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STREET FILE
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.21620 80-1"4' AVG, W,
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SIREET FILE
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-0220 FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
189 0 0() Q) Public Works 9 Planning e Parks a . nd Recreation * Engineering
LETTER OF TRANSMITTAL
Date: June 4, 1992
To: Juergen Schreiber
21620 80th Ave * W.
Edmonds, Wa. 98026
Subject: Critical Areas Checklist
Transmitting:
For your information: xx
As you requested:
For your file:
Comment and retum:
Note attachments:
Comments:
P1
Planning Division
Diane Cunninaham
LAURA M. HALL
MAYOR
PETER E. HAHN
DIRECTOR
4 Incorporoled AUqLlSt 11, 1890 0
Sister Cities International — Hekinan, Japan
890 14944 Ila
City of Edmonds
Critical Areas Checklist
Tbe Critical Areas Checklist contained on
this form -is to b� filled out by any person
preparing a Development Permit
Application for the City of Edmonds prior
to his/her submittal. of a developmentTermit
to the City�
The purpose of the Checklist is to enable
City staff to determinewhether any potential
Critical Areas am or may be present on the
subject propert�. Jim information.nceded. to
complete the Checklist should be easily
available from observations of the site or
data availabld 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 chocldist, make, a precursory site visit�
and make a determination of the subsequent
steps necessary to complete a development
permit a�fffication_
Mrith a signed copy of this form, the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the-subjcct
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conjunction with
this Checklist to assist 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:
Naine
. Applicant Representative:
Name
'�)'i k C-
6�ltu "V C-7, P, \S'/3
Title Title
cP162c) �Po /-1PLF- 60.
Street Address Street Address
®rM 0 1,1D5 JUP 'Y.0626
City, State, ZIP Phone City, State, ZIP Phone
Sipt/ Date Signature Date
STREET FILE
Critical Areas Checklist
RECEIVED
J U N 0 1 1992
Site Information PERMIT COUNTER
ProjectName: I*Wl 117ol(l,,e6coA,57-Rc,,c7lovPermit Number:
er
Site Location: 06'20 P07"dV25-. 0,41,71,11o,11-bS Property Tax Account Numb 0 4
Approximate Site Size. (acres or square feet): /0 4Ca ST,
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged? IWJ C- Xl-'�;,-AA16 4P6- Date of most recent action:
VR13
Soils Topography .,41V
COArP66-,� -9
2. In the Snohomish County Soil Survcy� what is the mapped soil type(s)? .54 6/oc
3. Describe the general site top ography. Check all that apply.
t,/ 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 of horizontal distance.)
steep: grades of greater than 30% present on site.
Comments
Hydrology/Vegetation
4. Site contains areas of year-round standing water: Vo
5. Site contains areas of seasonal standing water: —,�, C, Approx. Depth: q A .
6. Site is in the floodway NO floodplain --- � �0�of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? NQ� flows
are year-round? _zL/�Flows are seasonal?
8. Site ispn-man-ly: forested NA meadow L2 ;shrubs /'V,4 mixed IV;4
9. Obvious wetland is present on site: Al v
10. Wetland inventory or map indicates wetland present on site: NOO
11. Critical Areas inventory or map indicates any Critical Area on site: /04C.)
Fo.r.City Use Only
STREET FILE
CITY OF EDMONDS
COMMUNITY SERVICES DEPARTMENT
BUILDING DIVISION
SINGLE FAMILY RESIDENTIAL PLAN CHECK
DATE
CHECKED BY
DESCRIPTION
ADDRESS
ARCHITECT, CONTRACTOR OR OWNER
TELEPHONE
VALUATION AN-D FEES
DESCRIPTION
EST.. VALUE -PER SQ. FT.
VALUATION
FIRST -FLOOR
TOTAL VALUE
TOTAL MODIFIED VALUE
PLUMBING
NEE
mmmk M.,
TOTAL FEES
9/84 c
NOTICE:
No warranty of accuracy.
The -information'shown on the attached
map(s) was compiled for use by the City 0�
Edmonds, its Employees and Consultants.
The City of �Edmoncls 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
inquiry regarding the information shown on
tFe -map(s), inctuding, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may, not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
ernp-l-o-yees or officers shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
for
The City of Edmonds LE 'i LE SIODE SEWER PERMT EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS 0
0 NF �-4 2(Da TRACTOR- 4
V*r R ------------------------------------------------------------------------------------------------------ CON ........................................................ PERMIT No . ......................
IPTION: LOT .......... BL4DCK No . ............................................
ADDRESS ............................................................................................................ LEGAL DESCR No. ..................
NAMEOF -ADDITION ... ............................................................. ............................................................... ...
0
0
proved:
DATE..... �V .......... By ............. . ......... .... .....................
............
-Ag
P
"'§EWE PERM
0 tot
v x i
P'. ..3
4i I., "'-WAT-ER�.'S]H;WER�*)DEPAIRTMEN,�
A, 411i
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47.
