17404 76TH AVE W.PDFIIIIIIIIIIII
6209
7404 76TH AVE W
ENVIRONMENTAL ASSESSMENT FILE #
DESCRIPTION OF PROMIAL: Aovin 10/.j -Aj s//,1rAj_C_
�rAm (L,4 R& S I pefj
780590
PROPONENT:
PEET FILE
EXISTING_�SE: C
e, rl,�M LAI
ENVIRONMENTAL IMPACTS FROM PROPOSAL:
SOILS/TOPOGRAPHY Ttxo:SZ-,c-r W11-L "VeP-' 0tAA-,A- -1-AAT
W IV ILI
(_Ag�)67NJ � 4U&WVj -BOT - N oT -,T- M 9 KCT
09- soll-ca I-M Aij� C-6r6N3-r,
WATER/DRAINAGE -k-.;,ONc
yp
. V Fr gN4.
_rMok"r Pwtjl�j-r Of- qukl�ITY
AIR QUALITY
CIRCULATION eukeut-4-TIO�j -ro T*, 40 . ADVI-riO^/AC Tle-kV�FIC- 'C,�K
_K("%L6AA,5, 4D-pj-rj6AJ 70
1A
VEGETATION
0'r C>0& --BLV6
Z)'p (_Q OIJ
ECON014IC
16, aF) -n V
CITY SERVICES tfo AA 6, 01
4
ENVIRONMENTAL FINDINGS:
There will be certain environmental impacts but they do not constit ute� a signif-
icant adverse impact on the environment and no environmental. impact statement
will be required.
There will be significant adverse impacts on the environment and an env.ironmental
impact statement will -be required.
There will be certain impacts on the environment howeverit is necessary to obtai
more information before a declaration of significance or -non-significance is made
X) Zo
/,1 1-7 3'
CITY PLAINER DOE
CITY ENGINEER DATE
E/A '76
0
fURLIC WORKS ENVI . RO . NMENTAL REVIE'd
sl
PROJECT NAME:,--�-m=,--- FILE
ASSESSMENT DATED:
AN ENVIRONMENTAL REVIEW OF THE PROPOSAL 14AS-BEEN
COMPLETED AND THE FOLLOWING DETERMINATIONS HAVE
BEEN MADE:
f-T4::b!9,r- 7( r, ": 4
Am
P�- r n ME T� t T
....... ...
PREPARED BY: DATE'
REVISED: 10/77LV
S-TREF,T FlU
PUBLIC WORKS EN VIRONMENTAL' REVW4
PROJECT NAME: F I LE :q:
ASSESSMENT DATED:
780590
AN ENVIRONMENTAL REVIEW OF THE PROPOSAL HAS BEEN
COMPLETED AND THE FOLLOWING DETERMINATIONS HAVE
BEEN MADE:
I -2-S 1.
pm lr--
c L-s-= . o I ga-A ) L-J." r
V-Acnt-AT—= .
