212 SKYLINE DR.PDFiiiiiiiiii lill
13130
212 SKYLINE DR
0 46
ADDRESS:
TAX ACCC
BUILDING
COVENANTS (RECORDED) FOR:
CRITICALAREAS:. DETERMINATION: Ej Conditional Waiver Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED: 12-L-11 6 9
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DA'
SIDE SEWER PERMIT(S) #:t
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
LID #:
LOT: BLOCK:
LATEMP\DS'Ps\Fomis\Street File ChecklisLdoc
41
DECK PLOT Pkonk- Corner Fla&_
etbaekq Required Actual
SCALE I If= 201 Front 9J 30 P�2
Sides 1.5 —T
Rev RTH
(-o FT ceda r
W/2 lcrxe-D V1,465
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ATTACHMENTA
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SKY LINE DRIVE
A." -
Zone 9 S- (2- Comer Fla&_
Setbacks R�guired
Actual
Front N -- 30
Sides.,,/S -7--Y"- 17-5
Rear e-� .7-5-
Other
P90VED PLA N16NG
113 ot
APPROVED ;BY aPNNING
7 X 0
SEE-,,#
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AUG 2 8 2008
1�'EVACPMEWT SERVICES CTR.
tiliv P-7 ET-MNDS
PLANNING DATA
SINGLE FAMILY RESIDENTIAL
0 1 _�E7T F �1 I
Name: k Date:
"'te
Site Address: Plan Chec # -7
Project Description:
Reduced Site Plan Provided: (YES NO) Zoning:
Map Page: .26� Corner Lot. (YES Flag Lot: (YES
Critical Areas Determination ff: e2o Oc z> OIL
)4—Study Required (a'A �\A
11 Waiver
SEPA D t anination:
X=pt
El Needed (for over 500 cubic yards of grading)
0 Fee 0 Checklist EJ APO List with notarized form
Requireof - tbacks
Street: Sid Side:
3,o -7 � 5- . S 5r
Actual Setbacks
Street: Side: q. Sid e. 30
Detached Structures:
Rockeries: -4- SVI ,;:-5-
�e
El Fences[Trellises: c do(4
El Bay Windows/Projecting Modulation:
FE?Stairs/Deck: =ff=2� C-k iC- k
__--fluildlil fleig
Datum Point: Datum Elevation:
TActual
Maximum Height Allowed: Height:
Other
Parking Required:
Parking Provided:
Lot Area:
13131
Maximum Lot Coverage: 35% Proposed: TU-- � 70
Lot Coverage Calculations: _)q0VSe_ (Z 6) -4- E�(A(e-, ckc4 its-) /vtA/ o(4LA,r� 6
ADU Created: (YES / NO)
Subdivision:
Legal Nonconforming Land Use Determination tssued: (YES / NO)
COM,WentS
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im
Plan Review By: 1q, M�OE 7 13 LOZ —
Pldrwulq Data form 04 -11,06 doC
LA
0 #P20
Critical Areas Checklist
CA File No: CPAIW� Erj 9 (o
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: :;,), / ;�_ S
An, Z ;4
2. Property Tax Account Number: ()QW2eD6t)C0r-5000L-)
3. Approximate Site Size (acres or square feet): 1=?S69
4. Is this site currently developed?
yes; no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation'change over entire site.
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 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 standing water: —IV Approx. Depth:
What season(s) of the year?
8. Site is in the floodway '/'/ 0 floodplain of a water course.
9. Site cont a creek or an area where water flows across the grounds surface? Flows are year-round?
Flows are seasonal? (What time of year? Y
10. Site_!���: forested meadow shrubs- n-dxed
ur an laKdscaped- (lawn, shrubs etc
11. Obvious wetland is present on site:
For City Staff Use Only
1. Plan Check Numb
,q, if applicable?
2. Site is Zoned? C-S — D_
3. SCS mapped soil "(s)?
4. Critical Areas mvent ry or C.A. m indicates Cri
5. Site within designated earth subsidence landslide I
Area on site? brft e-, f
area? k".)
DETERMINATION
STUDY REOUIRED
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Reviewed bv-.
#P20
City of Edmonds
Development Services D�"ent
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
'Me 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 the application 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)-
0
DateReceived: CAA,2DDq0QCJJ,,
City Receipkft: �-N V
Critical Areas File #: -q a I O<R
Critical Areas Checklist Fee: ' $135.00
Date Mailed to Applicant
A property owner, or his/her authorized 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
inforniation (e.g. site plan, topography, map, etc.) or
studies in conjunction with this Checklist -to assistant staff
in completing their preliminary assessinentof the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the proces. I sing. of the application agrees
to release, indemnify, defend and hold the City of Edmonds harn-dess from any and a ' 11 damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, 'misleading, inaccurate or
incomplete information finnished by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as'listed below.
