20415 81ST AVE W.PDF11111111 lill
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20415 81 ST AVE W
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Critical A
Site Information
ProjectName: aolm4s W41-itt Permit Number:
Site Location: dOq(S7 u-- — Property Tax Account Number:
Approximate Site Size (acres or square feet): VO 0,00
Have you filled out a Critical Areas Checklist for a. project on this site before?
General Site Conditions
1. Has the site been cleared or logged? Date of most recent action:
Soils / Topography (_!��tx o b --,j R;�tv Ul
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? aqwpiAaX )L - S_AA;�
3. Describe the general site topography. Check all that apply.
40 Flat: less than 5 feet elevation change over entire site.
t--'�__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 of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments L_ t L
Hydrology/Vegetation
4. Site contains areas of year-round standing water:
5. Site contains areas of seasonal standing wateff A/ 0 _Approx. Depth:
6. Site is in the floodway r-16-2 floodplain___ILJ 0 of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? ILD flows
are year-round? AJ 0 Flows are seasonal?/L--/
8. Site is primarily: forested meadow, _; shrubs mixed
9. Obvious wetland is present on site:
10. Wetland inventory or map indicates wetland present on site:
11. Critical Areas inventory or map indicates any Critical Area on site: _A�Z)
--------- — --------- — - — -- --For City Use Only
STUDY REQUIRED: Critical areas study is required.
CGNDITIONAL WAIVER: Critical areas study not required if specified conditions satisfied.
WAIVER: Critical areas study is not required.
V'4__� .1
Determination Number. CA - IL - 12-1 Reviewer
� r— 4 � 19'22
Planner Da
Rev 3/27192
6190 -199 -
City of Edmonds
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.
With a signed copy of this fbrm� the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conjunction with
this Checklist to assist staff in completing
their preliminary assessment of the site.
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner Applicant:
Applicant Representative:
Zk
Narne
Name
Title
Title
Street Address
Street Address
City, State, ZIP Phone
City, State, ZIP Phone
Signature Date
Signature Date
NOTICE:
-N-o--w-arra-nty---of- -a-ccu-r-a-cy, -
The information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edm.qnds does not warrant the
accuracy of anything set forth on these
map(s-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
-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]-o-yee-s o-r office-rs -sh-a-11*1 be Via-b-'Fe for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
for
8 M
The Cityof Admonds FU SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIR EASEMENT ..........
s LYNN PLANT
-Z
. I
i . 19 m,-- 5 k 26-
OWNER....................................................................................................... I ...... CONTRACTOR ....... P.W.Al .... le ............................................................ ......... PERMIT N(b.
ADDRESS ...... i2PWS.- ......
......................... LEGAL DESCRIPTION: LOT No . ............................................. BLOCK No . .................. ... ...
NAMEOF ADDITION ....... . ... .................................................................
0
0
,4,n27- ( -3 26 Pz-',9 7-3 o iE- 7-AE,q c- 7s 0, / /, 12� 13
J/' tZ- E ll�D.,q 2�� �q ce-0 je D' fl*> 7-0
0 7 3 26- c c��,e DS 0
S IV,0 M 0 /-t/-5/-/
0
Approved:
APPROVED
MAY 2 1967
.0 DATE -J.—�:7�4.7 ................ By ...................
-OF -EDMONDS
v,1ER DEPARTIVMNT
�W-ATER-SE tions
V C,
PERMIT
81stp%venue 'West ........................................................................
20415 ............................................. ovi n e r ...... * ...... ......
ADDRESS.................................... ..........
- ja?,m'es Kreiss .................... ............ CONTRACTOR ................................. NE CT a side s6Nver
OWNER .......................................................... . �? to REpAya or CON
V�ay 2, 19 ........ I for ........................ doY1
ed _� ------ ........... ... erning ordinfknces-
perinissiOn is gr:rnt appIleation on file and gov
rdance with
_".,,tll City Se,,Vel!.�; in acco contrar-tor must
licensed Side Sewer
C LLED TO TI.IE FOLLOWING: ie A B
,NTION IS i,� 3 construct sewer inside Prop:rtY itr eiore it has been in pected.
ATTF of the property may obtaln a permit t, Do not cover any Portion of ewer b n You get Permit-
- 1-,The owners. side sewer in street area, -tIO m grade of 2%
NOTE No be elilployeg to construct regarding ordinance 11.16.030 and Regul9 ns governing'side sewers whe
es Inside property line; mirlimn
NOTE No. 2—Obtain full information coverage at property line and 12 inch b . e responsible for
of side sower must have at least 30 inches d. condition. Contractors shall
NO�No. 3-�-TOP harper than Va will be permitte ed to original
F No bends in grade r e Of street' restor pletion. its appur-
4—Tr6nehes in street must be Water settled and surfaC f corn do any work on the main sewer or
b1ch may develop within one year 0
rE No. ure due to improper work w is provided for In the permit, or to
fail work than
to alter or do any other
NOTE No. 5—I� is "n's"ful the pipe into the -ye.
tenances except to insert
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,YY
f4 6w
K,
7
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06�ulv%a 17 oF P�A75
let- C 0 T,- -.p 0 /IA 01-1 t S
STREET FILE
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SC A L C-
'THOMAS WALSH
. TEL. 774-8643
20415 8 1 ST AVENUE W.
EDMONDS, WA 98026-6716
RE p r,'(04-
ell
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RECEIVED
JUL 0 9 1992
PERMIT COUNTER
1 Pic, ff
THOMAS WALSH
TEL. 774-8643
204158 1 ST AVENUE W.
EDMONDS, WA-'98026-6716
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