21100 86TH PL W.PDFIIIIIIIIIIII
8244
21100 86TH PL W
110 0 1� 0-14 V
STREET FILE
FILE# N/A
DETERMINATION OF NONSIGNIFICANCE
Description of proposal
Addition and Remodel of an existing single family residence
Proponent Cliff & Joanne Nelson
21100 86th PI W Edmonds, WA 98026
Location of proposal, including street address, if any
21100 86th PI W Edmonds, WA 98026
Lead Agency Edmonds Planning Division
The lead agency for this proposal has determined -that it does not have
a probable significant adverse impact on the environment. An
environmental impact statement (EIS) is not required under RCW
43.21C.030(2)(c),. This decision was made after review of a completed
environmental checklist and other information on file with the lead
agency. This information is available to the public on request.
X There is no comment period for this DNS.
this DNS is issued under 197-11-340(2); the lead agency will not
act on this proposal for 15 days from the date below. Comments
must be submitted by
Responsible Official Jeffrey S. Wilson
Position/Title Currenf Planning Supervisor Phone 771-3202
Address 250 5th Ave. N., Edmonds WA 98020
Date 3 12.1tt 't:1— Signaturc_-:�
9 / f I f
X You may appeal this determination of nonsignificance
to- Hearing Examiner
at 250 5th Ave. North, Edmonds, WA 98020
no later than 41-7 12 Z_
by filing a written appeal citing reasons.
You should be prepared to make specific factual objections. Contact
John Bissell to read or ask'about the procedures for
SEPA appeals.
There is -no agency appeal.
REcEIVED
CITY OF EDMONDS 1W 2 6 1992
ENVIRONMENTAL CHECKLIST PERMIT COUNTER
A. BACKGROUND
Name of proposed project, if applicable: - h &
2. Name of applicant: 41��4'szvo
3. Address and phone number of applicant and contact person:
"7T,*7
ZED M01r-'OS, Lx,) A 1?90 2- a 67 V-- 4� ? 3
4. Date checklist prepared: 3 - 114 4. q X
5. Agency requesting checklist: City of Edmonds.
6. Proposed timing or schedule (including phasing, if applicable):
(STAFF COMMENTS)
7. Do you have any plans for future additions, expansion, or further
activity related to or connected with this proposal? If yes, explain.
A(D
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 1 of 26
a. List any environmental information you know about' that has been
prepared, or will be prepared, directly.related to this proposal.
A&,a sy
(STAFF COMMENTS)
9. Do you know whet her applications are pending for governmental approvals
of other proposals directly affecting the property covered by your
proposal? If yes, explain.
(STAFF COMMENTS)
10. List any government approvals or permits that will be needed for your
approval, if known.
11.
(STAFF COMMENTS) ArS 0.e_--M . -
0 C/: �5
Give brief, complete description of your proposal, including the
proposed uses and size of the project and site. There are several
questions later in this checklist that ask you to describe certain
aspects of your proposal. You do not need to reDeat those answers on
this vace.
(STAFF COMMENTS)
CHKLT/10-8-9l.MASTER Page 2 of 26
12. Location of the proposal. Give sufficient information for a person to
understand! the preci ' se location of your proposed project, including a
street address, if any, and section, township, and range, if known. if
a proposal would occur over a range of area, provide range or boundaries
of the site(s). Provide legal description, site plan, vicinity map, and
topographic map, if reasonably available. While you should submit any
plans required by the agency, you are not required to. duplicate maps or
detailed plans submitted with any permit applications related to this
checklist.
(STAFF COMMENTS)
TO BE COMPLETED BY APPLICANT
B. ENVIRONMENTAL ELEMENTS
1. Earth
a. G I description of the site (circle one): lling,
steep slopes, mountainous, other: 'MLro
(STAFF COMMENTS)
b. What is the steepest slope on the site (approximate percent
slope)?
ode r At ea,
(STAFF COMMENTS)
CH KLT/1 0-8-9 1. MASTER Page 3 of 26
C. What general types of soils are found on the site (for example,
clay, sand, gravel, peat, muck)? If you know the classification
of agrigultural soili, specify then and note any prime farmland.
(STAFF COMMENTS)
d. Are there surface indications or history of - unstable soils in the
immediate vicinity? If so, describe.
(STAFF COMMENTS)
e. Describe the purpose, type and approximate quantities of any
fillijjg or grading,proposed. Indicate source of fill.