SIGNATURE oF APPLicANT/AGENT DATE
Property Owner's Authorization
By my signature, I cer* that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
"0'
SIGNATURE OF OWNER 'D-
DATE
PLEASE PRINT CLEARLY
Owner/Applicant:
ragd,Y k11'VbA1C-SJ
Name
e?la? JkvLi t. mj e- V- e-
Street Address /
Ed-;wo-ndj. A)A. 7XO"9 0
city I State Zip
Telephone: S-)
Email address (optional):
Applicant Representative:
A,'ff ufl-tA.
Name
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Street Address
City State Zip
Telephone:
Email Address (optional): 1a) 4CTI e <fd
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BUILDING DEPA�RTNIE
WV11
Applicant Fill
P
Z5E Le NUV 7602-06
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PERMIT APPLI, ATIO
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Inside Heavy Lines
jou
NA&IE JOR NAME OF BUS[Nep�
ADDRESS
Gaw cc OaG lw%cy'
LEGAL LOT
YES 0 NO
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VARIANCE OR
COND. USE No.
1400 No,
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NAME
PROPOSED YARDS
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UIEVVION
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REQUIREMENTS
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P'ANNI G Ta"PRO%AL
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NAME
DATE
LIE -IJO
STREET R/W
-i/32 FT. DEFICIE
EXISTING STREET R/WS NCY THIS PROPERTY
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ADDRESS
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COMP, PLAN ST. RIW32/32 FT. FT.
CITY
TELEPHONE NUMBER
REMARKS
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Drivewav slope not to exoeed those
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CITY LICENSE NUMBER
indicated on Standard Dwg. #3.0rHITCKEO BY
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Z21 -al� �RqE
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Legal rjescription of Property (Show Below or Attach Four Copies)
STREET AND/OR UTILITY 0 YES
WORK REO'D 0
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UNDERGROUND ES
ity
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0
WIRING REQ'D 0 No
TYPE CONNECTION IVIED BY
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SE TIC SYSTEM YES PERMIT NUMBER
APPVD 13Y CITY E.G. III�
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REMARKS
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FIRE ZONE TYPE OF NST
-RESIDENT
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SIGN
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-.-OL.S. [:]..TA -IN-
WALL
SPECIAL INS;��CTO
REOU IRED
GROUP LOAD
ALT.- E] .-C.VAT. FENCE
OR FILL
JARCA
C3 Yr S No
IOCCUPANCY JOCCUPANT
=7t=4 �r
I.:
PLAN CH.CKE THIS SITE IS LOCATED IN THE CI—TY
OF
REPAIR Ej PR -MOVE DSWIM
EDMONDS. LDCALC)SALES TAX
6�_4
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INSP POOL
SHOULD BE D D31 4
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NUMBER OF STORIE
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NATURC OF WORK TO BE DONE
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PROPOSED USE Z_
PLAN CHECK
VALUATION
NO.
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UTUACKS.
ABUTTING STRLETS)
BUILDING
PLUMOING
T O'H 0-0
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0
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HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
TOTAL AMOUNT Dtj'��
I hereby acknowledge that I have read thl8 &PPIlCation: that the In.
formation MY- to c�rrect: and that I am the owner. or the duly evtb�
,zed a gtnt Of U74 Owner. I agree to COMPly with elty Iund atate, law. nXII.
lat:ng coast-Uttlon; and In dololf the work authorIzed thereby, no per.on
ATTENTION
APPLICATION APPROVAL
w1l; be _'Ploy'a In VI-leAlOn of the Labor Code of the State of Waablogton
relatf�r to WorkMen's COMPen-tion Inaurmeep.
THIS Pr.R.IT
AUTHORIZES
This application Is not a permit until
/NCITE-119(ml Limit One "ear (FxAPt DrMOLITIONS "lCh
ONLY TH r
eigned by the Building Official or his Dep-
,hall be col"I"Nd In n1nety day#; 0VrD-1N BUILDINGS mhall be
M
WORK NOTED
uty; and fees are paid. fund receipt is ac.
__ pirted III I.Yolthit.)
knowledged In space
SIGNATUFV,a24VNeN GNKO
NSPUCTION
4P^RTMUNT
rvIdLd.