� r--4 IFF -
PREPARED BY: PAT�
V 1 S 1.9/771-V
. 3ED:
OLE
DATE:
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 FORIM
BACKGIZOU14D
.1. Name of Proponent 0 be CY e__
2. Address and 1).,o ol:,jryponent:
I - 17
. — Z he
3. Date Checklist SubMiLted 12 % Of 7 Ar - —
4. Agency Requiring ChecklisF
5. Haine of P - wal if ap lica Id"6
0 -e � -r- A. 4 f'-
6. Nature atill"Brier. DescripLion of the Proposal ( Inc
ing but not limited to its size, gencral desiRn cle-
Merits I and Other factors that wili j-
.,ive an accurate
understandin sco,)e and nature):
of it
+ tcdeC4
7. Location of Proposal (ciescribe the physicai Setting ol
the Proposal, as well as the exL:cnt o�- the land area
affected by any envirohii-,ental impacts, including any
other. informat ion needed to give an accurat:_� understand -
in f lIVIr nmen S;etAjJ_'0.g Of le proi) 1):
Z —SH —1.1-a —Le-d C�Omplc tIL: -Proposed Action:
1 - . Of 9,7 !%
9. List of all Perl'.11.us, Licenses or Gove-himenL Approvals
Required for the Proposal (federall Cate and local--
includl-lig rezones) : R& % I
#,& J�j
. I Acoo'e_
-31-
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STR-SET FILE
10. Do you have any plans for future additions, expansion,
or further activity related to or connected with this
proposal? If yes, explaiji:_
Iry Ur
11. Do you kno-.,i of any plans—U—yotners which may affect
the property covered by your proposal? If yes, explain:
A 1 0%
FV W
12. Attach any other application �orm t5at has been com-
pleted regarding the proposal; if none has been com-
pleted, but is expected to be filed at some future
date, describe the nature of such application form:
A! 7V P Perm f T1
IT. ENVIROMMENTAL IMPACTS
(Explanat ions of all "yes" and "maybe" answers are
required)
Yes 'Maybe No
(1) Larth. Will the proposal result in:
(a) Unstable earth conditions or in
chani,es in geologic substructures?
(b) Disruptions, displacements, com-
paction or overcovering of the soil?
(c) Change in topography or ground
surface relief features?
(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?
(f) Changes in deposition or ero-
sion of beach sands, or changes
in siltation, deposition or erosion
which may modify the channel of a
river or stream or the bed'o[ the
ocean or any bay, inlet or lake?
Explanacion:. n--e e
(2) Air. Will the proposal result in:
(a) Air emissions or deterioration
of ambient air quality?
(b) I'lie creation of objectionable
odors?
(c) Alteration of air movement,'
moisture or temperature, or any
change in c' Uriate, either locally
or regionally?
Explanation:
-32-
Y yes No
(3) Water. Willey rPU4:)U rVLt E n
2;
.3; (a) Changes in currents, or the
4 !' course or direction of water move-
5! ments, in either marine or fresh
6! waters?
71
8! (b) Changes in absorption rates,
9! drainage patterns, or.the rate and
10' amoulit of surface water runoff?
III
12i (c) Alterations to the course or
131 flow of flood waters?
141 15 (J) Change in the amount of sur-
161 face water in any water body?
17
18 (e) Discharge into surface waters,
or in any alteration -of surface
20 water quality, including but not
2111 limited to temperature, dissolved
22 oxygen or turbidity?
231
24 (f) Alteration of the direction
25 or rate of flow of ground waters?
26i
27 (g) Change in the quantity of
281 ground waters, either through
29 direct additions or withdrawals,
30 or through interception of an
31 aquifer by cuts or excavations?
32
33 (h) Deterioration in ground water
34 quality, either through direct in-
35 jection, or through the seepage of
36 leachate, phosphates, detergents,
37 waterborne virus or bacteria, or
38 other substances into the ground
39 waters?
40
41 (i) Reduction in the amount of
42 water otherwise available -for
43 public water supplies?
44
45 Explanation:
46
47
48 (4) Flora. Will the proposal result in:
49
50 (a) Change in the diversity of
51 species, or numbers of any species
52 of flora (including trees, shrubs,
53 grass, crops, microflora and
54 aquatic plants)?
55
56 -(b) Reduction of the numbers of
57 any unique, rare or endangered
58 species of flora?
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160
41,
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so
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55
M
(e) IntroductLon of new species
of flora into an area, or in a
barrier to the normal replenish-
ment of existing species?
(d) Reducti.oll in acreage of any
agricultural.crop?
Explanation: M o I
(5) Fauna. Will the proposal result in:
(a) Changes in the diversity of
species, or numbers of any species
of fauna (birds, land animals
including reptil . es, fish and shell-
fish, belithic organisms, insects or
(b) Reduction of the numbers of
any unique. rare or endangered
species of fauna?
