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19715 80TH PL W
City of Edmonds
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Site Classification Worksheet AUG 21201.5
Page I of 2
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The project's Site Classification will dictate the specific stormwater management
requirements applicable to your site. Completing this worksheet will help determine the amount of
regulated impervious surface and whether your project falls into the classification of a Small Site
(Category I or Category 2), or a Minor Site. Please reference the Glossm (pp. 10- 11), Figures Q and
E, (j2p. 8-9), and Examples (pp. I I - 12), to assist with comRletion of this worksheet.
1) Is Permeable Pavement' Proposed For Use on this Site? El Yes E] No
Refer to Stormwater Supplement Chapter 5.1
If YES, the subject area is to be considered impervious for initial site classification purposes. Include total
permeable pavement area in the calculation of Non -Regulated, Replaced and/or New impervious surface
areas in the table below.
2) Detern-dne the Amount and Type of Existing & Proposed Impervious Surface for the Site
Refer to Stormwater Supplement Chapter 2 and Fig. C
Line 1: Identify the Non -Regulated Impervious Surface Area.
Line 2: Identify the Replaced Impervious Surface Area, dividing the total between Exempt and Regulated; either or both
may be zero. Note: For project classification purposes, Replaced Impervious may only be considered exempt
under certain conditions. Refer to the Glossary and Figure D.
Line 3: Identify the New Impervious Surface Area for your project. All impervious areas created post -July 7, 1977 or
after the date of annexation into the City are regulated & should be included in this total unless they can be
categorized separately as a Replaced -Regulated area.
Line 4: Enter the sum of the total Replaced -Regulated plus the total New impervious areas.
Line 5: Identify the total area currently mitigated by an existing city -approved stormwater management system.
Line 6: Enter the sum of the value in Line 4 less the value in Line 5 to identify the total Regulated area in which
stormwater controls have not yet been applied.
Line 7: Identify the total area proposed to be mitigated through the use of Low Impact Development Techniques.
Line 8: Identify the total area proposed to be mitigated through conventional Stormwater Management Techniques.
** Provide a copy of the following table on the drainage plan sheet for the proposed project **
Line
Type
Area (square feet)
1.
Non -Regulated
Exempt
Regulated
Replaced
A2.
3. New (Post 1977) 4 4 4 4 44 4 4 4
4. Total Regulated Impervious Area
Mitigation required if in excess of 2000sf
+
40T67 SF
407;67"SF�.�
5.
6.
Total Area Mitigated by Existing Stormwater Management System(s)
Regulated Area Not Yet Mitigated
0
407.67 SF
7.
Area Proposed to be Mitigated by Low Impact Development Techniques
0
8.
Area Proposed to be Mitigated through Conventional SWM Techniques
0 4.0
I (e.g. porous asphalt, porous concrete, paver blocks, concrete open celled paving grids, or plastic lattices filled with turf or stone)
Revised on 310512012
E72-SWM_Erosion_Control-03.05.12.doc
Page 5 of 12
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City of Edmonds �qv E 04i 0 1.
Site Classification Worksheet
Page 2 of 2
3) Determine the Total Area of Land Disturbing Activity 492 sf
Refer to Stormwater Supplement Chapter 8
14) Detern-dne the Quantity of Grading, Fill and/or Excavation 9 —cy
5) Will the project convert 3/4 Acre or More of Native Vegetation to Lawn or El Yes [� No
Landscaped Area?
6) Identify the Watershed the Existing Site Runoff Discharges to
Refer to Stormwater Supplement Chapter 2.3
Based on Site Location and Watershed Map — Figure-C. Check all that apply.
A. F1 Direct Discharge B. E] Creek or Lake Basin
• Edmonds Way Basin
• Puget Sound Basin
o Puget Sound Piped Basin
DETERMINE PROJECT CLASSIFICATION USING THE INFORMATION ABOVE
AND THE PROJECT CLASSIFICATION CHART (Figure B, pg 4)
El Small Site - Category I ED Small Site - Category 2 M Minor Site
Stormwater Supplement Stormwater Supplement Stormwater Supplement
Chapter 5 Chapter 5 Chapter 6
Revised on 310512012 E72-SWM�_Erosion_Control-03.05.12.doc Page 6 of 12
NOTICE:
No warranty of accuracy.
