1590 9TH AVE N.PDFIIIIIIIIIIII
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1590 9TH AVE N
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City. of Edmonds
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.
Date Received: d
City Receipt #: o
Critical Areas File M
Critical Areas Checklist Fee: $135.00
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
The purpose of the Checklist is to enable City staff to .subsequent steps, necessary to _.complete a development
determine whether any potential Critical Areas .are,. or. permit application.
may be, present on the subject property. The information Please submit a vicinity map, along with the signed copy
needed to complete the" Checklist .should be easily of this form to assist Citystaff in finding arid locating the
available from observations of the site or data available at specific piece of property described on this .form. In
City. Hall (Critical . areas inventories, •maps, or: soil . addition, . ;the applicant, shall include other, pertinent
sure ys), information .(e:g. site ' plan,. topography ,L...
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
attorney's fees, arising from . any ; action or . infraction based in whole or ,part upon. false, misleading, inaccurate or
incomplete. information fiuriished'by the applicant, his/her/its agents or employees.
By. my. signature, -I certify that the information and exhibits herewith`subrmtimd` 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: r.
SIGNATURE OF APPLICANT/AGENT Ciyrtiv erf . DATE
Property. Owner"'s -'Authorization
By my signature, 1-certify that I have auth&izedAhe 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 CS 4 V\..Q._. CY . � DATE
PLEASE PRINT CLEARLY
Owner/Applicant: Applicant Representative:
�. WA YN
Name Name
1 5 9 0 -rN Av N
Street Address Street, Address
CPMe3rpS, AA.. 9c302c�
City State Zip City State Zip
Telephone: 47— 5- — 7 7 E. - 2 c Telephone:
Email address (optional): Email Address (optional):
#P20
Critical Areas Checklist CaFile No: DSO-
Site Information (soils/topography/hydrology/vegetation)
1. ` Site Address/ Location: 1 '5 q v ,_ N
2. Property, Tax Account.Number: 2-103 13 CDk 11 DOD Wl>7 1371 D34 11 DDDD
3. Approximate Site Size (acres or square feet): Cv 4
4. Is this site currently developed? ✓es; no.
If yes; how is site developed? Lti H 4 s c,�-��_� u� ►s n �- j�c�
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 yeai4ourid standing water: lJ-o Approx Depth:
7. Site contains areas of seasonal standing water: kA b ; Approx. Depth:
What season(s)of the year?
8. Site is in the floodway No floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds . surface? Flows are "year-round?
k u Flows are seasonal? tA v -(What: time of year? ).
10. Site is primarily: forested ; meadow ; shrubs ; mixed
urban landscaped (lawn, shrubs etc) r
11. Obvious wetland is present on site:
For City" Staff Use Only �G `t
1. Plan Check Number, if applicable?
2. Site is.Zoned? RS - 1 2
3. SCS mapped soil type(s)? ► 8 - e"J" 15 L,, , 19 -7, 5! K9
Critical Areas inventory or C.A. map indicates Critical Area on site? Na
Site within designated earth subsidence landslide hazard area? M,
DETERMINATION
STUDY REQUIRED ✓ WAIVER
Reviewed
CITY OF EDMONDS
7110 - 210TH ST. SW • EDMONDS, WA 99026 • (206) 771.0235 • FAX (206) 744-6047
COMMUNITY SERVICES DEPARTMENT — PUBLIC WORKS DIVISION
I -4-N1210011—
C�0
89Q-19
July 13, 1995
Wayne C. Jones
1590 - 9th Ave. N
Edmonds, WA 98020
Dear Resident:
LAURA M. HALL
MAYOR
I have reviewed your account and will allow a credit to your account in accordance with
our City policy. The policy states that the customer will be billed at the retail rate based
upon the average water consumption for the same period during the previous year. In
addition, the excess water lost from the leak will be billed to customer at the City's
wholesale rate with a 15% surcharge added for administrative cost. Only one leak credit
will be granted in any three year period.
Should you have any additional questions after you receive your new billing, please
contact Ilene Larson, Utility Billing Clerk, at 771-0241.
Sincerely,
Ron Holland
Water/Sewer Supervisor
RH/lk
cc: Ilene Larson
Utility Billing Clerk
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ACCOUNT NUMBER.
PAST DUE AFTER: "?/24/95
AMOUNT DUE: 83.86 POR99 ...
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EDMONIUS WA 9.8020-2627
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The City of Edmonds
gFiLE APPLICATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS E]
OWNER-- ------------------------------- .................
ADDRESS........ --------- 9 .............................
EASEMENT No..
CONTRACTOR ......... , W.- --- ................................... PERMIT No.
LEGAL DESCRIPTION: LOT No.14� BLOCK No.............................................
NAME OF ADDITION .........................................................
Approved:
DATE .... ..........
CITY OF EDMONDS
Call PRospect 0-1107 when work
CIVIC CENTER— WATER -SEWER DEPARTMENT i r IIIti (x i
e ready or epec on, o nspec- Fy
tions Saturday, Sunday or holidays.) I Q 2 9 W
SIDE SEWER PERMIT
ADDRESS ....... I .......... 1590 - ...9th N.orth. .... .............
OWNER ..................... Frank W....Fletcher....----------------------- CONTRACTOR.........M��..... Inc ................................-----...........
Permission is granted ................ApT'i.l 3 19..68, for ........................ days to REPAIR or CONNECT a side sewer
with City Sewers in accordance with application on file and governing ordinances.
ATTE14TION 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 In street area. Do not cover any portion of sewer before it 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 3% will be permitted.
\_,PE 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 within one year of completion.
NOTE No. 5—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appur-
tenances except to insert the pipe into the wye.
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION ❑ REPAIRS 0
EASEMENT No . ..........................................
OWNER ......... CONTRACTOR ........................... PERMIT No . ........................
;�r ------------------------ -
-6 -�?%BLOCK No. ............................................
ADDRESS ..... /S P • LEGAL DESCRIPTION: LOT No. 'a,
----- . ...........
NAMEOF ADDITION ......................................... ............................................................................ ...................
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Gas
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Approved:
DATE..................................
By.....................