21819 95TH AVE W.PDF111111111
9291
21819 95TH AVE W
CA File No: 6A
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: 02,10 95 ts" A,-V5
2. Property Tax Account Number: T 7 000 0 10 00
3. Approximate Site Size (acres or square feet): 4
4. Is this site currently developed? yes; no.
X
If yes, how is site developed?
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 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: Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain -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? - (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
Critical Areas Checklist.doc/3.19.2001
015"*9 /Oz/v ee# 0 /, Z 8 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).
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 f6hfi to assi . st 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 assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnif�,, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from 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 application on the behalf of the owner as listed below.
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 staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
X SIGNATURE OF OWNER
Owner/Applicant:
C ) AnAl
Name
7-1 K-- Z9 !�ZCA— Ae
St�re�eAddress
N'If 0 1
City State Zip
DATE
Applicant Representative:
Name
Street Address
City State Zip
Telephone: Telephone:
Email address (optional*): 14*e416 P101-1&1 Email Address (optional):
CqT6) q2,��>--W44.,-
Critical Areas Checklist.doc/3.19.2001
ee# 0�, 80
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
4C. 1%
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).
HEET Ell E
Date Received: ff/&/P/
City Receipt#:
Critical Areas File M
Critical Areas Checklist Fee: $45.00
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 assessment of the site.
The undersigned applicant, and his/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 from 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. 0
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 application on the behalf of the owner as listed below.
SIGNATURE oF APPLicANT/AGENT
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 staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
X SIGNATURE OF OWNER
Owner/Applicant:
)*0AJ N—A617
g
Name
StreetAddress
City State
Zip
Telephone:
Email address (optional):
P/01,1,001
logel,44-
Critical Areas Checklist.doc/3.19.2001
DATE
Applicant Representative:
Name
Street Address
City State Zip
Telephone: I
Email Address (optional):
0
Critical Areas Checklist CA File No: 0� _�)l -113
Site Information (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: C) C)15-T-0 A,\If,
2. Property Tax Account Number: 15TT) 000 0 10 0 0
3. Approximate Site Size (acres or square feet):. 4 ACre
4. Is this site currently developed? Xf yes; _ no. kone, 18VVIC41e�_ 4M,
If yes; how is site developed?
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 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-jq. (43yertical. 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: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway — floodplain —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? — (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
Critical Areas Checklist.doc/3.19.2001
PLANNING DATA
NAME: CLoor S TREE R s
SITE ADDRESS:- �-,i Ps%ct 0125aaue L,3.—DATE:-1B/ -a-
ZONING: 11-�- �5 PLANCHK#:
A0 a 11 *To] V I :A I P—MIRME-W.-
CORNER LOT (YeO'Nb) FLAG LOT (YesQ
SETBACKS:
Required Setbacks:
Front: 2-6' Left Side:--7 -5' Right Side:-j . G' Rear: IS
Actual -Setbacks: I I (DO
Front: 27 ' Left Side: Right Side: G Rear -
Street map checked for additional setback required? 0)
;L�
Q- 6-4��
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (YQ
LOT COVERAGE:
Maximum Allowed: 6c;40/n Actual:
S-rr-QC7rU&--L A.Ppjz� Ifs-5r4 t1V
B UILDING HEIGHT:
Maximum Allowed: &4-:Plo ---Actual Height:_ A L-r--,rS 7UAr,.')
Datum Point: Datum Elevation:
t.-7�r';L
A.D.U. CREATED?: r,(6
SUBDIVISION:
CRITICALAREAS#: Qi- lis
SEPA DETERMINATION:
LOT AREA:-(;?1CQ
,Cf�E�* I TI-A-r LO-V-- _ c4cc*,40
OTHER:
Plan Review By:
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APPROVED AS NOTED --
BY ENG31YN ERING
Date.
GUTTERS /DOWNSPOUTS
TO CONNECT TO EXIST. SYST.
-13 279 000 01 lb 00 ol-:�
-J3'L:K6k>b0
STR E E I T A LE
o-r = 0(2p 211�i 12'. F.