The information on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Eclmonds does not warrant the
accuracy of anything set forth on these
map(�_). Any person or entity -req uesting a
copy should conduct an independent
inquiry regarding the information shown on
tRe -map(s), including, but not limited to,
the loc'ation 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
ernp-1-o-yee-s o-r officerS, shall be Vilab-lfe for the
information given on this map(s), nor for
any one representation provided based
upon said map(s)..
The City of Edmonds
Water Service Drawing
EASEMENTNO . ............................................
NEW CONSTRUCTION 0 REPAIRS i2f' LID NO . .................. ASMT. NO . ..................
OWNER T ftAl ..... A1.46.e-AY' &JOI ................................. CONTRACTOR ............. : ....................................................................... PERMIT NO. Vo
JOB ADDRESS 7 IS- ..9 -
... P. ..w ..... . ................ LEGAL DESCRIPTION: LOT..NO . ...................................... BLOCK NO . ....................................
........................ ....... On . ....
...................................................................................................................................................................
NAMEOF ADDITION..: ......................................... * ..........................................................................
'POACH
-A
Approved:
PWW-0001-11/75 (REV. 11178) DATE .77.��-.Y.? .................... . By ....... . . . .. .... - — ---------
PLANNING DATA
SINGLE FAMILY PESIDtNTIAL
STREET=FT�i]
Name: -
Date:
Site Address: v L Lj
Tax Parcel:
P roject Descri ptio n: '-'�>2> 3
Plan Check #:
Reduced Site Plan Provided; NO)
Zoning:
Map Page:
corner Lot: (YES
Flag Lot: (YE S/0
Critical Areas Determination #V'kA2�01
El 'Study Required
Waiver'
SEPA Determination:
Exempt
El Needed (for.over 500 cubic yards of grading)
El Fee 0 Checklist 11 APO List with notarized form
Rec7ulr�d Setbacks
Street:
'Side: -
Side: -7
Rear: CS
ActualSetbacks
Street:
Side: IS..
Rear:
0 Detached Structures:
0 Rockeries:
El F'ences/Trellises:
El Bay Windows/Projecting 'Modulation:
El Stairs/Deck:
Buildin Height
Datum Point:
Datum Elevation:
Maximum Height Allowed: 2
Actual Height:
Other
Parking Required:
Parking Provided:
Lot Area: —7 -2—
Maximum Lot Coverage: _35% Proposed:
Lot Coverage Calculations: C_
ADU Created: (YES/<@)
Subdivision: P6_jo�� L%; c><D
Legal Nonconforming Land Use Determination Issued: (YES
-Comments
Plan Review By:
Plannlhg Data Form 07-14-09
IMPERVIOUS SURFACE CALCS. (SOLID SURFACES)
PROJECT: HEIGHT CALCS.:
CD
CN
v
OWNER: EXG. BUILDING ROOFLINE: 1589.06 SF (CONSTR. IN 1959) A = +100
C)
04
04
ALBERTSON RESIDENCE PROPOSED ADDITION (ROOFLINE): 407.67 SF B = +99
19715 80TH PL. W. C = +100
EDMONDS, WA 98026 NEW ROOF AREA = 620.5 SF D = +98
<
NEW INTERIOR FLOOR AREA = 333.7 SF
TAX ID#: 00506400001200 AVG. GRADE = 99.25'
cn
LEGAL DESCRIPTION: LOT COVERAGE: 1585 SF (18%) ACTUAL = 112.25'
V
8
MAPLEWOOD GROVE 2 BLK 000 D-00 - LOT 12 LOT AREA: 8712 SF (.2 ACRES) MAXIMUM 124.25'
-,
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a-)
-6
LOT SLOPE: FLAT (LESS THAN 5'ELEV. CHANGE)
Zone RS-S Comer Flaja
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Setba-Qks RegWred Actual
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Front 25 t1i (�In
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Ftear 196
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I EXG.RES. GUTTERS &
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01 w r-w-,-,/:�W- (1248 SF) DN.SPOUTS
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TO SPLASHBLOCKS
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w EXG. WALK S* cli NEWADDITION cl
ELEC. (333.7 SF)
1-,
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00 50'- 4 1/2"
cm
0
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EXG.ASPHALT
DRIVEWAY NEW SIDE EWER
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(SLOPE 10%) zo CLEAN OU LOC
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METER Y-Z \I,-+
DATU ENOTE: EROSION CONTROL MEASURES
61� ii��Eli aNHOLE Plot Plan "NEEDED
(TOP To I
9-325) TO BE INSTALLED AS PER
N
CI T
44 1 91 = 201-011 CITY STANDARD DETAILS.