(c) InLroduction of'ne%,, species
of fauna into.an arezi, or result
in a barrier to tile migration or
movement of fauna?
(d) Deterioration'to existing
fish or wildlife habitat?
Exp lana t ion:
(6) No i. s e . Will the proposal increase
exl7sEing noise levels?
ExpLanati.011:
(7) Li.&ht and !,'ill the pro-
Posar—p—r'-'-J-d—ce -n-ew light or
glare?
Explan at ion:
Yes tLaybe No
- -VOOO
(8) Land Use. Will the proposal
D, tile alteration of the
present or planned land use of an
area?
I . - Y
Explanation:
-34-
0 XS�s _jaybe n0--
I
(9) Will the pro -
(a) Increase in the rate of use
of any natural resources?
(b) Depletion of apy nonrenewable
natural resource?
Explanation:
(10) Risk of U2sct. Does the proposal
involve a risk of an explosion or
the release of hatardous substances
(including, but not limited to,
oilT pesticides, chemicals or
radiation) in the Sent of an acci-
dent or upset conditions?
Explanation:
(11) population. Will the proposal
alter tFc location, distribution,
density, or growth rate of the
human population of an area?
Explanation:
(12) nousinE. Will the proposal affect
existing housing availabilicy. or
create a demand for additional
housing?
Explanation:
(13) ation. Will
the proposai resuic in:
(a) Generation of additional
vehicular movement?
(b) Effects on existing parking
faciliCies, or demand for new
parking?
(c) impact upon existing trans-
portation systems?
(d) Alterations to present
patterns of circulation or move-
ment of people and/or goods?
(e) Alterations to watcrborne,
rail or air traffic?
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Z 7--
Yes nX�e No
(f) Increase in traffic hazards
to motor vehicles, bicyclists or
pedestrians?
11.*xplanatio . n-
(14) Public Services. Will the pro-
j7;`vezjij7c_ffect upon, or
re,. -,Lilt 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?
(f) other governmental services?
Explanation:
(15) E' n e r g y . Will the proposal result in:
(a) Use of substantial amounts of
fuel. or energy?
(b) Demand upon existing sources
of energy,' or require the develop-
menL of now sources of energy?
Explanation:
(16) u t Llities . Will the proposal
rcsufE �in a need for !azystems,
or alterations to the following
utilities :
(a) Power or natural gas?
(b) CoiTuilunica t ions systems?
(c) Water?
(d) Sewer or septic tanks?
(e),. Storm water drainage?
(f) 'Solid waste and disposal?
E,xplanation:
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2
31
4
51
61
7
8
11 10
III
121
131
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191
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22.
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291
301
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351
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(17) 141111.1114, Wi'll t11W propbsal
i7C-,-s--U1 —t:-1 -.1—twe crea t ion o f any
11 C;1 I t 11 �1 r d - � - .1
epp��n Fr 11-0 a 1, t I I
L 1_111 F --M
hazard e n i��s v I
n calth) ?
0 U tj
Explanation:
(18) Aesthet: i cs. Wil I the propo.,.1
F6TCl1_E_1l1 tile obsLructi.oll of any
Scenic Vista Or V'
1-Cw open to the
Public, or will tile Proposal rc-
sult ill 1:110 creat:ion of an
aestiletic;'lly offensive site open
to public view?
Explanation:
(19) Recreation. Will tile proposal
____ -7 fl�
" s ul L ill in'Pact Upon tile
quality Or quallcity Of existing
recreational Opportunities?
Explanati.on:
(20) st:orical Will tile
TtcraLioil of
a significaliC archeological or his-
torical site, structure, object
or building?
