21529 90TH AVE W (2).PDFlill iiiiiiii
8778
21529 90TH AVE W
JUL-18-2003 15:16
P. 08/09
Critical Areas Checklist
CA File No: 03 - I I J,
Site Infor.matiori (soils/ topography/hydrology/ vegetation)
L Site, Address/ Location: �)'JS-Qq
VF tv
7
21*' Property Tax Account Number: 0 9roodo /do 0
3. Approximate Site Size (acres orsquare feet):
4. Is this site currently developed? X\_ yes, — no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
X * Flat; less than 5-feet elevation change over entire site.
Rolling- slopes on site generally less d= 15% '(a vertical rise of 10-feet over a horizontal
distance of 66-feet).
Hilly: slopes present on site of more than 150,� and less than 30% (a vertical rise of 10-feet
over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 3()% 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: kQ 0
Approx..Depth:
What season(s) of the year?
8. Site is 'mi the'flobdwaY flo-odplain, of a
water course. 00
9. Site contains a creek or an area where water flows across the grounds surface7 Flows are year-round?
�\3 0 Flows are seasonal? (What time of year?
10. Site is primarily: forested ; meadow shrubs mixed
urban landscaped (lawn, shrubs etc) X
11. Obvious wetland is present on site; - 11;K0
--For City Staft Use Only
1 . Plan Check Number, if applicable?
2. Site is Zoned? _t5_ cp�
3. SCS mapped soil type(s)?
4. Critical Areas inventory or C.A.map indicates Critical Area on site?
5. Site, within designated earth subsidence landslide hazard area? t��j
-fT75 , - 1 1 4'.Z) 4':�c . —I
S42ru;'� 1'', -d I A
DETERMINATION
STUDY REQUIRED
-WAIVER
Revlewed by:
Date:
Critical Areas ChOcklist.doc/4.22.2003
JUL-lB-2003 15:18
P. 09/09
CIOF E 04,
City of Ednionds
Development Services Department
Planning Division
Phone: 425.771.0220
C4 Fax: 425.771.0221
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 Fdmonds prior to
his/her submittal of the application to the City.
The purpose of the Checklist is to enable City staff to
deterrnine whether ' any potential Critical Areas am, 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).
.Date Received: -7 1-3 0 1 C)3
City Receipt #: 1:), —
�1!4 �2
Critical Areas File #: C) I, - --k- t I a -
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
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessm ; ent of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in considention on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any a'ction or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information fUmisbed by the applicant, histher/its agents or employees.
By my signature, I certify that the infonnation. and exhibits h=with submitted are true and correct to the best of Tny
knowledge and that I am authorized to file this a lication, he behalf of the owner as listed below.
pp
17�
SIGNATURE OF APPLICANVAGENT DATE -71 &1 /0--3
Property Owner's Authorization
By my signature, I certify that I have authorized the above ApplicarittAgent 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�pw�ng attendant to this application,
SIGNATURE OF OWNER C:141 DATE '7/,�)/)0--s>
PLE.ASE PRINT CLEARLY
Owner/Applicant:
Name
?- i -s- 2-,1
Street Address
Ebm ot�jns Z 0 Z, u,
city State Zip
Telephone: '�-, _774- lb(q(-1
Email address (optional) -
Applicant Representative:
Name
Street Addrcss
City State Zip
Telephone:
Email Address (optional):
TOTAL P.09
JUL-18-2003 15:16 P.oe/oq
Critical Areas Checklist CA File No: 03 - I I ��
Site Information (soils/ topography/hydrology/ vegetation)
1. Site Address/Location: 9 A vc L/t/
2. Property Tax Account Number: 1995 0�roono 000
3. Approximate Site Size (acres or square feet): V1 1 7 d ( 5� -f4-/ 0, �;L-7 ac r
4. Is this site currently developed? 2-1\ Yes, — no.
lf yes; how is site developed?
5. Describe the general site topography. Check all that apply.
X
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 151� 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-feetover a horizontal
distmice 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: V-) 0 Approx. Depth:
What season(s) of the year?
8. Site is in the floodway _ floodplain of a watercourse.
9. Site contains a creelk or an area where water flows across the grounds surface? Flows are year-round?
I �Q 0 - Flows are seasonal? — (What time of year? Y
10. Site is primarily: forested ; meadow shrubs mixed
urban landscaped (lawn, shrubs etc)
11. Obvious wetland is present on site:
1---------- --For City Staff Uge Only
1. Plan Check Number, if applicable?
2. Site is Zoned?
�5—'�25
3. SCS mapped soil type(s)? r4
4. Critical Areas inventory or C.A. map indicates Critical Area on site?
5. Sjte�within % designated earth subsidence landslide hazard area? -4
Dj:n A
DETERMINATION
STUDY REQUIRED
Reviewed by: Date: —WAIVER
e A
I KILMI AreRs ItA"Mist.doc/4.22.2003
JUL-18-2003 15:18
P. 09/09
V E D-4f City of Edmonds
r -�4r
Development Services Department
Fax: 425.771.0221
Planning Division
Phone: 425.771.0220
za, 189
0.
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 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).
.Date Received: `7 1 -3 () 0 -3
City Receipt �)Lq (,0 -
Critical Areas File o'A — �j I
Critical Areas Checklist Fee:___$.135.00
I Date Mailed to Applicant:
A property owner, or his/her authorized Mpresentative,
must fill out the checklist, sign and date it, and submit it
to the City. 'ne City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
perinit application.
Please subrnit 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 assistant staff
in completing their preliminary assessm ; ent of the site.
The undersigned applicant, and bis/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising ftom any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I certify 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 a licatiOn, he behalf of the owner as listed below.
pp
7 &1 /0--,;�
SIGNATURE OF APPLICANVAGENT. DATE
Property Owner's Authorization
By my signature, I certify 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 Mff of the City of Edmonds to enter the subject property for the
purposes of inspection ands ng attendant to this application.
SIGNATURE OF OWNER DATE 7X-> )CL3
PLEASE PRINT CLEARLY
Owner/Applicant:
Name
?- i -s- 2- ci 9 o A v
Street Address
Er-w omns aiq 0 2, u
city State Zip
Telephone: _774- 1br'1(-1
Email address (optional):
Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Email Address (optional):
TOTAL P.09
PUBLJC WORKS — EWINEERING,
ACTION REPORT
N9 1 058
STREffE-11- FILE
SUSPENSE DATE:
Date: V Time: /45 F i I e #
Attachments: =Yes
SUBJECT: A- =No
REQUESTOR: NAME:
ADDRESS --
PHONE:
REQUEST RECEIVED BY:
TELEPHONE
CONTACT IN OFFICE
OTHER:
RECEIVED BY:
R01)TF TO -
ACTION
All Concerned Notified
Action Completed/File
APPLICATION
for
The City of Edmonds SEDE SEWER PERNaT
STRICIE---T Fit LiF, CONSTRUCTION REPAIRS E] EASEMENT No . ..........................................
111-04600
OWNER ........... Era-n.k .... tl ...... Ga-z-ewp-o-d ------------------------------------------------------ CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS ....... 21.529 ... 7! ... 9.0th ... Av.e.-...14 ................................................. LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAMEOF ADDITION .........................................................................................................................................
Ll
Dye Tested On Sewer 1972
Approved:
DATE............ ............ ...................... By ..................................................... ................