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1600 9TH AVE N.PDF111111111111 9815 1600 9TH AVE N APPLICATION u` The City of Edmonds w: for SIDE SEWER PERMIT EASEMENT NO. -------------------------------------------- £ NEW CONSTRUCTION REPAIRS ❑ LID NO. __I A ------ ASMT. NO. -_ ____. OWNER STRUGTtpN --_ C"rJ. CONTRACTOR _-.'TEE•_ CCONSTfRL�C'T'IplV cc•pERMIT NO. -----�^- JOB ADDRESS ---- •�----lAE= .-1V.----------=------- LEGAL -DESCRIPTION; LOT NOSE�_4. - CK NO. -- •------ NAME OF ADDITION---------------•----- CITY OF' EDMONDS - SIDE SEWER PERMIT WATER -SEWER DEPARTMENT PERMIT Call 775-2525 for side sewer Inspections BEFORE covering any portion of the construction.` Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday Inspections./ ADDRESS LOCATION OF CONSTRUCTION......... ...:::.:.:' .......................................................................................................... PROPERTYLEGAL DESCRIPTION ......................... ...................... :........................................................................................................................................ ................................................................................................................:........................................................................................................................................... i:'..':' �1'� i*"J W................................................................ONER AND/OR BUILDER .................................................... .......................................................................... TRACTOR'S NAME & ADDRESS ...... >111 ............... ... ........Z—/ �-17A...... Permission is granted .............:.:..........:..::.. : `:.,................. , 19.....r.:, for repair and/or connection of a side sewer to the city sanitary sewer s\\y,4em in accordance with City of Edmonds ordinances. A1'ThNTION 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—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office. NOTE No. 3—Obtaln full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 4—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 2/s will be permitted. NOTE No. 5—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, i NOTE No. 0—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 appurtenances except to In- sert the pipe into the wye. DISAPPROVED❑ Date ... _......... �....................... ..........By ................ Date............. By ................ Date .................................... By ................ APPROVED Date..S.. �r�Ti��: -By y?........ ..._....................................................................................... .k........ a Remarks: ........................................................................................................................................................................................................................ .................................................................._............................................................................................................................. ....................................................... — BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection -- I..........................................................................................I hereby certify that the aide sewer installation constructed under this permit (Owner of Contracting Firm Performing Construction) Wwj Installed in accordance with all -governing ordinances of the City of Edmonds. Datedthis ............................day of................................................................. 19......... �J J Check BEFORE you dig for: Water ❑, Gas ❑, Telephone ❑, Power ❑, Sewer ❑, Other ❑ J J r APPLICATION The City of Edmonds for EASEMENT NO. -"_"-------------------------- -- SIDE SEWER PERMIT rr NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO..."