19637 80TH PL W.PDF111111111111
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19637 80TH PL W
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
tf�e -map(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
emp-l-o-yee-s o-r officer,-) Sha III be lia-b-11-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
for
The City of Edmonds LE SIDE SEWER PERMIT IrYNN
Fl
EASEMENT No . ..........................................
NEW CONSTRUCTION E] REPAIRS R
OWNER............... CONTRACTOR .................................. ............................................... PERMIT No.
ADDRESS/3�WS-,�7..—. Z,6.el ...... ................. LEGAL DESCRIPTION: LOT No. ........................ BLOCK No . ............................................
NAME OF ADDITIONX2��.,x� ... Y.V��47.).d ...... . rp e ........... #1� ........................................
1--ji
0
Approved:
—/ L/, 7
DATE .................. / .................... By e5�51,�
..................................................
CITY OF EDMONDS
XIVIC CENTER — WATER -SEWER DEPARTMENT 'Call rRospect 6-1107 when ivork
Is ready for Inspection: (No Inspec-
XTO
lions Saturday, Shnday or holidays;) 2110
SIDE SEWER PERMIT
ADDRESS ..................... ....................... 1.9.6-3.7 .... .... 8.0
.th ... Place --- We.st_.. .... ...................................................................................
.. .........
__�OWNER ........... GeTa.ld .... Pe.ay ....................................................... CONTRACTOR .......... Own.e.r .........................................................
.... .. .. .... .... ..... ....... .. ..
Pern-jission is granted ..... April ... 2.5 ....... .......... 1 19�7_ 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:
—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must
NOTE No. I
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 Ordinance 11.16.030 an� Regulations governing side sewers when you get permit.
NOTE No. 3—Top, of side �ewer. 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.
NOTE No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for
failure due to improper work which may develop within one year of completion.
No. 5—It 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 V E D& ity
G of Edmonds
Development Services Department
Plannmig Division
Phone: 425.771.0220'
j"J"e. �1%9111 , Fax: 425.771.0221
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 the application 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).
Date Received: 0 -�2—
City Receipt#: C3.
Critical Areas File #:
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant:
A property owner, or his/her authorized 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 apiplication.
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 assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as, listed below.
SIGNATURE OF APPLIcANT/AGENT
DATE
Property Owner's Authorization
By my signature, I cer* that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to#s application.
SIGNATURE OF OWNER DATE.
PLEASE PRINT CLEARLY
Owner/Appticant:
<-t -( -.6,
Naine +L-
� 9 �3? U
Street Address
15-, 'D M ,
city State Zip
Telephone:
Email address (optional):
Applicant Representative:
Name
Street Address
city State zip
Telephone:
Email Address (optional):
Critical Areas Check] ist.doc/3.19-2001
Critical Areas Checklist CAFileNo:
Site Information (soils/ topography/hydrology/vegetatign)
1. Site Address/ Location: 16)6--5-7 IF '01� 11 2 �- W ,
2. Property Tax Account Number: _60 '5 0 (M10 6 1 661 13 0
3. Approximate Site Size (acres or square feet): - j 000
4. Is this site currently developed? Zes; — no.
If yes; how is site developed? -in r ot
5. De crii the general site topography. Check all thdat apply -
Flat: less than 5-feet elevation change over entire site.
R61hng: slopes on site generally less than 15% (a vertical rise of 10-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 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: ja Approx. Depth:
7. Site contains areas of seasonal standin water: \j\ 0 Approx. Depth:
What season(s) of the year? N� '�x
V - \ �
8. Site is in the floodway- tb floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
Z, Q Flows are seasonal? (What time of year?
10. Site is primarily: forested — ; meYow shrubs mixed
urban landscaped (lawnshrubs etc)
11. Obvious wetland is present. on site: __ IP 0
Critical AreasChecklist.doc/3.191001
0 V- EDLL,
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
/17 4C�C�`
I %9�) Fax: 425.771.0221
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 ofthe application 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).
Date Received:
City Receipt#:
Critical Areas File #: :Z-00-2-
Critical Areas Checklist Fee:_ $45.00
Date Mailed to Applicant: aj��T
A property owner, or his/her authorized 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 (eg. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attomey's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, .1 certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF Ai,PLICANT/AGENT
Property Owner's Authorization
DATE
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to 1� is application.
SIGNATURE OF OWNER DATE
PLEASE PRINT CLEARLY-` 7,
Owner/Applicant:
Name
Street Address
City State Zip
Telephone: —:2-� 1 3
Email address (optional):
Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Email Address (optional):
Critical Areas Checklist.doc/3.19.2001
Qriti.dal Areas.Chi�cklist
Site Informati6n (�oilo/topograpfi� ology/ vegetation),
/hydr.
1. Site Address/ LoqatiQn:
2.' Pro r
pe tv Tax Accqun��,Nu�er:. 0.
CA'FileNo-
M, V
s or sqtWe
3. Approximate Slte�.Siie'(acre 6 C)"
4. Is this site currently developed?', yes; no.
If yes; how is site developed?
5. De
,�cribe the general site to ography. Check,4 Mat apply.
-P
Flat less than 5.4eet elevation &angre.over, entire site.
Rolling: slopes on site generally less thin - 45 % ja 'Vertical rise of 10-feet over a horizontal
'"tanc*e of 66-fe6t)
Hilly: slopes present on-.si ' te..�of.m.ore thah.15% and less than 30%;(la vertical rise of 10-feet
over a horizontal distancelof 33 t6-66-feet).
Steep: grades of,greater tfi��.3k , �resent 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: 4. ;Approx. Depth:
7. Site contains areas of seasonal slan� water: \j\ Approx. Depth:
What season(s) of the year?
8. Site is in the floodway V-, b floodplAin': 'VC0 of a water'cou"rse.
VA
10.
11.
Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
V\� Flows are seasonal? (What time of year?
Site, is primarily: forested meYaow ;shrubs mixed
urban -landscaped Oawnshrubs' etc)
Obvious wetland is present on site:
Critical Areas Checklist.doc/3.19.2001
Date
Cj
Tj KA
Ej M %N,'M�S
PUBLIC WORKS ENGGINEERING
ACTION REPORT
SUSPENSE DATE:
N9
9/15/82_Time: 3: 16 PM— File #
Attachments:
f-hat did work at 19637-80th W.
1524 -
=Yes
EKRP
SUBJECT: j
left an awful mess. Anyone -walking on sidewalk
might get injured and the City will be sued.
PLEASE CALL AS SOON AS POSSIBLE111!
REQUESTOR: NAME: Mr. Peay
ADDRESS:
PHONE: 778-5398
REQUEST RECEIVED BY:
TELEPHONE
CONTACT IN OFFICE
OTHER:
RECEIVED BY: M. Levan
�
-�Mfhv
nm��
ACTION:
All Concerned Notified
Action completed/File