17222 76TH AVE W.PDF111111111111
6113
17222 76TH AVE W
Sr
C-,� ED4 r
Certificate of Occupancy
Building Division
J-1c.
This certificate is issued in accordance with the requirements of Section Ill of.the 2012 International Building Code
certifying that.'at the time of issuance this single family residence was in compliance with the applicable provisions of
the codes and ordinances of the city regulating construction and use of buildings.
Description: 64 - Single Family Residence New
Site Address: 17222 76TH AVE W, EDMONDS Permit No: BLD20140919
Constrdcti,pn Type: V13 Parcel No:, 2704070.0402200
Owner: K & M'S HOME CONSTRUCTION LLC Occupancy Group: R-3/U
�-.RO��OX 2019.
SNOHOMISH, WA 98291
10/26/2015
Byding Official Date Issued
POST IN A CONSPICUOUS PLACE
J 01F EDAI
City of Edmonds 0
Site Classification Worksheet
Page 1 of 2
The project's Site Classification will dictate the specific stormwater management
requirements applicable to your site.. Completing this worksheet will help determine the amount of
regulated impervious surface and whether your project falls into the classification of a Small Site
(Category I or Category 2), or a Nfinor Site. Please reference the GlossM (pp. 10-11), Figures. D and
E, (ppj-9), and Examples -(pp. 11-12), to assist with completion: of this worksheet.
1) Is Permeable Pavement' Proposed For Use on this Site? Ej Yes No
.. 1. 'Aefer to Stormwater Supplement Chapter 5.1
If YES, the subject area is to be considered impervious for initial site classification purposes. Include total
permeable pavement area in the calculation of Non -Regulated, Replaced and/or New impervious surface
a�eas in the table below.
I I
2) Determine the Amount and Type of Existing & Proposed Impervious Surface for the Site
Refer to Stonnwater Supplement Chapter 2 and Fig. C
Line 1: Identify the Non -Regulated Impervious Surface.Area.
Line 2: Identify the Replaced Impervious Surface Area, dividing the total between Exempt and Regulated; either or both
may be zero. Note: For project classification purposes, Replaced Impervious may only be considered. exempt
under certain conditions. Refer to the Glossary and Figure D.
Line 3: Identify the New Impervious Surface Area for your project. All impervious areas created post -July 7, 1977 or
after the date of annexation into the City are regulated & should be included in this total unless they can be
— categorized separately as a Replaced -Regulated area.
Line 4: Enter the sum of the total Replaced-Rekulated plus the total New impervious areas.
Line 5: Identify the total area currently mitigated by an existing city -approved stormwater management system.
Line 6: Enter the sum of the value in Line 4 less the value in Line 5 to identify the total Regulated area in which
stormwater controls have not yet been applied.
Line 7: Identify the total area proposed to be mitigated through the use of Low Impact Development Techni4ues.
Line 8: Identify the total area proposed to be mitigated through conventional Stormwater Management Techniques.
Provide a copy of the following table on the drainage plan sheet for the proposed project
Line
Type
Area (square feet)
1.
Non -Regulated --
Exempt
Regulated
2.
Replaced
3.
4.
New (Post 1977)
Total Regulated Impervious Area
Mitigation required if in excess of 2000sf
+
0, 4�1
5.
6.
Total Area Mitigated by Existing Stormwater Management System(s)
Regulated Area Not Yet Mitigated
= ift/0
7.
Area Proposed to be Mitigated by Low Impact Development Techniques
=
8.
Area Proposed to be Mitigated through Conventional SWM Techniques
I (e.g. porous asphalt, porous concrete, paver blocks, concrete open cel.led paving grids, or plastic lattices filled with turf or stone)
Revised on 310512012 E72-SWM—Erosion_Control-03.05.12.doc
RESUB
Page2j.(Lf 12j 1 26414
4L
FILE
.J - 4,
BUILDING DEPAR71VIENT
CITY OF EDMONDS
0,F EDA,,
City of Edmonds 0
Site Classification Worksheet
Page 2 of 2
3) Determine the Total Area of Land Disturbing Activity
Refer to Stormwater Supplement Chapter 8 sf
4) Determine the Quantity.of Grading, Fill and/or Excavation cy
1
5) Will the project convert 3/4 Acre or More of Native Vegetation to Lawn or Yes No
Landscaped Area?
