19518 94TH PL W.PDFiiiiiiiiiiii
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19518 94TH PL W
Nv CITY OF EDMONDS STREE7 FILE ASSET INFORMATION SHEET
5KNEW ASSET NO. L�6sl
ADDITION ADDITION TO ASSET NO.
RETIREMENT
DESCRIPTION
-7 Qkl�y
SERIAL NO.
LOCATION
9,5_1
DEP NO.
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
INITIATED BY
DATE
*PROJECTNUMBER
PROJECT COMPLETION DATE
COST 6 / ��
APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SLIBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
R�DEPRECIATE
0
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
Is G.L. ENTRY
REFERENCE
kvp) INITIAL
DATE
VERIFIED BY
PROCESSED
BATCH NO.
it X,
DEPARTMENT FILE
.:d*
co
CD
-RECEINED
CITY of EDMONDS S I D E SEWER PERMIT
SEP 14L
For Inspection Call 771-3202 PUBLIC Eff FILE PERMIT No.
Address of Construction: 16?- 94 RZ -
Property Legal Description (Include all 'easements): L Ot
EDMeNOS
Owner and/or Builder: TREATMENT, PLANT
Contractor & License No: */tAl �IZ:-Z 4 /9/6 61
Singl:e Family Residence
Mul ti-Family (No. of Units
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No I Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1 -800-424-5555)'bef ore any
excavation.)
Cross other Private,Property: No Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE'BACK-
I certify that I have'read and s,h,all-comply
with the items Tisted on the'back. --'
Permit Fee: _3,0
Trunk Charge: ��
Assessment Fee:
Partial Inspection:
Issued
Date Is
Receipt
9-
Date
Comments Date Initial
Final Inspection Approved: 9-9-as-
Date Initial.
Rejected:
eason
—5-a t —e n —it i a 1
Wh.ite Copy �- File
** PERMIT MUST BE POSTED ON JOB SITE **
Green Copy - Inspector
Buff Copy - Applicant 4.42
Th r; 9 cA...A Side Sewer Drawing I I
lu my %f EASEMENT NO. ...... _ --------------------------------- -
NEW CONSTRUCTION REPAIRS LID NO. ASMT. NO . ..................
OWNER T
---------------------- CONTRACTOR ------------------------------------------------------------------ _ ................ PERMIT NO. 73_77.1 ---
JOB ADDRESS AC351S ........ 94- 1 - r - ----- P-L—_W� --------
---------- LEGAL DESCRIPTION: LOT NO. _2 ..... ----------------------- BLOCK NO - --- ---- ..... EDMONDS_
I TREATMENT PLANT
NAME OF ADDITION -Nit4EYARD ----------- skk 4
ORT ..... SUB -1 ............................
4'
PWW-0001-1 1/75 (REV.1 1/78)
4 " L'j'T_ - li, D F,
C/O -z' VeAf.
4"Pu-L OF
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SACWOIC- TAP 0
'R*VV%AA_ SAP%
Approved: I
DATE .... q_- _.jj5j
.9 . . ....................... By .......... . . . ......................
NOTICE:
G -u
.0 ... w-a r-r a -a--c-c
N formation on the attached
The -in
Map(s) wa-s coM ' plied for use by the City 01
rnpl-oyees and Consultants.
Edmonds/ its E
Th,.e CItY of "Edm.onds does. not. warrant the
n these
accuracy of anything set for.th o
M a P (s). A n . y person or entIty -requesting a
copy should conduct an.independent
inquiry regarding the infbrrn-atlon shown, c
including, but not J'rn'ted to/
t F�� -m a p (S)Jj
n of any sew-er stub shown, Su(
the lotatio
sewer stubs may or may' not e.xlst and Ma\,
or may not exist at the location shown.
,;ty of Edmo-n(JES/ nor its
Neitheir the k--.Ij
em p`o-yee-s O*r Off i-cers *shalrl be !--i ab-'Fe. for th
information given on this map(5), nor for
e.ntation provided based
anyone repres
Upon'sald map(S).
