17018 76TH AVE W.PDF111111111111
6186
17018 76TH AVE W
��- Z, ' =' Five Side Sewer Drawing
..:
The City of Edmond
EASEMENTNO . ............................................
1... NEW CONSTRUCTION E REPAIRS ❑ LID NO ................... .ASMT. NO...................
OWNER -- IK.- ' 11F-- 5................................ CONTRACTOR----..0......------.........--------------------....------.. PERMIT NO.
JOB ADDRESS --1 �Q.. �„' ....L1�1� _...\N.. LEGAL DESCRIPTION: LOT NO................�................... BLOCK NO. ....................................
Old ----------------
NAME OF ADDITION ...... ...........
(REV.11178)
--- S REET FILE
CITY OF E D M O N D S LARRY S. NAUGHTEN
MAYOR
250 5th AVE. N. • EDMONDS, WASHINGTON 98020 • (206) 771-3202
BUILDING DIVISION
November 20, 1984
Walter D. Beck
Marilyn S. Christensen
17010 76th Avenue W.
Edmonds, WA 98020
RE: CHANGE OF ADDRESS
The City of Edmonds acknowledges.your request for change.of
address.
17010 76th Avenue W. changed to 17018 76th Avenue W
We will notify other City departments of this change, but it
will be your responsibility to notify all other interested
parties.
(,l xc&C 1)L1 `7C�=LYE � J
Cindy Rir gst d
Permit Coordinator
cc: Utility Billing
Police Dept.
Fir,iE�'Dept.
,ffireet Files
� STREET FILE
MEMO TO: Jeff Ristau
Finance Department
FROM: Gordy Hyde
Engineering Department
SUBJECT: 17010/17006-- 76th
6 0
August 9, 1983
I have checked the addresses in all our files and in the field.
The following is for your information and should allow you to
clean up this mess:
Address per side sewer as -built
Billing Account Number
Address per Fire Dept. book
Lot # (S-9-78)
Address per field check (on �nause�
Address per assessor's book.
Assessor's #
Owner per assessor
17010
302-25950
17010
2
17006
17010
072704-1-008-0008
Wash. Federal
Savings & Loan
Zoloth, A.M.
50-206-46-768-5
1423 Fourth Ave..
Seattle, Wa. 98101
17006
302-26000.
17006
1
17010
17006
072704-1-669-0004.
Nelson, Abner, Jr.
Dizard Bros. Invest
12633 Stone Ave. N.
Seattle, Wa. 98133
Please let me know how this turns out, so that we can change the files.
GH/st
SET FILE
August 9, 1983
MEMO TO: Rhonda March
Office Administrator
FROM: Gordy Hyde
Engineering Department
SUBJECT: 17010/17006 - 76TH
Due to confusion resulting from combined files for 1'I19�Q
and 17006 - 76th Avenue W., I recommend that separate files
be set up for these addresses.
GH/st
k
Date Noober 15, 1978
i
STREID:T FILE
MEMO TO: John B. Mitchell, Supt.
Water/Sewer Division
FROM: Fred F. Herzberg
City Engineer
SUBJECT:SEWER CONNECTION CHARGES
17% 0 76th Avenue West Edmonds Washington
Street A dress
K &' K HOMES, INC.
(Legal Owner
Single Family Residence X Subdivision Plat P.R.D.
Multiple Commercial
LEGAL DESCRIPTION:
Lot 1, K & K Homes Subdivision, S-9-78
Z.F.F. Calculation:
( 91.00) Z.F.F. x ( 5.50
( ) Lateral x(
cc: Owner
APPROVED BY:
) Unit(s) x( $25
_ $ 500450 Connection Fee
_ $, 0 Lateral Charge
$ Equivalent Count
25.00 (when applicable)
_ $ Trunk Charge
$ 10.00 Permit
$ TOTAL
Fr-N
Leif Larson
Director of Public Works 10/78
Date 9 ;
MEMO TO: John B. Mitchell, Supt /� 7e,
Water/Sewer Division Ig;?'
