20504 81ST AVE W.PDF111111111111
7413
20504 81 ST AVE W
CA FILE NO 9 S —5
Critical Areas Checklist
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Site Inforohtion (soils/topography/hydrology/vegetation)
1. Site Addte,ss/L.ocation: 1pas-ylq;�-
2. Property Tax Account Number: 144 6DO OvLj e) c)
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? (---�—es; no.
If yes; how.is site developed?
5. Describe the general site topography. Check all that apply-
L�Iat. * less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 156/o (a vertical rise of I 0-feet over a
horizontal distance of 6.6-feet).
Hilly: slopes present o.n,s.ite of more than 15% and less than 30% 4 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: 'PI Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway P-7 D floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface7ql—ows are year-
round? Flows are seasonal? _ (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 City Staff Use Only ---------------------- -- — -----------------------------
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'Site is Z
oned?
so il type(s)?
I W6tland inven*tory.or C.A. map indicates.weflana present on site?
4. Critical Areas inventory or C.A. map indicates Critical Area on site?'-
5-�::-: :Site within designated earth siubsidence landslide hazard area?
6.' Site designated on the Environmentally Sensitive Areas'Map?
DEIMMINATION
^ca-chk.doc; Rev 10/03/97
4
City of Edmonds
Critical Areas Checkli'vr""'! ael� 1'9-'
S
��7c. 1 g9%J
The Critical Areas Checklist contained on
this forin 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
invent-ofies, maps, or soil:8i.irlveys).
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, M*e a precursory site visit,
and make a determination of the subsequent
steps ne.c.e.s.s.ar to complete a development
pe7nit app
lication.
With a sigtie, d 66 . py of this form, the
applicant should als,o submit a vicinity map
orplotp1qn:for individual lots of the parcel
with enouah detail that City staff can find
and identifv the, su0ject parcel(s). In
addition, t4p applicant shall i * nclude other
pertinent inf6r,mation (e.g. site plan,
topography map, etc.) or studies in
conjunction with this Checklist! to assist
staff in comple ting their prelin iinary
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:
Naine
Street Address
,4 7
City, State, ZIP Phone
Signature Date
Applicant Representative:
Name
Street Address
City, State, ZIP Phone
Signature
Date
-I'? C. 18 9 �)
1-7-98
CITY OF EDMONDS BARBARA FAHEY
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221 MAYOR
COMMUNITY SERVICES DEPARTMENT
Public Works 9 Planning/Building - Parks and Recreation * Engineering e Wastewater Treatment Plant
Filco Co. Inc,
P.O. Box 31228
Seattle, WA 98103
Subject: Determination regarding Critical Areas Checklist #98-005
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.
0
IMP �A F !ION TO
.QR'T.NTIN-. RMAT BE NO TEDR
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIST OR CRITICAL AREAS STUDY.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINA TION WITH ALL _4111110
PERMITAPPLICATIONS 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.
Thank you.
Diane Cunningham
Planning Secretary
Note Attachments:
*Architectural Design Board
C:ReceptIonWana\CRLTR.doc 1 0 Incorporated August 11, 1896 0
Sister Cities International — Hekinan, Japan
APPLICATION
Fit F - for
he City of lmw�- SIDE SEWER' PERMIT LYNN PLUANT
Edmonds- ITRE
s EASEMENT No . .........
NEW CONSTRUCTION -A REPAIRS 0
4 13
...............
OWNER CONTRACTOR.2 .. ...... ................ .................................... PERMIT No . ....
4 ... �BLOCK N . . .................................. .........
ADDRESS LEGAL DESCRIPTION: LOT No. .
NAME OF ADDITION ....................................
07 c
Zr
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J-P—K.
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Approved:
DATE................................................ By ..... ..... ......................................................
NOTICE:
The information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edmoncls does not warrant the
accuracy of anything set for.th on these
rnap(�-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information sho.wn on
t -map(s), but not limited to,
th I 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
ernpto*yee's o'r officerS sh-all be 1--ia-b-IFe for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS
Call PRospect 6-1107 when work
'CIVIC CENTER —WATER-SEWER DEPARTMENT Is ready for Inspection. (No inspee-
SIDESEWER PERMIT tions Saturday, Sunday or holidays.) N2 1816
ADDRESS .................... .................. 20504 - 81st Place West
............................. - ..................................................................................................................................
OWNER ----- William ... %T ..... 0.1 BrjeA. Owner
..... . ........................ . ............. CONTRACTOR ...............................................................................
Permission is granted -------- )�arch 20 ........ 1 19.6.7.., for ...................... days, to REPAIR or CO NNECT 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 maln sewer or its ap-
purtenances except to insert the pipe into the wye.