1521 10TH PL N.PDF1111111111
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1521 10TH PL N
ADDRESS: 150q I loth pc
TAX ACCOUNT/PARCEL NUMBER: oC / D 31 -3 0 0 4 v V V
BUILDING PERMIT (NEW STRUCTURF,):
COVENANTS(RECORDED)FOR:
CRITICAL AREAS: bg DETERMINATION: ❑ Conditional Waiver ❑ Study Required Waiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED: � /
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DA
SIDE SEWER PERMIT(S) #: 1/
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DA
LATEMMI)STsTormAStreet File Checklist.doe
PLANNING DATA
NAME: 4 DATE: 6
SITE ADDRESS: S l (o _ Al, . PLAN CHK#: C -Tao
PROJECT DESCRIPTION: Re^a tl a,%j-rlo, ,v t?0To knr2
REDUCED SITE PLAN PROVIDED?: e / No
MAP PAGE: 36 1 CORNER LOT: es No FLAG LOT:
ZONING: - CRITICAL AREAS DETERMINATION #: Dq -0f, l
❑ Studv Reauired:
Waiver .
❑ Conditional Waiver
SEPA DETERMINATION:
❑ Fee
❑ Checklist*
❑ APO list wl notarized form
jreeded for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
emptt
SETBACKS:?
Reaulred Setbacks: , ,{
Street: as Left Side: /� Right Side: Rear: ohs
Actual Setbacks: k
Street tyLLeft Side:Right Side: 13 Rear:Street map checked for additionaack required? es / No DN
U. DETACHED STRUCTURES: S�
ROCKERIES:
FENCES/TRELLISES: Li
BAY WINDOWS / PROJECTING MODULATION:/
STAIRS / DECKS: -
PARKING: Required: 0 Actual:
LOT AREA: yo.
LOT COVE 6���a000'qCalculations:
BUILDING HEIGHT: V
I 1
Datum Point:_ ! a� ` i eoe r/dot VQ Datum Elevation: Q�
Maximum Allowed: ?Sy� ell' Vgr'wA f Actual Height dL 7- S�
A.D.U. CREATED?: No / Yes
SUBDIVISION: n! k
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: Yes No
V-oq-d�(
OTHER: �iiaflov�c,( %`t'iSkj 'v d-7_ Sy 70 -,Tt
Plan Review
NewBPPlanningDataForm.DOC
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TIM AND SHELLY CROSBY
1521 10TH PLACE NORTH
EDMONDS. WASHINGTON 98020
APPROVED AS NOTED
BY ENGINEE ING
,n r�
t ✓ (IT"'�
Date:
RPROVED BY PLANNING
7 a`f
Pi141:WY'
1►
JUN 3 0 2004
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
ACC
SDR
• SCH
N-12
F81(
cl
SHADED AREA INDICATES IMPERVIOUS SHADING INDICATES AREA
SURFACE AREA OF 676.20 S.F. OF IMPERVIOUS SURFACE
TQ ROO Mn'
IMPERVIOUS SURFACE CALCULATION:
I
AREA 1 AND 2 - 676.20' S.F.
AREA 3 - 692.00' S.F.
TOTAL AREA - 1368.20' S.F.
GUTTERS/DOWNSPOUTS
TO CONNECT TO EXIST. SYST.
ADD OUTTERS/DOWNSPOUTS
AND SPLANKOCKS
TIM
AND SHELLY CROSBY
ol°ET
FILE
1521
10th PLACE NORTH
TAX
ACCOUNT PARCEL # 27031300408900
RECEIVED
.SUN 3 0 2004
DEVELC TY CTR.
OF EDMONDS
DRAINAGE
NORTH
PLAN
;APPROVED A"Cfff-D 1'-20'-0-
BY ENGIN RING
date: 7110 /
THE ECESS ELEVATION TO BE PLACE
HEFE TO FORM A GARDEN "Ai1EA FOR
THE OWNER.
•
Dl
BASEIFNT
LOWEST FOOTING ELEVATION • 98.08'
FINISHED SLAB ELEVATION -
FINISHED 1ST FLR. ELEVATION • 104.29'
GRADING CALCU.ATIONe
12.33'X21.92'• 270.3 SO. FT.
270.3 SO. FT.X 2.83'• 704.87 C.F.
CRAWLSPACE
LOWEST FOOTING ELEVATION • 97.17'
FINISHED 1ST FLR. ELEVATION • 104.29'
OWING CALCLI.ATIONt
5'X 17.0' • 85 S.F.