FROM: Fred F. Herzberg, P.E.
City Engineer
SUBJECT: SEWER CONNECTION CHARGES
Leggal Description:
T%at portion of Government Lot 2, Section 7, Township 27 North, Range 4 East, W.M.,
described as follows:
Beginning at a point on ,East line of Section 7, distant North 1011'45" East 500.75
feet from the East quarter corner of said Section 7 and proceeding thence West
20.01 feet to a point on the westerly margin of the.Meadowdale County Road, which
point is the southeasterly corner of the tract herein described and the true point
of beginning; thence West 297.07 feet; thence North 265.37 feet; thence East
71.57 feet; thence along westerly margin of Bertoia Road on a curve to the left
having an initial course of South 23001'30" East and a radius of 120.0 feet or a
distance of 80.69 feet; thence South 61033'10" East 198.53 feet; thence along the
westerly margin of the Meadowdale County Road South 1011'45" West 112.26 feet to
point of beginning.
Situate in the County off Snohomish, State of Washington.
Commonly known as- 7(iu 7006 >K'Ave. W. Owner: K & K HOMES
Z.F.F. Calculation:.
( 361.53 ) Z.F.F. x
( 0 ).Lateral x ( 0
( ) Unit(s) x ( $25
APPROVED.BY
CC: Owner
_ $ 1,988.42
$ 25.00
$ 10.00
$ 2,023.42
Lei Larson, P.E.
Direct r of Public Works
Connection Fee
Lateral Charge
Trunk Charge
Permit
TOTAL
6/30/78 jac
41
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17-49
ELR
ST REET FILE
780383
FILE #
FORM FOR ROWSM/FIi•;AL] DLCLts'.��TIOV OF [ �� /tiONSIGNIrICr'Q
Description of proposal Single family dwelling
Proponent K $ K Homes
Location of Proposal Southwest corner of the intersection of Meadowdale Road
(76th Ave. W.) and Berto a Road..,- 17010 76th Avenue West
Lead Agency .City of Edmonds,
This Prcr)osal has been determined to have] a significant, 2:3-.
verse it peel upon -the enviromicnt. Aii EIS �Wis not] required mm&er
itCld 4.3.21C.030(2) ((f) . 'This decision ims r:adc after revieiq by tie lead
agent y of a ce^:plcted envi.rorirrental checklist and other inforriation on
file with the lead agency.
Responsible Official Mary Lou Block
Position/Title Associate City Planner
Date July 10, 1978 Signatur
4•
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DATE: - /2- ?,
A'$25 fee will be collected by the City of Edmonds for analysis
of the Environmental Checklist and the preparation of a Threshold
Determination. No fee will be charged for proposals which would
be categorically exempt if they were not located in an environ-
mentally sensitive area.
