21710 76TH AVE W.PDF111111111111
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21710 76TH AVE W
CA RLE NO.
Cddcal Areas Checklist
Sdie Information (W&&1topqgraphyAVd I etation)
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1. Site Addressff"atiow. c;Kt -71 1/) - It 0,0-� U)
2 Property Tax Account Number. -5-:P-q'F�177�� RECEIVE[)
3. Approiimate Site Size (acres or square. feeO-- �--3 �� 0 MAR 1 4- 1995
4. Is this site currently developed? -no- L PERMIT COUKER
If yes; how is site devcloped?.—la. —:O�a
5. Describe the general site topography. Chack all dm apply.
Fiat- less than 5-teet elevation change ever enfire:site-
Rolling: slopes on site generally less than 15% (a vecdcal rise of 10-feet over a
horizontal dista= of 6"ad)-
Erdly: slopes present an she of wore than 15% and less dian 30% (a vertical rise
of 10-teet: ever a bodzoatd distance of 33 to 6"ed).
StcT: grades afgveaw dm 30% present on ske (a vertical rise of 10-ted over a
hodrontal &an= of tess, than 33-fc4
Other
please
6. Sike couciins arm of year-round standing water. AM=- Dcp&:
7. SdecoaW amofseasowlso Water. A -A AWw- Dqxk
What seasou(s) of the year?.
8. MW is in the floodway 6.449. of a water course,
9. SiW entains a CW& or an an Wbm VAWW 910" acma *e grounds surbo-O nom am Year6
round? AO-- FlomareseawaaP. A-t'J- (W1=fi=of`y=1
to. She is primatily: �fovesw ;.=eadow
shrubs etixed
urb= landscaped Qawashrubs eW)
it. Obvious wedand is present on skc
*Vrorystaffuscoaly—
Site i1i zoa�
g=a vpc(:sr. 1
of C-&.g1WPJd4C@A= Wdlmd Present el
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City of Edmon&
Critical 'Areas Checklist
'Me, Qitiml A=s ChecHig cmuined -on
dds f0m is W be Mad -out by =y pawn
Prcparing a Devdopmmt permit
APP"Cation fOr &-- GtY Of EdMnds psior
to his,4= subaftd of a dewippascat
Pcrmit to the City.
Ue PurP=,Of t6c Chodlist is to embic
Chystaff to ddcruCm whcdacr any
Potential Cdfical Ams aveor my be
P==t oa the subject pmpcgty. The
kformafm neoded to couvae dw
Chwkfist dwdd be easiiy avmlable fiom,
Obsonmfim of the site or data avaibble at
MY MU (Prifical Arms hwe"Ogics. =Vs.
or =9 survey$).
An applioug. or Wsfbw rep==ft&,r
must fiU OMACChOcIdist. sign and daft it.
2M submit it to the city. ne at
Y win
lv-o� dle chceldist- mab-- a prccursory site
visit. and make a deter4linafion of d1c
subsequent stcps acO==Y tO complctea
de-vdqxncat PMnit 2pplicafion.
With a siVW copy of dlis fo., the
aPPr=MsbOUId aISO sub -it a Ividity Mp
Or Fwx Obn for Wrmdua Faii Of �ihepwcei
with cwq* dcted dw City suffew fid
=W idcufify dn subject pawks). U
addWW6 the *PPGcmd sbaH Indude
*MW PaGme"t WOnnatiOn (A-r, she
PIM4 topovapby waN etc.) or sWdies 1.
000jaudi" uft " Checkfig to assist
StaffIR COURPIefing thew preliminary
assessment of the site—
CHfical Area Cbwift
Md aueg dw theamwem provided am
M
Owner/Apprmlift AppOcad
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SENT BY".LYNNWWOOD 3-13-95 13:05 STEWART TITLE- 206 672 9182;# 5/ 9
�-073 1 Cy
I HAOLEY A ci
CITY OF EDMONDS
SNOHOMISH COUNTYV V-1ASHINGTON
SCALE: IN& 50'
LAND SURVEY)nS CERTIFICATE
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TREASURER'�
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DEDI
44 A
rf A A',:
ACKNOW1
CITY OF EDMQNDS
0--P—UBLIC WORKS%DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
21706-21712 76th Ay. W.
Owner: Washington Natural Gas
Name
805 156th kye. N.E.
Mailing Address
Bellevue, Washington 98007
City, State, Zip Code
Contractor: same as above
Name
Permit No.
Issue Date
;7,17o(, svu-2:rr
Permit lssu�'d To: WNG-
e Type of Work to be Done: servide maintenance
e Work in Connection With:
0 Sub or Plat 0'.Single Family..
0 Comml. / Ind. D.A ri�o
Pt.. C6 d
0 Pavement Cut: El Yes N
i
Mailing Address State License Number
City, State, 'Zip Code Telephone Number
U
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE.
B. APPLICANT TO READ AND SIGN
1:0
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unfo reseen,' that may be.made.
