18208 80TH AVE W.PDF111111111111
7030
18208 80TH AVE W
City of Edmonds
IQIWF'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
infori-nation 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 infor m-ation (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:
N �m e
Street Address
�W' 20��'4-
City State Zip
57
Telephone
Signature
Applicant Representative:
A' 1.0"
Name
/o 7'V9 ;1'
Street Address
;22i�' �Ov/-X? 4a�
City "State Zip
Telephon
'e:-00
Signature V
Date
Date
crccepfion�anakacl.doc (over)
0
CAFILEIVO.
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soil shopo graphy/�Ydrology/ve getation)
1. Site Address/Location: 14';�214" A5 RECEIVED
2. Property Tax Account Number: I � 911 - M I — 0ZL - 0�c) FEB 0 4 2000
3. Approximate Site Size (acres or square feet): PERMIT-LOUNTER
4. Is this site currently developed? X yes; no.
If yes; how is site developed?
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 33 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: _A,,)j2 _; Approx. Depth:
7. Site contains areas of seasonal standing water: A/0 Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site contains a cr ek or an area where water flows across the grounds surface? Flows are ear -
round? '410 Flows are seasonal? _11_4�> (What time of year ? A 3
10. Site is primarily: forested d shrubs mixed
urban landscaped (lawn,shrubs etc) . )
11. Obvious wetland is present on site: 111-fl-2 - .
M"Als
Ac�_dk.dm Rw IQM3/97
�tz? C. 1 89\)
March 2, 2000
Betty Smith
18208 801h Ave. W.
Edmonds, WA 98026
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPM ENT SERVICES DEPARTMENT
Planning'. Building - Engineering
Subject: Determination regarding Critical Areas Checklist # 2000-15
GARY HAAKENSON
MAYOR
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 ENVIRONMENTAL CHECKLIS OR CRITICAL AREAS STUDY,_.
The 'DETERMINATION' 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:
Building Permits
Conditional Use Permits
Subdivisions
. Variances
Applications to the ADB* Land.Use Applications
Any other development permit applications.
Enc: Critical Areas* D6tehrniinakibn
Architectural Design Board
C:Receptic�nUana\CRLTR.doc
Thank y6u.
Sharla-Graharn
Planning Secretary
Incorporated August 11, 1890
Sister City - Hekinan, Japan
— --- --- ----
CA FILE NO. CA— U00- 1
Critical Areas Checklist
---------------- ---------------------------------------------
Site Information (soils/topography/Pnydrolc)gy/vegetation)
1. Site Address[Location: RECEiVED
2. Property Tax Account Number: 4� FEB o 4 2000
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? /K yes; no. A i Pi-=Rher OUNTER
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire
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
10-feet over a horizontal distance of 33 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: -,d,2i2 ;Approx. Depth:
7. Site contains areas of seasonal standing water: AIZ,�' Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain_ of a water course.
9. Site contains a cr k or an area where water flows across the grounds surface? Flows are25ear-
round? :�O — Flows are seasonal? _11LA___'> (What time of year? A
10. Site is primarily: forested m adow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
DETERMINATIOW..:
��chk.d"; Rev IQW/97
Jf - - -
City of Edmonds
N,TW -- CWTICAL 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 infor m-ation (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:
Nirne
Street Address
city State Zip
,�� - L�-
, -r
Telephone
Signature
Applicant Representative:
6/2)" I(I(Aplule xv�
Name 1/1
/45 7
9
Street Address
City Itate Zip
Telephon
Signature
Date
creceptionyanakad.doc
Date
(over)
— il
-1,0 '. J 8 9')
March 2, 2000
Betty Smith
18208 801h Ave. W.
Edmonds, WA 98026
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
Subject: Determination regarding Critical Areas Checklist # 2000-15
GARY HAAKENSON
MAYOR
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.
...................... : ...... .............. I .................. -- .......... .................... - ... ....... ...................... ......
IMPORTANT INFORMATIONTO BE NOTED.
PLEASE EXAMINE THIS"DETERMINATION11 FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED To SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL OR CRITICAL AREAS STUDY,
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
mo, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION MTH ALL, 411111
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the. following:
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Enc: Critical Areas Determination
*Architectural Design Board
Thank you.
Sharla Graham
Planning Secretary
C:Reception\Jana\CRLTR.doc
Incorporated August 11, 1890
Sister CitV - Hekinan. Jar)an
SNOHOMISH HEALTH DISTRICT
DIVISION OF SANITATION
IMM`ckefeller Avenue, Everett, Washington
STREETFILE'
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
4/e (S b it 3 Copies)
Permit to be issued to: ........... AJ-117 ..... .. ........ ... .......
For installation at: (street address) ------- e��.ya.e gl 8,0
.. .................................. A'.'0.9 ----------------------------------------------------------
Addition or Subdivision -------- . ....... Rzoo� --------------------------------------------------- ... Lot ---------------- Block ----------------
----------------------
Type of Building: New--.-.Y--.-. Existing ------------ Single family residence-- Y__ 4� Number of bedrooms----.3 ........ I --------
Other: (specify type or use) .........................................................................................................................................................
