17503 72ND AVE W.PDF111111111111
5636
17503 72ND AVE W
CA FILE NO� Cl'� Y —2-46
14 Critical Areas Checklist
----------------- ----------------------------------------
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Site Information (soils/topography/hydrolggy/vegetation) RV t"A
1 . Site Address/Location: (757 ltpAe I-(-) p r -2
2. Property Tax Account Number: 15
I FL04N'W��;
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? X yes; no.
If yes; how is site developed?':S
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of I 0-feet over a
horizontal distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of
I 0-feet over a horizontal distance of 3 3 to 66-feet).
Steep: grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped. (lawn, shrubs etc)
11. Obvious wetland is present on site:
6: Sii��;,dest'gn'ate,,d-:o'n.:the��Eo*o �:S6sitive Area*s' M;q,p9
^ca_chk.doc; Rev 10/03/97
City of Edmonds
CRITICAL AREAS CHECKLIST
The Critical Areas Checklist contained on this form is
to be filled out by any person preparing a
Development Permit Application for the City of
Edmonds prior to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The
information needed to complete the Checklist should
be easily available from observations of the site or
data available at City Hall (Critical.Areas inventories,
maps, or soil surveys).
An applicant, or his/her representative, must fill out
the checklist, sign and date it, and submit it to the
City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map along with the signed
copy of this form to assist City staff in finding and
locating the specific piece of property described on
this form. In addition, the applicant shall include
other pertinent information (e.g., site plan, topography
map, etc.) or studies in conjunction with this Checklist
to assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
PlIr i e—
Name
(7-5293- 72A-"&1e
Street Address
P A
T
City State Zip
Telephone
Signature
Date
c:rccepfion\jana\cac1.doc
Applicant Representative:
/Le /-00 /Y--) Co
Name
Street Address
Z a,-4r,2�,7j 1,41W— �<EO 3
City State Zip
�s (�' - //// * -
Date
(over)
,It? C. 1 So \3
CITY. OF EDMONDS BARBARA FAHEY
MAYOR
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works - Planning/Building e Parks and Recreation e Engineering e Wastewater Treatment Plant
October 23, 1998
Rocky Gibbs
The Deck & Sunroom Co.
15919 Hwy 99
Lynnwood, WA 98037
Subject: Determination regarding Critical Areas Checklist # 98-248
Dear Applicant:
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of, the form (bottom of page).
It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
............ ..........
IMPORTANT INFORMATION TO BE NOTED:
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENT 0
ALCHECKLIS OR RITICAL AREAS STUDY.
The 'DETERMINATI ON' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
cc: Pirie & Cindy Hart
Enc: Determination
* Architectural Design Board
C:ReceptIonUana\CRLTR.doc
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you.
Planning Secretary
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
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Proposed deck replacements
Hart roj ect
1750 - 72nd Ave. W.
nds WA 98026
Gulley
lot line not
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CA FILE NO. ZJ
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soil s/topography/hydrolo gy/vegetation) R. WT C 'F�_
I Site Address�Location: ( 75-0 2 1998
2. Property Tax Account Number: om
J. Approximate Site Size (acres or square feet):
4. Is this site currently developed? X yes; no
If yes; how is site developed? :!!�2
5. Describe -the general site topography. Check all that apply. NOV 3 19�8
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of I 0-feet over a
horizontal distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of
I 0-feet over a horizontal distance of 3 3 to 66-feet).
Steep: - grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped. (lawn, shrubsetc)
11. Obvious wetland is present on site:
DETERMINATION
'R�viewe.d by
^c&_chk.doc; Rev 10/(
City of Edmonds
-N�W CRITICAL AREAS CHE-CKLIST
The Critical Areas Checklist contained on this form is
to be filled out by any person preparing a
Development Permit Application for the City of
Edmonds:.'prior to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The
information needed to complete the Checklist should
be easily available from observations of the site or
data available at City Hall (Critical.Areas inventories,
maps, or soil surveys).