L.ocv,
9 0 0. F�, e2 4.12 �lo
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—L UTILITE15 e-,cJ577
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RECEIVED
AUG - 6 2001
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
15- I*--ol
NOTICE:
o
No"Wa -ra n y.. -a
The -inform ation'shown on the attached
Hed for use by the City Of
map(s) was com ' p
Edmonds/ its Empl-oyees and Consultants.
Th,e City of Edm.onds does not " warrant the
accuracyof anything set for.th on t * hese
M a P ('S*'-). A n . y person or entity -requesting a
copy.should c:onduct an.independent
inquiry regarding the InfOrmation shown, o
-Map(s), including, but not himited to,
c ion of any sew-er stub shown. Suc
the lo' at*
sewer stubs may or may- not exist and may
or may not exist at the location shown.
(-ity of EcArnond-AS/ nor its
Neit-heir the
M p-,-O-yee-s o*r off icers -shal] be a-b-Ife for thE
on this map(5), nor for
information give' d
any one representation provided base
upon'sald map(5).
F- APPLICATION
The City of Edmonds for EASEMENT NO . .......... ....... .........................
SIDE SEWER PERMIT
NEW CONSTRUCTION Fj REPAIRS 0 LID NO - ------------------ ASMT. NO - ------------------
OWNER-,. --------- .......... ---------------------------------- CONTRACTOR ------------------------------------------------------------------------------- PERMIT NO. ': ------- .........
JOB ADDRESS ---- ... \-V ----------------- LEGAL DESCRIPTION: LOT NO . ........... 1,e- �, -------------------- BLOCK NO . ....................................
.................................................. ............................................................................
----------------------------------------------------------------------
czcxj-_%p,
F-f=l
X- 1-1�1---�
..... ............ Dy
.I-,'
............. yuiq
7
-OF: EDM NOS- S111DE'SEWER OEM,
CITY
WATER -SEWER DEPARTMEN7,
TE,
'61
w n of the ,construction.
Gal�L 1.75-2525, for side �e' er Inspeictions7 BEFORE, covering, iany portio
at. INY'sat.,, Sun., or holiday Inspections#
Inspection, will! be pr�yided�withln� 24hour&..&fter requ
............................. ........................ ............................................
5)
LO0DA1T6N,-,'OF-'CONST. C T16N .... ...... fl,
ES 11 RU
ADDRI
................
............. ...........................................
PROPERTY LE I GiA1L ..................
I.DE9CRIPTION ............ ...........
..........................
.........................
........... ................................. ........................................ ...................................................
................... I ..............................................
a............. .......................................................................
wN�Ejt AND/OR BUX-11MER.
................ ........... ........ 0
..........................
'R .......... ..................... ... ..........................
RE ......... ........ ------- ........
CONTRACTORS".NAMIE�'& ADD SS 7 ............................
19u; t sewer
PennissloiVis, granted ............ ...... ........... for reildir. and
/or. connection of a side sewer to. thib- ty,,sanitary
...................
inaccord'anco with City of: Edmonds-ordihancesi'
`k"E.NT1*01 M -IS �CALLED TO.-TH M-FOLLOWING:
A licensed Side Sewer Contractor�must be employed to,construct
NOTE!--Nb� I—The,,,owner�,'of Ahe property -inELy obtairr a permit to construct sewer Inside, property line.
side,Rewci M street! area.. Vo not. cover any portion, of sewer"before it has been inspected.
it obtalnable from the'6ity Rngineer's- offici.
of Right -of -Way, Perm
NOTE� No'. �11� work. performed in city right -,of -way- requires �an Invasion
'NOTE'No. 3�O'btain "full' lnf�rmatlon. regarding Ordinance 11.16.630 and �Rejulations . governini,side sewers when you get permit.
rty line;' minimum grade. of 2%..,No!,bends in grade
NOTE No. 4 —Topi-of slde�,.,ewer must. have at least 30 In,chew coverage, at property line and f2Anchea inside prope
sharper than 'A, Wili be permitted. Contractors shall -,f p
NOTE No. 5-- 1 Trenches in street must be water'settled and surface of street restored to original condition. be responsible for allure� due to impro er
work,which, may develop within, one year of completion.
for 'in the -permit, or to, -do any work on the ma.Jn-seN�ier or its,mppurtenances except to in-
NOTE'No. :6—It: Is: unlawfuli to alter or do, any other work than I's provided
sertAhe pipe intoAhewye.