ENVIRONMENTAL CHECKLIST FOR^t
I. BACKGROU14D
1. Name of rroponent A' � k Ael;7e-r
2. Address and Phone Nlwnber of Proponent:
2 00.t i 4C T ��. S; Gi/, , L y t,rV iiso'Ci7 l�'Yf i jf
3. Date Ciccl-list:- Su rateit5--(2-7�;
4. Agency Re(I it i nf; Checklist C 't rr
5. frame of Pr pos'al ,' if applicable:
6. Nature and }met Description of tt-ne Proposal inc: u -
inF but not linited to its size, general desi;,n ele-
merits, and other factors that will give an accurate
understanding of its scope and nature):
I � / •� T
Lli�ly 1E�Lflc:a•• 6� /%�ruL'lGl.yc k,�•t� /1L�c:�
s'TN Ali i) cavT i • A-/,7� J1o•-f
Cal f' Fa{ /�r/v t c . ,' P c tit
7. Location of Proposes uescri e the. physical seLL ng of
the proposal, as well as the extent of the land area
affected by azi. environn;enLal in„pacts, including any
other. information neecied to give an accurar_, undersLand-
ing of the environmcnLal setting of the propoJal):
_'LOCa/1W--j '- Sal%✓• il,,-ne," ,,A: -/c4 zp A',t4 0wG(4A X-74ai-(
s.— ' ! r-/
8. Estimated Date or Comp Lion of tnc: Propose Action: 0
_ /I(' � 'i
9. List� 1'c:'cruts, Licen!;es er GOV01rlrl:Crlt /;pprnva s
Required for the Proposal (federal. state and local --
including rezones):
sf�orr �[/�l �cr(�/�i�/C ; �, r(� rr/r'r' �fr,�/fs•
-31-
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10. Do IOU have an plans for future ad ions
Y P expansion,
or further activity related to or connected with this
proposal?' 11 yes, exi)lain:
11. Do you n� any p a;is__1,y hers which may atrect
the property covered by your proposal? If yes, -explain:
•12. Attach any ocher app icati.on iOr�lat has been com-
pleted regarding the proposal; if none has been coin-
pleted, but is expected to be filed at some future
date, describe the nature of such application form:
II. ENVIRO2:PlENTAL IMPACTS
(Expl.znations of all "yes" and "maybe" answers are
required)
• Yes Maybe No
(1) earth. Will the proposal result in:
(a) Unstable earth conditions or in
changes in geologic substructures?
(b) ,'Disruptions, displacements, com-
paction or, overcovering of the soil?
(c) Change in topography or ground
surface relief features?
j(
(d) The destruction, covering or
modification of"any unique geologic
or physical features?
(e) Any increase in wind or water
erosion of soils, either on or off
the site?
y�
T
(f) Changes in deposition or ero-
sion.of beach sands, or changes
in siltation, deposition or erosion
which may modify the charnel of a
river or stream or the bcd'of the
ocean or any bay, inlet or lake?
Explanation:
(2) 'Air. Will the proposal result in:
(a) Air emissions or deterioration
of ambient air quality?
(b) The creation of objectionable
odors? _
(c) Alteration of air movement,
moisture or temperature, or any
change in C ilnate, either locally
or regionally?
Explanation: iFF_ A17IKMF_Q
-32-
Y
Yes
Maybe No
1'
(3) Water. Will the proposal result in:
2;
3';
(a); Changes in currents, or 'the
4
course or direction of water move-
5:
ments, in either marine or fresh
61
waters?
8!
(b) Changes in absorption rates,
9!
drainage patterns, or the rate and
10'
amount of surface water runoff?
11i
121
(c) Alterations to the course or
' 13i
flow of flood waters?
jL
14 {{
i —
•.
151
(d), Change in the amount of sur-
161
face water in any water body?
17'
! —
—
18I
(e) Discharge into surface waters,.
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or in any alteration of surface
20
water quality, including but not
21
limited to temperature, dissolved
oxygen or turbidity?
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—
24i
(f) Alteration of the direction
25
_
or irate of flow of ground waters?261
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(g) Change in the quantity of
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ground waters, either through
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direct additions or withdrawals,
30
or through i.ntcrception of an
31
aquifer by'cuts or excavations?
32
—
—
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(h) Deterioration in ground water
34
quality, either through direct in-
jection, or through the seepage of
36
leachate, phosphates, detergents,
37
waterborne virus or bacteria, or
38
other substances into the ground
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waters?
40
—
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(i) Reduction in the amount of
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water otherwise available for
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public water supplies?
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—
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Explanation:
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47
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(4) Flora. Will the proposal result in:
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(a) Change in the diversity of
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species, or numbers of any species
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of flora (including trees, shrubs,
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grass, crops, mi.c.roflora and
'
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aquatic plants)?
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--
—
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(b) Reduction of the. numbers of
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any unique, rare or endangered
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species of flora?
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2
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41.
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Yes Maybe No
(c) Introduction of now species
Of f1Oi•a into an urea, or in a
barrier to the normal replenish-
ment of Cxisting species?
(d) Reducti.on in acreage of any
agricultural crop?
