20204 81ST AVE W.PDF111111111111
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20204 81 ST AVE W
ICATION
The City of Edmonds for -V CARD
S.Mh ,9EWER PERMT
EASEMENT No.
OUTSIDE INSIDE E] REPAIRS F1
OWNER --- ----------------- -- -------------------------------- ...... CONTRACTOR -7- /-ERMIT No.
Zp
STREET
HOUSENo. -------- . ...... . .......... ------------- AVETTUE LOT No . .............. F ..................................................... BLOCK No . ...............................................
T%TATvTP. AT)n Q
FAR
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
SEWER WORK ORDER ISSUED ..........................................
DATE ... � -2V-6? .......... ':�'
.. .................... ........ 13Y
The City of Edmonds
FEET FILE
APPLICATION
1, CARD No - ---------- j ...........................
for PLAIYT
SIODE SEWER PERMT EASEMENT No . ......................................
OUTSIDE Ej INSIDE El REPAIRS F1
...... � ZikRMIT No
/7
OW'NE --------------- ..... ........................................ CONTRACTOR 288
--------------------
STREET
HOUSENo. - ------- = ......... . .................... AVENUE LOT No . .......................... ........................................... BLOCK No . ...............................................
NAMEADD . .......................................................................................................... ....
-� Lu
BACKFILL WORK ORDER ISSUED ....................
SEWER WORK ORDER ISSUED ...........................
.... DEPOSIT, $ .............................................
DATE..... s ..................... .................. By 7--a--<�
N
CHARLES A. HANSEN, Bul'ideir
346�7 P,4-Rt West - PR 8-7452
ED�OND�-3, WASH�
6 9 - �31 \/V
4 rr7 dn ds
Al-3- 0 :rc_a t #42 ' MQt. WHmn-rilia ncIrA.—J)d1rision 99-ac
except the east 110.,00:thereof together wi.th the North-304DO
nt UP- eas_t_11a_W_oX__the ;q.ho-,-rn (jPQr%rihP(j tract_ Ilic)l .12 C)?
Platt page 60. Record of Snohomish- County- . Washington..�
r
T _V�0 10MOINbs'
ENTER',t-'WATER-SEWER DEPA Tr4ENT
IMF SEW R-PERMIT
Call PRospect. 6rilo.7 when worl�,
Is ready. foj,inspe�"on.* (No Jn7pec
tions Saturday, Sunda;y or holidays.)
22
-202o4 81st West
............................................................................................................................... ...........
NDDRt§S ................................ 7 ........................
North end septic Tank
Charles'Hansen
OWN-M ..................... : ....................................................................... CONTRACTOR ......................................................
Permission is granted ......... ... j�y ... ........... iq:�T, for ...... I ................. days to REPAIR or CONNFCT a side sewer
with city Sewers . in accordance With application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING: licensed Side Sewer Contrar-tor must
NOTE No. I —The owners of the property may obtain a permit to construct sewer inside property line. A
be emliloyed to construct side sewer In street area. Do not cover any portion of sewer before it has been inspected.
NOTE No. 2�C&ain full information regarding Ordinance 11.16.030 and Regulations gover . ning side sewers when You get permit.
a 'coverage at property line and - 12 . Inches inside property line; minimum grade of 2
:NOTE No. 3—Top of side sewer must have at least 30 Inche
No bends in grade shaxper than % will be permitted.
surface of -street iestored. to original condition. Contractors shall be respo a his for
No. 4—Trenches in street must be water settled and
failure due to improper work which may develop within one year of completion.
NO�E No. 5—It is unlawful to alter or do any other wo . rk 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.
CA F1LE NO. qq,-33z—
Critical Areas Checklist
--------------------------------------------------------------
�,.Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: 16 X 0 4- Aw- W
2. Property Tax Account Number: q �.j) _ 0\16 c) -11
3. Approximate Site Size (acres or square feet): 8"
j,OVO
4. Is this site currently developed? X yes; _ no.
If yes; how is site developed? 3 fect v--a c 0 Le -5 e
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).
X, Hilly: slopes present on site of more than 15% and less than 30% a vertical rise of
I 0-feet over a horizontal distance of 3 3 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: 'Vn 0 Approx. Depth:
7. Site contains areas of seasonal standing water: -h 0 Approx. Depth:
What season(s) of the year? -)I j C,
8. Site is in the floodway -A o floodplain -h. 0 of a water course.
9. Site contains a cre ek or an area where water flows across the grounds surface? Flows are year-
round? - vi, c, — Flows are seasonal? o (What time of year?
10. Site is primarily: forested ; meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
— -------------------------------------------------- — For ity Staff Use Only ------------- — ------------------ — -----------------
'I.- Site is Zoned?
:2 .
-M, 7-11MAMT, MWIME
Wetland inventory or C.A. map . indicates wetlandpresenionsite? )VO
Critical Areas inven tory or C.A. map indicates Critical Area on site? Nr
Site within designated earth subsidence landslide hazard area?
Site designated on the Environmentally* Sensitivei Area's Map?..'. k)-Q . .....
DETERMINATION
jjUDYA
Reviewed by:
CONDITIONAL WAIVER.
V fiate
ft�_chk.doc; Rev 10/03/97
I
City of Edmonds
RECEIVEb
DEC 2 11999
DEVELOPMENT SERVICE; Up.
-V4W CWTICAL AREAS CHECKLIST
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 sub ect 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
th� 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).
Owner/Applicant:
-7-1'-`11V A, M U PC P 1-Y 4Z
Name
-9 k, k- A
Street Address
CPr-1GND:i , NA -
city State Zip
42 7 -7 5— +
Telephone
Signature
00.,.- .11,
Date
cxeceptionNjanakaddoc
Applicant Representative:
Name
Street Address
city State Zip
Telephone
Signature
Date
(over)
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
January 5, 2000
John A. Murphy
20204 81st Ave. West
Edmonds, WA 98026
Subject: Determination regarding Critical Areas Checklist # 99-332
GARY HAAKENSON
MAYOR
Dear Applicant:
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
................. -
&TANTINFORMATION TO BE NOTED:
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS OR CRITICAL AREAS STUDY.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
mo, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL 40
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Enc: Critical Areas Detennination
* Architectural Design Board
C:ReceptionUana\CRLTR.doc
Thank you.
Sharla Graham
Planning Secretary
Incorporated August 11, 1890
Sister City - Hekinan, Japan
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