A001
Date........... * ......... ............... By ................
DISAPPROVED! E]'' Date ............. ................... ....... .... ................. BY ................ .
By ................ Date ......
.. ........................... .......................................................
....... lie-
C ..... .. ............. ... ....
A,PP,ROVED'. ....... 7 ......
........ By
Ulre
...... ...... ... . ............. ............................................. .................... .....................................
............. .......... . ..................................... I ....... .........
........................................ .......... ....................................... I ...... ............................................................... * ........
"Be,Signed By Owner -of Firm, Perf orining Construction PRIOR To Requ6st- For Inspection
BOM Permit Copies MUST
t 'under
this permit
.......... .... .. hereby certlfy�that'the: s de sewer installation cons ructed
....................
(0 o f'Con tracting Firm Performing, Construction)
wner
d 'in acc,6rdance-.M7ith- all. governing,ordinances. of the, City of Edmonds.
.19,;7
................. r� e� . ....... .
Date& this ..... ................. day of .........
yoll, 1p� ower Sewe Other 0, V
V;,,'.,Clfeck, BEFORE, dig for:. Wat6r.,0;,.' Gas Telephonei,,E];,
,e The City of Edmonds
APPLICATION
for
SIDE SEWER PERMff
NEW CONSTRUCTION El REPAIRS
EASEMENT
LID
---------------------------—-- —
-�Md- NO - ------------------
----------------------
OWNER. ------- - -------------------------------------------------- CONTRACTOR j - - ----- ----------------------- .- PERMIT NO.
-7-,4
JOB ADDRESS A8�1—? --- ----- -- — -------- t4 ------- - --------------------- LEGAL DESCRIPTION: LOT NO - ------- A? ----------------------- BLOCK NO - ------------------------------------
------------------------ ....................................... --------------------------------------------- ---------------------------------------------------
NAME OF ADDITION -------- ------- ------- --------------------------------
RECEIVED
AU G 3 1976
blic Works Dept.
DATE
BY--------------------------------------------------- YiHi�
Da te Se2tember 17, 1975
Memo to: Director of Maintenance & Operation
Public Works
From: City Engineer
Subject: Sewer Connection Charges
Legal Description:
Lot 18, Plat of R.C. Munger's Addition #3
RECEIVED
SEp 18 1975
Commonly known as: 21819 95th Ave. W. Owner: Kenneth Schwartz
Z.F.F. Calculation:
0 Z.F.F. x o $ 0 Connection Fee
o Lateral x o $ 0 Lateral Charge
1 Unit x $ 25 $ 25.00 Trunk Charae
$ 10.00 Permit
$ 35.00 TOTAL
*.Per agreement with developer of
Plat of Bellin,Gardens
cc:
Form 6
STREET FILE
CITY OF EDMONDS
ENGINEERING DEPARTMENT
505 BELL STREET
EDMONDS, WASHINGTON 98020
APPLICATION FOR INVASION OF RIG,HT-OF-WAY
(Submit In Duplicate)
Permit to be issuea to: 4 k 1,
For work at: (address or vicinity) 6 12 9,5 14 i1c"-, CU
Type of work to be done: W
(Attach Drawing When Applicable)
Owner: J< f to q —/ 2—
Name
A / F / ? — �' S— k-
Mailing Address
City State
f3o/D lkti:,
Name
7- 1/ G'O
7 7 Lrr - 4?� 7, �/
Telephone Number
'FC'J -t� 0 V4 d-S L", — �-q -t- - S-:5 1 -?
City State Telephone Number
Signature: iel� f - .19 u,9, 3
Owner or Agent Date Signed
DO NOT WRITE BELOW THIS LINE (To be completed by. Issuing Agency)
Permit Issued (date) Permit Number
,Rernarks:
NOTICE:
Upon issuance of -this permit, the contractor is responsible Work subject to inspection and restoration in accordence
for workmanship and materials for a period of one year with city code. A 24 hour notice is required for inspection.
following inspection of the restoration by the Engineering Call 775-2525
Dept.
CITY OF EDY'O'N])S
ENOINMING DEPA�Tiil-.NT'
Insp Dafe-. ............... By ...........
