15826 68TH AVE W.PDFIIIIIIIIIIII
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15826 68TH AVE W
CITY. oSTREET FILE'S
f EDMONDS IDE SEWER PERMIT
For Inspection Call 771-3202 PERMIT NO. 0 7 6 5 2
EY.NNWOOD 6FNE
Address of Construction: ro
Property Legal Description (-Include all easements):
Owner and/or Builder:
Contractor & License No:
Single Family Residence
Multi -Family
L/
(No. of Units )
g 19 1987
Commercial (No. of fixture Units ) PUBUC] OR 3.
Invasion into City Right -of -Way: No (/ Yes (If Yes, Right -of -'Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No L-� Yes (If Yes, easement required,
attach legal description and.county.easement number.)
PLEASE', READ THE ITEMS LISTED ON THE BACK
�O/Z7
e-r" a_f- th t-I have read and shall comply - Date
ith the items listed on the back.
MM
Permit Fee:
Trunk Charge:
Assessment Fee:
Issued By: _,
Date Issued:
Receipt No.: S�
Partial Inspection:
Comments Date Initial
Final Inspection Approved: 2-IG-87
Date Initial .
Rejected:
eason
** PERMIT MUST BE POSTED ON JOB SITE **
Wh.ite Copy - File Green Copy - Inspector
Date Initial
Buff Copy - Applicant
Side Sewer Drawing
i
,V
L
The City of Edmonds EASEMENT NO- --------------------------------------------
MEAD . C0NNEc.'r1014 +t A
0
NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO. Z1------ ASMT. NO - ------------------
OWNER .G!iEpu-D-----` F--9E... -------------------------------------------------- CONTRACTOR T--'k tj.SS--- dOAK—SO N..-------------------------.--- PERMIT NO. 76-S-2-
p LYNNW00D tt
JOB ADDRESS - 50 2.(O--�H---T-H--Avg W,.............. LEGAL DESCRIPTION: LOT NO. ------- ------------------------------ BLOCK NO. ... - --- - -
c.o.GAP
1.5'OP.
PWW-0001-11/75 (REV.11178)
---------------------------------------------------------------------------------------------- ------------------------------------------------------------------
NAMEOF ADDITION--=----------------------------------------------------------------------------------------------------..------
T
11' .
34' -)
3;oe
c o.cAP
1.5'GP.
15826
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9• � + 175
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3'
5fo'
Approved:
DATF �--- -- i
-----------------------
19 BY �
STREET FILE
Critical Areas Checklist'
Site Information
Project Name: - con" L-EZ— Permit Number.
Site Location: f%24 614' 6-w to • Property Tax Account Number: S 31 - 060 - 037 - 04
Approximate Site Size (acres or square feet): 2/7 AC
Have you filled out a Critical Areas Checklist for a project on this site before? �0
General Site Conditions
1. Has the site been cleared or logged?
Soils / Topography
Date of most recant action:
2. In the Snohomish County Soil Survey, what is the mapped soil typc(s)? 4PMV 0
LAgu. 3 Cowl JDcc5c -
3. Describe the general site topography. Check all that apply. Z�•
Flat: less than 5 feet elevation changeover 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 greaW than 301% present on site.
Commcnts
Hydrology/Vegetation.
4. Site contains areas of year-round standing water. l�
5. Site contains areas of seasonal standing water: NYC Approx_ Depth:
6- Site is in the floodway " floodplain of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? PD flows
are year-round? PD Flows are seasonal?
8. Site is primarily: forested : meadow U ; shrubs ; mixed
9. Obvious wetland is present on site: II/�
10. Wetland inventory or map indicates wetland present on site:
11. Critical Areas inventory or map indicates any Critical Area on site:
For -City Pse Only
Rev 3127N2
City of Edmonds
Critical Areas Chec*Mklist
The Critical Areas (Mocldist contained on
this foam 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 Chheckist should be easily
available from observations of the site or
data available at (Sty Hall (Critical Areas
inventories, maps, or soil surveys).
An applicant, or his/her representative, must
fill out the checidist, sign and date it, and
submit it to the City. The City will review
the checklist, make a precursory site visit,
and nWw 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
of the parcel with enough dew that (Sty
staff can find and identify the subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or stddics. 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
-®dam( 0
City, State, ZIP Phone
2, $7
Signature .
Date
Applicant Representative:
Name
Title
Street Address
City, State, ZIP
Signature
Phone
Date