(STAFF COMMENTS)
f. Could erosion occur as a result of clearing, construction, or use?
If so, generally describe.
(STAFF COMMENTS)
CHKLT/10-8-9l.MASTER Page 4 of 26
9- About what percent of the site will be covered with impervious
surfaces aft ' er project construction (for example, asphalt. or
buildings)?
(STAFF COMMENTS)
h. Proposed measures to reduce or control erosion, or other impacts
to the eV�L4, if any:
(STAFF COMMENTS)
2. AIR
a. What types of emissions to the air would result from the proposal
(i.e., dust, automobile, odors, industrial wood smoke) during
construction -and when*the project is completed? If any, generally
describe,and give approximate quantities if known.
(STAFF COMMENTS) V0/_At/'z— 6��Tgacfwl_)
b. Are there any off -site sources of emissions or odor that may
effect your proposal? If so, generally describe.
(STAFF COMMENTS)
CHKLT/10-8-9l.MASTER Page 5 of 26
C. Proposed measures to reduce or control emissions or other impacts
to the, if any: �# A
0-7
(STAFF COMMENTS)
3. WATER
a. Surface:
(1) Is there any surface water body on or in the immediate
vicinity of the site (including year-round and seasonal
streams, saltwater, lakes, ponds, wetlands)? If yes,
describe type and provide names. If appropriate, state what
stream or Xver it flows into.
Yi)
(STAFF COMMENTS)
(2) Will the project require any. work over, in, or adjacent to
(within 200 f eet) the described waters? If yes, please
describe available plans
(STAFF COMMENTS)
(3) Estimate the amount of fill and dredge material that would
be placed in or removed f rom surface water or wetlands and
indicate the area of the site that would be affected.
Indicate the source of fill material.
CHKLT/I 0-8-9 1. MASTER Page 6 of 26
(STAFF COMMENTS)_
0
(4) Will the proposal require surface water withdrawals or
diversions. Give general description, purposef and
approximate quantities if kn9wn.
(STAFF COMMENTS)
(5) Does the proposal lie within a 100-year floodplain? if so,
note lor
,ation on the site plan.
(STAFF COMMENTS)
(6) Does the proposal involve any discharges of waste materials
to surface waters? If so, describe the type of waste and
anticipated ;Vume of discharge.
(STAFF COMMENTS)
b. Ground:
(1) Will ground water be withdrawn, or will water be discharged
to ground water? Give general description, propose, and
approx�mate quantities if known.
CH KLT/1 0-8-9 1. MASTER Page 7 of 26
(STAFF COMMENTS)
(2) Describe waste material that will be discharged into the
ground from septic tanks or other sources, , if any (for
example: Domestic. sewage; industrial, containing the
following chemicals... ; agricultural; etc.). Describe the
general size of the system, the number of such systems, the
number of houses to be served (if applicable), or the number
of animals humans the system(s) are expected to serve.
4f
(STAFF COMMENTS)
C. Water Runoff (including storm water):
(1) Describe the source of runoff (including storm water) and
method of collection and disposalf if any (including
quantities, if known). Will this water flow into other
waters? .3jf,so, describe.
(STAFF COMMENTS)
(2) Could waste materials enter ground or surface waters? if
so, generally describe.
(STAFF COMMENTS)
CH KLT/1 0-8-9 1. MASTER Page 8 of 26
d. Proposed measures to reduce or control surface, ground, and runoff
water impacts, if any: -r L
4. Plants
a.
(STAFF COMMITS)
check or circle types of vegetation found on the site:
decid uous tree:� aspen, other:
.4j)r"'evergreen tree: fi edar pine, other:
rubs
rass
Ron" M"
MEOW=
cabbage, other:
cattail, buttercup, bulrush, skunk
w ter plants: water lily, eelgrass, milfoil, other:
L a
6—other types of vegetation:
(STAFF COMMENTS)'
b. What !S�nd and amount of vegetation will be remove or altered?
CHKLT/10-8-9l.MASTER Page 9 of 26
(STAFF COMMENTS)
C. List threatened or endangered species known to be on or near the
site.