6) Identify the Watershed the Existing Site Runoff Discharges to
Refer to Stormwater Supplement Chap ter 2.3
Based on Site Location and Watershed Map — Figure-C. Check all that qpply.
A. Direct Discharge B. Creek or Lake Basin,
[i Edmonds Way Basin
• Puget Sound Basin
• Puget Sound Piped Basin
11
I
DETERMINE PROJECT CLASSIFICATION USING THE INFORMATION ABOVE
AND THE PROJECT CLASSIFICATION CHART (Figure B, pg 4) i
El Small Site.- Category I El Small Site - Category 2 El Min6 r Site
Stormwater Supplement Stormwater Supplement Stormwater 'Supplement
Chapter 5 Chapter 5 Chapier 6
Revised on 310512012 E72-SWAI�_Erosion_Control-03.05.12.doc 'Page 6 of 12
a ""TREET FILE
C�
City of Edmonds
Site Classification Worksheet
Page 2 of 2
3) Determine the Total Area ofLand Disturbing Activity st,
Refer to Chapter 8
4) Determine the Quantity of'Grading, Fill and/or Excavation
5) Will the project convert, -Y4 Acre or More of Native Vegetation to Lawn or Yes No
Landscaped Area?
6) Identifv the Watershed the Existing Site Runoll'Discharges to
Refer to Storinwater Suppletnent Chapter 2.3
Based on Site Location and Watershed Map — Figure-C. Check all that apply.
A. F] Direct Discharge B. n Creek- or Lake Basin
o Edmonds Way Basin
o Puaet. SOUnd Basin
C7
0 PU-et. SOUnd Piped Basin
'DETERN41NE PROJECT CLASSMICATION USING THE JNFORMATION ABOVE
AND THE PROJECT CLASSIFICATION CHART (Figure B, po 4)
Small Site - Category I E, Small Site - Category 2 1 Minor Site
Storlinvater Supplement Storinwatcr Supl)1einew StO I'll I W', I/(' r Supplell I ent
Chapter 5 Chapter 5 Chapter 6
Rri-kol,o 3/05/2012 E-1 0., 1.)5 11 /,,, Pugc 6 cy- I'
City of Edmonds
Critical Area Notice of Decision STREET FILE
Applicant:
Property Owner:
KAM'--, 14oe-cws�.On
Critical Area File #:
Permit Number:
U
Site Location:
Parcel Number:
Project Description:
Netc,
rfte ekt. J.'VCJ
"5/1-37tq06y Arrr,
Conditional Waiver. No critical area report is required for the project described above.- A Illtliq V,, WJ1,,j fww.
1. There will be no alteration of a Critical Area or its required buffer. On
2. The proposal is an allowed activity pursuant to ECDC 23.40.220, 23.50.220, and/or
er
23.80-040.
3. The proposal is exempt pursuant to ECDC 2,3.40.230. svo-om ko &0771Y
F1 Erosion Hazard. Project is within erosion hazard area. Applicant must, prepare an erosion and
sediment control plan in compliance with ECDC 18.30. sWi �s re-tm; red.
Critical Area Report Required. The proposed project is within a critical area and/or a criticalairea
buffer and a critical area report is required. A critical area report has been submitted and.evaluated
for compliance with the following criteria pursuant to ECDC 23.40.160:
The proposal minimizes the impact on critical areas in accordance with ECDC 23.40.120,
Mitigation sequencing;
2. The proposal does not pose an unreasonable threat to the public health, safety, or welfare
on or off the development proposal site;
3. The proposal is consistent with the general purposes of this title and the public interest;
4.. Any alterations permitted to the critical area are mitigated in accordance with ECDC
23.40.110, Mitigation requirements.
5. The proposal protects the critical area functions and values consistent with the best
available science and results in no net loss of critical functions and values; and
6. The proposal is consistent with. other applicable'regulations and standards.
Unfavorable Critical Area Decision. The proposed project is not exempt or does not adequately
mitigate its impacts on -critical areas and/or does not comply with the criteria in ECDC 23.40.160 and
the provisions of the City of Edmonds critical area regulations. See attached findings of
noncompliance.
Favorable Critical Area Decision. The proposed project as described above and as shown on' the
attached site plan meets or is exempt from the criteria in ECDC 23.40.160, Review Criteria, and
complies with the applicable provisions of the City of Edmonds critical area regulations. Any
subsequent changes to the proposal shall void this decision pending re -review of the proposal.