... Remarks-_;IWATAR� .... ZA��.W��L
Insp Date ------ ........ _By -------------------- - Remarkp—o
Insp Datt
....... By ................ --marks��— .. ..
........ Rc
lns.P'Dxte� By.
Qms. ...................... ------------------------------ --------------------------------------
y-
--I�v ..... DV. Lmt;
------------------- ....... - --------
*STREET FILE
Memo to: Direct or of Maintenance Operation
Public Works
From: City Engineer
Subject: Sewer Connection Charges
Legal Description -
Date Selatember 17, 1975
Lot 18, Plat of R.C. Munger's Addition #3
Commonly known as: 21819 — 95th Ave. W. Owner: Kenneth Schwartz
Z.F.F. Calculation:
0 Z.F. F. x 0
0 Lateral x o
I Unit x $ 25
*Per agreement with developer of
Plat of Bellin Gardens
cc:
$ 0 Connection Fee
$ 0 Lateral Charge
$ 25.00 Trunk Charge
$ 10-00 Permit
$ 35.00 TOTAL
Form 6
- - �c
REGARDING: 21819 - 95th Avenue West 40's-- 6-,?6 3WO
(address)
R E C 0 R D 0 F C 0 N T A C T S
DATE NAME, PHONE NO., & COMMENTS ACTION TAKEN INITIALS
ADDRESS of CALLER
2/13/76 Kenneth Schwartz Certified Letter No. 406741 sent Letter received. JT
requiring hook-up within 60 days.
4/14/76 Bob Aklin to install. JT
8/3/76 Bob Aklin obtained permit #5533. JT
8/4/76 Connection completed. JT
A-,
CITY of EDMONDS
200 Dayton Street - Edmonds, Washington 98020 - Telephone (206) 775-2525 ,
Department of Public Works
February 13, 1976
CERTIFIED MAIL*"75//
Mr. or Mrs. Kenneth Schwartz
21819 - 95th Avenue West
Edmonds., Washington 98020
Dear Mr. or Mrs. Schwartz:
City records indicate that you are the owner of the property located
at 21819 - 95th Avenue West, and that sanitary sewer service is available
to your residence. Homeowners abutting this sewer main installation have
sixty (60) days in which to connect to this sewer service following con-
struction completion, per -Edmonds City Code'. Enclosed, you will find
copies of applicable excerpts from the Edmonds City Code (11.16.020,
11.16.0013, 11.16.010, and 11.16.240), explaining connection procedures.
In accordance with the aforementioned City Ordinances, you are hereby
instructed to make the necessary sewer connection. Failure to accomplish
this connection within sixty (60) days from the date of this letter will
result in the termination of water service to the subject property, in
accordance with City Code 11.16.240.
Requirements for obtaining a Side -Sewer Permit are a plot -plan drawing
of the proposed connection, the legal description for the property, payment
of connection fees and copies of all recorded easements (where applicable),
and payment of the $3S Permit fee. Side -Sewer Permits may be obtained at
the Public Works Department, 200 Dayton Street, Edmonds, between the hours
of 8:00 a.m.,and S:00 p.m., Monday through Friday. Please phone Mr. John
B. Mitchell, Water/Sewer Superintendent, at 77S-2S25, extension,226, for
any information or assistance you may desire.
Sincerely,
SIGNED
J. HERB GILBO
Director
JBM: j t
Enclosures
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No. 406741
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TO Sewer Department
S
Public Works,
I
INTER -OFFICE COMMUNICATIONS
DATE January 19, 19 76
F R 0 M Richard H.. Allen
Assistant City &gineer JAN-20 1976
SUBJECT: Sewer for Plat of Bellin Gardens
7�-ie subject sanitary sewer has -been inspected and accepted for hook -
UP. It is now pen-nissible to issue side sewair pezrftits. For those
PrcPerties witIlin the City� abutting this sewer line that have not
made ccmectionsto date, a notice should be sent requiring ther.tc)
M"Inect within the tim lin-Lit as set -by Ordinance.' Connection b,1P_,1,os
have been made up and forwarded to your offioe for ead-i of the prop-
erties effected.
IM:mjr I