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I T E P LA N
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CITY OF EDMONDS-
ADOPTION OF EXISTING ENVIROM92UAL DOCLM4T
Adoption for (Check appropriate box) (�D EIS Other
Description of current proposal single family residence
Proponent Lois M. Vinyard
Location of current proposal 19518-94th Place W.
Title of document being adopted Declaration of Nonsignificance
Agency that prepared document being adopted Edmonds. Planning Department
Date adopted document was pre
Description of.document (or portion) being adopted Determination of
Nonsignificance prepared for S-12-81
If the document being adopted has been challenged (197-11-630), please describe:
The document is available to be read at (place/time) Edmonds Planninq Dept.,
250 Fifth Ave. N., Edmonds, WA 98020
We have identified and adopted this document as being appropriate for this proposal
after independent review. The document meets our environmental review needs for
the current proposal and will acconpany the proposal to the decisionmaker.
Edmonds Planning Department,
Nam of agency adopting document
Contact person, if other than
responsible official Phone
Responsible official Bruce G. Finke
Position/title Associate City Planner Phone771-3202, Ext. 253
Address .250 Fifth Ave.-N., Edmonds, WA 98020-
Date Aug. 30, 1985 -Signature
8. List any environmental information you know about that has been prepared. or will be prepared, -directly'Telated to
this proposal. ?
0
9. Do you know whether applications are pending for governmental approvals of other proposals directly affecting the
property covered by your proposal? If yes, explain.
I . No
I
10. List any government , approvals or permits that will be needed for your proposal, if known.
OrIty C_ ' i,
" -b
11. Give brief, complete description of your proposal, including the proposed uses and the size of the project and site.
There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not
need to repeat those answers on this page. (Lead agencies may modify this form to include additional specific infor-
mation on project description.)
See— C( e-70 r-��F 6:tt' C(
12. Location of the proposal. Give sufficient information for a person to understand the precise location of your pro-
posed project, including a street address, if any, and section, township, and range, if known. If a proposal would occur
over a ran2e of area, provide the range or boundaries of the site(s). Provide a legal description, site plan, vicinity map,
and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not
required to duplicate maps or detailed plans submi ted with any permit applications related to this checklist.
ak:�- C� <
TO BE COMPLETED BY APPLICANT
B. ENVIRONMENTAL ELEMENTS
1. Earth
a. General description of the site (circle one): Flat, rolling, hilly, stee mountainous,
other P(9
b. What is the steepest slope on the site (approximate percent slope)?
0
EVALUATION FOR
AGENCY USE ONLY
ENVIRONMENTAL CHECKLIST
Purpose or Checklist:
The State Environmental Policy Act (SEPA), chapter 43.21C RCNAI, requires all governmental agencies to consider
the environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be
prepared for all proposals with probable significant adverse impacts on the quality of the environment. The p*urpose of
this checklist is 10 Provide information to help you and the agency identify impacts from your proposal (and to reduce
or avoid impacts from theproposal, if it can be done) and to help the agency decide whether an EIS is required.
Instructions for Applicants:
* This environmental checklist asks you to describe some basic information about your proposal. Governmental agen-
cies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring
pre i paration of an EIS. Answer the questions briefly, with the most precise information known, or give the best --de-
scription you can.
You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you should
be able to answer the questions from your own observations or project plans without the need to hire experts. If you
really do not know the answer, or if a question does not apply to your proposal, write "do not know" or "does not ap-
ply". Complete answers to the questions now may avoid unnecessary delays later.
Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer
these questions if you can. If you have problems, the governmental agencies can assist you.
The check -list questions apply to all parts of your proposal, even if you plan to do them over a period of time or on
different parcels of land. Attach any additional information that will help describe your proposal or its environmental
effects. The agency to which you submit this checklist may ask you to explain your answers or provide additional-irl-
formation reasonably related to determining if there may be significant adverse impact.