'
against the City of Edmonds, or any of its departments or employees, including or'not limited to ' the defense of any legal
0.
proceedings including defense costs, court costs, and attorney fees by reason of granting this permit.'
0,
U
for for,
Upon issuance of this permit, the contractor is responsible workmanship and materials a period of one year,
ca
following the final inspection and acceptance of the restoration by the Engineering Division.
0.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final'street . paich is completed, at
which time a debit or credit will be processed for issuance to the a plicant.
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Work is to be inspected. Restoration to be in accordance with City Code. Traffic..Contro.t.to. be inni'accordan.ce with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour nonce is required-f6r inspection.�y'Epjinee
Call 775-2525, extension-2ile- �2 517
vaitTbr— rp
I understand that this per �t the jq*ite for inspection pu oses at aft tim6.`
Signature*: Dati.
Owner or Agebt
Z
U
nd
0
THIS PERMIT MUST BE POSTED AT THE JOB SITE FOR INSPECTION, PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:-d
Time Authorized: V oid after —.days
Special Conditions:
Ammendments:
od
Permit A— 7TWV-,f- n
Security Deposit:
Receipt No.:
Fund III Fee:
Street Cut Dimensions
x
_�,ORK TO BEGIN PRIOR TO PERM YIJSSUANCE��t.
Eng. Div. Dccembcr 1978
NOTICE:
No warranty of accuracy.
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of Edmonds does not warrant the
accuracy of anything set forth on these
map(s). Any person or entity requesting a
copy should conduct an independent
inquiry regarding the information shown on
the map(s), including, 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
employees or officers shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT .
Call 775-2525 for side sewer inspections BEFORE covering any portion of the constructi I
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspecti 0.)
ADDRESS LOCATION OF CONSTRUCTION .......................................................................................
POOPERTYLEGAL DESCRIPTION... ....................................................................................... . ..........
. ................... ................................... OWNER AND/OR BUELDER ---------------------------------------- - ----------------------------------- -------------------------------------------------------
CONTRACTOSIS NA31E & ADDRESS --------------- - ---------------------
............................................... ...... . ................ . . .............................................
OwmAssion fa,.gT=tled ........... . ................................ ........ . i
IV --------- for repair and/or connection of a side sewer to the city sAidtary sewer
4"tem In aeusirdance with City of Edmonds ordinances.
'TION IS CALLED TO THE FOLLOWING:
No. 1—The owners of the property may btain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be elzPloYed to construct
sift sewer in street area. Do notocover any portion of sewer before it has been Inspected.
rE No, 2—All work performed in city right-of-wair requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Tbp of side sewer must have at least 30 inches coverage at property line and 12 inches Inside property line; minimum grade of 2%. No bends in grade
oharPer than % will be permitted.
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failive due to improper
work which may develop within one year of completion.
NOTE No. 6--It in unlawful to alter or do any other work than is provided for in the permit, or to do any work on the maln sewer or its appurterances except to in-
Nert the pipe into the Wye.
Dll$"FWVM Date.. By ............... - Date ........... B
. ..... e --------------------------- y— --- ---------- Data ................ ................ . By ----------------
me-. 49.0t.0 i
"PROVED 1K.7-1 ............... By --- - -- .. .......... . .. . .................. .................................................................
Remarks: ..... . .................................... . .............. . ...................................................
........................................... . . ..... ................... -------------------- I ................................... . .............. ..................................... ......................................................
— BOTH Pe
AWST Signed B wner of Firm Performing Construction PRIOR To Request For Inspection
----- .. ........... --- hereby certify that the side sewer installation constructed urder this perrait
0 'of C Ing Construction)
ustalled In a rd g ordinances of the City of Edmonds.
Datedthis ........................... day of --------------------------------- ...................... ........ 19 ---------
V Check BEFORE "'14. dit-for: Water 0, Cms E], Telephone E], Power [], Sewer [], Other 0 4
APPLICATION
The City of Edmonds for EASEMENT NO. . ............
SIDE SEWER PERMIT
NE-%V CONSTRUCTION REPAIRS 7, LID NO. AA!�� ..... ARWI7. NO
OWNF CONTRACTOR '�;iTN-- "--J��XPFNSPERMIT NO.
. .............................................. .................................... ................. ........................... .... .... .. ....
-TH -t
JOB ADDRESS2-lT-4:)------7(n::: ----------- T��-= . ....... LEGAL DESCRIPTION: LOT NO - --------------------- ................ BLOCK NO . ....................................
i I . T ......................................................................................................... ........................................................
A Ve:. aE2-jc:D,
INA.XlE OF ADDITION ....................................................................... ...........
- I -
tNt
Approved:
....................
DATE -------------- BY
APPLICATION
The City of Edmonds for
SIDE SEVv= PMMT
NEW CONSTRUCTION jit REPAIRS 0 EASEMENT No . .........................................
4OW"fe ........ ---------- c ... 1�.. ....... --- .400
OWNER
;;� CONTRACTOR t-ta ..... ............ PERMIT No. AV ..........