-f �' ....... .ASMT. NO. --------"_---_---- OWNER ......................................... CONTRACTOR - 4-1 .-L tV .1------ (� ......................... PERMIT NO. _' --- ---"- JOB ADDRESS ---- I&C�----�'�fk-'----------------"------------------"------ LEGAL DESCRIPTION: LOT NO. ----------------------------- -------- BLOCK NO.------------------------------------ ----------------------------------------------------------------------------------------------------------- ------ ----------------------------------------------- NAME OF ADDITION--------------------------------------------------------------------------------------------------------------- RECEA'IE'Q JAN 2 ;1976 Public Works Dept, Approved: DATE-------------------------------------------- BY------------------------------------------------------------ SCHEDULE "A" PAR",EL A: That portion of the Southwest quarter of the Southeast quarter and of Government Lot 3, all in Section 13, Township 27 North, Range -3 East, w.m., described as follows: Commencing at the intersection of the centerline of Newport Avenue with the centerline of Second Street, according to the Original Plat of North Edmonds, Washington, according to the plat thereof recorded in Volume 2 of Plats, page 75, records of Snohomish County, Washington, said Second Street centerline also being the South- easterly margin of the vacated Northwesterly one-half of Second Street; thence South 38*34100" West, along said centerline, a dis- tance of 54.00 feet; thence North 51*26100" West, parallel with ll� the centerline of Newport Avenue, a distance of 300.00 feet to the True Point of Beginning; thence North 38°34'00" East, a distance of 10.26 feet; to a point on the East line of that certain Tract conveyed to George Strieck and Fern H. Strieck, husband and wife, by deed recorded under Auditor's File No. 1970543; thence North 51*02100" West, a distance of 140.05 feet to a line parallel with (O and 40.00 feet North of the South line of Government Lot 3; thence -n South 89047130" 11--st, along said line, a distance of 119.14.feet;-- n thence South 0°38'00" East, a distance of 19.99 feet; thence North 89047130" East, a distance of 16.91 feet; thence South 51002100" East a distance of 208.33 feet to a point lying South 38*34'00" rn West from the true point of beginning; thence North 38°34'00"-East C) a distance of 69.74 feet to the True Point of Beginning. .Situate in the County of Sno}ionish, State of Washington. PARCEL B: r'. non-exclusive ea Bement for ingress, egrass and uti,ityes over the follofiing described property: All that portion of Government Lot 3, Section 13, Township 27 North Range 3 East; 4;IJI.,, describe4 as follow! Commencing at a point on the center line of Euclid Avenue (as shown on the original plat of North Edmonds, Washington, according to the CP plat thereof recorded in Volume 2 of Plats, on page 75, Records of Snohomish County, Washington) north 51° 26t West 290 feet from the centerline of Second Street; thence North 38*34' east 176 feet; thence north 51*26' west 255.31 feet to a point on a line 35.01 feet north of and parallel to the south line of Government Lot 3, said Section, and the true point of beginning. Thence south 89*4713011 West parallel to the south line of said Government Lot 3; 261.11 feet to the east margin of Charles Avenue, extended (100th Avenue West); thence south 0*12' east along said street line 15.00 feet; thence North 89047t 30" east 281.60 feet; thence North 0*12130" west 15.00 feet; thence south 89*47130" crest 20.38 feet to the true point of beginning. All situate in the County of . Snchor-iish, State of. Lashiregton. 2418445 4 89p_19"-)_ City of Edmonds RIGHT—OF—WAY CONSTRUCTION PERMIT permit Number. �9,5--19 Issue Date• T - t — A. Address or Vicinity of Construction: 1600 9 Av N ( 9518222 } B. Type of Work (be specific): Install Service C. Contractor: -Washington iatu%$3 Gas Mailing Address: 1122 75 St SW Everett State License #: 98203 D. Building Permit # (if applicable): Contact: wrO..ay Swnu Phone: 447-3284 Liability Insurance: Bond: $ Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project ® Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ Other INSPECTOR: INSPECTOR: F. Pavement or Concrete Cut: [RYes ❑No G. Size of Cut: x _ H. Charge $ (2eu ) APPLICANT TO READ AND SA:.�"� INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be trade against the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal proceedings including defense coats, and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL i.. INSPECTION AND ACCEPTANCEPF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY CITY ARCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. Work and material is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. I have read the above statements and understand the permit requirements and the pink copy of the permit will be available on site at a l ' es for ' s ct' n purposes. Signature: /� Date: 8-31-95 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: W 4 L''~ RIGHT OF WAY DEPOSIT TIME AUTHORIZED: VOID AFTER _90\1 1_ G DAYS ' SPECIAL CONDITIONS: � k DISRUPTION FEE/FUND III: RESTORATION FEE: PERMIT FEE: (X) . TOTAL FEE: COMMENTS: Cam! RECEIPT FEE: DATE; ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994 FIELD INSPECTION NOTES Comments• Dia¢ram (Fund 111 - Route copy to Street Dept.) CONTRACTOR CALLED FOR INSPECTION ❑ YES Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: ❑ NO 1 � I WA I f" I N ►10.1�.{ '` M•►O��c�f f a (3) 1661 N ? 0 r a r- �.5vt• ,.17,, L43t' �•� Z �061 3 417fc , 4�� c�9 N k / 96/ 16ZO 1576 1510 cA 7 Al M to 1D� co� �► (V ''A 00 N r r- J • A M Washington Natural Gas A Wa9i ,gtai Fty fqV Ca»cxvTv Ut i 0 Addendum to: City of Edmonds Right of Way Permit Application Submitted by: Mariamne Kingsbury Engineering Aide Washington Natural Gas 1356-7500 X7596 000 O1 Awl N� C-1L\1-S Rey: Watermain depth -W- Water-G- Gas -SS- Sewer Z gas main -- Water hydrant Q Water valve Washington Natural Gas Company 1122 75th Street S.W.. Everett. Washington 98203. (206) 355-3331 690.19"- City of Edmonds Critical Areas Checklist The Critical Areas Checklist contained on and submit it to the City. The City will this form is to be filled out by any person review the checklist, make a precursory site preparing a Development Permit visit, and make a determination of the Application for the City of Edmonds prior subsequent steps necessary to complete a to his/her submittal of a development development permit application. 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, 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: AU C/v � S usA-AJ ✓I TT" Name Street Address 5DAlaNDS4 ISM 94foZO 77I-2 ,5T City, State, ZIP Phone Signature Date Applicant Representative: 14L,B6e-T /l. C.o/ICA/ Name 33o DA-Y710ti1 ST 4-(- Street Address ezM6 It 6, b4,0 9ER02,0 City, State, ZIP • C&t'to-•--- Signature 77G-7373 Phone Date CA FILE NO. Critical Areas Checklist Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: /&00- 921 A 06. AJ6A Y -- 2. Property Tax Account Number: I 3.-.)-1 3. Approximate Site Size (acres or square feet): 4. Is this site currently developed? V yes; no. If yes; how is site developed? 5. Describe the general site topography. Check all that 9pply. Flat: less than 5-feet elevation change over entire site. t/ 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: IU o ; Approx. Depth: 7. Site contains areas of seasonal standing water: �J U ; Approx. Depth: What season(s) of the year? 8. Site is in the floodway 0 o floodplain N 0 of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year- round? ji t7 Flows are seasonal? 00 (What time of year? ). 10. Site is primarily: forested ; meadow ; shrubs ; mixed ; urban landscaped (lawn,shrubs etc) 11. Obvious wetland is present on site: 140 - --- -=-- --- =— For City.Staff Use Only- 1 r Site is Zoned?: 2 SCS mapped soil type(s)? 3. :Wetland inventory or C.A. map indicates wetland present on site? , )o 4. Critical Areas inventory or C.A. map indicates Critical Area on site? �(�7 5': Site within designated earth subsidence landslide hazard area? 7 6. Site designated on the Environmentally Sensitive Areas Map? DETERIMNATION STUDY REQUIRED WAIVER.. . Reviewed by: Pla e CONDITIONAL WAIVER Date Rev 09/29/93 CA FILE NO. '`� '—L7 Critical Areas Checklist Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: /&00- �9 A Ve. AJo97W 2. Property Tax Account Number: 1 —401 b 3 4 . ©S-1 M — 3. Approximate Site Size (acres or square feet): <gD- ") 4. Is this site currently developed? V yes; no. If yes; how is site developed? ff 5. Describe the general site topography. Check all that pply. Flat: less than 5-feet elevation change over entire site. t1l 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: IU 0;Approx. Depth: 7. Site contains areas of seasonal standing water: /J o ; Approx. Depth: What season(s) of the year? 8. Site is in the floodway I.J o floodplain N O of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year- round? p o Flows are seasonal? 00 (What time of year? ). 10. Site is primarily: forested ; meadow ; shrubs ; mixed urban landscaped (lawn,shrubs etc) 11. Obvious wetland is present on site: tjy WAIVER:.. - ;.Reviewed by RN 09/29/93 & 9 0 , 199- 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: Au,z:?/ � SUsArd ✓I TT" Name A,00-9',"ff. tii6g: m Street Address 5D,A46NDS4 WA e)?- o 77%?�oSB City, State, ZIP Phone Signature Date Applicant Representative: A1-867e-r /� cbhio�l Name 33o DA-YMA S% *`(- Street Address ED4MC6, /,(1,4 5?02o City, State, ZIP ,�&a7l- Lam,--- Signature 77G-7373 Phone ss Date PLANNING DATA SITE ADDRESS: = q4-2& Al, —DATE: g3 ZONING: &-17- PLAN CHK#: PROJECT DESCRIPTION: A2P) 7-7 CW SETBACKS: Required Setba Front:_�Left Side: 10 Right Side:QRear: _ Actual Setbacks: Front: _Left Side:/Right Side: Rear:_ 10-6 "-6x (sT, CORNER LOT tJ r) LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED LOT COVERAGE: Maximum Allowed: L'e/_�Actual: l g o BUILDING HEIGHT: Maximum Allowed: ctual Height: SUBDIVISION: CRITICAL AREAS #: SEPA DETERMINATION: N-,,� &,Q UT561t> LOTAREA: J5 ,:Z:�%� OTHER: Plan Review By: CITY OF EDMONDS USE PERMIT 2ONE ' :I NUMBER .7.7 i.11 i► °f CONSTRUCTION PERMIT APPLICATION JOB SUITEAPTa ADDRESS /1 " — t / /CHJECK OW ER NAMN AM OF BUSINES r vJ �r v,G uI LEGAL DESCRIPTiION SUBDIVISION NO LID NO w p1 .r. MA LII/N}G AA,DDRESS 1/ K/�_ "� e /VO• TESCP Approved ❑ i W V • —� PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. ❑ CITY ZIP ^ j >S ��� V TELEPHONE NUMBER 1� �� / RE°UIRED DEDICATION )POSED POSED RW Permit Required Street Use Permit Req'd ❑ Inspection Required ❑ Sidewalk Required ❑ NAME f METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED Q w VES ❑ NO ❑ Z ADDRESSVv / U A 0� �{. /V '1 REMARKS w a Z CITY P f fvZIZc) TELEPHONE NUMBER 774-'7373 "M& OS W NAME atfnl C'7lt! 8c-.T'NS7�evc7loiV ADD SS 2 (I `_Fj i� l'�`�l % A,w i c; tr ENGINEERING MEMO DATED REVIEWED BY U ¢ Z CITY R�' ZIP EPHONE NUMBER 7' '7f R'5(2—I