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21911 88TH AVE W.PDF111111111111 8500 21911 88TH AVE W 06/12/97 THU 10:24 FAX 339 5254 1� SNOHOMISH I *T1 3020 Sucker, Ev-drett, WA Water/Wasle ENVIRON HLTH DIV FOR POS USE ONLY JUN 2 3 199'? PDS PLAN CHECK #— ENWNEERING' SEC-63/GMA Compliance Required? YES N:) REQUESTFORA HEAL71H DISTRICT CONSTRUCTION CLE4RANCEANDIOR WATER sUppLyCOA#MffNr Property Tax Account Number: S- 0-C z - o)o 0 0 2- - 0 0 0 Owners Name: /4�/ e,o Phone: �24 6 - 7 7:� - MailAddress: 919-:�111 City: —r-7 i Contact Person: f- Im n Phone: I ��r - .-� 4 1-� Mail Address: City: )52111011�Aj 23p: C) SITE ADDRESS; 7- ? 41 9 ,,f CITY - SITE LEGAL DESCRIPTION AND LOT '�4 Z /Old Li�- -SP #A:-lat name Is Septic System/Drainfield: d INSTALLEDJEXISTING* 0 PROPOSED NOTAPPUICABIX LL— *if installed/exIstIng, approximate year of installation I ?, (,- !r Has a now onsite sewage disposal system application been made to the Snohomish Health DisMet in conjunction with this proposed building project7 LU _ yes no. ;.,v Indicate source of water- 0 INDIVIDUAL WATER SUPPLY X PUBLIC WATER SYSTEM Has an individual water supply ap licaicin been made to the Snohomish Health Disthct in conjuncticri with this building project? yes no XP 'J,4, Explain building project and its use (SFR, addition, shed, etc.): Cf.) is plumbing for any structures. 0EASTING 0 PROPOSED OTHB(ISTING(PROPCiSED/vo Indicate total number of bedrooms before and after construcdon: ATTACH A COPY OE PLOT PLAN - 8 1/2' x 11' minimum showing: 1. Dimensions of Property Lines. 4. Location of Septic Tank and Drainfield, If known. 2. Dimensions of Existing Structures and 5. Roads, Easements, Driveways, Pwidng and Pavement Areas. their distances from Lot Lines. 6. Location of Water Well. 3. Dimensions & Description of Proposed Construction. 7. North Arrow' NOTICE; A Review F a May Be Payable Upon Issuance of the Building Permit SIGNATURE OF APPLICANT- DATE; 7 �FOR HEALTH DISTRICT USE ONLY WATER SWPJ?-LY--1hF-Q8MA1LQ&- (If Required By Building Department) Appears to be consistent with recommendations contained in "Guidelines for Determining Water Availability for Now Buildings*, issued April, 1993 as per Section 63 of Growth Management Act (GMA). Does not appear to be consistent with recommendations contained In 'Guidelines for Determining Water Availability for New Buildings', issued Apdl, 1993 as per Section 63 Growth Management Act (see attached shoot for deficiencies). ONSITE 5gWAGE DISPQ�Al- SYSTEM S75 Fleld Flevi $40 OffiGe RevIew APPROVED: CONDITIONAL APPROVAL El DISAPPROVED: REVIEWING SANITARIAN: DATE: 13UILDING CLEARANCE APPRQVED: BASED UPON REVIEW OF THE ONSITE SEWAGE DISPOSAL SYSTEM INFORMATION AND, WHEN APPLICAE� �TH5 WATER SUPPLY INFORMATION. REVIEWING SANITARIAN: DATE: bl-lf 7 rcv031497je JUN 12 '9? 11:24 339 5254 PAGE.01 HEALTH DISTRICT #102 96201-3971 Water Section 339-5270 M is 0) LO 00 C\j Sharpe 21911 88th Ave. W. Edmonds Proposed New Bath (Hot Wtr Htr x 2�"tr 22�t22 00 3011 C\j V— x (D co ZT 1 11 0 < rn 4211 — 3411 1191, OD C\l 30" 3211 = I I ;�k x = > C) CV) CY) r- 14. P, I BEDROOM MASTER BEDROOM (tit APPROVED Date ; 6-12-q7 SNO)IOMISK H EA! - 7 H DISTRICT BEDROOM EXISTING BATH LIVING ROOM KITCHEN BATH TO DECK CLOSE /-/�z/Z /Z /I NG EXISTI /I ylffilll,�, OPENING GARAGE Sharpe 21911 88th Ave. W. Edmonds Proposed Layout 1/4" = 1' EET FILE CITY OF EDMONDS 250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221 '9RJ COMMUNITY SERVICES DEPARTMENT Ammm— 4;) Public Works 9 Planning * Parks and Recreation @ Engineering 9 0 . 19 C� February 16, 1993 Occupant 21911 - 88th Ave. W. Edmonds, WA 98026 Dear Property Owner: LAURA M. HALL MAYOR As you may already be aware, sewers are available for your place of residence. This can be accomplished via Olympic View Water and Sewer District. The main sewer line for connection is located on 220th Street Southwest on the south side of the road. At this time, there is no absolute requirement to connect to the sewers. However, the city does reserve the right to require hook-up within 60 days if septic system failure occurs or other health hazards exist. Following the.procedures listed below should help and simplify the installation process and minimize the inconveniences: 1. You will need to acquire a side sewer permit from Olympic View Water and Sewer District. The cost will be $35.00 for inspection. If you have not paid assessment frontage already to Olympic View Water, you will be required to pay a $7.00 per frontage foot of your lot in addition to the $35.00 fee for inspection. There is also a $856.00 general facilities fee that is required by Olympic View Water District. 