20301 81ST AVE W.PDF111111 lill 11
7396
20301 81 ST AVE W
CA FILE NO
Critical Areas Checklist
----------------- --------------------------------------------
Site Information (solls/topography/hydrology/vegetation)
I . Site Address/Location: 20301 - 81st Avenue W
2. Property Tax Account Number: 00431200001602
3. Approximate Site Size (acres or square feet): 16,967 sq. ft. (0.3895 acres)
4. Is this site currently developed?
If yes; how is site developed?
X yes;_ no.
One single family residence
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
3 0 20M
PER441T COUNTpp
X Rolling: 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 I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: No —; Approx. Depth:
7. Site contains areas of seasonal standing water: No —; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway No
VA
floodplain_ of a water course.
Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? No Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc) X
11. Obvious wetland is present on site:
me
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OtTERMINATION
Aa_chk.doc; Rev 10/03/97
City of Edmonds
11.� . .......
Development Services Departinent
. . . . . . . . . . . . . . . . . .
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
Critical Areas File #: 00— IRV�
Critical Areas Checklist Fee: $45.00
Date Received by Dev. Serv. Dept:
CityReceiptNo:- J(P&&-1
Date Mailed to Applicant: 1Z - 1-71C�00
CRITICAL 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 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).
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 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).
PLEASE PRINT CLEARLY
Owner/Applicant:
Nalund & Associates, Inc.
Name
9792 Edmonds Way #266
Street Address
Edmonds, WA 98020
City State Zip
425-771-7270
Telephone
Signature
1113d2ovv
Date
Applicant Representative:
ABA, Inc.
Name
6141 NE Bothell Way
Street Address
Kenmore, WA 98028
City State Zip
425-485-9711
Telephone
Signatur?"
1113.0
Date
d:receptiort4ana/CACLHandoLd.doc
Revised 4/10/2000
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St'-c-1pal and 'Notatic"Is 'I'alc
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A""proxic(I by Public
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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 for.th on these
map(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
_tKe -map(s), including, but not limited to,
th e 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
ernp]-oyee-s o-r office.rs -shall be 11a-b-l-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 00t SIDE SEWER PERMT
.tt3r&l NEW CONSTRUCTION [] REPAIRS 0
OWNER ..... ---------- \
ADDRESS............................ ...............
4AI
EASEMENT No . ..................................
Z /P 43 F
CONTRACTOR .. ...... rejq�� --- �e4 .. �CPERMIT
LEGAL DESC N: LOT ----------- ---------------- BLOCK N,.
�Z" �6� p- , . .............
NAME OF ADDIT1014 ........ acAl ---- ........... ....... 2.1 . ............................................
hi J 9WA-J 1p, 10 / - . , --I-- I A/
Pee
.......................
CITY OF EDMONDS - SIDE. SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 7.76-1107 for side sewer inspections BEFORE covering any portion of the construction.)
Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspections.j
ADDRESSLOCATION OF CONSTRUCTION ................................................................. ............. I .......................................................................................
PROPERTYLEGAL DESCRIPTION .................... ............ .................... ....................................................................................... ; ..........................................
................................................... ...................................... : ................................................
......................................................................................................
................................................................ OWNER ANDXOR BUILDER ......... ..................... ................................. 1_ ....................................................
CONTRACTOR'S NAME & ADDRESS .............
................................................................................................................................................................
.mission Is granted ....................... .................................. 119 ......... for repair and/or connection of a side sewer to the city sanitary sewer
�__Acm in accordance with City of Edmonds ordinances.
AmTENTION IS CALLED TO THE FOLLOWING:
E No. I —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—All work performed in city right-of-way requires an Invasion of Rlght-of-Way Permit obtain -able from the City Engineer's office.
NOTE No. 3—Obtain full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—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 them 1/8 will be permitted.
NOTE No. 5—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. 6--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 appurtenances except to in-
sert the pipe into the wye.
DISAPPROVEDF-1 Date ........................................ By ................ Date .................................... By ................ Date ............................. ...... By ................
APPROVEDD,t ..... 6 ............ . ..................... ... . .... . ...................................................
Remarks: ................................................................................. : ............................................................................... � ....................................................
.................................................................................................................................................................................................................................................... .........
BOTH Permit Copies MUST B 4,Slg edd By Owner of Firm Performing Construction PRIOR To Request For Inspection
---- ------- * .......... .... hereby certify that the side sewer installation constructed under this permit
(6 4�n e, fcrrr�ing Construction)
-wn.s installed in accordance with allgoverning ordinances of the City of Edmonds.
Datedthis ............................ day of ................................................................. 19 .........
N1 V Check BEFORE you dig for: Water [], Gas E], Telephone E], Power E], Sewer E], Other E] -� V