Conditions. Critical Area specific condition(s) have been applied to the perm it number referenced
above. See referenced permit number for specific condition(s).
-T
, e-n 111 q45
Reviewer ,----S&gna �re��� Date
Appeals: Any decision to approve, condition, or deny a development proposal or other activity based on the
requirements of critical area regulations may be appealed according to, and as part of, the appeal procedure, if any,
for the permit or approval involved.
Revised 1211612010
CRITICAL AREAs DETERMINATION FOR
K&M's Home Construction, LLC — 17222 76 th Ave. W
Tax Parcel No. 27040700402200
Acre Project #14020
Prepared By:
Acre Environmental Consulting, LLC.
17715 28t' Ave. NE
Lake Forest Park, WA 98155
(206) 450-7746
For:
K&M's Home Construction, LLC
Attn. Kevin Mavis
PO Box 2019
Snohomish, WA 98291
May 13, 2014
A141Y
SITE DESCRIPTION
On May 12, 2014 Acre Environmental Consulting, LLC Visited the approximate 0.33-acre site
located at 17222 76 th Avenue W in the City of Edmonds, Washington. The site is further located
as a portion of Section 07, Township 27N, Range 4E, W.M. The parcel number for this property
is 27040700402200. The purpose of this site visit was to locate and assess regulated critical
areas on add adjacent to the subject site. Surrounding land use is comprised of single-family
residential development.
th
Access to this undeveloped site is gained from the east via 76 Avenue W. The site has a gentle
west 'aspect slope and is occupied by maintained lawn with scattered fruit trees and
ornamental vegetation around the perimeter. Vegetation in the lawn is comprised of colonial
bentgrass (Agrostis tenuis, Fac), square gooseneck moss (Rhytidiodelphus squorrosus, Nol/Upl),
and scattered common da ndelion (Taro'xocum officinale, FacU). The landscaping ind I udes sweet
cherry (Prunus avium, FacU), Western red cedar (Thujo plicato, Fac), English laurel (Prunus
lourocerasus, Nol/Upl), Pacific Rhododendron (Rhododendron macrophyllum, No,l/Upl), and
various other ornamental shrubs and herbs. I
Acre Environmental Consulting, LLC used the routine methodologies described in the
Washington State Wetlands Identification and Delineation Manual (Washington State
Department of Ecology Publication #96-94, March 1997) to make a determination regarding
regulated wetlands on the site. In addition, Acre Environmental Consulting, LLC evaluated the
site using the U.S. Army Corps of Engineers Wetland Delineation Manual produced in 1987 and
the U.S. ArmV Corps of Engineers Regional Supplement to the Corps of Enginee'rs Wetland
Delineation Manual: Western Mountains, Valleys, and Coast Region produced in May 2010.
No wetlands or streams are located on the subject site. Outfall Creek, a Type Np stream is
located off -site approximately 30 feet to the southwest of the subject property. Thi ' s perennial
stream is between two and three feet wide between the Ordinary High Water Mark:s.(OHWM),
flows north, and eventually drains to Puget Sound. This stream is labeled as a creek.on the City
of Edmonds GIS maps. This stream is not mapped by The Forest Practices Application Review
System maps produced by the Washington Department of Natural Resources, the Salmonscape
maps produced by the Washington Department of Fish and Wildlife or the fish �listribution
maps produced by Streamnet. Outfall Creek is mapped by Snohomish County Landscape
Imaging (SnoScape), but it does not show this stream extending as far south as the s ' ubject site.
SnoScape shows fish use in this stream ending approximately 900 feet north of the subject site.
Potential fish access past this point appears to be impeded by a combination of culverts and
downstream gradients which in some areas exceed 16 percent slopes. Furthermore, much of
the upper reach of this stream has been altered to accommodate the existing adjacent
residential development. These alterations include multiple culverts, banki armoring,
straightening of the channel, and the removal of vegetation. -Due to these alterations and the
natural, downstream gradients, this stream appears to lack the necessary in channel habitat to
I
Acre Environmental Consulting, LLC �ay 13, 2014
Critical Areas Determination for K&M's — 17222 76 th Ave. W Page 1
Edmonds, WA
support fish use, and therefore, meets the criteria for a Type Np stream in the,City of Edmonds.
View from the southwest property corner looking southwest at Outfall Creek.