Use of checklist for nonprojecl proposals:
Complete this checklist for nonproject proposals, even though questions may be answered "does not apply." IN AD-
DITION, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D).
For nonproject actions, the references in the checklist to the words "project," "applicant," and "property or site"
should be read as "proposal," "proposer," and "affected geographic area," respectively.
A. BACKGROUND
1. Name of proposed project, if applicable: N/)+
2. Name of a plicant: I -
p LC, , 5 M - V, n Y C� r-
3. Address and phone number of applicant and contact person:
comtacJ- ?ef--so": I6-M kv,4-er-sen
? 9,q - 4 747
4. Date checklist prepared: k " 7;- 19 0,G-
5. Agency requesting checklist: C �
_, _y
6. Proposed timing or schedule (including phasir�g, if applicable):
7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal?
If yes, explain. No i
TO 13E COMPLETED BY APPLICANT EVALUA I TION FOR
3. Water AGENCY USE ONLY
a. Surface: W�.
1) Is there any surface water body on or in the immediate Vicinity of the site (including
year—round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type
and provide names. If appropriate, state what stream or river it flows into. 114
2) Will the project require any % rk over, in, or adjacent to (within 200 feet) the described
waters? If yes, please df attach available plans.
1\0 �, N 0
3) Bti
imate the amount of fill and dYge material that would placed in or removed
from surface water or wetlands and ind7te the area of the site 11 t would be affected. In-
dicate the source of fill material. /t
4) Will the proposal require surface wat thd a S Or diversions? Give general de-
scription, purpose, and approximate quantities If kno'w' X11
5) Does the proposal lie within a 100—year flood in? f so, note location on the site
plan. �rl 4
6) Does the proposal involve an), fi-s-Marges Af waste m rials to surface waters? If so,
describe the type of waste and antigfpated volum� of discha e.
k, (
b. Ground:
I ) Will ground wa
general description, p
withdrawn ' , or will water be discharge to ground water? Give
and approximate quantities if known.
2) Describe laste material that will be discharged into the ground f rmn septic tanks or
I
other sourcestif any (for example: Domestic sewage; industrial, contai ing the following
chemica agricultural; etc.). Describe the general size of the sys,\ the number of
te ,
such sys 'S s t'� e number of houses to be served (if applicable), or the num er of animals or
humans th/system(s) are expected to serve.
X
TO BE COMPLETED BY APPLICANT EVALUATION FOR
AGENCY USE ONLY
c. What general types of soils are found on the site (for example, clay, sand rav I peat�
muck)? If you know the classification of agricultural soils, �9
farmland. specify them Unnote any prime
d. Are there surface indications or history of unstable soils in the immediate vicinity? If so,
describe.
e. Describe the purpose, type, and approximate quantities of any filling or grading pro-
posed. Indicate source of fill. Z�
e_e— � , P
V"tQ C, � Zvt, Z
Pe Y, \a -S 0 -=1010
ic a -It- ev+.-o , k—k � 0 e-- t-- 0 C-ke 1-y t — -1,
f. Could erosion occur as a result of clearing, construction. or use? If so , generally describe. -T"t- CZ C4
d(4 r- -41,3 CO A "OPPI 'tO opVt Q- oleo ce-
A)eowl
ION
g. About what percent of the site will be covered with imper �gus surfqces after pro ct
construction (for example, asphalt or buildings)?
h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: 1-0 1'1�, -t� at.