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CITY -1
Do Ff T
TO R'S St C ATU
EDMONDS
NOTE: Applicant ST to Plan CICCk I-W
t5ATTC
This Permit covers o,k to,6o -don on private property ONLY.
775-2525
A ny cons . truction On the publ c dome in (curbs, sidewalks, driveways,
ORIGINAL. rilo YELLOW e!
MBrquO", OtC.) Will reqvire sopwat& permission .
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Nr'TJCP NO WARRANI� Or ACCURACY The informstic, shrur
on the
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27 COM to; USL by the City of Edm
Tb� Cit� of Edaiwds doe,, no th c
'cc fe'.".. tj" .11 iap Anj parsoo oi entity rec,.
C", lnquiiy regadlin4 the
b. vi limitec, to, the locatirw of an� sC-1,.,.
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FILE
APPLICATION
for
Ther City of . Edmonds SIDE SEWER PERMIT EASEMENT NO - ---------------------------------
NEW CONSTRUCTION REPAIRS LID No ---------------- - - ---------
0 WNER ------- ------------------------------------------
JOB ADDRESS ...... 1) ..................... -------------------
CONTRACTOR ------------------------------------------------ PERMIT NO - ------------ ------
LEGAL DESCRIPTION: LOT NO - ------------ 1� - ------------------ BLOCK NO - ------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------
NAME OF ADDITION ------- ld ------- P /'/ IS -------------------------- I ...................
Pt.
Approved:
DATE..................................... ...... By --------------------------------------------------------
11/75
a
0
7
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER,-SEWEK DIM"TIHM"
4.
PERMIT
any portion of the construction.%
Can 7IS-2525 for side sewer inspections BEFOU19 Covering
(Inspection will be provided within 24 hours after requat. No Sat., Sun., or holiday inspediona.1
jine Drive ... ............................... .......
............... . . . . .... . ..............
ADDRESS LOCATION OF CON&MUOMN ..........
Lot 58, Eu-.,erald Hills .. .... .... ...... ..............
PROPERTYLEGAL DESCREMON ................... . ..................................................... . .......... . .. . .......... . .. . ...........
. ... ........ ................... ........... ......... .......................
............... . ........... I .............. .......... . ........... .................................................... . .................. . .............. .
----------------------------------- OWMM MMIOR, BUEUDM ------ .......................... ... . ...... . ... .................. . .. . ... . ... . . .
....................................................
Rob A;J in . ..... ......... .......................
........... ...... ............. .....
0ONTRACTOWS NAME & ADDRESS --------------- - --------- 7 r�
Pannisdon Is granted ........... . ......... Au - - u - s - t --- 5 . ........... for repair aWor conneetim of a side mwer to 00 CKY Mawy 5!i!�
r Nem fn acoordam* wfth City Of EdJU0UdS ordinanom
AV"NTION IS CALLED TO THE FOLLOWING: truct sewer lusido A licensed Side Sewer Contractor must be OP4960"d �IWO
NOTE No. I —The owners of the property may obtain & permit to cons
side sewer in street area. Do not cover any portion of sewer before It has e from the City EngineWs Offics.
MWIS No� 2—An work performed in city right-Of-w&Y requires an Invasion of Right -of -WAY Permit obtainabi
No" No. 3--ObtaLn full information regarding ordinance 11.1&030 and Regulations governing side sewers when you get Permit.
Ina and inches nalde proPert ine minimum Cr"* Of 2%. No ban" to V$A#
NOTE No. 4—Top of side sewer Must have at least 30 inches coverage at property 1 12 1 y I ; I
sharper than % will be permitted. ir fanazo me imvs*�
surface of street restored to original Condition. Contractors -ball be rosPo""Aw V to
140TS No. 5—Trenebes In street must be water settled and
work which may develop within One year of completion. ded for in the permlit, or to do any work On the Main sewOr Or Its GWW""Mess "dept to
NOTIN No. 6—It is unlawful to alter or do any other work than in provi WON
sert the pipe into the Wye. I � *0
DjSAPPROVED0 Date -- - ----------------------------------- By ----------------
'5— C� — --0 ----------------------
"PRONVID, PL .. . ........ ......... 4;
Bemmrks: ------------------------------------------------------------------------
................... . ......... - -- ----------------------- - ------------------------------------------
BOT11 permit Copies MUST Be Signed BY owner of Firm Perf0ming construction. ruxoR To Request For InspWUOn
. ........................... ..................... hereby certify that the side sewer lnsta'llaton constmted under tbig peilialt,
g Firm Performing construction)
installed in accordance with aU governing ordinances of the City of F-dmonds-
Dated thi& ------ . ..... e ------ day If— .............. ........ ..... . .