Explanation:
37 111 SIGINATURI-1-
38
Y NO
_Z
39 tile undernigned, 0
state that: tO tile. best. of my knowIc_,&c
40 Che above information is true an(] it is understood
41 that tllc-! lead apency may wiLildraw any declaration of non-signi-
42 ficance that iL`migkt issue in reliailce upon this ell cl-Ilirt
44 on nly part. ack of full disclosure
43 should there be any' inisrepresellcation or C
45
146
47 Proponent:.
48
A 1�!AC 197-1.0-370 WITHDRAI-ML OF
50
LJv,1.LJ\N1!,AT1ON- IT It
THI-la"711OLD
�
111Y time aft:er tile
tioll of sipllificMICC,
crLry t)f a cleclara-
the
51
52
pl.-oponellt:
so ullac, ill t:11e 1""Odifics 01C, proposal
Judgilellt of the lead at�,Cncy,
53
adverse envil-ollmentil
ilt:ed, the decl�irati.()Il
all Sip'llifical.
j.1,,1pact:s 1: sult Ilp It
0 i _ from are,
there
54
and a declarat:ioll
elimill
of S.j,, nif i cance�!Iall be 1:hdrawn
55
(if
lead aAellcy Shall 11so
, i.r lif ica:1c
, e entered instea(.j. The
56
57
public inforumvioz, center
rcxyi,�o e
th, regist:c�rs -It its SEPA
accordingly. If
58
PolWnt of I Proposal is
f,llall not: be '
tile pro-
a 1)1:j\,z ite t:hc
59
consi.ci Cred iiiodi.fic!(J'u-")Pl"C'-"'t:' Proposal
ntil 111 license applica-
Ci011s for the proposal are
revised to reflect: the modification.
-37-
780590
ST
ENVIROI`RIEINTAL ASSESSHENT
PROT NAME
DATE SUGNITTED
.In order to meet the requirements of the State Environmental Policy Act of 1 971,
the responsible official must make a declaration of environmental impact as early
as possible in the process of evalu�tingla' project.
The information in Viis form �vjill be :used to determine viliether it IM1 b I e necess-
ary to require an environmental impact statement. If an in, pact. statement is —
not required,,a Statement of lleaative Declaration will be placed in the file.
If an impact statement is required, a draft s . tatement must be filed with this
office, public notice.given and a revieii period of 30 days allowed. The final
statement: and corrients must be filed with the Department of Ecology, Office of
the Governor and t)e Ecological Commission.
The Edmonds Pl.anning. Staff will assist you in any way we can in accumulating
this information and we would appreciateyour cooperation.
1. Land:
Area in acres
A
Soils type e I Limitations
Description of topography (% slope)
Grading:
Filling-
2. Water:
estimated cubic �jd�__ NOTE: If grading or filling
ii-TT exceed 500 c bic yards
u
estinated cubic yds. a a
grading and filling plan
must be submitted with the
application.
Stream. - estimatedflow (cubic feet per second)
Will stream b*e altered?
To what degree? -
Imp act on storm drainage (increase in run-off)
Estimated area.to be paved —Co q 3�i A- r
Estimated area in open space %
Shorelines: within 200 ft. of Mean Higher High Water iv C2
Adjacent to shorelines zone No
En,vi ronmental Assessmentl RZRMt FILE on
3. Vegetation_ or)
'Y' ' . -I& 11:��
Type of trees. Me— Jame Wj, % to be removed
Minimum diameter of trees to remain
Ground cover 6 be. -removed
Proposed landscaping, if any
4. Existing.Land Use within 300,ft. radius of proposed development:
Vacant
Single
Fami ly
Multi -
Fami ly
comm.
Other
North-
SOU4-11:
Eas t
West
5. Circulation:
Estimated increase in auto trips daily
Estimated demand for.public transportation lr,�(pn e-
- Degree of change on. adjacent streets C) r) e
6. Areaff imoact:
nei ghborhood
city-wide
regional,
7. Effecton ai-r quality: �2-
8. -thanges in noise generation:
APPLICATION
j4e City of Edmonds SEDE SEWER PERMT LYNN PLANT
EASEMENT No . ..........................................
NEW CONSTRUCTION E] REPAIRS
Z-1,0
139
... .............. ................................................................................. PERMIT
.... . ..... ...........