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ISE FOR �f!�,;& nstru t
, . r .,;. - it. �0 ,on:
t�.INO- Sfit., sun.4dr`jh6llday, Inspections),
4 2 6 20. %�4i 80t I-
I' ��Ve " - - '. 4 ''.. � -� �. �,, - �.' � 1, . .
-F ........ ..... .....................................
--AD1DRESSi,L0CAT70Nf-0 ','CONSTRUC,.T.ION,;��.t.��..�.-... ............................. ............................................................. ..................
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................................................
PROPERTY.N. ......... . .. ........... 6 ............................ 4 .................... i ............ ..............
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TH ��.W,-.135 ....... .6";
f, -80 51�� 'Z! TH N
................................ .................... ...................... ........................ ................. ....... .....
JAM.-SCAR0 Ek'
.......... ........... ...... ......... ............. %VNER. ANDYOWBUIME ..... ................................................ . ... ... . .............................................
h, A�
E* T enmo
..................... .
-RAG TTORISDMAM 41"Ab nrl
....................................................................................... . ................ .... .............. ...............
Ue �c tw�
7,
i'-, f of �,the,�c tp�
........................... .................. ovyep4 r,
ofd1n*it�n"s.tI:.,.'�,...,
0
-r J�i ON.'.1 S*,!& LLil D �;ro JH E F LLOWING:�
'fofconstruct, ed!,Side. we -Contractor.. must' eferr
WK 'TW76wn6'�s��'�i:.ihb,p a' ermit 'sewer, �Jnsldej prop, It cen Sb r
:L r6perty,�msy,,obtain p Drty ri�'
sidb�sewerJn:Arect areai�]Do,notxover,any portion of!sewe0-bcfoWit 'hai"be6n-i6s�6cied.�',;;."!':"
rom%thef�Cit`�, I
�NOTE�No;.!2!��All-,work,perform6d� in'; iit�,, rikfitl�f-way ;t-
"It I information, bu
c d''
bTF,: I* " " I .. jqgj'si
i3L:1-01�'Lgir�f�fu el,sewers-.wh i4,'y .-��f.p
No;r�E,No. 4*,—"��pl,.i�i.i�'ei�ewer'*.must'have,at:,Iea�t,��o,inch�s��overige-laf property, lin�. i�nd,.12)i'n'c��;Liinsid'���r��erty,iiihe; rnininou r
stiarper'than V.� will', be, permitted.
f
,&--Trencives'jin��it6e� ��nust:bc' w 'n'�6,bn`dlifor-i -:Co-nt-r-actor8.- shall be-res s - , . 11 roper,�
NOTE! No: hiter.settled'and,isurf ace tof; stid6.t-;r6st*qred�,to..orJgl r..,, 4,
f , "w6ii-whichl iniLy'divelop-within. br,6, year of',cornpletlow. :"A,
- . I ., 1. . . . Of
NO�E',��. �Z�=.Ii'js':unlaw f u.%Nto; alter or,- do anyot 6ri.worli.tfian,'.is�,pro,vi"ded"for,,in Ahe: �nr.workjon,, the main -se er,10 .r:. :.t0j
�tjjel. loqAtito thel��ye.
%
By,' D*
ate .. .... .. . .. .... ..... 4,
..............
iOW ............. .....................................
ANPPROVEV, ....... ......
- A/0 ........
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..... ....................... ...... t
rl., I
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i 7**".�***-'.�:'-,*7�.'�:.��,"�:*,--'t�';* ..................................
'it . . — , !4.
............
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1,., '17 7; 7" 7,_7 7 71* 7:11 .. ............ ....
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e�
ST`B di"m w. e uesti'FO�,;*iAs�.��iici�`
0,
atAhe�si e, 'under, Ah i t!
s e e r,� ifi s f a I I'a t i 6 n, nst eted.
�66
d
41
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sa . n kw
ade:of ben
lble o du�
r, its ap,
�66'
wner-of Contractinj
m n,�' v
r- nstall edrint��cbordan ce;.%,�i U ordin'
ivall',governiT�g' aftees,�o
S,
44
...........
3 '-�'D' t d;'tWS�.-..t'
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a e .;j
Sewer Otheri�E]j��,.�,V,'Kjj`
"CheeW -AEF-6kk Y6�-�ig
A
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—ic
The City of Edmonds
APPLICATWH
for
SWE "WEB PritmT
NEW CONSTRUCTION REPAIRS
owl.. C-K ......
ADDRESS
.... .......................... . ...........................................................
rAsrmm" No . .........................
CONTRACT., ...... ...................... PERIM No.
LEGAL DESCRIPTION: LOT No.._, ...................... .................... BLA)4= No . ............................................
NAME OF ADDITION ........
sec- 3 . -rL, p I?
7- _ L4 C)) 4y g 6 fy 0 S"_,!V41 (Vff Vq T#
—4— C-10 ,Y-r
-v' 9�r r-r IvilL, -T� P a To
TH
FT
E
T D' T P Z
APWoved:
DATE............ .................... w