.(STAFF COMMENTS)
d. Proposed landscaping, use of native plants, or other materials to
preserve or.enhance vegetation on the site, if any:
Do a 14 __
(STAFF COMMENTS)
5. Animals
a. Check or circle any birds and animals which have been observed on
or near the site or are known to be on or near the site:
—birds: hawk,..heron, eaglejs6ngbirdsj other:
—&—mammals: deer, bea I r, elk, beaver, other:
0—fish: bass, salmon, trout, herring, shellfish, other:
(STAFF dOMMENTS)
CH KLT/1 0-8-9 1 MASTER Page 10 of 26
b. List any threatened or endangered species known to be on or near
the site.
(STAFF COMMENTS)
C. Is the site pe4rt of a migration route? If so, explain..
4:
(STAFF COMMENTS)
d. Proposed meas to preserve or enhance wildlife, if any:
(STAFF COMMENTS)
6. Energy and Natural Resources
a. What kinds of energy (electric, natural gas, oil, wood stove,
solar) will be used to meet the complete oJect's energy needs?
- _�!"K _�
Describe whether it will be used for Keating anufacturing, etc.
(STAFF COMMENTS)
CHKLT/10-8-9l.MASTER Page. 11 of 26
b.. Would your project affect the potential use of solar energy by
adjacent properties? If so, generally describe.
C.
(STAFF COMMENTS)
What kinds of energy conservation features are included in the
plans of this Provosal?
(STAFF COMMENTS)
7. Environmental Health
a. Are there any environmental health hazards, including exposure to
toxic chemicals,. risk of fire and explosion, spill, or hazardous
wastel that could occur as a result of this proposal? If so
describe.
(STAFF COMMENTS)
(1) Describe special emergency services that might be required.
a
(STAFF COMMENTS)
CHKLT/10-8-9l.MASTER Page 12 of 26
(2) Proposed measures to reduce �r control environmental health
hazards, if any: — f .
(STAFF COMMENTS)
b. Noise
(1) What types of noise. ' exist in the area which may affect ypur
project (for example: traffic, equipment, operation,
other)?
(STAFF COMMENTS)
(2) What types and levels of noise would be created by or
associated with the project on a short-term or a long-term
basis (for example: traffic, construction, operation,
other)? Indicate what hours noise would come from the site.
(STAFF COMMENTS)
9�5
(3) Proposed. measures to reduce or control noise., impacts, if
any: of 1.
(STAFF COMMENTS)
CH KLT/1 0-8-9 1. MASTER Page 13 of 26
Land and Shoreline Use
a. What is the r en
*1Z - - - C I - t-
of the site and adjacent properties?
.'09 1 A
(STAFF COMMENTS)
b. Has the s*t been used for agriculture? If so, describe.
(STAFF COMMENTS)
C. Describe any structures on the site.
10 C 0. Joe
(STAFF COMMENTS)
d. Will any structures be demolished? If so, what?
No
(STAFF COMMENTS)
e. What is the current zoning classification of the site?
CHKLT/10-8-9l.MASTER Page 14 of 26
(STAFF COMMENTS)
f. What is the current comprehensive plan designation of the site?
(STAFF COMMENTS) 1-ow &7xP 11-/ /Z.-& 4)-�Ln�
S re,
9- If applicable, what is the current shoreline master plan
designation of the site?
(STAFF COMMENTS)
h. Has any part of the site been classified as
an "environmentally
sensitive" area? If so, specify.
pe,
(STAFF COMMENTS)
/4
ri ry OF Z---D.,-t0AVS V,&JI- /7'0�
i. Approximately how many people would reside or work in the
completed project?
(STAFF COMMENTS)
CH KLT/1 0-8-9 1. MASTER Page 15 of 26
Approximately how many people would the completed project
displace?
(STAFF COMMENTS)
k. Proposed meas r s to avoid or reduce displacement impacts, if any:
(STAFF COMMENTS)
Proposed measures to ensure the proposal is compatible
existing and pr J te and uses and plans, if any:
(STAFF COMMENTS)
9. Housing
a. Approximately how many units would be provided, if any? Indicate
whether hi middle, or low-income housing.
V1,12
(STAFF COMMENTS)
CHKLT/10-8-9l.MASTER Page 16 of 26
b. Approximately how many units, if any would be eliminated?
Indicate whether hig)i,.rjiddle, or low-income housing.
(STAFF COMMENTS)
C. Proposed measures to reduce or control housing 2.mpacts, if any:
R /A-,
(STAFF COMMENTS)
10. Aesthetics
a. What is the tallest height of any proposed structure(s), not
including antennas; what is the principle exterior. building
material(s) proposed? A
(STAFF COMMENTS)
b. What v ' iews in the immediate vicinity would be altered or
obstructed?