Explanation: Lle AC -Yr j
(5) I•'auna. Will the proposal result in:
(a) Changes in the diversity of
species, or numbers of any species
of fauna (birds, land animals
including reptiles, fish and shell-
fish, benthic organisms, insects or
microfauna)?
�-
(b) Reduction of the numbers of
any:unique, rare or endangered
species of fauna?
(c) Introduction of new species
of fauna i.nto.an area, or result
in a barrier to the migration or
movemcllt of fauna?
(d), llet_erioration.Lo existing
fish,or wildlife habitat?
Explanation:
(6) Nvoi se: l•]i.11. the proposal increase
existing noise levels?
Explanation:
(7) LiLlit and Glare. Will the pro -
light or
glare?
Explanation:
(8) Land Use. UIM the proposal
res-ult in the alto -ration of tli'e
present or planned land use of an
area?
Explanation:
-34-
Yesaybe No
1�
1.
1;
L
1�
1'
if
1;
if
M
2C
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149
•50
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(9) Natural I!�:;ources. Will the pro-
posa� r—C-S C .n .
(a) Increase in the rate of use
of an n t 1
y a ura resources?
(b)' Depletion of any nonrenewable
natural resource?.
Explanation:
(10) Risk of I) -,set. Does the proposal
invo
ve a risk of an eplosion or
the release of hazardous substances
(incluciirltr„ but not limited to,
oil, pestici(Ies, chemicals or.
radiation) �n the evcrit of an acci-
dent
or upspL conditions?
— —
�
Explanation': r
Sp:
(11)
Po ilaLion. Will the proposal
alter
t}lc local=.i_on, distribution,
density, or growth rate of the
human popuI,<:tion of an
area?
Explanation: 1-7
t dJc ram,
c<<t��c t,��1
c_ i1 —
I
(12)
HousingWill the proposal affect
exi.stinf; housinf; availability, or
create a demand for additional
housing?
Explanation:
•
(13)
I
Transport,? Q011MI—culation. Idil1
tCp2'oposal _re.:ulr 11:
(a) GeneraVi.on of additional
vehicular- movement?
s
(b) fffects on exi.stinr parkin;
facil.iei.es,
or demand for nL-w
parking?
(c) Impact upon existinf; trans-
portation 5y:te[i1S?
---
--
(d) Alteratl OnS t0 prl'.SC?nt
patterns of.c•i.rculation or move-
ment of people ,Ind/or roods?
�-
(C) AILerat_j.oilS to 4JatCrborne,
rail or air traffic?
-35-
Yes Maybe No
.1
3
4,
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10
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16
17
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46
47
4Q
4c
5C
51
5'
5`_
51
5.
5E
5�
St
5!
6(
6:
(f) Increase in traffic hazards
to motor. vehicles, bicyclists or
pedestrians?
_.
Explanation: 1�
(14)
Puhli.c Services. Will the pro-
-effect upon, or
re:;ult in a need for new govern-
mental services in any of the
following areas:
(a) ; Fire protection?
_.
(b) Police protection?
(c) Schools?
_
(d) Parks or other recreational
facilities?
=-
(e); Maintenance of'public facili-
ties., including roads?
_
M Other governmental services?
Explanation: '2 s'y✓i�� flti��_
f'�r�'l/mccn,
(15)
Enc'r Y. Will the proposal result
in:
(a) Use of substantial amounts of
fuel or energy?
(b) 1 Demand upon existing sources
of energy, or require the develop-
ment of new sources of -energy?
++
Aoy_'S't%���tC,>
Explanation: Z
(16)
Utilities. 4'ill the proposal
resu.CL in a need fol. r..•• 'Vstems,
or altc'r.ations to the f0,110wing
utilities:
(a) Power or natural gas?
_
(b) Communications systems?
(c) Water?
_
(d) Sewer or septic tanks?
(e).. Storm Triter drainage?
(f) ' Solid waste and disposal?
