21025 83RD AVE W.PDF111111111111
7752
21025 83RD AVE W
CA FILE NO.__qG_&_-0
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: 2 le a 5- 0 3:_!?� - f
2. Property Tax Account Number: A-1-po. 09L 00:7 0104) RECIEIVEZ)
3. Approximate Site Size (acres or square feet): /a. 5-av F-7'- -
MAY'
4. Is this site currently developed? yes; _ no.
If yes; how is site developed? L R.I.,
5. Describe the general site topography. Check all dig apply.
�e Flat: less than 5-feet elevation change over entire site. MAY 15 1995
Rolling:. -Slopes on site generally less than 15% (a vertical rise of 10-feit I
OVVWAVA�;
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 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal stabding water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway Zz 12 floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows 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
4. .'Site is'Zoned? M Z
2- -.......�-SCS'mapped soil type(s)?
_fxp d,
3. Wetland inventory or C.A. map indicates wetland present on site?
4., Critical Areas inventory or C.A. map indicates Critical Area on site?
.5. Site within designated earth subsidence landslide hazard area?
--Site designated on the Environmentally Sensitive Areas Mapl
.I)ETERMNATION
STUDY REQUIRED CONDMONAL WAIVER
y" WAIVER
Reviewed by: c_
Flarv*r Date
Rcv011M4
a 90-199-
City' of Edmonds
I Areas Checklist
Ica
CriticalArm Clec.1dist contained on
V'
be filled out by any.person:
zzi preparing a Development Permit
App4cation 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. T'he
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
revww 4he checklist, make a pregursor
y site
-:visit, - and:make a determination of the
subsequent steps necessary to complete a
development permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). . In : -
addition, the applicant shall include
other pertinent infonnation (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 Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
21,0 2 5- - g,
Street Address
Applicant Representative:
0 .0 / g -�� � ,
Street Addra
City, State, ZIP Phone' City, State, ZIP 'Phone
,�& - 4F�
Signiture Date Date
e-1007, ^
--AMNN— C) lz�
9 0 - 19
N 0 T I C
TO PERMITTEE AND/OR OWNER
PARTIAL APPROVAL
VIOLATION
CORRECTIONS REQUIRED
Pennit Number Owner 4ALL-AAAKA0KJ
Job Address 2- 10 -Z 3 R-0 At,457 L�
No PERMIT -STOP WORK -REMOVE CONSTRUCTION OR OBTAIN PERMIT AND MAKE WORK COMPLY
Lj WITH ALL APPLICABLE CITY CODES.
F-1 CONSTRUCTION Is NOT IN ACCORDANCE WITH APPROVED PLANS AND PERMIT - STOP WORK.
MAKE WORK COMPLY WITH APPROVED PLANS AND PERMIT OR REMOVE.
F-1 STOP WORK - UNTIL AUTHORIZED To CONTINUE By CITY INSPECTOR.
F-y-j CORRECTIONS LISTED BELOW MUST BE MADE: BEFORE WORK CAN BE APPROVED AND/OR THE
NEXT PHASE IS STARTED; To AVOID POSTING OF A STOP WORK ORDER, ORDER To
CORRECT, OR ABATEMENT PROCESS.
JOB CARD MUST BE POSTED ON SITE AND BE VISIBLE FROM STREET.
F-1 APPROVED PLANS MUST BE AVAILABLE To INSPECTOR ON SITE.
F-1 WORK DESCRIBED ]BELOW HAS BEEN INSPECTED AND Is APPROVED.
F-1 CONTACT INSPECTOR AND ARRANGE FOR APPOINTMENT.
RECALL FOR INSPECTION. U FON C-0 Of%- %�_T% a fJ B%-( N 0 V '-3o-rH
7HE OsSiLIF-L, PMOCAOCq Arli�,eA, C0X)STP1)C__CF-r_-> OFF- 83r'-0 MUS7
'5E PAVE�P Pa(L. CATY 00_0lMAtJr_e__ F-- C- C) C� k 4�5, 8 0 , 0 CP 0 C-
THE ACTIONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN
DAYS OR PENALTIES MAY BE APPLIED. FOR INSPECTIONS CALL 771-0220.
F-1 r--rl
Building Division Planning Department =;bkngineering Department Lj Fire Department
CITY OF EDMONDS
Inspector N00 I R - q8 Date
- N.,
w
APPLICATION CARD No . ......................................
The City of Edmonds STREET FILE for
SIDE SEWER PERMaT
OUTSIDE E] INSIDE REPAIRS E] EASEMENT No . .................. . . ...............
/-/,o lel (4/1�li
OWNER -ZV2?5� V77-
............ /4.�—Zz .......... ..... CONTRACTOR PERMIT No.
........................
STREETL ...... .......................... BLOCK No . ................. / ...........................
....... . . ..... ...................
HOUSE No. ............ AVENUE LOT No. -1 ................
NAME ADD . ................... al&c.Q'---1 ..... -.1 .......
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .....................
SEWER WORK ORDER ISSUED ..........................................
/-o � 7, AjcjtrL0ooc4 Mc,-oop Mocl
3)3,,-IEI Al. 3o, Z Corne-r OF
Th, NE-LY AlT. -SElY Moor r, 6�
L�-Y,n-Roo_,� q.�.7, 7c, -rpf3 ec)�lj_dJELY
q C13, T P B
APPROVED
JAN 2 0 1970
wwwow .........
Approved:
...............
DATE.. .............................................
............................... 1-1- ....... .........
0
NOTICE:
No warranty. OT aC-c--u--r-a-c-.*
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edrn.onds does not . warrant the
accuracy of anything set forth on these
a
rnap(�-). Any person or enti
copy should conduct an independent
inquiry regarding the inform-ation shown on
tFe -map(s), including, but not limited to,
th-e lociation 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]-o-yee-s o-r office-rs -sha-1.1 be l--',1a-b-11--e for the
information given on this map(s), nor for
ation provided based
any one represent
upon said map(s).
CITY OF EDMONDS Call FROSP-t 6-1101 when v'Or"
is ready for insPeCtka- (No inspec-
civic CENTER — WATER -SEWER DEPARTI%'ENT tjous Saturday, Sand" 0, holidsays.) N2 3549
SIDE SEWER PERMIT
----------------- * --------- --------------------
ADDRESS ---------------
mildred Hall .......... ....................... -------- ColrrRAcTOR ---------- B.en ... H....-FAr-Ker ................................
OWNER --------------------------------------------------- 9.70- for ------------------------ days to REPAIR Or CONNECT a side sewer
----20 ...... jMnCeS'
...... january
perinission is granted application on file and governing Ord
with City Sewers in accordance with wer contractor must
ATTF,NTION IS CKLLF-D TO THE FOLLOWING: rmit to construct sewer inside Property line. A licensed Side se
been inspected.
NOTE No. I —The owners of the property may obtain a Pe:area. Do not cover any portion of sewer before it has
be employed to construct side sewer in street side sewers when You get permit.
NOTE No. 2--obtain full information regarding ordinance 11.16.030 and Regulations governing es inside property line; minimum grade Of 2%-
ide sewer must have at least 30 inches coverage at property line and 12 inch
NOTF, No. 3—TOP Of s permitted. eet restored to Original condition. Contractors shall be responsible for
No bends in grade sharper than % will be [I surface of str ar 0
. in street must be water settled an, ye f completion.
NOTF, No. 4—Trenches r work which may develop within one r to do any work on the main sewer or its aPPUr
failure due to imprope
NOTE No. 6--It is unlawful to alter or do any other work than is provided for in the permit, 0
tenances except to insert the pipe into the wye.