6 !e
(STAFF COMMENTS)
CHKLT/1 0-8-9 I.MASTER Page 17 of 26
C. Proposed measurl to reduce or control aesthetic impacts, if any:
AP
(STAFF COMMENTS)
11. Light and Glare
a. What type of light or glare will the proposal produce? What time
of,day would it mainly occur?
(STAFF COMMENTS)
b. Could light or glare from the finished project be a safety hazard
or interfere.wIt views?
INA-
(STAFF COMMENTS)
C. What existing off -site sources of light or glare may affect your
proposal?
(STAFF COMMENTS)
CHKLT/10-8-9l.MASTER Page 18 of 26
I
d. Proposed measures.to reduce or control light and glare impacts, if
any: . a .
(STAFF COMMENTS)
12. Recreation
a. What designated and informal recreational opportunities are in the
immediate vicinity? -A a -
(STAFF COMMENTS)
b. Would the proposed project displace any existing recreation uses?
If so, describe.
(STAFF COMMENTS)
C. Proposed measures ' to reduce or control impacts on recreation,
including recr6atio n opportunities to be provided by the project
or applicant f any:
(STAFF COMMENTS)
CH KLT/1 0-8-9 1. MASTER Page 19 of 26
13. Historic and Cultural Preservation
a. Are there any places ol- objects listed on, or proposed for,
national, state, or local preservation registers known to be on or
next to the site? If so, generally describe.
(STAFF COMMENTS)
b. Generally describe any landmarks or evidence of historic,
archaeological, scientific, or cultural importance known to be on
or next tQ the site.
(STAFF COMMENTS)
C. Proposedjea
,pyres to reduce or control impacts, if any:
(STAFF COMMENTS)
14. Transportation
a. Identify public streets and highways serving the site, and
describe proposed access to the. existing street system. Show on
site plans,.if.any.
(STAFF COMMENTS)
CH KLT/1 0-8-9 1. MASTER Page 20 of 26
b. Is site currently served by public transit? If no, what is the
approximate
.,distaaga,A�o the nearest transit stop?
i
(STAFF COMMENTS) 62DVVAJa- �97Z:),R-S 4 a ez^ Z�,e.C-
C. How many parking spaces would the completed project have? How
many would th1V project eliminate?
(STAFF COMMENTS)
d. Will the proposal require any new roads or street, or improvements
to existing roads or streets, not including driveways? if so,
generally des r (indicate whether public or private).
(STAFF COMMENTS)
e. Will. the . project use (or occur in the immediate vicinity of)
water, rV, o ir transportation? If so, generally describe.
Y
(STAFF COMMENTS)
CHKLT/10-8-91.MASTER Page 21 of 26
4
How many vehicular trips per day would be generated by the
completed project? If known, indicate when peak volumes would
occur.
(STAFF COMMENTS)
9. Proposed measures to reduce or control transportation impacts, if
any: 1 9 .
(STAFF COMMENTS)
15. Public Services
a. Would the project result in an increased need for'public services
(for example: fire protection, police protection, health care,
schools, other)? If so, generally describe.
It As
(STAFF COMMENTS)
b. Proposed measures to reduce or control direct impacts on public
services,.if.apy:
(STAFF COMMENTS)
CHKLT/ 10-8-9 1. MASTER Page 22 of 26
16. Utilities
a. Ci. lit* rrently available at f h- ite: ectricit
Cna:- ural ter
�! gas , �4a anitary sewer
P. '.c�
sys
sys emm er
sep Ic er:
(STAFF COMMENTS)
b. Describe the utilities that are proposed for the project, the
utility providing the service, and the general construction
activities on the site or in the immediate vicinity which might be
needed. . 2 .
.V- - -
t
(STAFF COMMENTS)
C. SIGNATURE
The above answers are true and complete to the best of my knowledge. I
understand that the lead agency is relying on them to make its decision.