................... ................ . 6t, . es7 -------------------- CONTRACTOR. MIT No..
..... — ................. I ...... F���OCK No . ............................................
ADDRESS ...... lll� .... — ----- ............................................ LEGAL DESCRIPTION: LOT No. ;��
4
46
NAMEOF ADDITION .................................................................................................................. ......................
C,
-4
to 7,�
P Die.,ye —
,6:9se m e,;—j . - , rw #9 ;,V — I . ,
-�,D O'Lu JO; Jou rivw -
Sj! ounu-jr
-�j jo 4*.-,w ple.
i4o
1 31 �-171 I ` -3'�'-j
N'l-
-�3 ns—")l
Approved:
DATE .... .................................... .........
By�-
-vz
�5 I
?
!Q
17
GLEN' HILL
VV I,
411
'Joe
4 #456
l4a": SHE
cy ,2 OF 2
AkCtL w#C
w,
COMMENCI�'NG AT' THE NORTHEAST CORNER OF YHE'� 9� NE�l SE! v"
St C T 0
N19 T.27 N.9 RAX69 W. N. THENCE N 880531W 'ALOgG
0,69 1 w
THE NORTHLINE OF SAID SUBDIVISION 254.4 FEET; THEN6 N bi
`6 # 69 FEET TO THE TRUE POINT OF BEGINNING EN -b T NUI
TH CE c N 1.
t
''ALONG SAID LINE N 810091W 17-15 FEET TO A' PO I NT 01111, A CURVE T
HE LEFT HAVING A CENTRAL ANGLE OF 310 AND A RADIUSfOF 472 22
-EET
THE TANGENT OF WHICH.8EARs N 76 016 1 W;
C OF SAID CURVE TO THE LEFT 255-50 FEET TO A POINT N i�-
�,'A�ONG AR
N.
it 0,
NORTH LINE OF SA10
NEA,,' SE+; THkNCE N 881153'W.55-00
S 1*071W 1M-(r FFET; THENCE 8 680531t 245-00
�,IFEET; THENCE
00 y
tY
"F* 1
ENcE 3 6;--'045'E 38.(10 FEET; THENCE N 27015'E'.1m..
Iff E T TH
it E T't THENCE ;N 1007IF 43.00 FrEy.To YmE Potky or BEGINNIINC, pl
47
WITH A NON-EXCLUSIVE'EASEMENT FOR '-I kGRE S S AND
V.,
-,111GRESS'AND FOR UTILITY PURPOSES OVER AND'UPON A, STR;'P OF:,
OL
-.'LANo 22.9 IN WIDTH THE OOUTH LINE Or VHCH 13 'rSCRIBE0 AS
xv
44,
FOLLOWS:
E. '01 r,j"E ..
"l," 74" BEGINNING AT A PO'NIT ON THE SAID NORTH LIN
lit
W, S�i 20 FEET WEST OF THE NORTHEAST C�PNER; THIN4
KC
N 88053fWALONG.THE NORTH L:NE :234.4 FEE 'THE
'N. 1005' W 92.84 FEET TO A POINT OF COVE.` `tHk TANCE04-T
OF HICH BEARS N 760 161W; tWNCE' WESTERLY,
cq- W
ALONC 'TWk
4
ARC OF A CURVI TO THE LEFT9 HAVING A A AD WS OK-.-�
P, ILI
,�,;* - ZL � '472.22 FEET A DISTANCE or 255.50 FEET
wn, -
Q! TO A :PCI N
A ANGENT ON T4E L I NE OF SA,10
SEj- $A I"b' 'T*ANGENT�,
44 W, rmE END OF SAID OESCRIPTIO'
'Of AR S' S 7�O
OGETW.R WITH AND EASEMENT FOR iNGPESSLAND EGRESS ANQ
A STR;P OF LA140 FEET jej WIDT
TY'PURPOSE3, OVER
q
ACEeVT TO THE A8f'VE DiSCRISED YRACT9 MORE PART'l CUL ARL'
4,
t*CRlp�0 AS FOLLOWS:
8E0J'NN-NG AT THE NPRTHEA�$T CORNER, OF SA)D SQ0
:,SECT ON 79'T.27N.1, R.4E.9 W.M.; -THENCE N W0531W :254 04
4.