85 S.F. X 1:41 F.•119.87 C.F.
119.87 C.F. / 9 C.F. • 13.32 C.F.
---------------
COMMICONTRACTOR IS RESPONSIBLE FOR
LION CONTROL AND DRAINAGE 100 . m0 , 1
STREEIILE
TIM AND SHELLY CROSBY
1521 10th PLACE NORTH
TAX ACCOUNT PARCEL # 27031300408900
GRADING
APPROVED AS NOTED SCALE:
BY ENGINEERING
NORTH
PLAN
T-20,_O"
0 0
NAME
ADDRESS OF PROPOSED BUILDING
r
LOT APPROVAL STREET
ADDRESS1/'_
�.CA.C"
LEGAL DESCRIPTION: LOT BLOCK ADDITION
TYPE OF, USE_,, _NO. OF BEDROOMS SIZE OF LOT X0 X 7✓/
SOURCE OF DRINKING WATER: Public Supply Private Well .410
a. SURFACE DRAINAGE
1. Is disposal field site well drained?�I � S NO
2. Any water course (stream, drainage ditch, etc, through site?
b. TOPOGRAPHY
1. Any heavy slopes in field area? NO
2. Will present-topsoi in field area be removed or graded before field tiles
are installed? 1
3. Will any fill material be used in the disposal field site.
If yes, how much?
c. SOIL CONDITIONS-
1. Hasa hole at least 4 feet deep been dug in the disposal field area to,dete,44
mine the type of soil present? I - S
2. Auer hole is dug record the soil conditions at the following depths. (Re-
cord as sand, gravel clay, packed sand, loam, etc.) t
12 inches P , w -YANDOO inches SA/v D
T$ inches 5 #Hp36 inches S N
24 inches �$gNp 48 inches s S N
3. Any ground water encountered before reaching a depth of 4 feet?
If so at what depth?
d. WATER TEST
0
A simple water test will show how well this soil will drain or percolate water.
To perform this test:
1.
Dig hole at least 36 inches deep. Use a shovel or post hole digger —
size of hole makes no difference --only depth.
5
2.
Fill hole with water. Now let all water run out of hole. This soaks
the ground and will give a more accurate reading.
3.
Again pour water in hole to a height of 12 inches from the bottom.
Let water run out until there is just 6 inches from bottom left in h
4.
Note how many minutes it takes for this last 6 inches to seep away.
/
Record this time below.
Number of minutes for last 6 inches to seep away
S.
Divide this time by 6 to obtain the rate .per inch „ 26 /v M h4 8,Q :7NC.N
6.
Date water.test was performed 4 - 23- may
I hereby certify the above information to be -correct and the above tests were
performed by -me as prescribed.014--o' 4e_ef
Signed
Address /S; ,,
NOTE: A septic tank permit is issued on the basis of the above information. If
there are any changes or alterations in the above stated soil conditions it may
result in the installation being rejected at the time of inspection.
A
r,
•
Percolation Rate and Required Absorption Area. ''For single Family Dwellings.
Percolation Rate (Time in Lineal feet of 4 inch tile
minutes for water to fall using trench with width of
one inch) two feet
3 150' minimum
4 175
5 190
7 225
10 250 "
12- •265
15 -285
30 375 n
Over 30 Soil Unsuitable
0
Critical :Areas Checklist CA File No:
Oq -5
Site Information(Soils%topography/hydrology/vegetation)
1. Site Address/Location: _ Cd 7 N
2. .. Property Tax Account Number:;
3. Approximate Site Size (acres or' square feet):
4. Is this site currently. developed? ✓es; no.
if yes; how is site developed?.2:�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 greateri.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: Approx. Depth:
7. Site contains areas of seasonal standing• water::- IYD ; Approx. Depth:
What seasons) of the. year?