Signature of Proponent Date Submitted
CHKLT/10-8-9l.MASTER Page 23 of 26
3/1 �01
STRE.ET FILE
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140,j<,f
NO 37�6-(,Y,5 -0167-;7-(_7-'
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,---CtTY OF EDMONDS
CON?NrUNITt SERVIC -T
4
RIGHT - OF - WAY CONS E
A. * Owner: Washington Natural Gas Com any
Name
815 Mercer Street
Mailing Address
-Seattle, Washl. 98111
City State Zip
mo
B. e Contractor:
ndljoell
G State License Number Telephone Number
C. 9 Address or Vicinity of Construction: - 21100 86 Place West
Type of Work to be Done: Inst. 2" PE IP Main from 14IN to ROIJIKOJ�fheodifrll Of
Bowdoin Wy. Per Attached Drawing: 912-367(2)
5-1 CA
Permit No. 1— 09
Issue Date --,2, IQ _<�
Name
Mailing Address
City State Zip
D. 0 Work in Connection With: El Sub or Plat El Single Family
El Commercial 11 Multifamily
E. 0 Pavement Cut: 91Y El N F. 0 Size of Cut: (2) 2 x 4
� APPLICANT TO READ AND SIGN
Z
U
11 City Projects
xx utility
INDEMNITY: Applicant understands and by,his signature to this application,.,,agrees to hold the City of Edmonds
harmless from any injuries, darnages,- or claims of any kind or description whatsoever, forseen or unforseen, that may
be made against the City of Edmonds, or any of its departments or employees, including or not limited to the'defense
of any legal proceedings including defense costs, court crts,-.and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AN6 MAYERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Estimated restoration fees will be held until the final street patch is completed by City forces, at. which time a debit or credit will be
processed for issuance to the applicant.
• A 24 hour notice is required -for inspection; Please call Engineering: 771-3202
• Work is to be inspected during progress and at completion.
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
• All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above and that this permit must be available at the job site for inspection purposes at all times.
Signature: Date: March 19, 1991
Owner or Contractor
This Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
APPROVED BY: &))e' W
. r
Time Authorized: Void after ---30 —days.
Special Conditions: NA
PERMIT FEE: 313 . N-) t�' L�
Restoration Fee:
Receipt No.:
Fund 111 Fee:
Street Cut Dimensions. x
RELEASED By,,�A Date INSPECTED BY Date
NO WORK TO BEGIN PRIOR' TO PERMIT ISSUANCE
I . Eng: Div. March 1989
FIELD INSPECTION NOTES (Fund I I I Route copy to Street.. Diepf'.) -
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES El NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. J
STREET FILE
CITY OF EDMONDS
250 - STH AVE 'i - EDMONDS. �4�A 98020 - (206) 771-3202
COMMUNIT; Y SERVICES:
Public Work-;z a Planning * Parks and Recreation - Engineering
9 0 C�
X"
May 11, 1990
Mr. Doug Reilly
21218 - 86th Pl. W.
Edmonds, WA. 98020
LARRY S. NAUGHTEN
MAYOP
Re: Letter from residents of 86th Pl. W. to City dated May 8, 1990
Dear Mr. Reilly:
PETER E. HAHN
DIRECTOR
We received your May 8, 1990 letter and concur with your recommendation
that a new waterline be installed. We will consider your letter as
permission to work within the private drive. The City crews will
schedule the installation of a new pipeline this year. The exact
schedule is not known at this time.
The City's contact persons for this project will be Bobby Mills and
Archie Brena. Please feel free to contact them at your convenience.
Sincerely,
ROBERT J. ALBERTS, P.E.
City Engineer
RJA/sdt
c: Bobby Mills
REILLY/TXTST530
" Incorporated August 11, 1890 e
Sister Cities International — Hekinan, Japan
Dear Sir:
As residents of Edmonds, we write this letter with the hope that you
may provide us with a better quality of water. We reside on 86th
Place West, which we are aware of is a private street.
Our wat.er..,problem has been an ongoing dilemma for us. The severely
rusted and corroded main water line has reached a point where your
city crews are spending more and more time flushing out the lines to
help clean it out. It hasn't been helping the water quality however.
We find our white landry coming out with rust stains. We are forced
to buy bottled water to avoid drinking the "brown" water, which is
an expensive substitute. Our bathroom fixtures are water stained
with no hope in sight. A few of us who are looking at home additions
and remodeling face the inevitable staining when our new fixtures
are installed. We are discouraged to invest money in our homes
with this in mind. Our fear is that we would not be able to recover
our investment due to poor water quality.
Our request is that you take into consideration the replacing of our
water main for our 6 homes on 86th Place West. This would eliminate
the necessity of having city crews come out to continuously maintain
the pipes. It would also enable us to feel safe using our water for
drinking purposes once again.
We look forward to hearing from you. Please contact Doug Reilly at
778-5993 or 344-6688(work).