�— D C, lic V_ �-_y 4 S 01,4 4-,e, I
W e- Q 0 &o,- I ot P C--a&e-k 6 %.s
2. Air
a. What types of emissions to tile air would result from the proposal (i.e., dust, automobile,
odors, industrial wood smoke) during construction and when the project is completed'? If
any, generally describe and give approximate quantities if known. rt� o v, A(LA �',j 0- t-y
WPi*A-e,je-4- 'C 45 " "P 0n t IN IL- \Af 4M %J.S a ,
b. Are there any off-iite sources of emissions or odor that may affect your proposal'? If so,
generally describe. N /4
c. Proposed measures to reduce or control emissions or other impacts to air, if any: �4o re
e
.1 — I
TO BE COMPLETED BY MIPLICANT
c. Is the site part of a migration route? If so, explain. tj D
d. Proposed measures to preserve or enhance wildlife, if any: 'AJ 0 a <__
EVALUATION FOR
AGENCY USE ONLY
6. Energy and Natural Resources
a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet
the completed project's energy needs? De
ucribe whether it will be used for heating, manu-
facturing, etc. o " se c- &-3 e- 1,e- k v-
e- r-.e w,*11" 46.& /a. e e &t -i� e
-P&
b. Would your project affect the potential use of solar energy by adjacent properties? If so,
generafly describe. 06
c. What kinds of energy conservation features are included in the plans of this proposal?
List other proposed measures to reduce or control energy impacts, if any:
& 5/0�5,r (2D �J
7. Environmental Health
a. Are there any environmental health hazards, including exposure to toxic chemicals, risk
of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal?
If so, describe. k) 0
1) Describe special emergency services that might be required.
2) Proposed measures to reduce or control environmental health hazards, if any:
b. Noise
1) What types of noise exist in the area which may affect your project (for example:
traffic, equipment, operation, other)? rg SCLWs
2) What types and levels of noise would be created by or associated with the project on a
short-term or a long-term basis (for example: traffic, construction, operation, other)? Indi-
cate what hours noise would come from the site. S k 0 + + 0- #-,-- -J 0 6 a 44- S Ch
AS Lin - I A 1�s Cot 4- C%5 a, I-F � . �_ .5 r% 5 * e- I- V-e�, L,'� k�z Q_ tN 6 "% C. ,
W 0 f- L_ OLJ F) CD C,(,.s e-j & 44 /a( k c -Pt-0 ev� .9,'010 1*10- S-,' 00 ICI 07pq
TO BE COMPLETED BY APPLICANT EVALUATION FOR
AGENCY USE ONLY
c. Water Runoff (including storm water):
1) Describe the source of runoff (including storm water) and method of collection and
disposal, if any (include quantities, if known). Where will this water flow? Will this water
flow into other waters? If so, describe. D a t-j iA s p cp f, o, —of d r, 1, u ef_aav
_s /-'o
2) Could waste materials enter ground or surface waters? If so, generally describe. �to
d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if
any: T-7 4 c�K y 0 &-+(3, t, s a�- t-5 +-o r- && v� -0 t. (9 . ccD ^ sf- tt, e- f 's )4 t
o ; ff -tr� jo C o,-,+a. i+ ow\ 1-4, e- I o We, r� &t t,% ' -s -/ &1 1, -e- ( p - 7-
4c loi- 6y -Wa,4- ctrea, by P�,2-,"s
4. Plants
a. Check or circle types of vegetation found on the site:
-A-'*d'eciduous tree: alder, maple, aspen, other
evergreen tree: Fir, cedar, pine, other
shrubs
_-V grass
— pasture
— crop or grain
— wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other
— water plants: water lily, eelgrass, milfoil, other
— other types of vegetation
b. What kind and amount of vegetation will be removed or altered? Op., 1,, tj t- e 0 1-, ro c- lee rX
Q1- f- '�-o 6 e-, cD-1 QIK,*,c4e#e loc:> /ga P, s
c. List threatened or endangered species known to be on or near the site. �j
d. Proposed landscaping, use of native plants, or other measures to preserve or enha nZ4 9- on' 4&Se
vegetation on the site, if any.: j-0 J6 e_ Ptjy I Q V� d % C, at 10 "1 4 ax/
5. Animals
a. Circle any birds and animals which have been'observed on or near the site or are known
to be on or near the site:
birds: hawk, heron, eagle, songbirds, other: 'cl- 4-c-
mammals: deer, bear, elk, beaver, other: ............ ................