�FcIT�; THENCE N 81009'W 75.69 FEET.� THENCE 9 1 V74W
151H FEET;
THENCE 75.69 FEET; THtNC9I'S'88*53`lE'
'4 FEET; Tmr,.NcE'N 1008'E 15.W
254
FEET TO THE POINT OF
BEGINNING. LESS THE EAST 2P FEET' FOR ROAD
k,
;T
NAI'V", - . I , * & ASSOCIATES
JAMES H. KID:
ji
;4 C9N3
J24 MaiA St.
PR. 8-1171
%%ONDSP WASH
4s.
CITY OF EDMONDS
"I Plitol 1-1107 when work
CIV141i�'CENTER — WATER —SEWER DEPARTMENT Is ready for Inspection. (No inspec-
. 6 . - 1 69 33 �06-
tions Saturday, Sunday or holidays.) N?
SIDE SEWER PERMIT
17404 - 76th West
ADDRESS..................... ................................................................................................... . .............................................................................
OWNER ........................ Q19A --- G.Jilll ..................................... CONTRACTOR ---------- Bob—Aklin .............................................
Permission is granted ..... April --- 1 --- 1 .............. M --- 70, for ------------------------ days to REPAIR or CONNECT a Side sewer
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contr actor must
be employed to construct side sewer in street area. Do not cover any portion of sewer before it has been inspected.
NOTE No. 2—Obtain full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 3—Top, of side sewer must have at least 30 inches coverage at property line and 12 inches Inside property line; minimum grade of 2%.
No bends in grade sharper than % will be permitted.
NOTE No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for
failure due to improper work which may develop within one year of completion.
NOTE No. 5--It is unlawful to alter or do any other work than is Provided for In the permit, or to do any work on the main sewer or Its appur-
tenances except to Insert the pipe into the wye.
17Y
STREET FILE
FILE #
FOR4 FOR [FROPOSED/MM] DECUUZATION OF [916KIP)IV&WiNONSIGNIFIC.,�N-CEI
Description of proposal Addition to single-family dwelling
7
Proponent Robert Greene
Lotatioll of Proposal 17404 76th Avenue West
Lead Agolicy City pf Edmonds
3his pyoposal has been cictermined to [J=,Wrot have] a significant a.-d-
C>
verse jjpv*,i�-t upon -t,�e onvirorn-icnt. An EIS �Wis not] requixed tmdcr
IL-1-1 43.21C..030(2)(6). This dccision was made after review by t1he lead
aoell-)r o_r
I a ccm.pleted envirm-'ilcntal chec1dist and other inforniation on
file with tlie lead agency.
Responsible -Off jCjjl Dan Srrfith
Position/Title Planning Technician'.
Date October 12, 1978 Signature .4-
JILDINO III ARTMEN1W
ApplicantFill
USE P E
ZONE N R
PERMIT., APPLICATION
: Inside Heavy Lines
JOB
ADDRESS f 1711 &V/ — 7
NAME 100 "^"% Or OVS!H 9 a S)
LEGAL. LOT
L NAME
UBDIVISION NO.
PUBLIC RIGHT OF WAY PER ORDINANCE N
EXISTING R IGHT OF WAY
w
z
0
CITY
'BLEPHONE NUMBER
-714 - 144,0
PROPOSED RIGHT OF WA yo-
MAMIE A)
4
L=4jE8
N\t
DEFICIENCY OF RIGHT OF WAY
D YES
STREET/UTILITY WORK REQUIRE.