8. Site is in the floodway floodplain of'a water course.
9. Site contains a creek or an area where water flows across --the grounds surface? Flows are year-round?
0 Flows are seasonal? (What time of year? . ).
10. Site is primarily: forested` ; meadow ;'shrubs • mixed'
urban landscaped (lawn; shrubs' etc)' e
11. Obvious wetland is present on site: &0
For City Staff -Use Only" .�ql
1. Plan Check Number, if applicable?
2. Site is Zoned?
3. SCS mapped soil type(s)? - .: A I acr es W bh„ I"
4. Critical Areas inventory or C.A. map indicates Critical Area on site? No - rr•k,f-A, \,CPU4 `(ZA) c• A;6j.
5. Site within designated earth subsidence landslide hazard area?
DETERMINATION,'_`;,
STUDY;REQUIRED .,, 1� , WAIVER
Reviewed by: -t :,. ; Date: Z/ 3 /Z->4
Critical Areas Checklist.doc/4.22.2003
.City o Edmonds
Development Services_Department
Planning Division -
Phone: ,
Phone: 425.771.0220
CitV'Receipt #: U
Critical Areas File: #
C�iticai Areas Checklist
Fax: 425.771.0221 l . ' a' Dane Mailed to. P1
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).
A.property owner, or his/her authorized;representative,.
must. fill out the checklist, sign and: date it, and submit it
the fo 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 City staff 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 withthis Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned. applicant, and his/her/its heirs, and ass' s,._m 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
attorneys 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/,itiagents 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 l 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 DATE
i
Owner/Applicant:
CT
Name I
l �-?_( l v�l . /V
Street Address
s:. ;,,. 1l,JAI I
Applical f Representative:
Wt ,er'
Name
Street Address
City State Zip City State
Telephone: . ��Z\ - I I i -1-W 7 q
Telephone:_
Email address (optional): ra Email Address'(optional):
6171-\(C49+.r{'
Zip
Critical Areas Check] ist.doc/4.22.2003
STEPHENS N SN USPAGt
1521 IOfih_ PL.AC1= "019TH
EDMOW D5, WASH I NGTOM
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I EXISTING 10
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PHONE: 77& -n295
STREET F/LE
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`no. 194-
Clty Of Edmonds PERMIT NO: 99$9.
SIDE SEWER PERMIT
PERMIT EXPIRES
Address of Construction: 16'2 / /Q 14 pL V LID #
Property Tax Account Parcel No. 0-10 31 3 o.0 13100
Attach copies of all access and utility easements Verified and Approved by
Owner and/or Connor: �%�� Vfa c Rd t
Contractor License #:�EON -r�-Q16-Al % Building Permit #:
Rq Single Family
❑ Multi -Family (No. of Units
❑ Commercial (No. of Units )
❑ Public
Invasion into City *Right -of Way: ❑ Yes No
*RW Construction Permit #
Cross other **Private Property: Yes ❑ No
**Attach legal description and copy of recorded easement.
zf?2�xr Owner/Contractor /
Owner or contractor signature and acknowledgement statement: Date
By signing for this permit I certify that I have read the City's public handout entitled.
Side Sewer Specifications, and shall comply with all City requirements outlined therein.
2 CALL DIAL -A -DIG (1-800-4E5555) BEFORE ANY EXCAVATION 2
Iff FOR INSPECTION CALL 425-771-0220 extension's (o ff
24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REQUESTS
FOR OFFICE USE ONLY
........
B }�
Permit Fee $ Repair Fee $_ Issued y: It a
(oil
e-$ c� . Od Date Issued: � — � "' � 5
Assessment Fee $ Receipt No:
City Permit Surcharge Fee 4 5.00 Total Fees Paid $ q�®. 00
NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED.
Job Site Ready YES NO - Date: Initial:
Partial Inspection: Date: Initial:
Partial Inspection: Date: Initial:
FINAL INSPECTION APPROVED: Date: Initial: As -built to Street File: ,®
t� PERMIT MUST BE POSTED ON JOB SITE t�
White Copy: File Green Copy: Inspector Buff Copy: Applicant
L;temp;bldg;forms;ssperrnitj Ig4/00
16); PZ /A\
3�
CITY
OF EDMONDS SIDE SEWER AS -BUILT
ADDRESS
/
PERMIT
NUMBER �a
HOMEOWNER
CONTRACTOR
DATE �/2
BY
10PLN
ED.�_ ICITY OF EDMONDS SIDE SEWER AS -BUILT
r
d ADDRESS HOMEOWNER
u' 1521 - 10 PL N _CROSBY
CONTRACTOR
DATE DRA VM
03/02/2005 BY S I B R E L 03/ 18/2005
SCALE
NTS
PFRMJT
NO. 9971
a
TIM AND SHELLY CROSBY
1521 10TH PLACE NORTH
EDMONDS, WASHINGTON 98020
APPROVED AS NOTED
- BY ENGIN ERING
Date: Q ¢
APPROV D BY PLANNING
RECEIVED
' ` ; �' 3 0 2004
°`S : F�
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS