16612 72ND AVE W.PDF111111111111
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16612 72ND AVE W
ALE
DETERMINATION OF NONSIGNIFICANCE
Description of proposal
FILE## N/A
Addition and Remodel of an existing single family residence
Proponent Peter Dugan
16612 72nd Ave. W. Edmonds, WA 98026
Location of proposal, including street address, if any
16612 72nd Ave. W. Edmonds, WA 98026
Lead Agency Edmonds Planning Division
The lead agency for this proposal has determined that it does not have
a probable significant adverse impact on the environment. An
environmental impact statement (EIS) is not required under RCW
43.21C.030(2)(c). This decision was made after review of a completed
environmental checklist and other information on file with the lead
agency. This information is available to the public on request.
X There is no comment period for this DNS.
This DNS is issued under 197-11-340(2); the lead agency will not
act on this proposal for 15 days from the date below. Comments
must be submitted by
Responsible Official Jeffrey S. Wilson
Position/Title Current Planning Supervisor Phone 771-3202
Address 250 5th Ave. N., Edmonds WA 98020
Date 3/ lb/qL Si gnatur
X You may appeal this determination of nonsignificance
to Hearing Examiner
at 250 5th Ave. North, Edmonds, WA 98020
no later than March 27, 1992
by filing a written appeal citing reasons.
You should be prepared to make specific factual objections. Contact
John Bissell to read or ask about the procedures for
SEPA appeals.
There is no agency appeal.
CITY OF EDMONDS
ENVIRONMENTAL CHECKLIST k �'
MAR 0 r��y
A. BACKGROUND
1. Name of proposed project, if applicable:
2. Name of applicant:
3. Address and phone number of applicant and contact person:
l4-ry r2 — -72Mb tab t-te•�,DS �T FoZb
4. Date checklist prepared:
5. Agency requesting checklist: City of Edmonds.
6. Proposed timing or schedule (including phasing, if applicable):
S'cJ HKNL_ � 2
(STAFF COMMENTS)
7. Do you have any plans for future additions, expansion, or further
activity related to or connected with this proposal? If yes, explain.
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 1 of 26
S. List any environmental information. you know about that has been
prepared, or will be prepared, directly related to this proposal.
N'oNe�
(STAFF COMMENTS)
9. Do you know whether applications are pending for governmental approvals
of other proposals directly affecting the property covered by your
proposal? If yes, explain.
(STAFF COMMENTS)
10. List any government approvals or permits that will be needed for your
approval, if known.
til
(STAFF COMMENTS) pecM
11. Give brief, complete description of your proposal, including the
proposed uses and size of the project and site. There are several
questions later in this checklist that ask you to describe certain
aspects of your proposal. You do not need to repeat those answers on
this page.
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 2 of 26
12. Location of the proposal. Give sufficient information for a person to
understand the precise location of your proposed project, including a
street address, -if any, and section, township, and range, if known. If
a proposal would occur over a range of area, provide range or boundaries
of the site(s). Provide legal description, site plan, vicinity map, and
topographic map, if reasonably available. While you should submit any
plans required by the agency, you are not required to duplicate maps or
detailed plans submitted with any permit applications related to this
checklist..
( STAFF COMMENTS) ( CZ Z �Z 1 ? �L(► ��' . 1
TO BE COMPLETED BY APPLICANT
B. ENVIRONMENTAL ELEMENTS
1. Earth
a. General description of the site (circle one): Flat, rolling,
hilly, steep slopes, mountainous, other:
(STAFF COMMENTS)
b. What is the steepest slope on the site (approximate percent
slope)?
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 3 of 26
C. What general types of soils are found on the site (for example,
clay, sand, gravel, peat, muck)? If you know the classification
of agricultural soils, specify them and note any prime farmland.
(STAFF COMMENTS)
d. Are there surface indications or history of unstable soils in the
immediate vicinity? If so, describe.
No
(STAFF COMMENTS)
e. Describe the purpose, type and approximate quantities of any
filling or grading proposed. Indicate source of fill.
(STAFF COMMENTS)
f. Could erosion occur as a result of clearing, construction, or use?
If so, generally describe.
Vo
(STAFF COMMENTS)
CHKLT/1 0-8-9 1. MASTER . Page 4 of 26
g.. About what percent of the site will be covered with impervious
surfaces after project construction (for example, asphalt or
buildings)?
k- ?A 14.0 s cp rcT
(STAFF COMMENTS)
h. Proposed measures to reduce or control erosion, or other impacts
to the earth, if any:
(STAFF COMMENTS)
2. AIR
NCD AA=T_
Alan
a. What types of emissions to the air would result from the proposal
(i.e., dust, automobile, odors, industrial wood smoke) during
construction and when the project is completed? If any, generally
describe and give approximate quantities if known.
�Si lV��2�l�t2• L'c;,,v T7V_00770- J
)&VIDsW7y%L. �t-ti7�� Cb•v si-2y Cirio , 3
(STAFF COMMENTS)
b. Are there any off -site sources of emissions or odor that may
effect your proposal? If so, generally describe.
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 5 of 26
C. Proposed measures to reduce or control emissions or other impacts
to the, if any:
(STAFF COMMENTS)
3. WATER
a. Surface:
(1) Is there any surface water body on or in the immediate
vicinity of the site (including year-round and seasonal
streams, saltwater, lakes, ponds, wetlands)? If yes,
describe type and provide names. If appropriate, state what
.stream or river it flows into.
NOWT
(STAFF COMMENTS)
(2) Will the project require any work over, in, or adjacent to
(within 200 feet) the. described waters? If yes, please
describe available plans.
(STAFF COMMENTS)
(3) Estimate the amount of fill and dredge material that would
be placed in or removed from surface water or wetlands and
indicate the area of the site that would be affected.
Indicate the source of fill material.
CHKLT/10-8-91.MASTER Page 6 of ,26
(STAFF COMMENTS)
(4) Will the proposal require surface water withdrawals or
diversions. Give general description, purpose, and
approximate quantities if known.
N . Ar
(STAFF COMMENTS)
(5) Does the proposal lie within a 100-year floodplain? If so,
note location on the site plan.
(STAFF COMMENTS)
(6) Does the proposal involve any discharges of waste materials
to surface waters? If so, describe the type of waste and
anticipated volume of discharge.
(STAFF COMMENTS)
b. Ground:
(1) Will ground water be withdrawn, or will water be discharged
to ground water? Give general description, propose, and
approximate quantities if known.
CHKLT/10-8-91.MASTER Page 7 of 26
(STAFF COMMENTS)
(2) Describe waste material that will be discharged into the
ground from septic tanks or other sources, if any (for
example: Domestic sewage; industrial, containing the
following chemicals...; agricultural; etc.). Describe the
general size of the system, the number of such systems, the
number of houses to be served (if applicable), or the number
of animals or humans the system(s) are expected to serve.
(STAFF COMMENTS)
C. Water Runoff (including storm water):
(1) Describe the source of runoff (including storm water) and
method of collection and disposal, if any (including
quantities, if known). Will this water flow into other
waters? If so, describe.
Sly' V D AAA. .7)9"^!'S SY S"
(STAFF COMMENTS)
(2) Could waste materials enter ground or surface waters? If
so, generally describe.
Nb
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 8 of 26
d. Proposed measures to reduce or control surface, ground, and runoff
water impacts, if any:
(STAFF COMMENTS)
4. Plants
a. Check or circle types of vegetation found on the site:
deciduous tree: alder, maple, aspen, other:
evergreen tree: fir, cedar, pine, other:
shrubs
gra 7 s
ure
crop or grain
wet soil plants:
cabbage, other•_
cattail, buttercup, bulrush, skunk
water plants: water lily, eelgrass, milfoil, other:
other types of vegetation:
(STAFF COMMENTS)
b. What kind and amount of vegetation will be remove or altered?
l�(o w
CHKLT/10-8-91.MASTER Page 9 of 26
(STAFF COMMENTS)
C. List threatened or endangered species known to be on or near the
site.