2. After you have completed the above, you will need to have a bonded contractor do the crossing on 220th Street to the property line. The contractor must obtain a city of Edmonds of Right -of -Way permit for $30. A patch restoration will be approximately $150 for a 3' X 60' patch. 3. You should contact Olympic View at 774-7769 for their inspection schedules and requirements. 4. After your inspection is completed, you will have two (2) days to collapse your septic tank lid and fill the tank with sand or pea gravel per Uniform Plumbing Code. Please feel free to contact me at 771-0235, extension 349 should you have any questions Thank you for your cooperation, 'R4on Aoi�&n"C Water/Sewer Supervisor RH/l k OV/CONN/TXTWATER 9 Incorporated August 11, 1890 0 I;i, . ;tpr C.ifip- International — Hekinan. JaDan 8 -1-alsomp— C) 9 0 - 19 February 16, 1993 CITY OF EDMONDS 250 - 5TH AVE. N. s EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221 COMMUNITY SERVICES DEPARTMENT Public Works e Planning * Parks and Recreation e Engineering Patricia Sharpe 6888 Friars Rd. #422 San Diego, CA 92108 Dear Property Owner: LAURA M. HALL MAYOR As you may already be aware, sewers are available for your place of residence. This can be accomplished via Olympic View Water and Sewer District. The main sewer line for connection is located on 220th Street Southwest on the south side of the road. At this time, there is no absolute requirement to connect to the sewers. However, the city does reserve the right to require hook-up within 60 days if septic system failure occurs or other health hazards exist. Following the procedures listed below should help and simplify the installation process and minimize the inconveniences: 1. You will need to acquire a side sewer permit from Olympic View Water and Sewer District. The cost will be $35.00 for inspection. If you have not paid assessment frontage already to Olympic View Water, you will be required to pay a $7.00 per frontage foot of your lot in addition to the $35.00 fee for inspection. There is also a $856.00 general facilities fee that is required by Olympic View Water District. 2. After you have completed the above, you will need to have a bonded contractor do the crossing on 220th Street to the property line. The contractor must obtain a city of Edmonds of Right -of -Way permit for $30. A patch restoration will be approximately $150 for a 3' X 60' patch. 3. You should contact Olympic View at 774-7769 for their inspection schedules and requirements. 4. After your inspection is completed, you will have two (2) days to collapse your septic tank lid and fill the tank with sand or pea gravel per Uniform Plumbing Code. Please feel free to contact me at 771-0235, extension 349 should you have any questions Thank youf.�ir your cooperation, Ron Holland Water/Sewer Supervisor RH/l k OV/CONN/TXTWATER * Incorporated August 11, 1890 0 l,i-,tpr Cities International — Hekinan. Jat)an I 10�' S t . 18 9 "') CITY OF EDMONDS 250 5TH AVENUE NORTH - EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221 COMMUNITY SERVICES DEPARTMENT Public Works 9 Planning * Parks and Recreation * Engineering Date: November 13, 1996 Project No.: TO: 'Pat Sharp 21911 - 88th Ave. W. Edmonds, WA 98020 Re: Transmitting: Information you requested As you requested x For your file For your -information For posting in public place As we discussed For signature and return For appropriate action BARBARA FAHEY MAYOR &�0_4a /1 6 4 �_ ReMarkS: Dear Ms. Sharp, here is the information you requested. Please contact me if'you have any questions. TRNSMTL.DOC