Explanation: 5't ' 4T%i�r`MIV2
i
-36-
. .l .., (11) y )hnunn�, Will tilt pinpusal -
2 ' resul he creation of :nly
3 health hazard car potential health •
41 hazard (excluding mental health)?
5 _
61 Explanation:
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41.
42
43
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46
47
48
49
50
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52
.53
54
55
56
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58
59
(18) Aesthetics. Will the proposal
resull in the obstructi.otl of any
scenic vista or view open to the
Public, or will the proposal re-
sult in the creation of arr
aesthetically offensive site open
to public view?
Explanation
%%/, ///`/>
(19) Recreation., Will the proposal
resulC in an i.n:pact upon tine
qua'li.t:y or 'quantity of existing
recrcationa'1 opportunities?
Explanation:
(20) Archvolog_i.ca1./lli stori.cal. Will the
propon re U L , an artcration of
a significant archeological or his-
torical site, structure, object
or building?
Explanation:
III. SIGNATURE
I, file undersigned, state that to the best of my tkno�•�1.cd�;e
he above informaticIt is understood rtl is true and cortplcte•
that the lead al;ency may withdra,.,, any declaration of non-sigtli-
ficance that it might issue in reliance upon this checiclict
Should there be any misrepresentation o.r7lack.of fu7.1 disclosure
on my part.
Proponent : •
IdAG 197-1.0-370 WI'THDRAI:'AL OF AFFIRMATI E"TIII;ESIIOLL)
DETEI�iii.',\'1'1G:.n -1Z�at any tirr,e after the crrEry of a declara-
tion of: siF,nificance, the proponent 1:rodif.ies t
so that, he proposal
i.n ithe judL,ntcnt of the lead al crlcy, al.l sii-,'Aficant
adverse env.ronr„0ntal. i.rlpact:s resultinc; tl�r.refrom are elimin-
ated, the decic�ratiorr of si.f;,,ificancc rlrall be withdrawn
and a declaration of nfica:lce entered c withd. n
lead al;ency shall also revise the rce ellt:rs at its Sla'AThe
public information center accordingly. 1.f the pro_ poncnt of a propose]. is a private applicant, the p;-oposal
shall not be considered niodi.ficd until a].1. li.cerrse applica-
tions for the proposal are revised to reflect the modification.
-37-
ENVIRONMENTAL CHECK LIST.
II.
I. The project is designed to work within the existing soils conditions.
2.a b Approximately 4 cars will be added to the neighborhood. Some additional
deterioration may take place during construction.
3. The project will be designed to maintain existing runoff patterns and flows.
1
4. c Some non-nativellandscape may be introduced around the house.
5c d Domestic animals will be introduced and some habitat .will be destroyed by house
construction. As only two houses will be built this will beta minimal
reduction.
6. Construtuion noise will be the largest potential increase.
8. Vacant land in!a residential area will be built upon.
8.. Resource use will take place regardless of site selection. Land itself is the
primary non-renewable resourece used.
I
10. Limited to potential construction accidents.
13. Two households will not generate signinficant increase in traffic.
16. These systems will be extended onto the property.
18. The dwellings on this site should not obstruct any existing residential views.
One lot should be screened by existing rees in the ravine, the other $ouse
will be in view of the road.
PROJECT NAME
DATE SUBMITTED 2-�8
1 ENV IRON'IENTAL ASSESSMENT
i
In order to meet the requirements of the State Environmental Policy Act of 1971,
the responsible official must make a declaration of environmental impact as early
as,possible in the process of evaluating a project.
The information in this form viill be used to determine whether it will be necess-
aryto require an environmental impact statement. If an impact statement is
not required, a Statement of Negative Declaration �-iill be placed in the file.
If an impact statement is required, a draft statement must be'filed with this
office, public notice given and a revie,:i.period of 30 days allowed. The final
statement and comments Hust be filed with the Department of Ecology, Officelof
the Governor and Vie Ecological Commission.
The Edmonds Planning Staff will assist you in any way vie can in accumulating
this information and .�ie viould appreciate your cooperation.
