19002 DELLWOOD DR.PDF11111111111111
10878
19002 DELLWOOD
DR
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER: C0446mo oc)
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: gto - I tL DETERMINATION: 0 Conditional Waiver Ej Study Required N-Waiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DN
EASEMENT(S) RECORDED FOR:
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORTPLAT
SIDE SEWER AS BUILT DATED:-5 2k[ - V+
. I
SIDE SEWER PERMIT(S)
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
LID #:
LOT: 221 BLOCK:
LATEMP\DSTs\Forms\Strcet File Checklist.doc
7
CA FILE NO.
fFitical Areas Checklist
Site Information (soils/topogra'phy/hydrology/veg��iCion)
1. Site Address/Location: I L tAl o
2. Property Tax Account Number:
_0 o 0 - p..),
3. Approximate Site size (acres or square feet): 6,-z—v 0,
4. Is this site currently develop�d? yes; no- "kko- 1,9
9
If yes; how is site developed?
5. Describe the general site topog7raphy- Check I that ap ly.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generall ' y less than 15% (a vertical rise of 10-feet over a
horizontal distance of 6(5-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: grad es of greater -than 30% 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: _7A Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What se4sqn�(S) of the year?, -77-A
8. Site is in the floodway floodplain 'Y% u of a watercourse.
1 1
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)
I I . Obvious wetland is present on site: - 0
For City Staff Use Only
I. Site is Zoned?
2- �CS mapped soil type(s)?
3. Wedand inventory or C-A. map indicates wetland present on site?. /11_�
4.:- :-,.Critical Areas inventory or C.A. map indicates Critical Area on site?'
5. within' designated earth subsidence landslide hazard area?
6. ''SIte des*;ignated ory the Environmentally Sensitive Areas Map? A-V
LE-TERNMATION
'-'-:'STUDY REQUIAED
CONDITIONAL WAIVER
-'WAI
1Z V
Reviewed by:- Acj
Planner, Date
Rcv 0 1/04194
89 9q
City of Edmon&
Critical Areas Checklist
The Critical Areas Checklistcontained on
this forni is to be fined 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
presenton the subject property. The
information needed to comple
,te 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 adetermination of the
subsequent steps necessary to complete a
development permit application.
'ArAh a signed copy of this form, the
applicant should also submit a vicinity map
or plot planfor individual lots of the parcel
withenough detail that City staff can find
and identify the subject parcel(s). in
addition, the applicant shall include
otherpeifinent 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 Area Checklist and attest that -the answers provided are
factual, to the best of my knowledge (fillout the appropriate column below).
Owner / Applicant:
Name klo(7-ae-Z
19 o 0 L L Li o () z3
btreet Address
D rn o A) z 53 ? 2 4 42Y 7
City, State, ZIP 't ? c�a' Phone
Sig�nature�4 Date
Applicant Representative:
Narne
Street Address
City, State, ZIP Phone
Signature \ . Date
The City of Edmonds
14lq -015 o
OWNER
0
0
APPLICATION LYMY PU#,flff
for
SEDE SEWER PERMIT BASEMENT No . ..........................................
NEW CONSTRUCTION ��S
. . .................................... CONTRACTOR ...
�- �-,- - V -ne .... A4, ... LEGAL DESCRIPTION
t
-�,,.IL4�PERMIT No.
No. ............................................. BLOCK No . ............................................
.....................................
Approved:
DATE 7 ......... BY ........ . .............................
.-.-two
of Sanitation
3011 Ror-kefeller Ave.-ALpine 94061
Everett, Washington
Permit No. 4 Date
01
-T / -
bedrooms- -1 —Lot size- I
Lft_Z:� Block�. Addition,
Remarks:
Date inspscted by _ installer
Approval Mailed To Date
Rec. #
Septic tank Capacity " _�Z� - -gal-ions. Disposal field length
a
ipect
arr. OF' EDM0N,D&:_ call - PRO 0-1107- wheik wOrIc
WATER�SEWER, DEPARTr4ENT6�;�?-,Is�read*,�t�r��speeti6i'.--ig�
C IC-XENTER
--tioi;8' �Fjay,--,s Own
up r
:$EWERPERMIT.-
-.SIDE
........... .......... ..................................... .
d q; .................... .......................
A002' ..... Y ........................
ADDRESS.......................
V.
pim 7 K ..................
CTOP ..........
CONTRA
.........................
V U ..... ...................
OWNER ..... .........
pAIIR�oi:CONNECT a-SIde-0ewer
ditys to BE
Is- granted _March-.'�10 .. .............. for ............
governing. -ordinances.
ji pli I on file and
d . ; .
-�-'._Mth qty-.,Sewer� In..accor &nee wit ap �at on
ATTENTION JS - CALLED TO THE, FoLLQ1qING:. Contractor- must
line. A -licensed Side Sewer
f- the Property may obtajn.a permit to construct. dower. Iii-side.property A
1�The owners o o it of siewer before :it has been. speqed.
--NOT er in'street area. 'Do.not cover
�be.�ernpjqyed to construct side sew. were, , when You get permit.
governing side -se
g Ordinance 11.16.0,.30 and Regulatt ns*
77-qbtain:f 11 Information.regardin urn grade of.2%.
_,2 _.0 ty line and -12 inches inside- pyopeFt line; minim
verage at proper
_�_Top of side sewer . muit'have at least 30 inches co
',—A No� :�N harper, than % will be permitted�
o bends in grade s ._ , . i -rqSponsiblejor
Contractors shall be
No, '4�-Trenches in street must be water settled and � surface W street restored to orlgin,al condition.
develop wlthW one year of completion.
failure due �to. Improper work which may
work I than Is provided torAn the permit, or to do any work on the: main: sewer. Or lt&�ip�,
NOTE: No. 5�jt is unlawful to alter or 'do any other %yye.
purtenaiices. except to -insert the pipe into thi'