-1-W I -
Cbeck B=roRz you dig for: Water 0, Gas 0. U100000 [3, power 0, Sewer a Other 0 -14
DAt& ---------- - -- - --
J�
IF,
10 E S/�
CITY OF EDMONDS fAEWER PERMIT
PERMIT
Address of Construction: 2 5 k I A4_4' 4 /,-A i y
Property Legal Description (Include all easements):
z1g 3C -,, 0no — 0 ;5� tc-- n
EDIVIONDS -CF-IVED
_I RF
AUG 1 3 1993
Owner and/or Contractor:
f
State License No. R FLC U ilding Permit No.
Single Family Invasion into City Right -of -Way: %No Yes
El Multi -Family (No. of Units—) RW Construction Permit No.
El Commercial Cross other Private Property: WNo El Yes
El Public STREET FRafilegal description and copy of recorded easement
I certify that I Kave-.(ead andWhall comply with all city requirements
as indicated on the back of the Permit Card.
Date
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION *
OFFICE USE ONLY
* FOR INSPECTION CALL 771-3202, PUBLIC WORKS DEPT.
Permit Fee: — :y C . Issued By
Trunk Charge: M Date Issued:
Assessment Fee: Receipt No.:
Lid No.:
Partial Inspection: Date —Initial.
Comments
Reason Rejected: Date —initial
Final Inspection Approved: DateX&:?__5 Initial/
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Revised 3 90
Side Sewer Drawing 1.
The City of Edmonds EASEMENT NO . ..........................................
NEW CONSTRUCTION F-1 REPAIRS [ja0000" LID NO - ------------------ - ASMT. NO. - ---------------
OWNER------------------------------------------------------------------------------------------------ CONTRACTOR ------------------------------------------------------------------------------------ PERMIT NO. '6501
JOB ADDRESS ------ & k -') - ------------ :qk-4-VW-q- - -------- - ----------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
4 PWW-0001-1 1/75 (REVA 1/78)
------------------------------------------------------------------------------------------------------------------------------------------------------------------
NAMEOF ADDITION ................ ------------------------ -----------------------------------------------------------------------------
5
7�4 N�
9'tt
100
4
EVI-stua 15 f
L El:'\,ICN�S
PLANT]
11LA
Approved:
DATE R.-JO .... .... (? ............ By ------------------
WIC 3%YORKS DEPAMOU Date
BUnDING PEX�aT REVIEW 'Address
Street Right -of -Way Existing REQD ------
A ccess Easements Existing REQD
Utility Easement Existing REQD
Lot per Subdivision Plat Assessor map
Site Plan Checked for Accuracy
Underground Wiring Reqd. vu n
Check Accuracy of Legal Description 2_1
IUA
Environmentally Sensitive Area. )AAA
i�� UA_.
Environmental Checklist R�_14.
Flood -Hazard Zone
Shoreline Management Area wA
Slope, Soil, Vegetation.
Strearn, Creek, Drainage Basin
Existing Zoning Per Code
Anxmities Design Board Approval Reqd. ADB # Approval
Board of Adjustment AnDroval Reqd.
Review By: Date:
Existing Water 'Main Size
Water Main �eqd.
Service Line Reqd.
Hydrant Size Existing
,Hydrant Reqd. Per F ire Code
Detector Check Meter Re
q.
Cross Connection Inspection
Fire Department Caments
Water Meter Charge ReqO.
Review by: Date:
epr-ic -ianx oes
Septic Tank Permit Reqd.
Sanitary Sewer Availability,
Drawing No.
Side Sewer Availability
Sanitary Sewer Connection Fee
Revia%T By:
te:
Permit No.
Pr0j.
File No.
Date:
-Open 'Ditc1i Existing
Culvert Reqd._ Size
V. Catch.Basin Reqd. jndicate on Site Plan
0 Shoulder dr.-finage unintaiii coll swale open runoff
llecti On �4al e
Mkwdiole rcqd. Indicate on Site Plan
Soil Conditions and Gro ter Field Checked
R&,,icna by
Street Paving Rcqd.
Curb and Cutter Reqd.
