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1221 8TH AVE S
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NAME:
SITE ADDRESS: /22/ f�vc f DATE: / %
ZONING: �S 0 PLAN CHK#: 9 -7Z? 7
PROJECT DESCRIPTION: c_ �r- WIA 4, {j w
CORNER LOT JU, (Yes/No)
SETBACKS: LI ro-1
Required Setbacks:
Front:VLeft Side: �` Right Side: Z s Rear: 1 //-
Actual Setbacks: g
Front:29 _Left Side: � Right Side: Z Rear: 7�
Street map checked for additional setback required? cs (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED — (Y/N)
LOT COVERAGE:
Maximum Allowed: 35�' Actual:
Z 7 /L
BUILDING HEIGHT: i
Maximum Allowed: Z'� Actual Height:
Datum Point: - - Datum Elevation:
A.D.U. CREATED?:
SUBDIVISION:
CRITICAL AREAS #: 9 W - ! JA ✓� .
SEPA DETERMINATION:__/
LOT AREA: of 17 d %�
•. 101
Plan Review By: �ifrli✓ l Dv27cy-(1-7
cAfiIcAperm it\^plandat. do
ar90.19y
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: Applicant Representative:
Name Name
Street Address Street Address
77s�t��4-
City, State, Phone
Signature Date
City, State, ZIP Phone
Signature
Date
,STR 3•' FILE CA FILE NO. C j- - qL/— 7 rJ
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
I. Site Address/Location: !-JAQtir .
2. Property Tax Account Number: 'S<7d ow
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? _dyes; no.
If yes; how is site developed? SiIIJ6if, PWILQ�-
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
__j 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: Z 124 )F ; Approx. Depth:
7. Site contains areas of seasonal standing water: A )tjA )C ; Approx. Depth:
What season(s) of the year? ,()1A
8. Site is in the floodway) D floodplainofa watercourse.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? L) N F Flows are seasonal? AggE (What time of year? --- ).
10. Site is primarily: forested ; meadow ; shrubs • mixed
urban landscaped (lawn,shrubs etc) 1�
It. . Obvious wetland is present on site: AJO
Rev OIM04
6�90.19
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
cogjunction 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
f � �
._ " ♦_ L�
Street Address
G;�, /: J i r
City, State, Phone
4r 1
f)ate
Applicant Representative:
Name
Street Address
City, State, ZIP Phone
Signature Date
STR.EET FILE CA FILE NO. qq— %?
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: i a_D.l
2. Property Tax Account Number: oco oo3 Oo_
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? _yes; no.
If yes; how is site developed? St BJri� u ti
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: Z & )t- ; Approx. Depth:
7. Site contains areas of seasonal standing water: 4joA )F ; Approx. Depth: _
What season(s) of the year?
8. Site is in the floodway ,�o ) D floodplam of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Li - F 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: 4j () .
Rev01/004
FLI
The City of Edmon9TREET FILE
L/ -lo9222n
APPLICATION
for
SIDE SEWER PERMIT
OUTSIDE ❑ INSIDE ❑ REPAIRS ❑
CARDNo. ..-•....................... ..........
EASEMENT No- -------------------------------------
® :: - •--.... ti 9.............•-------------•-•------•---- PERMIT No. ... .. .. .
OWNER -•-------..�.-� ..�:.r'. ...-..� � �. �...�.!�.--•---- ---�,d.A.- ,,..k`�.'�....... CONTRACTOR ............ .. ..11:7�:. --
0 STREET
J
HOUSE No. ...... fir` f.....-------•............................ AVENUE LOT No. BLOCK No.
ME ADD. - F ........ 6 41 1 f
Date
Approved:
APPROVED
• ! , 20 '
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .......................... -..................
SEWER WORK ORDER ISSUED .............. L ............................ DATE - ----....- ---- - ;
CITY. OF EDMONDS
_CIVIC CENTER —WATER -SEWER DEPARTMENT Gall rxospect o-1107, when work
• - is ready ?d or Inspection. (Nonspeo-
_ - -tlons Saturday Sunday or holidays.)** - . 1-0-2 9
SIDE SEWER PERMIT
-ADDRESS .................. 12.21..-.... $th-..Av..etxue...-Sou:kh...:-...-................................................................................ ,...............................
OWNER.... -Bert"• Thayer........................................................... CONTRACTOR.......Ro Allen -.--......-
Permission isgranted...... April"-"--20 ......... , 19.§A., for ..............:.:..... days, to REPAIR or CONNECT a side sewer
with City Sewers.in accordance with, application on file and governing ordinances.
ATTENTION Is CALLED TO THE FOLLOWING:
NOTE No. 1—The owners -of the property may- obtain a - permit to _ construct sewer inside property line. A licensed Side Sewer Contractor must
be employed to construct side sewer 1n street:area. Do not- 'cover any. portion of sewer before 1t has been Inspected.
NOTE No. 2—Obtain full information regarding Ordinance 11.16,030, and Regulations governing side sewers when you get permit. _
."NOTE. No. 3—Top of side sewer must have at least 30 inches coverage at.property line and 12 Inches Inside property line; minimum grade of 2%.
No bends' in grade sharper than 'A will be permitted. - -
NOTE No. 4—Trenches In street must be water. settled and surface of street restored to original condition. Contractors shall be responsible for
failure due to Improper work which may develop,wlthin one year of completion. -
NOTE No. S—It is*.unlawful to alter or do any other work than is provided for in the permit, or to do any work on the maln sewer or Its ap-
purtenances except to insert the pipe Into the wye.