1061 6TH AVE S.PDF1061 6TH AVE S
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.. City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
a' PERMIT Permit Number: 173 3S�
Issue Date: `.JU
A. Address or Vicinity of Construction: a
f 90 19�j1J B. Type of Work (be specific):
8-.1 '
C. Contractor: Contact:,l,r�./
Mailing Address: �OPhone: "7'% - 62ie�
State License #: 02<n7PR Liability Insurance: Bond: $
D. Building Permit # (if applicable): 3 b�% %LI Side Sewer Permit # (if applicable):
E: ❑ Commercial . Subdivision ❑ City Project ❑ .Utility (PUD; GTE, .WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family .Other-.
INSPECTOR: INSPECTOR:
F.. Pavement or Concrete Cut : ❑ Yes ❑No G. Size of Cut: x H. Charge $
APPLICANT- TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, 'agrees to hold the City of Edmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unfore'en, that may be 'made against the City of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees' by reason of granting this permit.
i
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC770N
AND ACCEPTANCE OF THE WORK. ES77MA7ED RESTORA 77ON FEES WILL BE HELD UN77L THE FINAL STREET.PATCH IS COMPLE7ED BY i
CITY FORCES, AT WHICH-77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. ,
Construction drawing of proposed work required with permit. application. r.
A 24 hour notice is required for inspection; • Please call the.Engineering Department'
Work is to be inspected during progress and at completion. 771-0220 '
Restoration is .to be in accordance with City Codes.
Street shall be kept clean at all 'tiijes.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior. to the end of the working day;
NO EXCEPTIONS.
I have,. read the above statemen and understand tl e�permit ' requirements. and the pink copy of the permit will be available
on site at all times for ins" on ureose
Signature: Date: .
(Contractor or Agent)
CALL DIA&A-DIG PRIOR. TO BEGINNING WORK
I
.DATE ,.;. .... ISSUED BY:.: .................
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street .Dept.)
Comments: .
Diagram:
4
CONTRACTOR CALLED FOR INSPECTION O YES D NO.
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 1985
APPLICATION
for
The City of EdmondsILE SIDE SEWER PERMIT
107-01300
NEW CONSTRUCTION REPAIRS ❑ EASEMENT No ...........................................
❑
OWNER......... C1-ark---M'--•Kt10W--25---------------------••---•-•----------------•--.....-----. CONTRACTOR---•--........................................................................................... PERMIT No.......................
ADDRESS .....1.061... .- ... 6th-.Avenue...S............................... ................. LEGAL DESCRIPTION: LOT No. .............................................. BLOCK No. ............................................
NAME OF ADDITION .........
0-
DYE TESTED ON SEWER
JULY, 1972
Approved:
DATE................................................ By----.............---------.............------•-•--....................
� O
89�-199
City Of Edmonds
Critical Areas Checklist
The Critical Areas Checklist contained on
this form is to be filled out by any Fuson
preparing a Dcyelopiuenj.pc mit
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 pmperty. The information needed to
complete the Checklist should be easily
avallable from observations of the site or
data avarlable at City Hall (Critical Areas
inventories, maps, or soil surveys).
An applicant, or his/her representative, must
fill out the chocidist, sign and date it; and
submit it to the City_ The CityMU review
the checidist, melee a precursory site visit,
and make a determination of he subsequent
steps nocc;ssaty to complete a development
permit application.
With a signed copy of this fora,,, the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject
Paroel(s)_ In addition, the applicant is
encouraged to include any other pertinent
information 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
Title
Street Address
Applicant Representative:
Name
Title
Street Address
77�-Sb�t 9
9�020
City, S IP Phone City, State, ZIP
.e 44 /
Phone
q3
Date Signature
Date
STREET FILE
Critical Areas Checklist RECEIVED—:-
Site Information
AN z 4 1993
Project Name.- ossi _ Permit Number. PERMIT COUNTER
Site Location: /06/- 6'6 R✓c. So. Property Tax Account Number. 6/f-01-006 -006 -Ooo4
Approximate Site Size (acres or square feet): /ar, /coo CI
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged? No Date of most recent action:
Soils / Topography
2. In the Snohomish. County Soil Survey, what is the soil s ? �✓�2 fl�A✓Ez;�G
mapped type( ) . �`iND Y t_ o AM _ r� `7"n �
3_ Describe the general site topography. Check all that apply. 5`oPE3
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 of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
Hydrology/Vegetation
4. Site contains areas of year-round standing water_ o
5. Site contains areas of seasonal standing water. A v Approx. Depth:
6. Site is in the floodway No floodplain_ 1 o of a water course_
7. Site contains a creek r an area where water flows across the grounds surface? LIP —flows
flows
are year-round? Flows are seasonal? Z
8.
9.
10.
11.
fi
Site is primarily: forested : mea ow ; shrubs �+�eeY ; mixed
Obvious wetland is present on site.
Wetland inventory or map indicates wetland present on site:
Critical Areas inventory or map indicates any Critical Area on site:
i=or Gty,Use Only
F.. x 1N1VFR Cnucal areasstudy s;tiot regtfireil.
Determination Number /�� Reviewer
Rev 3nM2
annei oat