Note the bank armoring and other alterations.
In the City of Edmonds, Type Np streams typically receive 50-foot protective buffers measured
horizontally in a landward direction from the delineated ordinary high water mark (OHWM).
Per EMC 23.40.280, buildings and other structures shall be set back a distance of 15 feet from
the edges of all critical area buffers. Landscaping, uncovered decks, and building overhangs (if
,such overhangs do notextend more than 30 inches into the setback area) may be allowed in
the building setback area
Acre Environmental Consulting, LLC May 13, 2014
Critical Areas Determination for K&M's — 17222 76 1h Ave. W Page 2
Edmonds, WA
TERMS & CONDITIONS
The environmental consulting work conducted, including this Wetland a nd Stream
Determination Report (collectively the "Services") is supplied to K&M's Home Construction, LLC
(the "Client") as a means of determining whether any wetlands, streams, and/or fish and
wildlife habitats regulated by the City of Edmonds exist on, or adjacent to the site. The Services
are provided in accordance with the following General Term and Conditions (the 'Ierms"). In
accepting the Services provided by Acre Environmental Consulting, LLC ("Acre")i' the Client
voluntarily enters into and agrees to the binding effect of the following Terms.
This report is intended to provide information deemed relevant in the Client's attempt to
comply with the regulations currently in effect. The work for this report has confoemed to the
standard of care employed by professional ecologists in the Pacific Northwest. All, other
representations or warranties, whether express or implied, are hereby disclaimed �concerning
the work or this report. This report is based largely on readily observable conditions and, to a
lesser extent, on readily ascertainable conditions. No attempt has been made to determine
hidden or concealed conditions. If such conditions exist or arise, the information contained in
this report may be rendered inaccurate or incomplete based upon those conditions. Acre acts
solely as an independent contractor in providing the Services to the Client, and nothing in the
provision of such Services shall be construed as creating an agency, partnership, joint venture
or other similar legal relationship between Acre and the Client.
I I
Please note that Acre did not provide detailed analyses of other permitting requirements not
discussed in this report (i.e., structural, drainage, geotechnical, or engineering requirements).
i
The laws applicable to Critical Areas are subject to varying interpretations. While Ade observed
professional industry standards when completing this review, the information included in this
report does not guarantee approval by *any federal, state, and/or local permitting agencies.
Therefore, all work on this property should not commence until permits' have bee ' n. obtained
from all applicable agencies. If there are any questions regarding this report, please contact me
at 206.450.7746. 1
Acre Environmental Consulting, LLC.
Louis Emenhiser
Principal Wetland Ecologist
Professional Wetland Scientist #1680
Acre Environmental Consulting, LLC I�Iay 13, 2014
Critical Areas Determination for K&M's — 17222 76 1h Ave. W Page 3
Edmonds, WA
0
EXISTING
OFF -SITE SFR
N
APPROX. SCALE 1" 30'
0 30 60
NOTES: THIS MAP IS APPROXIMATE BASED ON AERIAL PHOTOGRAPHS
AND SITE RECONNAISSANCE. THIS DOES NOT REPRESENT A WETLAND OR
STREAM DELINEATION. IF ANY QUESTIONS ARISE REGARDING THIS MAP,
PLEASE CONTACTACRE ENVIRONMENTAL CONSULTING, LLC DIRECTLY.
OUTFALL CREEK
TYPE Np STREAM
50'BUFFER
173RD ST SW
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.PLANNING DATA FILE
SINGLE FAMILY RESIDENTIAL
F__
.Name:- R>Al Lindarp—
Date:
Site Address:
Tax Parcel: -10!Y 0-4 00qQ 2,100
Project Description: Netz s;
Plan Check'#: f'.%LVa,01qo919
NO)
Reduced Site Plan Provided -7
Zoning -
Map Page:
Corner Lot: (YES AD -�Fla`gl_ot:
(YES
Critical Areas Determination #: CAx�A*10 I �M_Oq2
0'
-r 5 44,
Sm C"ce, S,,a %liq115'. Type
�Study Required. SA,ea,� Mp r-A ." flet"
%-iwaa stk6&w-k. per- G coc- :X3.1 0 4 23.90.
