10502 231ST ST SW.PDFlill iiiiiiii
3710
10502 231 ST ST SW
ADDRESS: 41"-c%e S V
TAX ACCOUNT/PARCEL NUMBER: 69`i 2 i DDD[/ I �U D
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS : M - - 6C16 DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S: Hbj I - ct -S5
DRAINAGE PLAN DX
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED: 1'l2 0�7
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: 12 BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
LATEMP\DSTs\Fomu\Street File Checklist.doc
ADDRESS: I lJ6M 231 Sr 57 mew aZ
TAX ACCOUNT/PARCEL NUMBER: X 42tp 1 VCVV 12 OC7
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS : (�] DDETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S: ft - 05 / 95
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DA
SEWER LID FEE
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S)
GEOTECH REPORT DATED:
STREET USE /ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
LID #:
LOT: I BLOCK:
LATEMPOSTAFormAStreet File Checklist.doc
#P20 0 5 -q 3
Critical Areas Checklist CA File N°:
Site 'Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/Location: l0 3/qd S a%f
2. Property Tax Account Number: 4 0 Ya G 1` 6 0 0 •6 I a' 6 llll a
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? Y yes; no.
If yes; how issite developed?. y /)OGJ, f l✓A M I LY f Tl O f II 71 f1 L
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)., �� yN s+,+« fix, c
t ' �fi � . 1 I
:� ° i
Hilly: slopes present on site of more thf°15►,�ii(d la v �.�.se ofl0-feet
over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30°�6 present on si (artical ris,) of ;�eet`over a ahonzontal `
distance of less than 33-feet). 3
Other (please describe):
6. Site contains areas of year-round standing water: Aln ; Approx. Depth.
7. Site contains areas of seasonal standing water: Ali ; Approx. Depth. -
What season(s) of the year?
8. Site is in the floodway X/d floodplain /VO 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) k
11. Obvious wetland is present on site: No
For City Staff Use Only --�=�
1. Plan Check Number, if applicable? PC., O 5 29 O .
2. Site is Zoned? �S-
3. SCS mapped soil type(s)? i7 - Ftfr a r¢- ,, S yy- 9 °7,
4. Critical Areas inventory or C.A. map indicates Critical Area on site? Kb
5. Site within designated earth subsidence landslide hazard area? jso
DETERMINATION .
STUDY REQUIRED WAIVER
Reviewed bv: (I I M/lAl (n51 /f/t/Dl/ Date:
r
IS #P2U
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
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 the application to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
Date Received: 41 i��
C/ �
City Receipt #: /
Critical Areas File M GA. ZOOS-6 q 3
Critical Areas Checklist Fee: $135.00
Date Mailed to Applicant:
A property owner, or his/her authorized 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.
may be, present on the subject property. The information Please submit a vicinity map, along with the signed copy
needed to complete the Checklist .should be easily . of this form to assist City staff in fording, and locating the
n to specific piece of property described on this forma In
e addition, the applicant shall include, other pertinent
eys . information (e.g. site plan, topography map, etc.) -or
�j,� studies in conjunction with this Checklist to assistant staff
APPLICAMN PIC�OSC completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, . arising from any action or infraction based in whole or part upon false, misleading, inaccurate or.
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I.cer* that the information and exhibits herewith submitted are true and correct to the'best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF APPLICANT/AGE DATE G,/i�e S
Property Owner's Authorization
By my signature, I cer* that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF
Owner/Applicant: r(
JkSAA1 Q la c°-►�s NnFA�i��/�
Name
/0':O � -J3 i sz
Street Address
- C,G1r0fyo r L44 /(1 od b
City State Zip
Telephone: ,_�(> 6_14y�
DATE
Applicant Representative: .
Name
Street Address
City State Zip
Telephone:
Email address (optional):J415,4 l ` &1Q/�'(�fXll/%4�iti'C, Email Address (optional):
PLANNING DATA
REDUCED SITE PLAN PROVIDED?: Q1 No)
MAP PAGE: 053 CORNER LOT: (Yes / o FLAG LOT: ()Les / o)
ZONING: P-S ' fS CRITICAL AREAS DETERMINATION #: 2005_ 0113
❑ Study Required:
® Waiver
❑ Conditional Waiver
SEPA DETERMINATION: (VM t
❑ Fee
❑ Checklist .
❑ APO list w/ notarized form
❑ (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
an Exempt <50 (AA10iG yard* Of 9rAAiln9 PMPVe.7ed•
SETBACKS:
Required Setbacks: O
jJ Street:a�tT t i e �• 5, Right ide: • Jt Rear:
Actua Setbacks: I
Street: P5QI teftSide: S t Right, Side: ear: 7if5
Street map checked for additional setback required? (Yes / No / NA
® DETACHED STRUCTURES: 4-A I 0 6 V1 CA - a p p ea rh -tv m et s•ei'b a G IG � $' 1-0 w
® ROCKERIES: MPe+s 51t'10aCk-5'f)-hv�
❑ FENCES/TRELLISES:
❑ BAY WINDOWS / PROJECTING MODULATION: l
® STAIRS/DECKS: MiiLtS q t tv
PARKING: Required: I- Actual: P • 2X f 5i1 n 5 V1 cA y' 0 �
LOT AREA: 015fS5V 'exi6f1'n� 8Ar4ge a h0uge =2(0933° 3063,0
LOT COVE •QG(di-Hon /dtGk N 2�-pFd ��I
Calculations_ �J2�• GOVtAY14 jei • nt�+! tGu'rS / I avt df h A ^� (yOJd
BUILDING HEIGHT: A'- 105 • O I
Datum Point: Wxylviol?z LOJY• Datum Elevation: t B : I O 3. 3
Maximum Allowed: '%/$ t I'li T • Actual Height: Z I • Zi (� : (O 3�j
A.D.U. CREATED?: (No / Yes)___ d I OD. O�
SUBDIVISION: l�.�G� � � l.�• =-
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: ()es No) ` 0 2.4
OTHER:
ZPlan Review By: (�1�4wL�J Lam" A.X'4 t /
Ydie line, (2�'
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