fish: bass, salmon, trout, herring, shellfish, other: ........ rQQe! P ..............
b. List any threatened or endangered species known to be on or near the site. ev &I e
-5-
TO BE COMPLETED BY APPLICANT
9. Housing
a. Approximately how man), units would be provided, if any? Indicate whether high, mid-
dle, or low-income housing. . � � 0,.., - ,( 4 1'a. -+ '/ P 'r-
b. Approximately how man), units, if any, would be eliminated? Indicate whether high,
middle, or low-income housing. A) 0 A
c. Proposed measures to reduce or control housing impacts, if any: PJ 0 oA -(
10. Aesthetics
a. What is the tallest hei0ht of any proposed structure(s), not including antennas; what is
the principal exterior building material(s) proposed? rn v I- a o'
'V S' '�'& Q, ke " X e +0 q-&k -C kV a. I (,a 9 f, t__4 e9 �p Q_
b. What views in the immediate vicinity would be altered or obstructed? WeD n ._
c. Proposed measures to reduce or control aesthetic impacts, if any: W co t., a
11. Liaht and Glare
b
a. What type of light or glare will the proposal produce? What time of day would it mainly
occur? vj fb V% f
EVALUATION FOR
AGENCY USE ONLY
low C �O 0 OFI PA
b. Could light or glare from the finished project be a safety hazard or interfere with views? A�a
c. What existing off -site sources of light or glare may affect your proposal? /'V a
d. Proposed measures to reduce or control light and glare impacts, if any: A10,,V6-7
12. Recreation
a. What designated and informal recreational opportunities are in the immediate vicinity?
_nr C- I q &-6A S."C'
�M cqrvt &
b. Would the proposed project displace any existing recreational uses? If so, describe. N 1 0 t^ c
5-IM
TO BE COMPLETED BY APPLICANT
EVALUATION FOR
AGENCN, USE ONLY
3) Proposed measures to reduce or control noise impacts, if any: " &q -0-
8. Land and Shoreline Use
a. What is the current use of the site and adjacent properties? I-
b. Has the site been used'for agriculture? If so, describe. IN 0
c. Describe any structures on the site. ,PV 0 --� e
d. Will any structures be demolished? If so, what? MJ CP .,1 4,
e. What is the current zoning classification of the site? V- <1 5.) ' 'Y., " �� -, I I
f. What is the current comprehensive plan designation of the site? t-e -s .'Wz - �i- j' a, I
g. If applicable, what is the current shoreline master program designation of the site? Aelyl
h. Has any part of the site been classified as an "environmentally sensitive" area? If so,
specify. to
i. Approximately how many people would reside or work in the completed project?
. 2 +
IN
j. Approximately how many people would the completed project displace'?
k. Proposed measures to avoid or reduce displacement impacts, if any:
1. Proposed measures to ensure the proposal is compatible with existing and projected land
uses and plans, if any: we 0, t- 0- 0 r C5 r� *0 kz�, �, , ( -( t- -Q S �d C ^ f- +ypz
k,) .. S e- t' ^ 'A, (-- C'- 's - -1 M ( + te) 0- .� at-, t�5 0 ?,- Vs 0 0 e (
�7—�
III
TO HE COMPLETED BY APPLICANT
g. Proposed measures to reduce Or control transportation impacts, if any: NO 4-1 f.
15. Public Services
a. Would the project result in an increased need for public services (for example: fire pro-
tection, police protection, health care, schools, other)? If so, generally describe.
C'
F"n
b. Proposed measures to reduce or control direct impacts on public services, if any.