NOA/tT
(STAFF COMMENTS)
d. Proposed landscaping, use of native plants, or other materials to
preserve or enhance vegetation on the site, if any:
1 IA- •
(STAFF COMMENTS)
5. Animals
a. Check or circle any birds and animals which have been observed on
or near the site or are known to be on or near the site:
birds: hawk, heron, eagle, ongbirds, other:
i
mammals: deer, bear, elk, beaver, other:
fish: bass, salmon, trout, herring, shellfish, other: T
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 10 of 26
b. List any threatened or. endangered species known to be on or near
the site.
( STAFF COMMENTS)
C. Is the site part of a migration route? If so, explain.
No
(STAFF COMMENTS)
d. Proposed measures to preserve or enhance wildlife, if any:
�. 14
(STAFF COMMENTS)
6. Energy and Natural Resources
a. What kinds of energy (electric,. natural gas, oil, wood stove,
solar) will be used to meet the completed project's energy needs?
Describe whether it will be used for heating, manufacturing, etc.
H6vrn Al C
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 11 of 26
b. Would your project affect the potential use of solar energy by
adjacent properties? If so, generally describe.
No
(STAFF COMMENTS)
C. What kinds of energy conservation features are included in the
plans of this proposal?
A-.
(STAFF COMMENTS)
7. Environmental Health
a. Are there any environmental health hazards, including exposure to
toxic chemicals, risk of fire and explosion, spill, or hazardous
waste, that could occur as a result of this proposal? If so
describe.
12
(STAFF COMMENTS)
(1) Describe special emergency services that might be required.
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 12 of 26
(2) Proposed measures to reduce or control environmental health
hazards, if any:
(STAFF COMMENTS)
b. Noise
(1) What types of noise exist in the area which may affect your
project (for example: traffic, equipment, operation,
other)?
(STAFF COMMENTS)
(2) What types and levels of noise would be created by or
associated with the project on a short-term or a. long-term
basis (for example: traffic, construction, operation,.
other)? Indicate what hours noise would come from the site.
St�fot�' ?Z" HW 02
(STAFF COMMENTS)/
(3) Proposed measures to reduce or control noise impacts, if
any:
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 13 of 26
8. Land and Shoreline Use
a. What is the current use of the site and adjacent properties?
(STAFF COMMENTS)
b. Has the site been used for agriculture? If so, describe.
(STAFF COMMENTS)
C. Describe any structures on the site.
(STAFF COMMENTS)
d. Will any structures be demolished? If so, what?
(STAFF COMMENTS)
e. What is the current zoning classification of the site?
CHKLT/10-8-91.MASTER Page 14 of 26
(STAFF COMMENTS)
f. What is the current comprehensive plan designation of the site?
(STAFF COMMENTS)
g. If applicable, what is the current shoreline master plan
designation of the site?
(STAFF COMMENTS)
h. Has any part of the site been classified as an "environmentally
sensitive" area? If so, specify.
Y&'.5 . [o qL ?o�i
( STAFF COMMENTS) x(a�- ( a" eJ-n Pc� �cAr�
S tT^C Ok- t2�
i. Approximately how many people would reside or work in the
completed project?
Z • ( VA2e)
(STAFF COMMENTS)
CHKLT/1 0-8-9 1.MASTER Page 15 of 26
j. Approximately how many people would the completed project
displace?
Flo lvz'
(STAFF COMMENTS)
k.. Proposed measures to avoid or reduce displacement impacts, if any:
^v A .
(STAFF COMMENTS)
1. Proposed measures to ensure the proposal is compatible with
existingand projected land uses and plans, if any:
^/A
(STAFF COMMENTS)
9. Housing
a. Approximately how many units would be provided, if any? Indicate
whether high, middle, or low-income housing.
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 16 of 26
b. Approximately how many units, if any would be eliminated?
Indicate whether high, middle, or low-income housing.
O AIR"*
(STAFF COMMENTS)
C. Proposed measures to reduce or control housing impacts, if any:
/A
(STAFF COMMENTS)
10. Aesthetics
a. What is the tallest height of any proposed structure(s), not
including antennas; what is the principle exterior building
material(s) proposed?
(STAFF COMMENTS)
b. What views in the immediate vicinity would be altered or
obstructed?
"0lwn:"
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 17 of 26
C. Proposed measures to reduce or control aesthetic impacts, if any:
AJ A'
(STAFF COMMENTS)
11. Light and Glare
a. What type of light or glare will the proposal produce? What time
of day would it mainly occur?
(STAFF COMMENTS)
b. Could light or glare from the finished project be a safety hazard
or interfere with views?
�O o
(STAFF COMMENTS)
c. What existing off -site sources of light or glare may affect your
proposal?
(STAFF COMMENTS)
CHKLT/1 0-8-9 1. MASTER Page 18 of 26
d. Proposed measures to reduce or control light and glare impacts, if
any:
(STAFF COMMENTS)
12. Recreation
a. What designated and informal recreational opportunities are in the
immediate vicinity?
N �•
(STAFF COMMENTS)
b. Would the proposed project displace any existing recreation uses?
If so, describe.
No
(STAFF COMMENTS)
c. Proposed measures to reduce or control impacts on recreation,
including recreation opportunities to be provided by the project
or applicant, if any:
Af(*
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 19 of 26
13. Historic and Cultural Preservation
a. Are there any places or objects listed on, or proposed for,
national, state, or local preservation registers known to be on or
next to the site? If so, generally describe.
%VC7'
(STAFF COMMENTS)
b. Generally describe any landmarks or evidenceof historic,
archaeological, scientific, or cultural importance known to be on
or next to the site.
(STAFF COMMENTS)
C. Proposed measures to reduce or control impacts, if any:
(STAFF COMMENTS)
14. Transportation
a. Identify public streets and highways serving the site, and
describe proposed access to the existing street system. Show on
site plans, if any.
(STAFF COMMENTS)
CHKLT/1 0-8-9 1. MASTER Page 20 of 26
b. Is site currently served by public transit? If no, what is the
approximate distance to the nearest transit stop?
No
( STAFF COMMENTS) �% 2_ s ibt i G.TZ f.Lyn��G
C. How many parking spaces would the completed project have? How
many would the project eliminate?
(STAFF COMMENTS)
d. Will the proposal require any new roads or street, or improvements
to existing roads or streets, not including driveways? If so,
generally describe (indicate whether public or private).
Urn
(STAFF COMMENTS)
e. Will the project use (or occur in the immediate vicinity of)
water, rail, or air transportation? If so, generally describe.
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 21 of 26
f. How many vehicular trips per day would be generated by the
completed project? If known, indicate when peak volumes would
occur.
(STAFF COMMENTS)
g. Proposed measures to reduce or control transportation impacts, if
any:
(STAFF COMMENTS)
15. Public Services
a. Would the project result in an increased need for public services
(for example: fire protection, police protection, health care,
schools, other)? If so, generally describe.
�O
(STAFF COMMENTS)
b. Proposed measures to reduce or control direct impacts on public
services, if any:
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 22 of 26
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d FILE
CITY OF EDMONDS
250 - 5TH AVE. N. • EDMONDS, WA 98020 • (206) 771-3202
COMMUNITY SERVICES:
Public Works • Planning • Parks and Recreation • Engineering
8g0.19
y
February 8, 1991
Mrs. Anne E. Dugan
16612 - 72nd Ave. W.
Edmonds, WA 98026
Dear Mrs. Dugan:
LARRY S. NAUGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
I have reviewed your account and will allow a credit to your account
according to our City policy: the average consumption for the same
period during the previous year charged at normal customer rates, plus
the excess usage charged at the City's cost, plus a surcharge of 15%
applied to the excess only. Only one leak credit will be granted in
any three year period.
Should you have any additional questions, please contact Ilene Larson,
Utility Billing Clerk.
Sincerely,
Ron Holland
Water/Sewer Supervisor
BM/lk
cc: Ilene Larson
Utility Billing Clerk
#304950/TXTWATER
• Incorporated August 11. 1890 •
Sister Cities International — Hekinan, Japan
February 6, 1991
Ron Holland
Water/Sewer Supervisor
Edmonds Public Works Department
200 Dayton Street
Edmonds, WA 98020
Dear Ron,
RE: Water Leak - 16612 72nd Ave. West, Edmonds
With reference to your letter dated January 3, 1991 and our recent
telephone conversation concerning credit for the above, enclosed is a
receipt for the repair of a water .leak in our water system which was
completed on January 8, 1991.
Thank you for your consideration in this matter.
Sincerely,
Anne E. Dugan
16612 72nd Ave. West
Edmonds, WA 98026
P.S. The meter reading at the time of repair was 526.
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PorITION
E:F'i'"E:C;'T'IV8. MARCH 1 # 1991, RESIDENTIAL AND APARTMENt
'
SEWER RAT'I ; WILL I+F_ 'INCRC- ASIFE'D FROM $32 # b0 TO $36.20
. WITH I YOUR
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(IND SiLL0.7b PI•-11ONT'HLY. F'Cli`i'. COMMt~r=AAL ACCout4fs♦ THE
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SEVER F:A'r' � WILL. 1�� �:NLF.E:A�E� FROM 2. b0 70 ,.... # 22
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TEAR ALONG THIS PERFORATION -®� Message
Fla . � 6b::tU��C FEET OF ME'TimltEn WA'rEl� CgN$UMf''r'IQN..
For
IN ACCORDANCE; WITH ORDINANCE" di:�c2657#. PASSED RY THE
CITY COUNCIL 2/1b/HAr) 11' .IS IIAStb ON tHE FINANCING
' .." You
£�GF�E. IUt.. , Qt" THE NEW SECONDARY . Ri•~AGE 1RPEATME.NT
FACILITY ; ' REPAYMENT OF fIONb OBLIGATTON§' ETC THE
NE-bESSITY FOR TM1£ RATE INCREASE HAS . BEEN CONFIRMEb
BY . AN OU'T'S
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WATER : WASTEWATER
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STORMWATER/DRAINAGE .,
ADDRESS.
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SERVICE
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CITY
ENnINEER'S SEWER
CONNECTION
RECOMMENDATION
Date
Address of Property to be Connected: �Z 2` /�dE" A+,
Owner Name & Mailing Address HX POW I> 06A4
Legal Description:
Recommendation:
jWA#X ATWrrry r1iye exrkW clod r fir 7f
OF fop Nor Pam/ J AK arewpop ��/r ro ev ft e'
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13
Enpr. 6/14/74
•
•
CITY of EDMONDS
Civic Center • Edmonds, Washington 98020 • Telephone (206) 775-2525
Office of the City Engineer
Mr. Peter Du
Z66Z2 72d Av ue W.
Edmonds, Washi ton '98020
SUBJECT: Time Lz '
Dear Mr. Dugan:
Your requ
Z974,for connection
approved.
May 9, 1974
t 'Extension or S r 'C6niheetion
for a
the s,
It is our undie
had arrived at a time wY
extended trip to Europe.
extension till September Z,
y seiner system is hereby
,,ng that the notice sent to you
had already made plans for an
Yours very truly,
CITY OF EDMO DS
000,
RICHARD H. ALLEN
Assistant City Engineer
RHA: mjr
cc: Jack tehell, Public Works Departm t
I (
wl
fpt Ofib
Sip
P�w'
''� • t SPCT 'l'U W}IICH THIS POLICY
DESCRIPTION OF THE REAL ESTATE WITH 1L
IS ISSUED
B-42612
nAT) rr-I A -
The West 153.25 feet of the Fast 306.50 feet of the North half
of Tract 105, Plat of Meadowdale Beach, according
etorthe
ds ofplat
thereof recorded in Volume 5 of Plats, page ,
the
Auditor of the County of Snohomish, State of Washington.