Waiver
SEPA Determination: Ex"44
19 Exempt'
D Needed (for over 500 cubic yards of grading)
0 Fee [I Checklist 0 APO List with notarized form
Rec7uired Setbacks
Street,
Side:.-
Side:
0
Rear:
Actual Setbacks
Street:
tat
Side:
Rear:
El Detached Structures: Nene_ alkou3n
El Rockeries: No,e,
El F*ences/Trellises: None- SAwco4m vcv ?6^5.
Bay Windows/Projecting Modulation: Pc--V-.oe% of -fP&- floor CVle-ors owe locate P%60. loy a#%#- VoV of
Stairs/Deck:
Height '0` 0^ ?luft%
Datum Point: G... p
I A4 , /
14 in -464 SE ca.,.-er of
um Elevation: \00
3
Maximum Height Allowed: <
Actual H eight:
Other
Parking Required:
Parking Provided:
f1w L%
Lot Area: ,
IA14
Maximum Lot Coverage: 35% Proposed:. ej 7
-.1 q. q60 0 ta Ono 1* ,
a
,a for&
P 11A,600 0-4:
Lot Coverage Calculations: K6,0 fokA 21
ADU Created: (YES AD
Subdivis ion:
Legal Nonconforming Land Use Determination Issued:. (YES AD
Comments
C -w- T3. qo. 0 q0. C, . %AV—
W%
Plan Review By: Plannihg Data Form 07-14-09
City of Edmonds UITY COPY
Critical Area Notice of Decision
Applicant:
Property Owner:
KAM's Ra,e-r,,&6yV@on
Critical Area File #:
Permit Number:
r-RAX011COYI
Site Location:
Parcel Number:
1-+Oqo 00yo:X200
Project Description:
I
Conditional Waiver. No critical area report is required for the project described above.
At, on -&J* do
1. There will be no alteration of a Critical Area or its required buffer. 0--e- I
Frare4y 14-cle-
2. The proposal is an allowed activity pursuant to ECDC 23.40.220, 23.50.220, and/or
Is'
23.80.0410. 6460C. T�e.
3. The proposal is exempt pursuant to ECDC 23.40.230. 40 &"IY
F1 Erosion Hazard. Project is within erosion hazard area. Applicant must . prepare an erosion anclot,
sediment control plan in compliance with ECDC 18.30. ;s e-Z.;red.
F1 Critical Area Report Required. The proposed project is within a critical area and/or a critical area
buffer and a critical area report is required. A critical area report has been submitted and evaluated
for compliance with the following criteria pursuant to ECDC 23.40.160:
I The proposal minimizes the impact on critical areas in accordance with ECDC 23.40.120,
Mitigation sequencing;
2. The proposal does not pose an unreasonable threat to the public health, safety, or welfare
on or off the development proposal site;
3. The proposal is consistent with the general purposes of this title and the public interest;
4.. Any alterations permitted to the critical area are mitigated in accordance with ECDC
23.40.110, Mitigation requirements.
5. The proposal protects the critical area functions and values consistent with the best
available science and results in no net loss of critical functions and values; and
6. The proposal is consistent with other applicable regulations and standards.
F] Unfavorable Critical Area Decision. The proposed project is not exempt or does not adequately
mitigate its impacts on critical areas and/or does not comply with the criteria in ECDC 23.40.160 and
the provisions of the City of Edmonds critical area regulations. See attached findings of
noncompliance.
Favorable Critical Area Decision. The proposed project as described above and as shown on the
attached site plan meets or is exempt from the criteria in ECDC 23.40.160, Review Criteria, and
complies with the applicable provisions of the City of Edmonds critical area regulations. Any
subsequent changes to the proposal shall void this decision pending re -review of the proposal.
Conditions. Critical Area specific condition(s) have been applied to the perm it number referenced
above. See referenced permit number for specific condition(s).
Reviewer ---S'dgna �re��� Date
Appeals: Any decision to approve, condition, or deny a development proposal or other activity based on the
requirements of critical area regulations may be appealed according to, and as part of, the appeal procedure, if any,
for the permit or approval involved.
Revised 1211612010
890 . 194
�'# 1-11ft-111 It 414's ;' �
CITY OF EDMONDS
250 - 5th AVE N. *EDMONDS. WA 98020 e (206) 771-3202
COMMUNITY SERVICES:
Public Works 9 Planning e Parks and Recreation e Engineering
March 29, 1989
Mr. William K. Lindgren
1721'8 - 76th,Ave-. W.