An applicant, or his/her representative, must fill out
the checklist, sign and date it, and submit it to the
City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map along with the signed
copy of this form to assist City staff in finding and
locating the specific piece of property described on
this form. In addition, the applicant shall include
other pertinent information (e.g., site plan, topography
map, etc.) or studies in conjunction with this Checklist
to assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
cdy
Name
75-6�) 3-- 72
Street Address
'--7 �
';;1 41;A -
City State zip
q
Telephone
Signature
Date
c:reception\jana\cac1.doc
Applicant Representative:
Name
Street Address
Z ,-,,2,�7 bvezWz
cit/ State
Zip
Date
(over)
PLANNING DATA
NAME: C'
SITE ADDRESS: 7/0� Ak DATE: MIN
I I
ZONING: PLAN CHK#: qi - 371
4WININIff. NOW � Alf I "It"12TWIff-115m]
CORNERLO (Yes/No) FLAG LOT. .(Yes/No)
7
SETBACKS: 0h&14A:;0
Required Seibacks:
Front: Left Side:7. Right Side: 7. 5 Rear:
Actual Setbacks: �9't
Front: Left Side: Right Side: Rear:
Street map checked for additional setback required? (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE:
Maximum Allowed: <;.""—Actual:
BUILDING HEIGHT:
Maximum Allowed: —Actual Height:—///',q
Datum Point: Datum Elevation:
A.D.U. CREATED?: f Vo —
SUBDIVISION: —
CRITICAL AREAS
SEPA DETERMINATION:
LOT AREA:
OTHER:
Plan Review By: Zklal%ly� //j
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(0
CITY�OFEDMONDS� Permit No.
COMMUNITY SERVICES DEPARTMENT
RIG HT -OF -WAY CONS . TRUC . T . ION PERMITSTnIMET ru Issue Date' (0 kq-
Z
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A. * Owner: (21,yl��N\.&--_.?_,�n
Np%F,7
MAI"
Mailing Address
opn
B. e Contractor: 1_�Auc— I C, C
Mailing Address
�W\,A ,
City State Zip City Stat, Zip
r-
0�� (4 6-5�
State License Number ephdne Number
C. Address or Vicinity of, &16o?hffs?Tuct16n:
Type of Work to be
D. 0 Work in Connection With:
El Single Family
0 Commercial ' El Multifamily Utility
E. 0 Pavement Cut: El Y El N F. 0 Size of Cut: — X
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature, to this application, agrees to hold the City of Edmonds
harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforseen, that may
be made against the City of Edmonds, or any of its departments or employees,� including or not limited to the defense
of any legal proceedings including defense costs, court costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Estimated restoration fees will be held until the final street patch is completed by City forces, at which time a debit or credit will be
processed for issuance to the applicant. P d"
• A 24 hour notice is required'for inspection; Please call Engineering: 77lz22_02.
9 Work is to be inspected during progress and at completion.
• Restoration to'be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
• All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;.
NO EXCEPTIONS.
I understand the above and that this 1)er-mit must be
Signature:
at the job site for inspection purposes at all times.
Date: 23--R9 -
\J Owner orvContractor \_�
This Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
APPROVED BY:
Time Authorized: Void after 30 days.
Special Conditions: &fA —t-1yea- rZ D�p
RELEASED BY: --,0-
PERMIT FEE:
Restoration Fee:
Receipt No.:
Fund I I I Fee:
Street Cut Dimensions
G //I/ V INSPECTED BY
NO WORK TO.BEGIN PRIOR TO PERMIT ISSUANCE
x - = $
Date
Eng. Div. March 1989
FIELD INSPECTION NOTES (Fund I I I Route copy to* Street Dept.).
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. A
SIR,`
CITY OF EDMONDS
NEW
ADDITION
RETIREMENT
ASSET INFORMATION SHEET
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION DEPT. NO.
:2 6 -111-6
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
*PROJECT NUMBER 4,..) 2- :7� 443
PROJECT COMPLETION DATE 12-7 31-'&
COST 7-3 .-75
B.A.R.S. ACCOUNT NO. 3 -,�- 00 - 6 z
ESTIMATED LIFE
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT -
0 G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
B A T C H flN'
-0
INITIAL
ttnp
DEPARTMENT FILE
I
hkx STREET FILE
jton
NbUaW Com
CaMNM DEVEIM1ENT DIVISION
CIVIC CENTER
505 BELL STREET
EMCNES, WASHINGIMN 98020
Gentlemen:
I
Washington Natural Gas Company hereby applies for'permission to:
Permission is requested to install 2701 +/- of 2" Plastic Gas Main in 72 Avenue West
fran 171 to 253' North of the oenterline of 176 Street SW, to serve the address
of 17503 72 Avenue West.