PARCEL B:
A non-exclusive easement for ingress and egress over the South 15,.
feet of the East 153.25 feet of the North lialf and the North 15
feet of the East 306.50 feet of the South half of Tract 105,.
Plat of P4eadowdale,Beach, according to the plat thereof recorded
in Volume 5 of Plats, page 38, records of the Auditor of the
County of Snohomish, State of Washington.
i
i
i
11
LJ
•
REGARDING: 16612 - 72nd Avenue West 30/-0 39 00
(address)
R E C O R D O F C O N T A C T S
DATE NAME, PHONE NO.,
ADDRESS of CALLER COMMENTS
5/1/74 Peter Dugan Certified Letter No. 406182 sent
requiring hook-up within 60 days.
5/6/74 Am going to England for 1 1/2 mos.
Would like ext. to 9/l/74 to complete.
Might complete before then. Will
bring in legal, etc.
5/8/74 Came into office and obtained permit
#4728.
5/28/74 Granted extension to 9/15/74.
6/26/74 Connection completed.
ACTION TAKEN
Letter received.
Letter signed
INITIALS
TE
TE
TE
TE
TE
CITY ENGINEER'S SEWER CONNECTION RECOMMENDATION
Date _ _ July 3, 1974
Address of Property to.be Connected. 16612 72d Avenue W.
Owner Name 6 Mailing Address Peter Dugan, same as above
Legal Description: Not available - property in L.I.D. 164
RFcFivFb
JUC `5 19�
4
0
Recommendation: Owner requested time extension to September 1, 1974.
He had made plans for extended trip to Europe pri.or to receiving
connection notice. Per May 15th.policy, this situation is referred
to Public Works Department for decision.
Qt4yngineer
Engr. 6/14/74
CITY of EDMONDS
200 Dayton Street • Edmonds, Washington 98020 • Telephone(206) 775-2525
Department of Public Works
May 28, 1974
Mr. Peter Dugan
16612 - 72nd Avenue West
Edmonds, Washington 98020
Re: Property at 16612 - 72nd Avenue West, Edmonds
Dear Mr. Dugan:
In reference to your receipt of a Certified Letter of May 1,
1974, requesting you to connect your property to the Edmonds sanitary
sewer within sixty days; due to the hardship stated by you and indicated
below, you are herewith allowed an extension to September 15,.1974,
in order to make the subject sewer connection:
Time Extension Requested Because: Owner will be
vacationing in England, and does not expect to return
until September 1, 1974.
Sincerely,
CITY OF EDMONDS
tf
J . 4�, B
Director
JBM:te
ACKNOWLEDGED BY PROPERTY OWNER:
PROPERTY ADDRESS: Ilvb1� `1�-�.cR �•�sz��(--� �.t?5
MAILING ADDRESS: 1(-612-
ACKNOWLEDGEMENT DATE: tL a�t---��
r REGISTERED NO
SIGNATURE 0 A ODRE55EE (Must always',be tdled~�N
e ;
+
{CERTIF}IEW
11
.SIGNATU F°ADDRES SfiAGENT� IF ANV t
2 r F }
INSUREDe:,Np
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w
DATE DELIVERED
DELIVERED if rcqueoted aiidJencluda "'!P Code),
rSHOW .1YHERE !(Only
APPLICATION
for
T6 City of Edmonds SIDE SEWER PERMIT EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS 0
A)�)) lepi
OWNER------------- ...............1�4!..I:....---................•--..............
- -7&�Ajh AOT- U)
...............
ADDRESS ..........................................................................................