Edmonds, WA. 98020
Dear Mr. Lindgren:
LARRY S. NALIGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
On February 2, 1989, 1 mailed a letter requesting your cooperation in
removing a safety hazard from the public right-of-way in front of your
home. The following week we discussed the matter, and I felt I made
the City's position clear.
I believe we have waited a reasonable time in expectation of your
cooperation. If you have not removed the rocks from the right-of-way
by April 17, 1989, 1 will direct our Public Works crews to remove them.
Hoping for your cooperation, I remain
Sincerely,
GORDON C. HYDE
Engineering Coordinator
GCH/sdt
LINDGREN/TXTST530
W-L
Alberts t-
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
, 890 - 19 ') -
IaTnpr-T - FILE
CITY OF EDMONDS
250 - 5th AVE N. - EDIVIO',DS vVA 98020 - (206) 771-3202
COMMUNITY SERVICES�
Public Works 9 Plann -,g * Parks and Recreation * Engineering
May 22, 1989
Mr. William K. Lindgren
17218 - 76th Ave. W.
Edmonds, WA. 98020
Dear Mr. Lindgren:
LARRY S. N""UGHTEN
MAYO�
PETER E. HAHN
DIRECTOR
I have seen no sign of activity to move the rocks out of the public
right-of-way adjacent to your property. Apparently, you have decided
not to obtain the necessary right-of-way construction permit, which was
explained to you in my letter of April 24, 1989.
As it has now been fifteen weeks since. I first contacted you, and that
seems ample time to have the situation corrected, I am directing the
street crews to remove the rocks. I presume their work schedule will
allow this to be done by the end of the month.
Sincerely,
GORDON C. HYDE
Engineering Coordinator
GDH/sdt
M 6;— —
Alberts
LNDGREN2/TXTST530
* Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
V/,2 yly_�
8 go . 1 94
STREET FILE
CITY OF EDMONDS
250 - 5th AVE N. -EDMONDS, WA 98020 - (206) 771-3202
COMMUNITY SERVICES:
Public Works a Planning e Parks and Recreation * Engineering
April 24, 1989
Mr. William K. Lindgren
17218 - 76th Ave. W.
Edmonds, WA. 98020
Dear Mr. Lindgren:
LARRY S. NAUGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
Having received your letter of April 14, 1989, 1 can now understand
where some of the confusion lies. I have made a site inspection of the
right-of-way adjacent to your property and found the conditions shown on
the attached sketch.
As you can see, it appears that the rocks in discussion lie primarily
in the public right-of-way. Without undertaking a survey of your east
property line, it still remains that the rocks are placed dangerously
close to the travelled roadway.
I can appreciate your concerb that you are being singled out, however,
I can assure you that this is not the case. We are working with
several residents throughout the City to reduce or eliminate similar
hazards. If you care to report such hazards, please call me as I am
interested in solving these prdblems.
You indicate a willingness to comply by removing the rocks from the
right-of-way, and as it has been over eleven weeks since I first
contacted you, I hope you will do so at your earliest convenience. If
you wish to leave the rocks in the right-of-way, a right-of-way
construction permit is required under Section 18.60.000 of the Edmonds
Community Development Code. I would be glad to work with you to obtain
the permit if that is your choice.
If I can answer any further qui�stions or assist you in any way, do not
hesitate to contact me..
Sincerely,
GORDON C. HYDE
Engineering Coordinator
GCH/sdt
Albefts
Attachment
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
I�W& 22-141 50 SHEETS
IDA . 22-142 100 SHEETS
A— 22-144 200 SHEETS
MOA/()A,j=-AJ7Z';b
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a
EET FILE
C IT Y OF EDMONDS
SEWER DEPARTMENT
STOPPAGE OF SANITARY SEWER MAIN REPORT
DATE: TIME CALL RECEIVED: 4)
LOCATION OF STOPPAGE:
1. /
TIME OF ARRIVAL ON THE JOB SITE: 0,
TIME NORMAL FLOW OF SANITARY SEWER REESTABLISHED:
CAUSE OF STOPPAGE:
X 7-EA,1,0,F,
'le
4 P,04 12 r PL)
,o9 7—C— 1Z A
ACTION REQUIRED TO CLEAR MAIN AND/OR LATERAL: 7-0 Aa
A.1
/Z-.