Sincerely,
The Residents of 86th Plac st:
L
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CITY OF EDMONDS
NEW
ADDITION
RETIREMENT
�910
almu FILE ASSET INFORMATION SHEET
_5 V -7
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
*PROJECTNUMBER
PROJECT COMPLETION DATE X�l 4�7
COST 4=3
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
En DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
0 G.L. ENTR
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO.-
ltnp INITIAL
DEPAUMENT FILE
..Zr
00
C)
V)
CITY of EDMONDS SIDE SEWER PERMIT
For Inspection Call 771-3202STREET FILE PERMIT NO. 077N
a400 d�7'_
'01e�
Address of Construction: 6�
Property Legal Description (Include all easements): 714V _7/16�1
Owner and/or Builder:
Contractor & License No:
Single Family Residence
EDMONDS
TREATMENT PLANT
Multi -Family (No. of Units E
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No 'k Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
'Cross other Private Property: No Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON HE K
I certf- Wat 1, ave read an all comply
w i t
the i -Cems isted on the b,a'ck.
Permit Fee: 00
Trunk Charge:
Assessment Fee:
Partial Inspection:
Issued By:
,bate Issued:
Receipt No.:
_:Z6
Comments Date Initial
Final Inspection Approved: q:_ia_a M_ e:;5*
Date Initial
Rejected:
Reason —Na—te —I—nitial
** PERMIT MUST BE POSTED ON JOB SITE **
Wh-ite Copy - File ' Green Copy - Inspector
Buff Copy - Applicant
Side Sewer Drawing
The City of Edmonds EASEMENT NO - -------------------------- --------------
4
NEW CONSTRUCTION K REPAIRS LID NO . .................. ASMT. NO - ------------------
OWNER ---------------------------------------------------------------------------------------- — Ix 2 -ki�->
-------- CONTRACTOR .......... \ ---------------------------------------- -------- 3!�� ......... PERMIT NO.
TOB ADDRESS --aAA-P-P ......... 2.4.4 ..... ?.� ....... ��k .............. LEGAL DESCRIPTION: LOT NO - -------------------- ----------------- BLOCK NO - ------------------------------------
'A Itol
?-.0VotA-V'-, W4�
PWW-0001-11/75 (REV.11/78)
------------------------------------------------------------------------------------------------------------------------------------------------------------------
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
I
I t
2 S)-e4f-p.
43'
3� gg&?
,-V,P.V.t 0,10 Wse- )As ae,-b
EMIONDS
TREA*FlVlr-_NT PLANT
Approved:
DATE. . . ....... . ? ........... .................................
i
NOTICE:
..Warra -y o al
No n .,y o a -u,
The information 'shown on the attached
iled for use by the City Of
map(s) was cOMP
Edmoncls� its Employees and Consultants.
Th,e City of �Edrn.qnds does not warrant the
accuracy of anything set for.th on t - hese
Map(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform ation shown, on
t-He -map(s)/ including, but not limited to, -h
th . e location of any sewer stub shown. Suc
sewer stubs may or may* not exist and may
or may not exist at the location shown.
Neither the city of Edmonds nor its
empl.o-yee-s o-r office-rs -sh-a-11 be I..'la-b-Ife for -it-he
information given' on this map(5), nor for
e representation provided based
any on
upon said map(s).
CIVIC CENTER PRospecT a-lio-,-
250 FipTm Ave. N.
44
rp"
e
Xx.
A
Office of the City Engineer CITY OF EDMV ONDS
Leif R. Larson- Snohomish County, Washington
October 6, 1969
Mr. David M. Larson
21100 - 86th Place West
Edmonds$ Washington 98020
Dear Mr. Larson:
Reference is made to your letter of A.Ugust-29,.1969, relative to
the sanitary sewer hookup for your property, Assessments 47.0, 540 and 551
in L.I.D. No. 161.
In view of the fact there are no development plans for your
property and your house is 375 feet away from the sewer line, the require-
ment for immediate connection to the sewer is waived in accordance with
Section 11.16.010 of the Sewer Code.
In the event your property develops or septic tank difficulties
should arise, you will be required to connect to the sewer.