FIRE MEMO DATED REVIEWED BY W ¢ VI4 I W LL STATE LICENSE NUMBER E IRATION DATE SIGN AREA SEPA REVIEW AD NO. C ) L I, v i 0 I b ALLOWED COMPLETE EXEMPT Legal Description Property - include all easements 4�ROPOSED SHO LINE N o EXP a VARIANCE Oq CU BY it OAT U 104 �&LAIEW N W O � SETBACK —FEET HEIGHT LOT C ERAv (� ? Z a OW FRONT SIDE REAR Q Property / 3 Z 7 O3 / Ye 7- O 0 Tax Account .. + /V') REMARKS a Parcel No. ® FJ NEW RESIDENTIAL PLUMBING ADDITION COMMERCIAL 1:1MECHANICAL Iry vil REMODEL APT. SLOG. LJ SIGN CHECKED BY TYPE OF CONSTRUCTION CODE C OCCUPANT GROU GRADING FENCE CYOS. El I_ x REPAIR _—FT) SWIM POOL DEMOLISH WOODSINSERTHOT TUB SPA SPECIAL SPEC REQUIRED RED AREA LOCADUPANT 3 ❑YES GARAGE RETAINING WALL/ CARPORT ROCKERY RENEWAL R MARKS PROGRESS INSPECTIONS PER UBC 3OS FF USSLE. BUSINE.+�S OOR/�}R�)A TIVITY) EXPLAIN: 0(TYPE c Zyerm eg. 4 WW6 A�' •✓ I/1p ID cc NUMBER �l OF / NUMBER OF DWELLING / CRITICAL/J�� AREAS �i� 7 W o m STORIES �i•r UNITS ( NUMBER /,� DESCRIBE WORK TO 8f DONE (ATTACH PLOT PLAN) FINAL INSPECTION REQUIRED LT Vie M JV NIN6r- ivy ktw00C4 )ea J)/1;© VALUATION FEE PLAN CHECK FEE (r BUILDING f / HEAT SOURCE: 645 FA GLAZING I� ` �0i S+ 0 PLUMBING /0 Plan Check No. MECHANICAL �' GRADINGIFILL This Permit covers work to be done on private property ONLY. Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) Will require separate permission. STATE SURCHARGE 44 Permit Application: 180 Days STORM DRAINAGE FEE Permit Limit: 1 Year - Provided Work Is Started Within 180 Days ENO. INSPECTION FEE "Applicant,. on behalf of his or her spouse, heirs, assigns and u, successors in interest, agrees to indemnify, defend and hold W harmless the City of Edmonds, Washington, its officials, x employees, and agents from any and all claims for damages of whatever nature, arising directly or indirectly from the Issuance PLAN CHECK DEPOSIT -� 50 of this permit. Issuance of this permit shall not be deemed to —1 S y modify, waive or reduce any requirement of any city ordinance = nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE provision." I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL information given is correct; and that I am the owner, or the duly authorized agent of the owner. I agree to Comply with city and THIS PERMIT This application is not a permit until state laws regulating construction; and in doing the work authoriz• LITHO TIRES signed by the Building Official or his/her ed thereby, no person will be employed in violation of the Labor ONLYWORK NOTED Deputy: and fees are paid, and receipt is Code of the State of Washington relating to Workmen's Compensa• acknowledged in space provided. tion Insurance and RCW 18.27. INSPECTION SIGNATURE (OWNER OR AGENT) DATE SIGNED DEPARTMENT GNATURE DATE PS CITY OF / % &-h 0 .20 EDMONDS CALL FOR RELE DATE ATTENTION INSPECTION : - 4t7' IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771 0220 UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC r,MAPTFR 1. PINK — Owner GOLD — Assessor )ITS PLAN iCiAI. Z 1" = .20• m VA I b I$� S SI - 02 -ool a flew aeVPnaJ S 78 * 12 W I }J 51; Zo13. * I IJUAJ 2 0 l995 GR rnG,4c. AAE -s 9S—( 7 r,✓ai ✓6-r- PROJECT DATA OWNER: ADDRESS: 1(o p0- 9 A-1/E. R/�� ?-1 ED/�(OAJDS G�%4• ��O 2 O PHONE: 7 % 1 - 2(o S SITE: 5 A-M E ASSESSOR'S I.D. #• / 3 2%-o3({-Oe-%-.00 ZONING: P, -) 2 CRTY COPY ITS PLAN GAL Z 1" = .W. IJ v✓ 100.3 - ro de�tlr-i y "I 3g %it x a t3%89'ato � � slew el�Y� o. 15� �.IO2•S 0 � 5S�-OZ-cam f L l4o. o� 0:51 .o2•DOII w 0 0 12� �E1� DEG 7O O e)X f'04.f-*Y 2 ISE G�2rnG,�� AAA -s 7 wm ✓6-c PROJECT DATA OWNER: Xtt67J 4 506S EI%]Z77" ADDRESS: l (000- q-LA A-Vu. NoR-rH PHONE: 7 - 2(oS'8 SITE: 5 A-M 9- &-PM6M>5 14/4• e►��c��nrt�5 �.�. it• l � 77-n��l-nk7- Oo ZONING: I? S - 12