Per Attached Draqing: 823-104
We would like to begin construction about June 82 and will require
approximately 90 days to complete the work. If we have your
approval to'proceed, please sign--an.d return the original of this form.
(Please enter any special conditions.)
Application Date June 2, 1982
I
WASHINGTON NATURAL GAS CO.
---Tony
7T - - I-essitore
Distribution.Engineer
Eastern Division
Washington Natural Gas is hereby authorized to perform the work
described above in accordance with their franchise responsibilities
and are further subject to all applicable federal,state,county and/
or municipal.ordinances and specifications.
A.*u i
Approval Date
805-156th Avenue North Eau, Bellevue. WashinSton.9W.. Telepbone(200)2"101.
CI'C-Y OF EDMONDS
FOR INSPECTION CALL lqD
PUBLIC WORKS DEPART T Permit
SI . DE, -SEWER PERMIT 775-2525 1 Ext. 1 2*2 0 Issue Date
*.PERMIT MUST BE POSTED ON JOB SITE
'77777TA 'AW
l.. Address of Construction 17,5'62 3
2. Pro' erty Legal Description (include all, easements)7j,
p
�Vlvv� W'd "C91, 13r-,c4 V,1 S-
jS No. of Units
Multi-F mily
:Fi-ngYve /"'rdri�"Ae Z7 0 Z/ 8
3. Fa si
Commercial
4. Owner and/or Builder,
5. Contractor & License No. 2-Z3-61
6. Invasion into City Right -of -Way: No V Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
E-1 7. Cross other private property: Yes No V Easement required -
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
a4
a. Property owners must obtain a permit to install side sewers on
�H their property. A licensed side sewer contractor must be employed to
construct side sewers in the public' right-of-way.
b. The side sewer contractor assumes full reponsibility for each
E-4 installation for one year.
C. Commercial establishment requires a minimum of a six inch (6")
P4
side sewer line.
0 d. Side sewers may not be installed closer than thirty inches (30")
U to any structure.
e. Side sewer lines must be laid at a minimum grade of 2% (1.150)
and maximum grade of 100% (450).
0 0
f. No turn in side s8wer greater than 45 (1/8�bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and Wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is require d for bedding when installing sewer lines
through other than granular soil.
i. Cleahouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer lineirun.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required.
DATE:
I certify that I have read
and shall comply With the above
PERMIT FEE: 150 CT DISAPPROVED BY: Date:
B Date
D a t e
CONNECTION FEE:
APPROVED By
0
rX4 PERMIT MUST BE POSTED'ON JOB SITE
IV-P-Vol -Z 197
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Side Sewer Drawing
The City of Edmonds
EASEMENT NO. ......................................
NEW CONSTRUCTION 0 REJPA!kS'0 LID NO . ........... ...... . ASMT. NO.'...'..-'.'.-......-.`
OWNER................................................................................................ CONTRACTOR .......................................................... ............................ PERMIT NO . ...........
...........
JOB ADDRESS ......................................................................... - ------ LEGAL DESCRIPTION: LOT NO . ................ ...................... BLOCK NO . .............................. .........
................................................................................. ......................
----------------------------------------------------------
NAME OF ADDITION.
................................... .. .........................................
I V_A
W
PWW-Ml-11175 (REV.11/78)
39
c_ �O L A- V>\ CL VV,
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Approvid
... tl�
DATE.. ..... ..... ....... . .. . . ....
t
I
PUBLIC WOWS DEPAR7= . CHECKLIS`r `TREPT FALE
0 - a. 6a
BUILDING PEENIT REVIEW J7.03 2%V.V A21
(address) (date)
Street Rig�it-of-Way Exist
Z
Access Easements Existing
REQ�_
Utility Easement Exist' A
REQI�_
W
Lot Per Subdivision Plat
Assessor C_
Site Plan Checked for Accuracy L7
Z
Underground Wiring Reqd. vr:�
0
Check Accuracy of Legal Description
Z
Review by_L4;�...�_Date
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existing — — — — -- 5Z-�'
v4
Hydrant Reqd Per Fire Cod
Size
Detector Check Meter Reqd.
Cross Connection Inspecti
Fire Department ConTnents
:3
Water Meter ChaLre R,,eqd. 6,50,
Review by
Date 3 A;
Septic Tank Design Approved
Date -?/?-3
Septic Tank Permit Reqd.
Permit No.
Sanitary Seuver Availability
Proi.