16. Utilities
a. Circle utilities currently.available at the site(ele:ctri:c�it) natural gas, %N toe , riSfuse serv--;
I --. -- `_�N _ _: : N__�
ice, e2!�� septic system, other.
b. Describe the utilities that are proposed for the project, the utility providing the service,
and the -eneral construction activities on the site or in the immediate vicinity which might
0
be needed.
-W- to 4'
19 QQ.- t2q�5't_ f 'n a
C. SIGNATURE
The above answers are true and complete to the best of my knowledge. I understand that
the lead age . rel Jn!g o make its
lz%;E _S�n �t to d isi
Signature:
DateSubmiLLIZU. ..............................
EVALUATION FOR
AGENCY USE ONLY
4t_
_10-
TO BE COMPLETED BY APPLICANT EVALUATION FOR
AGENCY USE ONLY
c. Proposed measures to reduce or control impacts on recreation, including recreation op-
portunities to be provided by the project or applicant, if any:
13. Historic and Cultural Preservation
a. Are there any places or objects listed on, or proposed for, national, state, or local preser-
vation re-isters known to be on or next to the site? If so, generally describe.
0 K)o^ e—
b. Generally describe any land*marks or evidence of historic, archaeological. scientific, or
cultural importance known to be on or next.to the site.
. I . W
c. Proposed measures to reduce or control impacts, if any: 'Wo ^ -0-
14. Transportation
a. Identify public streets and highways serving the site. and describe proposed access to the
existina street system. Show on site �Ians, if a—nv. CC� A, e
k M4, r-n V
b. Is site currently served by public transit? If not. what is the approximate distance to the
nearest transit stop? 6 10 CJ< 's -�-(D V) -e n_ f.- e- S
c. How many parking spaces would the completed project have? How many would the
project eliminate'? T,+-&J0&L14 e I ;,-V% - " - V" 0 P1 f- at ",% A Q co a /4( r_0 to
,50,r-aj�r_ O�Ka a- ck-iv&uJaky *-k o,, +-- C-0 te" I d, e- o Kte, .1 2- e— C, t _g
d. Will the proposal require any new roads or streets. or improvements to existin- roads or
streets, not includine driveWays? If so. uenerally describe (indicate whether public or
private).
e. Will the project use (or occur in the immediate vicinity of) water, rail. or air transporta-
tion? If so, generally describe. 1KI 0 V� C
F. How many vehicular trips per day would be generated by the completed project'! If
known, indicate when peak volumes would occur. M cky 6e- 0 h C_ P Q- t- a( Ax
M
TO BE COMPLETED BY APPLICANT EVALUATION FOR
AGENCY USE ONLY
D. SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (Rezones, Code Changes, Annexati ons, etc
(do not use this sheet for project actions)
'Because these questions are very general, it may be helpful to read them in conjunction
with tile list of the elements of the environment.
When answering these questions, be aware of the extent the proposal, or the.types of
activities likely to result from the proposal, would affect the item at a greater intensity or
at a faster rate than if the proposal were not implemented. Respond briefly and in general
terms.
1. How would the proposal be likely to increase discharge to water, emissions to air; pro-
duction, storage, or release of toxic or hazardous substances; or production of noise?
Proposed measures to avoid or reduce such increases are:
2. How would the proposal be likely to affect plants, animals, Fish, or marine life?
3
Proposed measures to protect or conserve plants, animals, fish, or marine life are:
3. How would the proposal be likely to deplete energy or natural resources?
Proposed measures to protect or conserve energy and natural resources are:
4. How would the proposal be likely to use or affect environmentally sensitive areas or ar-
eas designated (or eligible or under study) for governmental protection; such as parks, wil-
derness, wild and scenic rivers, threatened or endangered species habitat, historic or cultural
sites, wetlands, floodplains, or prime farmlands?
Proposed measures to protect such resources or to avoid or reduce impacts are:
5. How would the proposal be likely to affect land and shoreline use, including whether it
would allow or encourage land or shoreline uses incompatible with existing plans?