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CITY OF
EDMONDS SIDE SEWER AS BUILT
ADDRESS
Permit Number
18302 72ncl
Ave W 1 9370
HOMEOWNER
CONTRACTOR
Colololestone
DATE
6-01-01
DRAWN
P. Lemcke
LID
No. 215.
]BY
PERMIT NO:. '937,0,
'City of Edmond$`.-
... . . PF.RART RYPIRF-9 1,11,1PY
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Address of Construction: __2Z' LID #
Property Tax Account Parcel No.
Attach copies of all access and utility easements Verified and Approved by.
Owner and/or Contractor: G�b(c_-.Sf-a�
Contractor Lic en se Co )A- 0 15�J L_ -Building PermitW:
CfrSingle Family Invasion into City *Right -of Way! E:1 Yes 12-Ko
Multi -Family (No. of U.nits *RW Construction Permit #
Commercial (No. of Units Cross other "Private Property: El Yes L�-�&
Public "Attach legal description and copy of recorded easement.
Owne '0(-
Owner or contractor signature and ackno wiledgement 'statement: D_ ate
By signing for this permit I certify that I have read the City's public handout entitled
ide Sewer Specifications, and shall comply with all City requirements outlined thereim
9 CALL DIAL -A -DIG (1-800-425-5555).BEFORE ANY EXCAVATION
W FOR INSPECTION CALL 425-�71-0220 extensionaS9112
24 HOUR -NOTICE REOUIRED FOR ALL INSPECTION REOUESTS
........... ...........
.. . ......... .
FOR OFFICE USE ONLY
... . .. .... . ....... .
Permit Fee RepaIrFee$ Issued BY: 6105M 1640d2l
Trunk Charge $ Date Issued: .
Assessment Fei $ Receipt No: i j 7!5 �g
City Permit Surcharge Fee $5.00 Total Fees Paid
NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE 'WILL BE CHARGED.
Job Site Ready YES NO. Date: Initial:.
Partial Inspection: Date: Initial:
Partial Inspection: Date: Initial:
Initi As -built to Street File: El
FINAL INSPECTION APPROVED: Date: 17a I al.flb-
1,�- PERMIT MUST E POSTED ON JOB SITE t�
White Popy: File Green Copy. Inspector Buff Copy: Applicant
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CA FILE NO.
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location:
2. Property Tax Account Number: 000 ol o o
3. Approximate Site Size (acres or square feet): o
4. Is this site currently developed? yes; no.
If yes; how is site developed? j I
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
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: _ /,)o Approx. Depth:
7. Site contains areas of seasonal standing water: Jj Approx. Depth:
What season(s) of the year?
8. Site.is in the floodway 1�; 0 floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? C� Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc) X
11. Obvious wetland is present on site:
.7";777777,7777
IT
777
Site li 204*.�*
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DET-MMINATION
"WAIVERA:
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SL_0F, E_� -
AC�_dLdK RW 10M/97
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City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
Critical Areas File #: LIDO — Id 9-
Critical Areas Checklist Fee: $45-.00
Date Received by Dev. Serv. Dept:
City Receipt No:
Date Mailed to Applicant: Ti-�-i -
CRITICAL AREAS CHECKL1STPLm�wiiai,"--:7'---
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).
PLEASE PRINT CLEARLY
Owner/Applicant:
Name
b)
y
Street Address
6,
r"a- - 1 � U.-) (10
City State Zip
Telephone
Signature
Date
d:receptionrjana/CACLHandoul.doc
Applicant Representative:
Name
Street Address
City State Zip
Telephone
Signature
Date
Revised 4/1 MODO
182-221
18,2,,25,,
18220
C)
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40 LO
Z
1822,8i
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COO
04
C\1 CY)
00
18227
1-8228
1-8301
18233
18302
18303 18304
ry
18304
18305
18308
18309
183110
18314
18314
18325
18320
18,32,
1831,9
183-1-2
18329
183-38
18327
18330
18402
18401
18,402
18400
18407
18412
6
------------------------------ MetroScan / Snohomish -------------------------
Owner
:Denovan Laura
RTSQ
:04E -27N -17 -NW
CoOwner
APN
:4775 000 014 00 09
Site Addr
:18302 72Nd Ave
W Edmonds
98026
Struct
:$63,600
Mail Addr
:18302 72Nd Ave
W Edmonds
Wa 98026
Land
:$70,000
Rec Date
:11/20/1998
Deed
Total
:$133,600
Price
:$158,000
Loan
:Blanket
LevyCd
:00220
Aud Fee #
Ln Amt
:$153,260
2000 Tax
:$1,687.06
ActualUse
Lender
:Keystone/Emeral
Phone
Vest Type
:Married Persons
IntTyp
:Fixed
%Owned
:100
Bldg Name
Vol
:13
Page
:91
Land Use
:11101 Res,Sgl Family
Res,Detached,l Unit
Easmnt
NbrhdCode
:522
Census
Zoning
:Rs-8000
ZoningRest:
Tract
:502.00
Sub/Plat
.:Homeview Add No
1
Block
:5
Legal
:BLK 000 D-00 -
LOT 14
Bedrooms
:3
Bldg SF :1,248
LotAcre
Bath F3H
:1
1st SF :1,248
Lot SF
Stories
:1
2nd SF
Heating :Forced
Fireplace
:2
3rd SF
Roof
Spa
4th SF
View
Units
:1
BsmntSF
WtFront
Year Blt :1960
EffYrBlt :1960
BldgGrad :Avg
BldgCond :Avg
WaterSrc :Public
Sewer :Septic
The Information Provided Is Deemed Reliable, But Is Not Guaranteed.