I
Yours very.�truly,
CITY OF E OND
LEIF Y. LARSON
City � tngineer
LRL: rf
cc: Ronald Whaley,
Asst. Director of Public Works
CIVIC CIENTEP
250 Firrm AVE. N.
4
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—all
Office of the City Engineer
Leif R. Larson
Mr. David M. Larson
21100 - 86th Place West
Edmonds, Washington 98020
Dear Mr. Larson:
CITY OF EDMONDS
Snohomish County, Washington
October 6, 1969
Reference is made to your letter of August 29, 1969, relative to
the sanitary sewer hookup for your property, Assessments 47.0, 540 and 551
in L.I.D. No. 161.
In view of the fact there are no development plans for your
property and your house is 375 feet away from the sewer line, the require-
ment for immediate connection to the sewer is waived in accordance with
Section 11.16.010 of the Sewer Code.
In the event your property develops or septic tank difficulties
should arise, you will be required to connect to the sewer.
Yours very truly,
CITY, ' OF Ell OND
LEIF �. LARSON
City8ngineer
LRL:rf
cc: Ronald Whaley,
Asst. Director of Public Works
'Roo-mc- 9-- n*7
0 V
STREET FILE
-,.�,10-oo fee for permit
SNOHOMISH HEA1774i DISTRICT
30-11 Rdakef kil&r AveswL_
Everett, Washington
LIDT APPROVAL SHEET
ADDRES S--f
ADDRESS OF PROPOSED BUILDING.
4 4 ' Zor 14 8Ze
LEGAL DESCRIPTION: LOT BL40CK ADDITION
Phone ALpine 9-2061
TYPE OF USEaTej10-711,;1NO. OF BEDROOMS _.-7 SIZE OF LOT-/ro / x .111le **
SOURCE OF DRINKING WATER: PUBLIC'SUPPLY___X _ PRIVATE WELL
A. SURFACE DRAINAGE
1. Is disposal field site well drained? _.e,�S
2. 'Any water course (8ATA6q* drainage ditch, etc.) through site? ;eV,&
B. TOPOGRAPHY
1. Any heavy slopes in field area? Yes
2. Will present topsoil in field area be removed or graded before field tiles
are installed? A-01100,
3. Will any fill material be used in the disposal field site?414000'If yes, hawmuch
C,_SOIL CONDITIONS
1. Has a hole at least 4 feet deep been dug iAnthe disposal field area to deter-
mine the type of soil.present?
2. After hole is dug record the soil conditions at the following depths.
(Record as sand, gravel, calypopacked sand$ loam, etc,)
12 inches -,S;L - 30 inches _Iegre"
16 inches A* 36 inches 00 ^f
24 inches J-14 48 inches ow
4. Any ground water encount--ered,before reaching a depth of 4 feet?
If so, at what depth?
D. WATER TEST
A simple water test will show how well this soil will drain or percolate water.
To perform this test:
I* Dig a hole at least 36 inches deep. Use a shovel or post hole digger
size of hole makes no difference - only depth.
2. Fill hole with waaer. Now let all water run our of hole. This soaks the
ground and will give a more accurate reading.
3. Again pour water in hole to a height of 12 inches from the bottom. Let
water run out until there is just 6 inches from bottem left in hole.
4. Note how many minutes it takes for this last 6 inches to seep away,
5. Divide this time by 6 to obtain the ra�e p4V inch.
6. Date water test was performed. 2ZP:grZeZ
I hereby certify the above information to , be correc the above tests were per-
formed by me as prescribed.
Sign
Address
NOTE: A septic tank permit is issued on the bas
is of the abo e informati6n. If
there are any changes or alteration in the above stated soil vconditions it may
result in the installation being rejected at the time of inspection.
P
AppL Na
AFMAMI HUM] P,
effy OF EDMONDS
A"UCA'nON a hmby ma& for a pamit to the following =rk, in acwTdam MA *3 =M'
panying plans .d vecificaticn& Two am are submitted hz=dth fa apple' IaL
e., t,,�alter Off -St.
et" '" 4 ................... Parking ......................
Workaddn repair .................. ................................................. ...........
Occupancy _------------------------- Const. type ................................ t Use zone .... C .... j...
........... Fire zone ------ _---_-------------
Addn........... ....... ......... .........
.............
Address ............ . ...................... .. ........
A
Alm ..... tan .......
Lot f rontage ........................................ ...................................... Septic k .......
rear .........
side ........ .
Bldg. set4wks — front ....................... r. si& ....................
.e
� . ............... Te ... !4
--A4dresa ........
Owner ..... ... .... .......... 1. No
................ Tel. No .. ........................
Builder ...... . ......... ...... Address .............
