21521 73RD PL W (3).PDF111111111111
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21521 73RD PL W
APPLICATION
The City of Edmonds STREET FLE for
SIDE SEWER PERMIT
ZAI) OUTSIDE)K INSIDE E] REPAIRS E)
................. ..... ..........................
0 WN E R //-v L) 'S.. c ( ...................................... --- PERMIT No.
../)./�) .......... CONTRACTOR ...... C—
... ...................
STREET
HOUSENo . .................... ------- . ............. ............. AVENUE LOT No. ........ .... .......... PLOCK No.. ...............................................
NAMEADD . ........................................................... ........................ - ...... ............. I ------------------------
APPROVED
AN 1
. .. . .................. .
�lj \J,
JA
�111' t? N�
Date Approved:
BACKFILL WORK ORDER ISSUED .................... .............. DEPOSITi $ .......................................
SEWER WORK ORDER ISSUED ..........................................
CARD No . ...........
.........................
EASEMENT No . .......................
.... ....... By
R9
11\
Z
CITY OF EDMONDS Call PRospect 6-1107 24 hours (plus
CITY EULL — WATER -SEWER DEPARTMENT Saturday, Sunday and Holidays) be- 1V?
fore work is ready for Inspection.
910
SIDE SEWER PERMIT
ADDRESS .......... 910-27th--Pla-al ... s .... .. .. ......... Zb�Alr� .... Z?xz .....
. . . .......................................................
OWNER ..............
GeO-Imehen .......... ............... ..................... : ........ CONTRACTOR ................ .
Permission is g ranted ........ V
......................... j 19-Q& f or ........................ days, to REPAIR or C'ONNECT- aside sewer
with City Sewer's in accordanc e. with application on file and governing ordinalices.
ATTENTION IS CALLED 'TO THE FOLLOWING:
NOTE No. I —The
Owners of the Property may obtain a permit to construct sewer inside Property line. A licensed Side Sewer Contraotor
must be employed to construct side sewer in street area. Do not sover 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 sieNyer must have at least 30 inches cover�ge at property line and 12 inches inside property line;
2%. No bends in grade sharper than % will be permitted. minimum grade of I
NOTE No. 4—Trenches in street must be water settled and surfac pf street restored to original condition. Contractors shall be responsible for
failure due to improper work which may develop within one year Of comPlation.
NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its ap-
purtenances except to insert the pipe into the wye.
Oki
40
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CA FILE NO.
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetafion)
') 1,!� --'/ �3 �:-, PL
L Site Address/Location:
2. Property Tax Account Number: 50 000 CC -7 0
3. Approximate Site Size (acres or square feet):
A, %
4. Is this site currently developed? yes; no.
'90
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
4--�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- q) _;Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway )Q 0 floodplain 62 0 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 seasonali � I (
(What time of year?
10. Site is primarily: forested meadow ;shrubs mixed
.. urban landscaped (lawn,shrubs etc) (k-
11. Obvious wetland is present on site: 0
--Fgr City Staff Use Only----
.1. Site is Zoned?
2.. SCS mapped soil type(s)?
3. Wetland inventory or C.A. map indicates wetland present on site?
4.:- :-.,Critir-al Areas inventory or C.A. map indicates Critical Area on site?
5. 'Site within' designated earth subsidence landslide hazard area?
6. Site designated on the Environmentally Sensitive Areas Map?
DETERMINATION
.."STUDY REQUIRED
WAIVER'
Revie wed by:_
�6ner
CONDITfONAL WAIVER
R,cv 01/0494
9
City of Edmon'&
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).
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.
With asigned copy of this form, the
applicant should also submit avicinit- map
Y
or plot plan for individual lots of t—he parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
otherpertinent information (e.g. site
plan, topography map, etc.) or studies in
conjunction with this Checklist to 2Lssist
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:
0 /L-1
Name
/ - 'f- —7
3 /0'
Street Address
city,
Date
Applicant Representative: -
Narne
.Street Address
City, State, ZIP Phone
Signature
Date
The City of Edmonds Water Service Drawing EASEMENT NO . ............................................
NEW CONSTRUCTION REPAIRS 0 LID NO . .................. . ASMT. NO . ..................
OWNER APT��.. CONTRACTOR .... 3At-%r--5 ... Ca�.-Zec�� ......................................... PERMIT NO.94�043��
... ....... ..... ....
JOB ADDRESS ....... 73.7"D ... PL-W ........ ......... .... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
.. .... ......
................................................................................................................................. ............. ..................
NAMEOF ADDITION ....................................................................................................................
12. A P.E.
4 4 "/2."
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10 3/4 c res
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31
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do aw
ALL V#,%-%JSS S640w" Afte 14A.14DW�W-El- -r-JFV-
ALL LOCATF-f> I'FRAI-4 3U'A-b'bjCV 1'/2",(1" ALGDuCze
ALL 'Pipe ts 'P-F-. 1440PS1 OlZiSCOPWC
wrrk-k Fusen 'SOINT-5 q -rRkcx--P- WtRe. 41
Deep cycrawr A.r
,+4.S'* 41.5 T-C� Sytsrime� 'PiPES A,-r- 'BLD63. I I Deep. 36.5
Via" P.C.
.4 1 4
PWW-0001-1 1/75 (REV.1 1/78) 7 3 R. 0 PL.\A/.
Approved:
VKR-rtNL I -
DATE �95.... By Y44A( ..... (
'01 ..... ....... — :--- P- .........................
STREET FILE'
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-0220 FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Q$ Public Works & Planning * Parks and Recreation e Engineering.
89 0 C)
February 22, 1993
James Colbeck
6534 - 48th Ave. N.E.
Seattle, WA 98115.
SUBJECT: WATER BILLING CREDIT AT 21521 - 73kD PL. W.
Dear Mr. Colbeck:
LAURA M. HALL
MAYOR
I have reviewed,your,account and will allow a credit to -your account
according to our City policy: the average consumption for the same
period during the.previous year charged at normal customer rates, plus
the excess usage'charged at the City's cost,.plus a surcharge of 15%
applied to the excess only. Only one leak credit will be granted in
any three year period. .
Should you have.any additional questions after you receive your new
billing, please conta . ct Ilene Larson, Utility Billing Clerk.
Sincerely,
Ron Holland
Water/Sewer Supervisor
RH/l k
cc: Ilene Larson
Utility Billing Clerk
#605600/TXTWATER
Incorporated August 11, 1890
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