�cavaQ� Poi -LNG
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CONTRACTOR............................................................................ --------- ----------- PERMIT No.
LEGAL DESCRIPTION: LOT No. ----- - "a . .................. BLOCK No. --------------------------------------------
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------------------------
P�
MAY 8 1974
b, I A . R P
4 3DT i (us—,
Approved:
DATE------------------------------------------------ By -------------------------------------
DESCRIPTION& THE REAL ESTATE WITH REOCT TO WHICH THIS POLICY,
IS ISSUED
B-42612
PARCEL A:
The West 153.25 feet of the East 306.50 feet of the North half
of Tract 105, Plat of Meadowdale Beach, according to the plat
thereof recorded in Volume 5 of Plats, page 38, records of the
Auditor of the County of Snohomish, State of Washington.-.
nenrVT n -
A non-exclusive easement for ingress and egress over the South 15
feet of the East 153.25 feet of the North half and the North 15
feet of the East 306.50 feet of the South half of Tract 105,
Plat of Meadowdale Beach, according to the plat thereof recorded
in Volume. 5 of Plats, page 38, records of the Auditor of the
County of Snohomish, State of Washington.
TP$ 6/69
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ow xgi , ---------------------------------------------- j_>LA_c= -------------------------------- CONTRACTOR -----------------------------------------------------------------
------------------- PERMIT NO..
------------------------------ > LEGAL
JOB ADDRESS - --------------------------------- L DESCRIPTION:- LOT NO-A�_T .................. E-C>. BLOCK- NO ................
------------------------------------------------------------------------------------------------------------------------------------------------------
NAMEOF ADDITION -------------------------------------------------------------------------
.......................... - ---------
1404TAX195 \mow G
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CITY OF EDMONDS_S DE� WER'PERMIT ..
WATEWSEWER DEPARTMENT •�
' PERMIT
t/call 775-2525 for side sewer inspections BEFORE covering an - `- -
g y portion of the construction.
>.r Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections./
ADDRESS LOCATION " �'• " `
i
CATZO
N OF
..
.._____________
PROPERTY LEGAL DESCRIPTION... ....i d- bey;_ _ ...
•---•---•----•---•...._...-.
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_......................
...................
----•-••-•--•-•---•...... .................. s -...........................-_..._. _ O_.._._..
__--•--••-•---•-••--•--••--
WNER AND/OR BUILDER----••f3''•I-srr..
-•••--
CONTRACTOR'S NAME & ADDRESS .......
;6 e -
Permission is - t -
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• granted -•--------•-•-••-•- =: rK J-- �_�............. . • ---- 1 --'�-�`'-- for repair •--- �
systelm in accordance with City of Edmonds ordinances. and/or connection of a side sewer to the city sanitary sewer
( NTION IS CALLED TO THE FOLLOWING: '
}� ,✓ No. 1—The owners of the 1I{ _ � • �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. 4
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—Obtain full information regarding Ordinance 11,16.030 and Regulations governing side sewers when _
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property Line and 12 inches 'n you get permit. '
sharper than % will be permitted. inside + de property line; minimu
m u ... O m NOTE
No. 5— grade of 2 Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible % ' No bends improper
ra
work which may develop within one year of completion, possible for failure due to
• NOTE No. 6—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.
at the pipe into the woe.
DISAPPROVED Date_.._..--•--•--•-•
• ............... BY---------------- Date.--••-
_ _
APPROVED Date.._-.-_-
_ _____---•---••-
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-........................................ _
.............................. _...........................................................
...................................
.. — BOT P it C ies ......................•-----• �.
Be Si
Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
N
' hereby certify that th
r- r
_ caner of Co rac Firm Perf ming Con air uction)• Y e side sewjinstion constructed under this permit
0installe n accord ce th all gov ruing ordinances of the City of Edmonds.
Dated -- _--_._._.day o
.. i
. 19__ _..-.
V Check BEFORE you dig for: Water
❑, Gas p, Telephone 0, Pow ewer
Other E] V� L
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