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1124 A AVE S.PDFiiiiiiiiiiiiii 10001 1124 A AVE S ADDRESS: ! 1'? A k iu u-e TAX ACCOUNT/PARCEL NUMBER: D 0 ( / L7 / 06 ` 6Q3bl BUILDING PERMIT (NEW STRUCTURE): I q M OZ `C �o COVENANTS (RECORDED) CRITICAL AREAS :,;20Qmn DETERMINATION: ❑ Conditional Waiver ❑ Study Required Kwaiver DISCRETIONARY PERMIT #'S: -- DRAINAGE PLAN DATED: 25/h PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED PERMITS (OTHER): PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: '. I W . f i / 1610 ,22 SEWER LID FEE $: LID #:- 14 SHORT PLAT FILET LOT: � BLOCK: SIDE SEWER AS BUILT DATED: .11 SIDE SEWER PERMIT(S) #: r7 I �O a7 GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: WATER METER TAP CARD DA L:\TEMP\DST's\Forms\Street File Checklist.doc S j Ll - 4 PA/E- 5 • 0 0 s9' _ ti►�v ! �EGK � � E7t7, OE�-K r -ro PiE REMOV �b � 3o Q Fll'f� NauS+� a o 4 i5 2J ;��PAVED_:..s 2sr DRivE WAY �l- S STREET FILE JUN 1 8 2003 PERMIT COUNTER APPROVED AS NOTED BY ENGINEERING b' f Date; IERJCOi\rl Ka: �� l i6 f'RiL:' CfiISIBLE FOR EROSION CONTROL AND DRAINAGE -PLOT PLJ4AJ APPROVED By PLANNIN Pf�OpEr-ry OvjkjEQ: _TEFF V-W& -7-7 j) j :1 � .iJ�� �y �h;}��• � � � t � � � ram.. '.-�'f"'s%3 '. 7S y •� s 4' k% .y { • - .. - .. - _ •. - .. U L NUulff r, CITY OF EDMONDS S —84024G CONSTRUCTION IDERMIT''APPLICATION — t 'A ou !•A4t. il.H !, 11 h,E GF H:: S,f.ES:;t nUUI a r �� * • 4 ,�i ��`� �' .S' is C � \ `-� � � L �: t' C 1� -- �. . q- 2R _ IE� .•,Ur.0 '.l.'+tftl. f'L6.i;: �.. .. _:•1EFf ypu �% L 1 H.L�GA w s r efix l Yia ---I ----- _L//,/�� 6• ' 'lirf/1i lr rar a. a —� H f� r"� u!�r� r t+ ram,.-.— • �,�y. 1 ^• ].. 77 f -gyp,; •I =. _"__.—_____._--___=—._..._- ._ __ I --__ , r , I _ yr d , pN , �d ;a.. r�, I I Litt •. _ .. .- ..—I_..__—._� . ... .__ .� � ', r. phut i '� `�� •' .. ... , .. .. - •-� ,., ,. � -' - .. .. � I { Critical Areas Checklist CA File No: ©3 g8 Site Information (soils/topography/hydrology/vegetation) I 1. Site Address/Location: 1124 19" RVENU°E 2. Property Tax Account Number: r (o 19 4 C) c)-7 603 a O . 3. Approximate Site Size (acres or square feet): %, 4. Is this site currently developed? yes; no. If yes; how is. site developed? S !N e LF Figmi or RFS / aW e_ E 5. Describe the general site topography. Check all that apply. 1 Flat: less than 5-feet elevation change over entire site. X 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: Ili b ; Approx. Depth: 7. Site contains areas of seasonal standing water: AID ; Approx. Depth: What season(s) of, the year? 8. Site is in the floodway lob floodplain of a water course. 9. Site contains • a creek or an area where water flows across the grounds surface? Flows are year-round? M D 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: 10 D "}} y y For.,G Staff Use Only 1S3 1. Plan Check Nuatber, if ap 2. Site is Zoned? J" 3. SCS mapped soil type(s)?. 1 ? - 6-�,¢ 14M..rl, s �,., 16a�, _ o - 4. Critical Areas inventory or C.A. map indicates Critical Area on site? _N 5. Site within designated earth subsidence landslide hazard area? No. 1 DETERMINATION ST:UsDY:R�QUIRED ✓ WAIVER Reviewed;by: ` ' Date: 6Z 2i103 Critical Areas Checklist.doc/4.22.2003 City oi*dmonds 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 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). Date ReceivW City Receipt M Critical Areas File M Critical Areas Checklist Fee'*:' S135.00 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. Please submit a vicinity map, along with the signed copy of this form to assist Citystaff in finding and locating the specific piece of property described on this form. In addition, the applicant shall. include other pertinent information (e.g. site plan, topography map, etc.) or studies in conjunction with this Checklist to assistant staff in 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 attomey'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 certify 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/AGENT DATE (g, • Property Owner's Authorization By my signature, I certify 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 PLEASE PRINT CLEARLY Owner/Applicant: Name t l24r )Sr A 5-- Street Address 1�01-r0►j 1:3962.0 City State Zip Telephone: - b`? Q- 200?� Email address (optional): DATE Applicant Representative: Name Street Address City State Zip Telephone: Email Address (optional): Critical Areas Checklist.doc/4.22.2003 CITY OF EDMONDS I FOR INSPECTION CALL >,PT?BLIC . WORKS DEPAR T Permit > 77'5-'�1,512°5 Ext. Z251 SIDE SEWER PERMIT ' I I'll _ � � •) t Issue Date 1, 0 �3. 4. 5. 6. PERMIT MUST BE POSTED ON JOB SITE iq ' EDMOND8 Address of Construction 1 TREATMENT PI ,.n. � . Property Legal Description (include all easements); Single Family Residence ' Multi -Family No. of Units Commercial e Owner and/or Builder Contractor & License No. ) h Ile !, y, Invasion into City Right -of -Way: No Yes (If Yes Right-of- way Construction Permit Required - Call Dial Dig (A1.-'j513V4') before excavation) . 1-II00-4m-5s55 7. Cross other private property: Yes No Easement required - attach legal description and county easement number. READ THE FOL.LOWTNG AND SIGN: a. Property owners must obtain a permit to install side sewers on their property. A licensed side sewer contractor must be employed to construct side sewers in the public right-of-way. b. The side sewer contractor assumes full reponsibility for each installation for one year. C. Commercial establishment requires a minimum of a six inch (6") side sewer line. d. Side sewers may not be installed closer than thirty inches (30") to any structure. e. Side sewer lines must be laid at a minimum grade of 2% (1.15°) and maximum grade of 100% (450). f. No turn in side sewer greater than 45° (1/8,bend) is°allowed between cleanout. All 90 turns must be constructed of a 45 (1/8 bend) and wye with removable cap. g. No down spouts, footing drains or floor drains can be connected to side sewer system. h. Pea gravel is required for bedding when installing sewer lines through other than granular soil. i. Cleanouts are required at 30"-60" from each plumbing exit line and at minimum intervals of 100' along sewer line run. j. Trenches within City right-of-way must be restored to original conditions. Contractors shall be responsible for right-of-way failure due to poor compaction of fill. k.. Side sewer must be left uncovered until inspected and approved by the City. 1. Inspection during normal working hours only. Two (2) working days notice required. DATE: I certify —that I have read and shall comply with the above H PERMIT FEE: () DISAPPROVED BY: Date: B Date: CONNECTION FEE:J4� APPROVED By: • Date� w * PERMIT MUST BE POSTED ON JOB SITE * Date: � The City of Edmonds Side Sewer Drawing EASEMENT NO- ------------------------------------------- NEW CONSTRUCTION REPAIRS ❑ LID NO. - ----------------- ASMT. NO. -------- --------- OWNER ---- S-V-F—N ------- -------------------- ------- CONTRACTOR la�vM! _DOXJN -C,4 --------- PERMIT NO. JOB ADDRESS ------ ------ 4"F -- - ------------------------------- LEGAL DESCRIPTION: LOT NO. ------- 5 ------ ----------- -------- BLOCK NO. ---------------------- I ----------------------------------------------- ----------------------------- I ------- -------------- -------- -------- I TREATMENT PLANT PROPWall C-Rmclk NAME OF ADDITION --- Ya-S-7-;5- ----- F-1 'T I I ------------- --------------------- it 4" Pv.c it, 41' 5'bP ,VlC.c.vftE 4">4V'FtW. I0 X C-G-CAP t, OP 1.5,0P WbE IC2. 4 4.5', 1124 A kjF- - Approved: - — — — — --l' N, S, OF IN CONDUIT a rn z C rn cl) 4 M M A �n r M DATE PWW-0001 -11/75 (REV. 11/78) B, CATC.14 BASIN: Alb Y IS'30(04 WOuAL ) STREET FILE TRENCH LtNGTH 2 r T*t►tCN COMA O .r}r T►`►r�u w c 1 4PERF /1PI TEE w/ 40Lo►r, LEGS L[Y?L TR=NCN CAP SYSTEM CROSS-SECTION MIRAffI 50OX TO EfF-! LAER rr W&\e-�L-:ED FlO_K T0.EtrCN COVER 3/46 - 0/2" wASNED G RA.V E 1 r 4 01A.M MRF P q-, - Cr -� TRENCH CROSS-SECTION N STANDARD DRAINAGE PLAN INFILTRATION SYSTEM PAGr� I OF 2 for location- // _? plan by phone date DESIGN DATA Trench Perc LF per Imperm Trench Number Rate 10D0 sq.ft. Area Req. 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). Preventive maintenance consists of preventing soil and other materials from entering trench during construction as well as after construction. Catch basins should be cleaned of floating material and sediment at re ular intervals (at least twice per year. CITY OF EDMONDS Cb LU® .ad LL t"® Lu ui M: v, a p LOT PLAN , ` SCALE : 1" =,lot O OT 1 0F' SP..tr CO.'W'W. CITY OF .Eoma VDg q HO r-LAAT" OF LOT 3 ILK '7 COSTS FITZST tip ` rO 1EVMONDS 'r'SY C.-F- JO"S,45 SNP /) W E- S W m. z Q LI-I U— Of 0 N `) V' 0-' P41►� J i v z_ D: w w z v Z w STREET FILE CITY OF EDMONDS ovC QNiEp • [DMONOb. wASNwGTON mm SINGLE FAMILY AULTIPLE COWERCIAL ENGINEERING a PUBLIC . WORKS PROJECT CHECK REVIEW LIST PROJECT WE �ELL�o°N -5-, CONTACT NAIIE & TELEPHONE NUMBER ADDRESS Ail 4 A A V'C ACCESS SLOPE AND VEHICLE ACCESS DRAINAGE PLAN STREET FILE LEGAL DESCRIPTION VERIFICATION QUIT CLAIM/DEDICATIONS EASEMENT - PUBLIC/PRIVATE CALCULATE SEWER CONNECTION IF NO LID / STREET PAVING REQUIRED CURB AND GUTTER REQUIRED SIDEWALK REQUIRED -� CURB CUT FOR DRIVEWAY. REQUIRED RIGNT-OF-WAY CONSTRUCTION PERMIT REQUIRED BOND REQUIRED FOR PUBLIC IMPROVEMENTS STREET NAME SIGN REQUIRED , OTHER SIGNING REQUIRED (ADDITIONAL COMMENTS ON BAC EXISIINC WATER MAIII SIZE�C� WATER MAIN REQUIRED _ All, SERVICE LIME REQUIPED W HYDRANT SIZE EXISTING _ 5 r' < HYDRANT REQUIRED PER FIRE CODE ,ti/A SIZE CROSS CONNECTION INSPECTION WATER 11FTER CHARGE RE UII:ED REVIEW BY l DATE /ti ��/ (ADDITIONAL, COMMENTS Ott BA+ Q SAXIYARY SEWER DZAIIING HUMMER FILE NLFIBER w SIDE SEWER AVAILABILITY SANITARY SEWER COr11ECTION FEE REQUIRED W OPEN DITCH EXISTIIIr, REOUIRED