Sidewalk Reqd._
Curb Cut: for Drivewa:y- -Reqd.
c4 Right -of -Way Construction P rmit :R(e2qd.
jBond Reqd. for Public Inpr4. nts
to Street Nam Sign Reqd.
Other Si_piinc, Rcqd.
Pre Perridt Site Inspection mde on
0 BY: S Ell E R
U
9-1 WATER
SMEET
E IGIN - ERING
r. " - -m to Comp icy Develop-ment Departnimt,
5 Special Rcqvdremoms isted in lin
BuilcLing I)ivision
BY
0 All iters filled in on Building P r
0� BY
Drawings Stam. i No -at* S le
Y/C
BY
ic /,Orl.-,s Dei),irtiT)mt
jApproved I )].
I Y/1-11 - - -
RCVj..';Cd: IV 10-1977
t ApplicaticE
Date
Date
Dc-fte
11*11C WORKS DEPARTI= CHECKLft Date
B�nzwpm= iEviEw
0
Z
H
Z
Z
W
P4
Street Right -of -Way Existing REQD
Access Easements Existing V---A C� r-A REQD
Utility Easement Existing REQD
Lot per Subdivision Plat gWMa,,,j.ELL
AA#sessor Map
Site Plan Checked for Accuracy
Underground Wiring Reqd. 1>11M la�o
Check Accuracy of Legal Description
Environmentally Sensitive Area
Environmental Checklist Reqd.
Flood Hazard Zone
Shoreline Management Area
Slope, Soil, Vegetation
Stream, Creek, Drainage Basin
Existing Zoning Per Code Nr�'—
Amenities Design Board Approval Reqd. ADB # Approval
Board of Adjustment -Approval Reqd..
Review By: 'I-- Y--?= a 1721!!-�
Date:
Existing Water Main Size
Water Main Reqd.
Service Line Reqd.
Hydrant Size Existing
Hydrant Reqd. Per Fire Code
Detector Check Meter Reqd.-
Cross Connection Inspection
Fire Department Comments
Water Meter Charge Reqd.
Review by: Date:
Septic Tank Design. Approved
Septic Tank Permit Reqd.
Sanitary Sewer . Availability
Size
Date:
Permit No.
Proi .
Drawing No.,-- File No.
Side Sewer Availability
Sanitaiy Sewer Connection Fee Reqd.
Review By: Date:
d
dress
q)en Ditcl-i Existing, Reqd.
Culvert Reqd. Size
P4 Catch Basin Reqd. Indicate on Site Plan
0 Shouldex drainaj.;e n-kiii-itain collection on swale open rmoff
E-
'.I-u�hole reqd. Indicate on Site Plan
Soil Conditions and Crowd Water Field Checked
Review by Rate
Street Paving Reqd.
Curb and Cutter Reqd.,
Sidewalk Reqd.
Curb Cut for Driveway Reqd.
P� Ri0it-of-Way Construction Pennit Reqd.
Bond Reqd. for Public Inprovements
Street Narm Sign Reqd.
g
10ther SiSming Reqd.
c:, . �Pre Permit Site Inspection made on P. W. DEP-f
r-AAN1:Mz.D
14
0 By
BY: SS,7ER
U REMARKS
W TA7,t%=
T
S
ENGINTEERINC
MONDS
Special Requirciiymts listed in mem to Comunit�y Development Department,
Building Division
BY Date
o All item filled in on Building Pennit Application
BY Date
Drawii-T-,s Stamed and Notations 1-1-ide
P4 BY —Dgte
lApproved by Public Works Deparum-iL
Revised: Iv 10-1977
0 qb
6
WASHINGTON NATURAL GAS
815 Afercer Street (P.O. Box 1869) Seattle, Wasbington 98111
Lief Larson
City Engineer
505 Bell -Street
Edmonds, Wa. 98020
Attn: Dick Allen
Gentlemen:
CQMPAN-Y
TeIrpbone (206) 622-676'
Washington Natural Gas Company hereby applies for permission to:
Install new Service At:
,212.Skyline- Drive ----
Construction is scheduled to begin Aiigligg-, 197A and will require
approximately Ju
and return the original of this form.
days to complete. If this work meets with your approval, please sign
Application Date August 2, 1978
WASHINGTON NATURAL GAS COMPANY
aA, V
Douglas V. Damm
Operations Supervisor
WASHINGTON NATURAL GAS COMPANY is hereby authorized to perform the work listed above in ac-
cordance with their franchise and subject to all applicable state, county and/or municipal ordinances and
specifications.
Approval Date 7av— /9'5P
WNG 566.1 47/76)