Builder ------- ----------------------_---- Address--
Designer..-Z-0/V --- A01Xa1--JK 1494�40C ------------ Address,;.P
---------------
Soil Log Hole No. 1 ........ 2 3
---- -- ------------------------------------- ----- --- --------_----- __ ...... --------------
............. .......................................... '�p te -4/9111 '&Z-19C-A:f fol Z17 "le
.. .............................. -------------------------- ---------------------------- ------------
Soil Log Hole- No. 2 --------------- - '09S
------ ........... Z7 ------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------- __ --------- -------------------------------------------------------------
Elevation of Water Table, if encountered. (Distance from ground surface) ---------------------_- --- _ ---------
Corrections to control surface water if needed
............................................... 7 ---------------------- ---------------------------------------------------------------------------------------------------------------------------------
C7
... ......
Specify if any removing or grading of topsoil in field area_ ....... 0 ...
---------------------
--- ....... ..................................................... ----------------------------------------------------- ..............
Percolation:
Test Hole No. I —Average Rate ------------------ ------------------------------------- (Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 2—Average Rate ..... 'Al-it-10 ----------------------------- ------- (Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 3—Average Rate .... 2io1110 -------------------- -------- ....... (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design ----- do
..................... ----------------------------
Septic tank requirements based on present rules and regulations:
Septic Tank Size ----- 0-100 ------------ gallons.
Amount of Square Feet of Disposal Field ....... ---- -----------
- ----------
Signature — Designer ------------- --------- --- Date ----- 40Z
-----------
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date) .................... ------------------ Permit Number ....... ----------------
Remarks: .............
.................................................................................................................................................................................. .......................
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PROVIDE d22. I- FT (OF 5r," WIPE
T 9AA) C 14 ArJ 7) --q " 71 L E
s \/S _,E IN ACC�0,44DAfOCE WITH
'SA�o�4cmpsH
9? "matv
7301 - 179th S. W.
EDMONDS, WASHINGTON �R 6-5880
PE fi-COLATION TEST
PLOT PLANS
0 CA Tl(-')IU,* le-92 045 - 6o 4 AkE lY IAT DEVELOPMENT COORDINATOR
=p 09'- 7 7 -6 -3
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
POILE NEW CONSTRUCTION E] REPAIRS [3
OWNER--/? ------ 467 ------------ ------------------------------------- ------
.... ... ... ... . ....................
ADDRESS ........ .... . .. ....... I
LYNN PLANT
EASEMENT No . .........................................
C014MACTOR ....... ---------------------- PERMIT No.
LEGAL DESCRIPTION: LOT No. J..Y ................................... BLOCK No. ..............................
NAME OF ADDITI
ON ......
VAJJ
pPR0VVD
ApR W)969
Yoe
tA
I
Approved:
. .. .....................
DATE ..... ......... B T. I ........
C/:
STREET FILE
14t / 9
1�t Pci
. - — 4.
lock,
CITY OF EDMONDS
Call PRospect 6-1107 when work
CIVIC CENTER — WATER -SEWER DEPARTMENT Is ready for Inspection. (No Inspec.
SIDESEWER PERMIT 'ions Saturday, Sunday or holidays.) N2 3258
ADDRESS .......... 18208 - 80th Avenue Wst
........................................ .................................... ................................. . ................................................................. : -----------
OWNER .............. B.arr.t-on .... B ...... Smi.th ........................................ CONTRACTOR n —Co.
.. ..... . .... .. . ....... ..... .......... y
!��q�?d Se wer C c n s t .. ..............
Permission is granted ...................... ApTi 1 9.
. ........... ... 19.0_ 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 Contractor 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 Or ' dinance 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.
4—Trenches. in street must be water settled and surface of street restored to original condition. Contraetors shall be responsible for
failure due to Improper work which may develop within one year of completion.
N"o. 5m—lt 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.
0
NOTICE:
No warranty of accuracy.
The -information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of 'Edmonds does not warrant the
accuracy of anything set forth on these
map(s-). Any person or entity -req uesting a
copy should conduct an independent
inquiry regarding the information shown on
th-e rnap(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may* not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
employees or officer-,-) Ishall be liabl-e for the
infor-mation given on this map(s), nor for
any one representation provided based
upon -said map(s).
9 MIS
"I F L-1 I
CITY OF EDMONDS WATERLINE AS -BUILT
tf� 1ADDRESSi
18208 80TH AVE W
PERMIT
No- BLD20070384
CONTRACTORi HOMEOWNER: SCALE:
xxxxxx I xxxxx I NTS
DATE INSPECTED: INSPECTED BY: DATE DRAWN: DRAWN BY1
4/11/07 1 J. HAWKINS I 4/16/C 1. ABILA