� A 776rl,�'19 4-
60 A�4 �a (L--z S- 0,
no /z 4-
CITY CREIV ON STOPPAGE CALL OUT (Personnel Involved):
e-7,—
J A,1 11-d 7— EAZ WA 7- C A/
LOCATION OF RESIDENCE AFFECTED:
--7
NAME,ADDRESS, AND PHONE MMER OF
PROPERTY OWNER:
A,) 77o9l A,,�
/ 7 2 1 ?- -761 t-t/ -�77 .,3o4q
DESCRIBE DAMAGE TO PRIVATE PROPERTY: rz- /2- ::�Ioot/
7— /Z,
REKMZKS: A149r1r-19C40 4,0, Al 4 A,1
WO V4 � 2 7 -/, -/, C- �
rd..; 40A.1, /1012- ,
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ok
44
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fl
PROVIDED, that the Surety may terminate its liability hereunder at any time by giving thirty (30) days written notice of.
such termination sent through the United States mail to the Obligee.
The term of this bond shall be from
1/11/71
to 11111'7 2 -'DFORD & SON
URED R RE Df,'ORD DBA RE
P r n c i p a I
GREAT AMERICAN INSURANCE COMPANY
Form 9515C License or Permit,Bond IRENE SHELTON.5 Attorney -in -fact
CITY OF EDMONDS - SIDE SEWER PERMJT
WATER -SEWER DEPARTMENT
PERMIT �,-S 6, C, � 9
Call 7,76-1107 for side sewer inspections BEFORE covering any portion of the construction.N
Inspection will be provided within 24 hours� after request. NO Sat., Sun., or holiday inspections.)
ADDRESS LOCATION OF CONSTRUCTION ............. :.- ........
....................................... : .................................. . .......................................................
PROPERTY LEGAL DESCRIPTION ---- ....... ----------- -- ----------- �_.-."-, .......... ........... I ........ ............................... .............................................
.................... : . . ......... ......... ...... ----------- .............. ....................... I ---------------------------------- ........ :� .......... ; .............................. . ....................................... L.4 ......
mtw AND/OR BUILDER 7:1
................................................................ 0 ER ............ ............ ............. ................................... . .......................................................
Z,
CONTRACTOR'S NAME & ADDRESS ------ ...... (-,- � t_� ; � - - - . - :;, �, I t
...................... ..................................... . ............ ................. . ............................... ............... ...........
Permission is granted ----------- ----
-- --_----------_------- ----------------- 19 .... �.!:, for repair and/or connection of a side sewer to the city sanitary sewer
system In a4mordance, with City of Edmonds ordinances.
fi—MENTION IS CALLED TO THE FOLLOWING:
Nh No. I —The o ners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
1\�' 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--Obtain 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 1/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.
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-
sert the pipe into the wye.
DISAPPROVEDE] Date ... . .................................... By ......... ...... Da( ................. B/ ------------- - Date ---------------- — ................... 'By ................
............................................
By
ate. .0 11-e ....... e 9.'21 .. .... ........
APPROVED D ....... �X._47
- - - - -------- --- ----------------------------
Remarks: ........................................... - -- - ------------------------------------------------------------------------------------------------------------------------------------------------------------------------
..................................................................... . ............................ ......................... : ..............................................................................................................................
e -136 Signed By Owner of Firm -Performing Construction PRIOR -To - Request- For Inspection
BOTH Permit. Copi MUS e
7
I ..... ;, ..... ..... ....... .. . .. . ... ... ... .............. .... hereby certify that the side seWer installation constructed under this permit
min
(owner of CCo*ntractingr-m Perfrr g Construction)
jl
installed in accordance wi all governing ordinances of the City of Edmonds.
Dated this ........ L� ---------- day of-- ---_--------------- 19.— .
Check BEFORE you dig for: Water [3, Gas 0, Telephone E], Power E], Sewer E], UOther [E]
APPLICATION
for
The City of Edmonds
SIDE SEWER PERAHT
EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS C3
-7 9 L /D
OWNER ..... ..... ..................................... PERMIT �Nc(L[70
...................... CONTRACTOR ..... .....
-ve
ADDRESS ........ —.169 ......... 4fa .......................... LEGAL DESCRIPTION: LOT No. BLOCK NO . ......................... =
NAMEOF ADDITION ..........................................................................................................................................
AUG -17
e,,9. -0
6, 11 'oe (
q0
L
/001
5'e,
Approved:
DATEA0 By ........