1. Land:
Area in acres 1, 35—
Soils type .1
Limitations
Description of topography (% slope) I-'1,4'(7ct Gzir/es. °
I
hz)u.�z x w� /� Ae hut, /t al �P�,� /�,�� «.� �/ r�f�
Grading: estimated cubic yds . ,&) )%a,-, /pD NOTE: If grading or filling
vi- i 1T exceed 500 cubic yards
Filling: .estimated cubic yds. kazm7�4h /DC a grading and filling olan
must be submitted with the
2. Water: application. y
'Stream - estimated flovi (cubic feet per second) �,y CFS P,142"ee., MopO
Will stream be altered?
To what degree? A11A
Impact on storm drainage (increase in run-off)m
/M/f //'i C?
Estimated area .to be paved
Estimated area in open space ?,5
Shorelines: wi thi n 200 ft. of Mean Hi giier Hi gh. Water /YA
Adjacent to shorelines zone /����
•
Environmental Assessment, page 2
3. Vegetation:;
Type of trees ry yrtej�. deetV/
&(.
% to be removed sue- ;2 1A
NLN/c' el G roc.-
Minimum diameter of trees
to
remain
6'`�
Ground cover 4,4c /�c�ritr;
leers`
rs; s aAd
% to be removed Sai
Proposed landsscaping,' if
any
'TY/',c���
4. Existing Land Use within 300 ft.-radius of proposed development:
Single
MUIti-
'
,Vacant
Family
Family
Comm.
Other.
North
X.
South
i x
East
X
West
X
1
5. Circulation:
Estimated increase'in auto trips daily 2X/G' = 2-0 Al j'
Estimated demand for public transportation;h,h,�
Degree of change on adjacent streets (M
6. Area of impact:
neighborhood
city-wide
regional U e✓r
7. Effect on air quality:
8. Changes in noise generation: imil rrng.
PI!iLIC ',jQMS L I V I U IA LI U I
PROJECT NAtIE: -weiv%visto
i L E
-'ASSESSMENT DATED:
AN ENVIROHINDITAL OF TM: nf., or)( r.
CCHPLETFI) AHD THE FOLLOWING
HEIN HADE:
780383
0 1)ZAWA460' AD A-rur w ora s or,
'grow so-jeQ.
0 lus 04
Ouse rvL-uU-clGj WtLA— tri SLACwrLy
C
PREPARED BY:
ATE:
UM I N 0 A-C�
I
REVISED: 10177LV
DESCRIPTION OF PRO
,ENVIRONMENTAL ASSESSMENT FILE
i
PROPONENT: t�/e/ t- J-tf
s 780383
EXISTING USE:
ENVIRONMENTAL IMPACTS FROM PROPOSAL:
01 ;014
SOILS/TOPOGRAPHY - y`'�i �•�-
WATER/DRAINAGE�
AIR QUALITY G
CIRCULATION - lVe
VEGETATION C_P �,e
O
ECONOr4I C
CITY SERVICES -
ENVIRONMENTAL FINDINGS:
There will be certain environmental impacts but they do not constitute a signif-
Tcant adverse impact on the environment and no environmental impact statement
will be required.
There will be significant adverse impacts .on the environment and an environmental
impact statement will be required.
There will be certain impacts on the environment however it is necessary to obtait
more information before a declaration of significance or non -significance is made.
b 17r
CITY PLANNER DAT
CITY ENGINEER DATE
E/A '76
CLIC WORKS DEPART�= CHECKA it Date
BUILDING PERMIT REVIEW
STPnEET FILE
Street Right -of -Way Existing REQD
Access Easements Existing 0 REQD
Utility Easement Exist' REQD [A
Lot per Subdivision Plat Assess r Map
z Site Plan Checked for Accuracy
Underground Wiring Reqd.
x Check Accuracy of Legal Description
w Environmentally Sensitive Area
w Environmental Checklist Reqd.