ADDRESS
................................. .....................
.................................................. LEGAL DESCRIPTION: LOT No . ............... .............................. BLOCK No . ............................................
NAME OF ADDITION ..................................
T 0 1
RFCFpVFr)
AUG 12 1974
5
Al.
............................. BY ......................................................................
--.01 %—W
NEI
SNOHOMISH COW4TY
"P"070 FtEcoAr5
VOL. F17-F PAGE
A . AD" MAP 4:01WIPANY. INC.
3EArILE
McGRATH, HOMES*..
REPLAT OF LOTS ig a 20, BLK. 1. HADLEY ACRES
SECTION 30- TWP 5>7 N Pd F W U
CITY OF E'DIVIONDS
SNOHOMISH COUNTY, WASHINGTON
DESCRIPWON lee
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ow
TREASURER'$ CERTIFICATE
&
DEDICATION
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SCALE* 1", 50'
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LAND SURVEYORS CERTIFICATE --fiCKNOWLEDGMENTS
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RECORDING CERFIF�ICAiTE
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APPROVALS
REGARDING: 21710 - 76th Avenue West
TaZTr—e —ssT
R E C 0 R D 0 F C 0 N T A C T S
DATE NAME, PHONE NO., & COMMENTS ACTION TAKEN
ADDRESS of CALLER
5/l/74 Robert Edwards Certified Letter No. 406373-sent Letter received.
requiring hook-up within 60 days.
6/11/74 Mrs. Ballard is taking care'of
INITIALS
TE
TE
property while Mr. Edwards is in Rome
for a year or longer. Easement will
be required.
7/1/74 Called and requested extension to TE
7/22/74 as contractor cannot complete
until then.
7/8�74 Came in and obtained permit #4951 and TE
signed letter of extension.
8/22/74 Cmae JT
'Fcz
CITY of EDMONDS
200 Dayton Street - Edmonds, Washington 98020 - Telephone (206) 775-2525
Department of Public Works
July 1, 1974
Mr. Robert Edwards
C/O Mrs. Ballard
21710 - 76th Avenue West
Edmonds, Washington 98020
Re: Property at 21710 - 76th Avenue West, Edmonds
Dear Mr. Edwards:
In reference to your receipt of a Certified Letter of May 1,
1974, requestin'g you to connect your property to the Edmonds sanitary
sewer within sixty days; due to the hardship stated by you and indicated
below, you are heretqith allowed an extension to July 22 19749
in order to make the subject sewer connection:
Time Extension Requested Because:
The contractor Mrs. Ballard hLs _eT loyed will not be
able to complete the sewer installation until mid -July.
JBM: te
Si ncerely,
"�OC I ED NDS
F� NDS
ED
J. H"RB GILBO
Director
ACKNOWLEDGED BY PROPERTY OWNER:
PROPERTY ADDRESS:
MAILING ADDRESS:
ACKNOWLEDGEMENT DATE:
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E Ter st C,
P E A"'SIE FIJIRNISH',� SERVICE(S)"IN616ATED BY '-.0 ECKED 13
LOCK(S)
(AiMitio4i�ai,clz'a,iris r,these servicW -
required fo
Show ac!J�ess.� a
R� �,; I pteliver 0 114 Ly-
e ed -toiaddirbs
where-:deliv so�
EGE1 P.T.
e --#uirlb�h:d
-
EGISTERED.�NO.`.
ATURE OR NAME OFADDRE
CERTIFIED .:NO.,:
'S: -SENT,!j F---,A Ny�-�
NATURE"OF.'ADDRESSEE .A
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J NSLI R Q NO.:i
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fS -iqqWcsted,-:ari1 in6l�d�;
I-IM)WHERE, DELIVER4P z
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RECEIPT FOR CERTIFIED MAIL-300 (pips
426-02'3'0-0-'-'--
postage)
EDWARDS % G. BALLARD
-EQSIMARK
bA Irk
2 1710 - 76TH AVE . W.
EDMONDS,
X0
QD
WASHINGTON
-
30
C:)
— - 98020
OPTIONAL SERVIZI:!�L�!I�Ujjffjij Ajj� :: I !I
RETURN I. qDITIONAI ij:�::
Thows
I .
to whom and date del i i � I
RECEIPT With delivery to addressee only
SERVICES 2. Shows to whom. date
and where delivered
With deliverY to addresse ly
DELIVER TO ADDRESSEE ONL e on
—DELVERY_
IS
850'
SPECl-4L
�e�ra fee�7—
required) . .. ..... ........ ...
50e
PS Form
Apr. 1971 38010 NO INSURANCE COVERAGE PROVIDED—
(See other side)
NOT FOR INTERNATIONAL MAIL
GPO: 19700.397-.Sa
R0UTING FORM
2.
3.
4.
Ln-- .1 - -
L tial Date
message:
-7,1 0 - 741.
Z— K;� �OZ�� A.1 �V—�
V 7-;
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Firm-
----------
Date:
JE-7-72
7,54