ENGINEERING DIVISIO EP!4R
A mnmono F=P� A Q IS I#T)7rr_m
Jl`% Tn %.op v
n �TLOZ I OCT 0 12015
6 1 htt I Mt BUILDING DEPAF7MEN . T
`-Try fW Ej-. --0s
Ell F:
The City of Edmond
A 6:
PPLI iION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION E] REPAIRS F-1
OWNER...... - ----- �/ ..........................
ADDRESS --- ............. ..... ........
I-YN*N RAW
No. ..........................................
L /,0
CONTRACTOR .......... .............................................. :--- PERMIT No.
LEGAL DESCRIPTION: LOT No. ........................... BLOCK No . .........
NAME OF ADDITION ......................
CITY OF EDMONDS
CIVIC CENTER —WATER-SEWER DEPARTMENT Call PRospect 6-1107 when work
is ready for inspection. (No Inspec-
SIDESEWER PERMIT tions Saturday, Sunday or holidays.) N2 1704
ADDRESS .......... ........ 19.715 ... . ... 8.0 th ... Pla.ce...We.s.t .......................................... ........................
OWNER ......... W_ui&..A__Nash ................................................... CONTRACTOR .............
Pennission Is granted ...-.March 2 ---------------------- 1 107., 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. 1—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 Ordinance 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.
'E 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.
NOTE 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 ap-
purtenances except to insert the pipe Into the wye.
Approved:
'7
DATE................................................ By ........ ... .......................
-0
pi
400 7-H RWt7 �� lidE57-
V Gr
IATEZ,
E
Cit 'O'f Edmonds
y
RIGHT-OF-WAY CONSTRUCTION""
PERMIT PermitNumber. -4?(0-
Issue Date: _7
A. Address or Vicinity of Constructiow, 1 7 15 80 P1 W (9617429)
B. Type of Work (be specific):. —Install Service
C. Contractor: Mashington Natural Gas Contact: Mariamne Kingsbury
Mailing Address: 1122 75 St SW Everett Phone: 356-7500 X7596
State License #: 98203 Liability Insurance: Bond:
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. E] Commercial El Subdivision El City Project JK] Utility (PUD, GTE, WNG, CABLE, WATER)
n Multi -Family E] Single Family E] Other
INSPECTOR: 114SPECTOR:
F. Pavement or Concrete Cut: b] Yes 0No G. Size of Cut: x H. Chargg�_$
)Cut
APPLICANT TO READ AN, ril�[X IGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City ofEdmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
emplo�ees, including or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICAN't
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above statements and understand thepermit requirements and thepink 6opyof thepermit will be
available on s e at a t mes for inspection p rposes.
pyi
Signature: Date:
tractor ror Agrntfl
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY:
TIME AUTHORIZED: VOID AFTER DAYS
SPECIAL CO Npff[ONS:
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND Ill:
RESTORATION FEE -
PERMIT FEE:
TOTAL FEE
COMMENTS: RECEIPT FEE:
W
DATE: ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT
ANCE
Eng. Div. 1994
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
I:Comments:
I Diag-ram.:
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
El YES
Date:
Date:
AMC
MMM� -
Hatur6i GwI,
AvA%hWwEreWCbnVffV
M)
F
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
'VashingtoniNatural Gas
1356-7500 X7596
IW
D b 01 (-a'(-+ 44L9
"�V\j
Key:
-w- Water
Watermain depth Oo ^c c-t-,,; -G- Gas
-SS- Sever
Water hydrant
2 gas main Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
MI
or
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Marlamne Kingsbury
Engineering Aide
Pas
1356-7500 X7596
D 01
CD
tW
��VIIIJ
Key:
-V- Water
Watermain depth Oc> -G- Gas
-SS- Sewer
Water hydrant
gas main Water valve
Washington Natural Gas Company
11 2275th Street S.W., Everett, Washington 98203, (206) 355-3331