2
Flood Hazard Zane i
c, Shoreline Management Area
2 Slope, Soil, Vegetation
w Stream, Creek, Drainage Basin
Existing Zoning Per Code
Amenities Design Board Approval Reqd- Mt �ADB # Approval
Board of Adjustment Approval Reqd. �.
Review By: Date:
Existing I-.Tater '-lain Size
Water Main Reqd. A JA
Service Line Reqd. -314, v
w Hydrant Size Existing O C
Hydrant Reqd. Per Fire Code Size
Detector Check Meter Reqd. IJ O
Cross Connection Inspection A,)D
Fire Department C iwnts
Water Meter Charge Reqd 35-0 0
i Review by: Date: 7/,5/-7 �r
Septic '1'a c s/ign t pprove ate: ,
Septic Tank Permit Reqd. — Permit No.
Sanitary Sewer Availabilit Proj.
i'
Drawing No. File No.
w
Side Sewer Availability o G yvy moo .�
w q Sanitary Sewer Connection Fee Reqd.
v; Review By: Date:
�R
BUIrLDING DEPARTMENT
USE PERMIT
Applicant Fill
ZONE I ^ NUMBER
PEWIT APPLICATION Inside Heavy Lines
, B
A
NAME JOR.NAME,OF BUSINESS)
ADDRESS I ?OI a ^6 ��
'
l] r�
SUUB7DIVISIO-LA-'LNAM,E ESSOR MAP NO. '
W A LNG ADDRESS ' ' -
`� 7
�
J
LEPHONE NUM
PUBLICRIGHT OF WAY PER ORDINANCE NO.
17Y
EXISTING RIGHT OF WAY C�O
'NAME CJ'
PROPOSED RIGHT OF WAY Q
U r L�/,/ /-",7."�//J f/
' - C
DEFICIENCY OF RIGHT OF WAY O
W ADDRESS
r `l ` ��'7L% /
STREET/UTILITY WORK REQUIRED INYES
N
❑NO Y
L/� �._..J �
PERMIT FOR WORK IN PUBLIC R/W YES
❑NO 3
m C T
/ / T.E LEPHONE NUMBER
UNDERGROUND WIRING REQUIRED DYES
NO U
CONNECTION TO SANITARY SEWER 19YES
N f►ME .
NO m
SEPTIC TANK PERMIT REQUIRED YES
IIyy
YIaNO a
SEPTIC TANK PERMIT N O.
Q ADDRESS
F
U
(
SEE MEMO DATED
I ICI
Z CITY TELEPHONE NUMBER
f
REMARKS
a
Z
.A0
U STATE LICENSE NUMBER CITY LICENSE. NUMBER
CHEC E V'
Legal Description of Property (Show Below or Attach Four COples)
METER SIZE BUILDING SUPPLY SIZE
Z
REMARKS
f
0
;
F.
i
w
a`
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SIGN AREA ENV, REVIEW'
ALLOWED PROPOSED COMPLETE
ADB NO.
IU
/V
EXEMPT
w
O
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i..
(
REMARKS
W
W
J
VARIANCE OR CU PLANNING REVIEW BY
DATE
YARDS LOT COVERAGE
FRONT /
'XwI NEW RESIDENTIAL GAS
❑ LINE
� SIDE REAR
FIRE
El
ZONE TYPE OF CONSTRUCTION CODE
HEIGHT
❑ SIGN
ADD
aDEMOLISH a RETAINING
WALL
SPECIAL INSPECTOR AREA OCCUPANCY
OCCUPANT
❑ FENCE
ALTER El
OR FILL X—�)
REQUIRED GROUP LOAD
❑ YES ❑ NO
REPAIR El PRE -MOVE SWIM
PLAN CHECKED BY THIS SITE IS LOCATED IN THE
OF EDMONDS. LOCAL SALES
CITY'
TAX
INSP, POOL
SHOULD BE CODED 31.04.
NUMBER OF STORIES
NUMBER OF
REMARKS
DWELLING
1.
