MAI" 5) 0 cuts in paving anticipated.
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711 Jf' ITEM OUAHT. DESCRIPTION STOCK NO.
BILL OF MATERIAL
PERMIT TAX CODE
PERMIT D.G. R. 9 - 2 ,
PERMIT V4 SEC.
_ '� ' PERMIT PLAT I ( Gz, c2o
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REVISIONS SCALE l"` 4-O' APP.