21507 88TH AVE W.PDFIIIIIIIIIIII
8484
21507 88TH AVE W
CA FILE NO.
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
I Site Address/Location: 2-1 4-, Va �:O a,-;[ 6
2. Property Tax Account Number: 20" 72- 3 -57 — 067a z9 e V — 67 evo e
3. Approximate Site Size (acres or square feet): !2 till a 4a d-,, /I"- a4" /00/X 190'
1 �/
4. Is this site currently developed? X yes; -- I no.
If yes; how is site developed? 211��
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 I 0-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
I 0-feet over a horizontal distance of 33 to 66-feet).
Steer): grades of greater than 3 0% present on site (a vertical rise of 1 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-r ound standing water: �/oNE Approx. Depth:
7. Site contains areas of seasonal standing water: /q0j\,4F— _.;Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain- , tl::ft 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? 24 (A (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: Aj C-)
City of Edmonds
V�W 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).
R9CEIV50,
FFR n 9 10f�n
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.
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 information (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 Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
-& x
Name d'
90 7- - 99 Au, �J
Street Address
City State Zip
(-q") 5') -7 -/ 5- - 5,f &�
Telephone
Signature dy
Date
Applicant Representative:
Name
Street Address
C ity S tate Zip
Telephone
Signature
Date
c:recept1on\jana\cac1.doc (over)
00,00',
BARBARA FAHEY
MAYOR
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
February 10, 1999
Marilyn A t . h Jay
21507 88 Ave. West
Edmonds, WA 98026
Subject: Determination regarding Critical Areas Checklist # 99-27
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.
IMPORTANT INFORMATION TO BE NOTED.
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS OR CRIT4CAL AREAS STUDY.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific cletennination not a
project -specific determination.
milo, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL _4111111111111
PERMIT APPLICATIONS 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.
Enc: Critical Areas Determination
* Architectural Design Board
C:Recept1on\Jana\CRLTR.doc
Thank you.
Sharla Graham
Planning Secretary
Incorporated August 11, 1890
Sister City - Hekinan, Japan
The City of Edmonds - — - - I= elde Sewer Drawing
ClITZM1 EASEMENT NO - -------------------
NEW CONSTRUCTION REPAIRS LID NO - ------------------ ASMT. NO - ----------------
OWNER f4 t-j A
--- J.0
1----,N -------------------------- ------- ---------------- CONTRACTOR -jj�07B ---- Akl,-114 --------------------------------------------- .. PERMIT NO. -707Z-,
JOB ADDRESS -21507 --------- 8-8-T - ----- AVE - ----- ---------- LEGAL DESCRIPTION: LOT NO. ----4 ---------------------------- BLOCK NO. --------------------------------
EDMONDS
REATMENT-PLANT
NAME OF ADDITION PAAZX I]
----------------------------- - --------------------
2 150 r7 88 -r" AVE.
$'I
II It- 3'- 1"COPP9
Ift, t L.— I" pt^sxlc
I-5,0ft * I
C.C.Wvc
2.6,bp
x(oft'V401
88 -rl4 AvE.
f*Z*
r ap
3:f
Approved:
0
3
NOTICE:
I
'0 Wa-r-r an 'lly
-N rf�-a.n " i -r --a--c- c ur a the attached
The -information 'shown on
Map(s) was compiled for use by the city of
Edmondsl its Employees and Consultants
Th,.e City of Edmonds does. not . warrant the
accuracy of anything set for.th on these
Map(s�. Any person or entity -requesting a
copy should conduct an independent
inform'ation shown on
inquiry regarding th*e
`tFi�e -map(s), including, but not limited to,
-er stub shown. SUC
the lotation of any sew
sewer stubs may or may, not e.xist. and may
or may not exist at the location shown
Neither the City of Edmonds nor its
empl-o-yee-s o-r offi-ce-rs -s-hal-1 be Habte for the
information given' on this rnap(s), nor for
any one representation provided based
upon said. map(s).
CITY OF EDMONDS
PUBLIC WORKS DEPART A T FOR INSPECTION CALL Permit
__ avr.' �1, -),-In,
SIDE SEWER PERMIT -pt Issue Date
n Iwo
PERMIT MUS-T-BE POSTED ON JOB SITE
EDMONDS
1. Address of Construction ITREATMENT PLANT-1
2. Property Legal Des cr tion (include all, easements)
4
3. Single Family Residence Multi -Family No. of Units
Commercial
4. Owner and/or Builder A
5. Contractor & License No. )3&4 kk -3vli i� P
6. Invasion into City Right -of -Way: No 1,'Y-es (If Yes Right-of-
way Construction Permit Required Call Dial Dig (342-5344) before
excavation) -
7. Cross other private property: Yes Nbt- Easement required -
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
a. Property owners must obtain a permit to install side sewers on
their property. 'A licensed side sewer contractor must be employed to
construct side sewers in the public' right-of�way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year.
C. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
d. Side sewers.may not be installed closer than thirty inches (30")
to any structure. 0
e. Side sewer lines must be laid at a minimum grade. of 2% (1.15
and maximum grade of 100% (450). 0
f. No turn in side s8wer greater than 45 (1/8,bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 1001 along sewer 'line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required. 4
DATE:
I certify that I have read
and shall comply with the above
PERMIT FEE: 3(�
DISAPPROVED BY: Date:
By. Date:
CONNECTION FEE: Date:
P4:n APPROVED By:7
0
P4 PERMIT MUST BE POSTED ON JOB SITE
low
> L
STREEr. FILE
ZONE
I r T%c.
SETBACKS:
FRONT
71'
OTHER
H-EIGHT
oil
st
lot
rA
MUF
LDT S, q- Lmj +1 RW/4 See,, WT Z-1 �!., K.4- &. v,4,m. r--ch%%IM wA
OF 41MTI�J, FILED tADa- WwTosz F(Le g0,5?jzvxz6,(0 2mo, CO.
?,0
STREET FILE
ZONE R!�� -19
SETBACKS:
FRONT
SIDE ---
REAR - IS-`
OTHER
H HT --- Z-S-
830445
4 A
DT 4uT W NW1+,Aw 1/4 V,- 507 VAP de WVAC
la"I ol CF jm.LW qgDa, 4ztToPX NZ Ao. iftl C.O.
il=2d
V
I/ `%�� Z
8 9 0 - 1 9 c�
. : City of Edinonds
Anw�fift NO-11 r "I
)1 nMWt1WF-WAY CONSTRUCTION
PF Permit Number: 3 -06a
1�' M6'
'k Issue Date:.
A. Address or Vicinity of Construction: 21507 88 Ay. W. (9310989)
B. Type of Work (be specific): Install New garvir-a
C. Contractor: Wash.6gton Nat'l. Gas Co. Contact* Frank Swan
Mailing Address:815 Mercer St.Seattle,Wni Phone: 224-2278
State.License #: 96111 Liability Insurance: - Bond:$
D. Building Permit # (if applicable)
Side Sewer Permit # (if applicable)-
E. F] Commercial 0 Subdivision 0 City Project a Ut ility (PUD, GTE, WNG, CABLE, WATER)
n Multi -Family 0 Single Family Other
INSPECTOR: INSPECTOR:.
F. Pavement or Concrete Cut : xUles ONo . G. Size of Cut< 122 x. 4@gas H. Charge$
J
APPLICANT TO READ AFD.SIGN
.4 Id City
INDEMNITY. Applicant understands and by his signature to this application, agrees(I ,he I of Edmonds harml damages, or
k 5 is
claims of any ikind or description whatsoever, foreseen or unforeen, that may be made against he C7iy of Edmonds, ora'�Mofilyiod'eSpa ents or.employ-
ees, including or not limited to the defense of any legal proceedings including defense costs, a a, es by reason of grantiQthid �ermh. I
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMANSHIP AND MA TERIALS FOR A PERIOD OF ONE YEAk FOLLOWING THE FINAL INSPEC77ON'
AND ACCEPTANCE OF THE WORK ES77MA7ED RESTORA77ON FEES WILL BE HELD UN77L THE FINAL STREETPATCH IS COMPLETED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. ##
Y., Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Departil --n
Work is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes. 771-0220
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material, 'rior tit the end of the working day;
p
No EXCEPTIONS.
I have read the above statements and understan:d the 't re nd the pink copy of the permit will be available
on site at all timesfor inspection purposes.
Signature: Date:- March 9, 1993
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
AP I PROVED BY: ..... RIGHT.OFWAY.DEPO.Sr
TMIE:AU.THORIZED:�:VOID:AFTF-R,. .. ......
....... . .::DAYS:. -.DISRUPTION FEEIFUND I.I.I.
:I IONS:: tJ 4 . . ...... ...RESTORATION:FEE:..
!AL.CONDIT . ....................
PERMIT.FEE...
RECEIPT NO:
TE:-:.�.. . ASSUIED-BY
TR'
Mk§'X A", 16 P M
MR111.1-UN-0
Engrg. Div. 1991
Eng. Div. July 1985
Addendum to City Of Edmonds
Right of Way
Permit Application
Submitted b G(J\\4L.& ()nQU0e,3
Engineering Aide
Washington wat"—, r-
21 c50-7 8P L-V. W. 52- / -52-4,S QQV
E D?t
J
i r
.,; .3
,wool
ff
WNG to window
Water main depth
unknown
2, 11 gas main-,_
Key:
_w- water
-9- gas .
-ss- sewer
-e- water hydrant
0 water valve
815 Merccr St. MO. Box 1869). Scattle, WA 98111 (206) 622-6767