/
UNITS /
Z
NATURE OF WORK TO BE DONE
WF.
`..
IL
W
j
PROPOSED USE
PLAN CHECK FEE
VALUATION
FEE
-- - --
- - --
O
t--.
'-Z
F
a
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PLOT PLAN INDICATE BUILDING SETBACKS,
__ W
=
ABUTTING STREETS),'
BUILDING
_
F
U
-- .___= a
+ In
PLUMBING
0
-- J
W
/
MECHANICAL
0
0
�`
---
-- 0
FENCE
__ >
SIGN
Z
RETAINING WALL
"--
-- 0
_ _ -• U
SWIMMING POOL
_
The Crantor..s herein ...
:..� �
for the consideration of .......
kj r�l 7K C..l nd..
J........ ay.. a.....lJr..Rha...L......C.1.ay..............::......�.
�i.. ...,,,.,;....fir...;«:r
$1 .00........... ................................. .......... ..:.......`....
the receipt of which is hereby acknowledged, and also of benefits to accrue ................................
•••••...... by reason of laying
out and establishing a public road through ..................................property, and which is hereafter described, do...... convey,
release and quit -claim to the City of Edmonds, State of Washington,
and highway, for the use of the public forever, as a public road
thL; r�il;,,,ir,g described real estate, including anv interest therein which
grantor may hereafter acquire, viz:
T OF .
THAT PORTION OF GOVERNMENT LOT 2
RANGE 4 EAST, W.M•, DESCRIBED AS FOLLOWS; , SECTION 7, TOWNSHIP 27 NORTH,
BEGINNING AT A POINT ON EAST LINE OF SECTION
1011'45" EAST 500.75 FEET FROM THE EAST 7' DISTANT NORTH
SECTION 7 AND PROCEEDING THENCE WEST 20.OlAFEET TER ORAEPOONTSOND
WESTERLY MARGIN OF THE MEADOWDALE COUNTY ROAD THE
SOUTHEASTERLY CORNER OF THE TRACT HEREIN DESC, WHICH POINT
IS THE
POINT OF BEGINNING; THENCE WEST 2 ' TRUE
FEET; THENCE EAST 71.57 FEET; 97'07 FEET; THENCE I�ORTH 265.37
BERTOIA ROAD ON A CURVE TO � THENCE ALONG WESTERLY MARGIN OF
OF SOUTH 23°O1'30" EAST ANDTAE LEFT HAVING A INITIAL COURSE
OF80.69 FEET; THENCE SOUTH 61°RADIUS OF 120.0 FEET'FOR.A DISTANCE
ALONG THE WESTERLY MARGIN OF 6103311011 EAST 198.53 F>=ET; .THENCE
1°11'45" WEST 112.26 FEE THE MEADOWDALE COUNTY ROAD SOUTH
SITUATE IN THE COUNTY OFTSNOHOMISH,POINT OSTATE-OF IWASHINGT ON.
S
situated in the County of Snohomish, State of Washington.
The Grantor.... hereby agree .. and consent.... to the establishment of said road as surveyed, and of record in the
City of Edmonds Engineer's office as Survey No .................... and to the perpetual maintenance of the same as a City
Street, and waive.... all claim for damages of whatever kind which may be occasioned to adjacent land by the location,
establishment, CUI1St1'UCt1U11, d1'A111agL' and main tc•n;lice of solid street, and agrees and consents to the right of the City to
make all necessary slupes for cuts and fills whenever they extend beyond the right-of-way line, upon at,uve mentioned
sired, all in enfur zinc l ith st:utcl::rL' practices of City street construction, and to the same extent and purpose as if
the rights herein gr.u,led 11ad becn acquired by conQemnatiun proceedings under Eminent Domain Statutes of the State
Of Washington, .
..............
rut covenants shrill run with the land and be binding upon tile .e grantor .... ...............
................
- ......successors or assigns.
Datc,d this (Jayof ..... "
: .. ..... C
,i .-.. ........ ................. � A.D., 19...cJ ...
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