................ V
...... ............ ....
Plansby ........................................... ................... ... Address ................................. .................. Tel. No ----
Remark& ..................... .............................................................................. .......... * ....... * ........
This ro-_I;-,.,*I'I covers work to be done
................ .....................
.... ......... .....
---------------------- ---------------_------ .................
c-i on the pu.!,,_,- loo, e,�,nain
...............................
--------------- �c --- ------------------------------------ ..............
jj��-ratc pz-rfis" 0% plicable Codes and State lava regulating thk
I i a ap
The above is a correct statement, an( agree to camp y WA
work-
.. 6_1 .............. Address ............................................ Date.
Signed Owner/Agent...,,k
PERMff for the above work is hereby approved, subject to the above =xditions, and to compliance with the ap-
proved plans and specificadens, and Building Department notations thacm
-2 ................. .
% , . ......... 3_3 --- &rr-cs, .......... Pmait fee ..... 4-Z -------------- PICA. by ..
7
Building Department, By ........................ ........ ... .. . . .................. Date ... ----------------------------
% * This Permit does not cover Plumbing. Sewer or Electrical instdil"i0m.
Side Sewer Drawing
The City of EdM,,! D, Rt
Er rr- i�
EASEMENT NO . ....................................
NEW CONSTRUCTION E] REPAIRS Ej LID NO . ............ ......-ASMT. NO . ..................
OWNERCWFFA-30ANN .... �A.G, SO.V,� --------------- - CONTRACTOR ............. .......................... ...................................... PERMIT NO - --------------------
JOB ADDRESS -9,11.00 ------- 8-co 71-k ...... p)-an.-.- --------------- LEGAL DESCRIPTION: LOT NO . ......... ............................ BLOCK NO . .............. - -------------------
....................... -------------------------------- - -------------------------------------------------------------------------------------------------------
NAME OF ADDITION ----------------------------------------- ------------
-D 7ES7-e-D
PWW-000 1 - 11175 (R EV. 11/78)
= E 6-7
A � AP4
_T
TRE�','11'�Er4'T
oN) SewCR-
ro - I r7 - SG
Approved:
DATE............................................ By -------------------------------------- ----------
REGARDING: 21100 - 86th Place West 4,; 6) 44
(address)
R E C 0 R D 0 F C 0 N T A C T S
DATE NAME, PHONE NO., & COMMENTS
ADDRESS of CALLER
5/1/74 David Larson Certified Letter No. 406361 sent
P.O. Box 429 reauiring hook-un within 60 days.
5/74
Waiver had been issued by Engr. Dept.
10/6/69.
ACTION TAKEN
Letter -received.
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RECEIPT FOR CERTIFIED MAIL-300 (pW1 Ps.,
423-04400 "x-,POST AR'
TE',
LARSON, D.
pos
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P79 'R'
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P. 0. BOX 429 Q
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EDMONDS, WASH.
197,�i
98020
OPTIONAL SERVICES FOR ADDITIONAL FEES
I Shows to whom and date d
RETURN > * efive,ed ............ 154
R 'es
ECEIPT With d0ive,, to add - S o"Iy 65,1
S 2. Shows to whom, date and where dejive�ed'a_ 3?0,
ERMES With de!ivey to addressee only ............ 85d
LU VER' fO ADDRESSFF nNI Y ............................... 506
__fP_Ec1AL VtLjVtt(y (extra fee required) ....................................
PS Form —
3800 NO INSURANCE COVERAGE PROVIDED— (See other side)
Apr. 1971 NOT FOR INTERNATIONAL MAIL GPO: 1270 0-397-458
W
SENDE�R. Besurc f 0 follo�tv irsfrucfiOns cn.oMer s4,_
PLEASE FURNISk �L�VICE(Sj c
yqDI ATED BY CHE
qKED BLOCK(S)
(441�tiowai charges required for, these ervices)
-Show address
iver . O�JLY
Where, delivered:' De"
_,6 adaressee
7
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C ivect-the numbereld'arficle describid 6e'1'6w'
flu. IG—
S NATURE OR N IE OF ADDRESSE
(Allust,
N`1-Ys b6 filidd i,,)
ERTIFIED NO.
4`06361, SIGNATURE ANY
INSURED No.--- 2 y . r A.UI1HtSSf:E'.S AGENT, TF�-
SHOW WHERE L_111LACLJ
(Un1Y if requested, arz��-�O� _ZIP Code)
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