Drawing No - L / -,D, 2-07
File No. -
Side Sewer Availabili VeT
Sanitary Sewer Connection Fee Reqd.--
:3:
Review by,
Da�e��?_
.Open Ditch Existing_2ed:!e
Reqd.
Culvert Reqd. _ZL,k4,A
-Size
C4
Catch Basin Reqd. I/ )J417
Indicate on Site Plan
0
Shoulder drainage maintain collection
on swale open runoff
Manhole reqd.
Indicate on Site Plan
Soil Conditions and Ground Water Field Checked 4!�,, A�
c�,
Review by
--Date
NJ
Re� sed: lvlO-1977
I.-OPW .4 �Ot-�
7 2;,
E. T F LE
Agreement entered into this day of 1981,
IJ
an �"Michael A. and Susan J. Gibb, Individually and as a maigital -
coimunity, aria Kirk and Connie Black, Individually and as a marital
community,
Michael A. and Susan J. Gibb hereby authorize Kirk and Connie
Black to removeAs many as five trees from Gibbs' property. 175,21.72 nd Avenue
West. Edmonds. Wa., and to deposit fill material on Gibbs' property In order
to- more,easily facilitate construction of a personal residence"on Blacks'
property. 1750372 nd Avenue West. Edmonds, Wa.
The trees to be removed shall be approved and tagged in
advance by Gibbs, and.the amount of fill material deposited on.'Gibbs'
property shall n ot'e�&eed that necessary to bring the level of I . Blacks'
property to a'de'pth approximately 12 feet above the lowest point of grade on-.
Blacks I.. property".
Further. it is.coptemplated by this agreement that the trees
to be removed. from both GibbsO property and Blacks@ property sh . all be sold
fo : r c . as : h by Blacks. Consequently. Blacks hereby agree to remit to Gibbs a
pro rata, portion.of the cash proceeds. less the costs associated with topping
and removing such trees on Gibbs' property, and the costs of opera . ti.on of ' fill-
wo rk on, Gibbs' property. ei6luding the cost of any fill material deposited on
Gibbs' property.
In the event that no such sale is consummated, Gibbs a &�'U'
have the option to retain trees felled on their property, and shall pay to
Blacks any costs of topping such trees. up to a total of $22 per tree.
u - F -thermoreq Blacks hereby -v
r agree to Mi liurse Gibbs, for any
&Ldditional damage to GIbbsO property, other than that contemplated by this
&9reemant, which is occasioned as a result of the construction on Bl.�cksl
property, and In addition Blacks agree to indemnify Gibbs for the fun amount
of anY.and all mterialmanst or mechanics$ Uene placed on Gibbs$ property
as a result of the tree removal and fill work contemplated by this agreement,
in witness whereof the parties hereto set their.signatures
on the�day and year first set forth abovet
Michael A. Gibb
Susan J. Gibb
Kirk Black
Connie Duck
1, E: I
3 5' �4,�
UL 1�14 Cl) T
y
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LL
3
3 4
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7
ST 5W,
F X. 2' 5T�k,' 1 1 -T"�
241 W-17
24, w -------
F_�\ I.STI NG 'o
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J U N 1982
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NOTE
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N 0. DESCRIPTION DATE BY_.
REVISIONS
NOTES.
CALL 48 HOURS
BEFORE YOU DIG
1-800-562-6478
F_ �A7- F_ j 7(4, S-1 S W
F i LLL'� T(�_, 4 5-r L J R t� 1 ('14 L /A N C_ A P C-_
4\ cS) FRC-',NT
TiE 1-7521 7Z'A)VW
(0043 _�
5 1 �5 2 kz,�(_"
44 TRANSITION P- i T T 78-800
3 1 a' -S F-R v � c E- 7E- E- K -7 SCO -7 E- -7'
-2 2 70' — 114 Z�)IREC_7
2 7C)' 2' P E P i F, E-_
ITEM QUANT. DES C R IPT ION
BILL OF MATERIAL
6 WASHINGTON NATURAL GAS COMPANY
PERMIT
I ,
R
, ( 8 2
PERMIT
1/4
SEC
C Ga
PERMIT
OP.
MAP
15 G- 0 G8
TAX CODE
PLAT NO.
ISEQ.
� 59 - 0-70
AREA
NO.
(D C�� 5 r� r) ( ,
2 to eE, IP MAIN FXTF-NSION
WE
1-7503 Ta 6N W
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JOB 04
APP'D CHK'D DRAWING
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