NO
U
W ADORIES%
PERMIT FOR WORK IN PUBLIC R/W OYES
ANO
071to Ar!;M�)(E-
LIN DERGROUND WIRING REQ UIRED WYES
ONO
U ELEPHONE NUMBER
M CITY T
CONNECTION TO SANITARY SEWER dYES
NO
SEPTIC TANK PERMIT REQUIRED 0 Y ES
94NO
SEPTIC TANK PERMIT NO._
0 ADDRESS
MEMO DATED
SEE Io/,
U
REMARKS
Cr CITY
TELEPHONE NUM BER
zo
CHECKED B
U STATE LIGNM
CITY LICENSE NUMBER
METER SIZE
UILDING SUPPLY 511-tw
IB
1 5 ... i Ri-eL�n ni K�rtv (Show Below
or Attach Four Copies)
REMARKS
0
SIGN AREA
ALLOWED PROPOSED
ENV. REVIEW
COMPLETE EXEMPT
ADB NO.
SHORELINE
M
w
REMARKS
ILI
VARIANCE OR CU
PLANNING REVIEW By
PLANNING REVIEW By
DATE
YARDS
LOT COVERAGE
GAS
S..
FRONT SIDE
/0 REAR
NEW
RESIDENTIAL
LINE
IRE ZONE
TYPE OF CONSTRUCTION
COD;
I
HEIGHT
MON-RESIDENTIAL
SIGN
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i 7(o
30'MAX
AGO
RETAINING
DEMOLISH
SPECIAL INSPE OR
REQUIRED
AR A
PANCY
P
OCCUPANT
LOAD
WALL
0 YES N-vcro-
2
ALTER XCAVATE FENCE
ED
R FILL X —FT)
PLAN CHECK D By
T IS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
PRE -MOVE swim
El REPAIR POOL
SHOULD BE CODED 31.04.
INSP.
REMARKS
W�>'Q 021-M 0 �J RE 7
t-
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NUMBER OF' STORIE
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NUMBER OF
0
DWELLING
UNITS
pp-
i? ecr vc-, P St
t: 14ATURIE Of' WORK TO BE DONE
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A r�,v �4
A
ILI
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PLAN CHECK FEE
VALUATION
FEE
PROPOSED USE
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PLOT PLAN JINDI-CATE 11 UILDING SETBACKS,
ABUTTING STREETS)
BUILDING
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ir
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in
PLUMBING
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MECHANICAL
0
>
FENCE
I
SIGN
=========4
In
chalf of his rs, assigns and
"Applicant, on b or her spouse, hei
In
ILI
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successors in interest, agrees to i ndemnify, defend and hold harmless
RETAINING WALL
7
the City of Edmunds, Washington, its Official s, employees, and
*nature,
(1:
agents front any and all claims for damages of whatever
<
directly or indirectly from the issuance of this permit. ISSLI-
SWIMMING POOL
I
arising
01;tll iw.t be deeined t(I j1p)(lit'v, %kjive i].r redLICC
DEPARrMDM CHE Daie"
G PER-1IT
W, Address
'76 A
Street Right -of -Way Existing
REQD
Access Easements Existing
F_ 3, I;EQD
Utility Easement Existing
REQD
Lot per Subdivision Plat Assessor Map X
Site Plan Checked for Accuracy.-
I CAV 2 r
Z
Underground Wiring Reqd.,-
Check Accuracy of Legal Description
41
Environmentally Sensitive Area,
Environmental Checklist Reqd.:.
Z
Flood Hazard Zone
0
Shoreline Managenent Area
Z
Slope, Soil, Vegetation
Strewn, Creek, Drainage Basin
�Nn
Existing Zoning Per Code
_P
Amenities Design Board Approval Reqd.
-No ADB # Approval
Board of Adjustnent Approval Reqd.
No
Review BV: _=W 11
Date: -79
.24
Existin S*
g Water Main J_ze 6
W t e r
Water Main Reqd. 0.
S r v 3 - c E
Service Line Reqd. LX4a N
W
H d r a n
Hydrant Size Existing
y t
H d r a
Hydrant Reqd. Per Fire Code
y n t
Size
D e t e c tc
Detector Check Meter Reqd. 0 eD
C ros s C
Cross Connection Inspection
F Jr
ire Department Cannents
Water Meter Chary Reqd.
R vj w
eview by:
Date:
Septic
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer Availability
Proj.
Drawing No.
File No.
I
Side Sewer Availability E��k
aft=
W
Sanitary Sewer Connection Fee Reqd.
AJOZ-Z,4'
Cr.
Revimq By- W/S
Date: (0/9tzg-
. XkK.
r
�Open Ditch Existing___& Reqd.
,Z
Culvert Rend. A1119- Size
04 Catch Basin Reqd.
-Indicate on Site Plan
Shoulder drainage maintah-i collection cm s,��ale open runoff 42-/Z2
Indiole rcqd. Indicate on Site Plan
Soil Conditions and Groupd Wate r Field Checked -,Da P,<.
RO\'ic'.'T I .)y - 060.4e/'�z Date 16- jo - --'Sl
Street Paving Rcqd.
Curb and Cutter Rend.
Sidewalk Rend.
Curb Cut for Driveway R&qd.
c4 Rioit-of-Way Construction Perudt Reqd.
Bond Reqd. for Public 1up.rovements
St reet Nam-- Sign Rend.
1OLher Signing Rend.
13
Pre P.endt: Site Inspection m.de on
BY: Shl-.IER dat
U
tyl LLI WATER
STREET
ENGINEERING
Special Rcqlaire-mei-iLs listed, in mcm to Co.mr-mfty Developmnt Departrwnt,
BLLilcting Division
BY Da te
o All iters filled in on Building Permit Application
By- Date
PL4 Drawings Staimed and Notations �kide
BY Mite
-br m
Approved by Nblic I ks Deimrt mnt
1v 10-1977
0
PUBLIC 11ORKS ENVIRTIMENTAL REVIF4
P R 0 J E C T - N A M E F I L;:
ASSESSMENT DATED:
AN ENVIRONMENTAL REVIEW OF THE PROPOSAL HAS BEEN
COMPLETED AND THE FOLLOWING DETERMINATIONS HAVE
BEEN MADE:
7(,"L 4N—,-.jF=
IF
T-C=
L-1 I MU Als
I c-
PREPARED BY: DATE
p -' � ! 7
. I �Fn: 1,9/771 V
Date VoXi/v
MEMO TO: Building Division
Community Development Department
FROM: Engineering Division
Public Works Department
SUBJECT: I I
After review of,the subject building permit application, we have the
following comments:
/V� Coordination of the location of any structure with respect to
utilities, streets, property lines and driveway grades.is the
responsibility of the contractor.
V —71-1"The contractor is required to keep the abutting streets cleaned
of dirt and debris caused by the construction.
/-7 The "Right -of -Way Construction Permit" is required, from the
Engineering Division of Public Works, for any work within the
Public Right -of -Way or public easement,.
Dtiveway slope not to.exceed 14%.
/7 Connection to sanitary sewer required.
L -7
Septic Tank Permit required, submit design.
Fire hydrant required, submit design.
/-7 Site drainage per code # See approved plans
/-7 Curb /-7 Sidewalk 177 Paving required.
/-7 Bond required for public improvements. Submit cost estimate.
/;7KUnderground 'wiring required.
L-7 Approved Engineering Plans required when applicable.
/-7
I A�®r Fre F. HeMzbe�rg, �PE
City Engineer
Department of Public Works
...Rev. 7/ 78
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CITY
WORK-
ADDRESS- 1?
OWNER-�lakl
APPROVED E,'
BY
BLDG. OF
KEEP T;
PLANS C..'
ALL 1'
PERMIT NO.
ZONE 61=1
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