Signature Don Fiene, P.E., Hydraulics Engineer Printed Name and Title 0 Incorporated August 11, 1890 0 Sister Cities International --Hekinan, Japan V Q-) UO 00 CO 8934 In CIO NOT ON NOT ON NOT ON SEWER SEWER SEWER 21904 21904, 21903 NOT ON SLIM NOT ON NOT NOT NOT 21914 SEWER ON ON ON ON NOT ON ON 21911 8713 SOVER SEWER SEWER SEWER SEWER SEWER NOT ON 21922-- SEWER In Ln Lr) 21919 Q) Q) Q) 0) NOT ON 00 NOT ON 0) CO SEWER SEWER ON 21930 SEWER 1 8725 220TH 22014 '?,91124 22019 1 22021 OD 8 . NAME ADDRESS PHONE NUMBER LEVEL 6F INTEREST COMMENTS Simoneau, Irene 8905 220th St SW_ Unlisted Unknown ISlight Wy-hre, Marion 8929 220th St SW (360)794-5225 Unknown, Call Back Rental McConnell, David 21922 88th PI W 546-9380 Rental, Need Cost Info Wood, John W. Jr. 21904 88th Ave W 776-7222 -778-1226 Unknown High Interest Believed Flink, Patrick "Wunn, 21930 88th Pl. W Unknown.left Message Rental Carolyn 8917 220th St. SW 778-0532 Unknown,left Message Coe,Susan 21903 88th Ave W 778-7929 Very Interested Guilmet, June W. 8725 220th St SW 776-5223 Slight Interest Need Cost Info Barrettt, Geraldine 21914 88th PI W 776-8262 Not Interested Weber, Richard 2195T8_8th PI W 776-9002 ' WotInterested Smith, Jack 21911 88th Ave W_ 776-9499 Very Interested Son-in-law of Owner Eangford, Rose 21919 88th Ave. W 776-7567? Very Interested— 4�- t . 189' May 20, 1996 CITY OF EDMONDS BARBARA FAHEY MAYOR 250 5TH AVENUE NORTH 9 EDMONDS, WA 98020 * (206) 771-0220- FAX (206) 771-0221 COMMUNITY SERVICES DEPARTMENT Public Works 9 Planning o Parks and Recreation o Engineering 9 Pat and Kim A. Sharpe 6888 Friars Road #422T San Diego, CA 92108 Ali 1.11 DIN EM TUT-171130714 17M Dear Mr. and Mrs. Sharpe, m"Ja 51'-Lo /?� As you may already know, sewers are available for your place of residence but your residence is not connected to the system. The main sewer line for connection is located on 220th Street S.W. on the south side of the road. Although there is no absolute requirement to connect to the sewers, the City does reserve the right to require hookup within sixty (60) days if septic system failure occurs or other health hazards exist. We are attempting to determine the interest in. sanitary sewer service within your neighborhood. Please contact me at (206) 771-0220 or by mail to the Engineering Division, 250 - 5th Ave. N., Edmonds, WA 98020 regarding your interest in connecting to the sanitary sewer system. Sincerely, DON FEENE, P.E. Hydraulics Engineer DF/JCW/sf SHARPE.DOC 0 Incorporated August 11, 1890 0 Sister Cities International — Hekinan, Japan -1.0 C. 1 S913 CITY OFEDMONDS 250 5TH AVENUE NORTH - EDMONDS, WA 98020 - (206) 771-0220 '- FAX (206) 771-0221 COMMUNITY SERVICES DEPARTMENT Public Works 9 Planning e Parks and Recreation * Engineering Date: . June 13, 1997 Project No.: To: Snohomish County Health District 3020.Rucker, #102 Everett, WA 98201-3971 Water/Waste Water Section BARBARA FAHEY MAYOR Re: Request.for a Health District Construction Clearance and/or Wnt-gr Supply Comment Owner: Kim Sharpe at 21911'- 88th Ave, W-, Edmonds, WA Transmitting: Necessary d- As you requested x For your file For your information For posting in public place As we discussed For signature and return For appropriate action x Remarks: If you'have any questions, please contact me at (425) 771-0220. extpnsion 323 Signature FrA e E.. �,d rCA L; 11 (. I E PQ Printed Name and 17de d TRNSMTL.DOC Incorporated August 11, 1890 0 Sister Cities International — Hekinan, Japan 06/12/97 THU 10:24 FAX 339 5254 ENVIRON HLTH DIV 16001 SNOHOMISH 3020 Rucker, Everett, WA Nai!25V Water/Waste FOR POS USE ONLY PDS PLAN CHECK 4 SECZYGMA Compliance Required? YES N:) REOUESTFORA HE4LTH DISTRICT` CONSTRUC77ON CLE4RANCEANDIOR WATER SUPPLYCommENT Property Tax Account Number:FOCZ -00o -o 6 2- - 0 0 0 41 HEALTH DISTRICT #102 96201-3971 Water Section 339-5270 Owners Name: -Asi LrAet rio C., Phone: 7 76 - ?4ZPf Mail Address: 860744 Xi/e, 441. - city: 0Af a/,r zp: Contact Person: fm YN )e tl-eAt M0113 i r-7) E Phone: Mail Address:. 2S0 Ax &J city. E7401"'O'�,b 0<. -24x 13�c)-L3 .- 0' srrE ADDRESS; 7-/ h?.G,00'X Wile aTy- z:rs0P, a#-:, A6 SrrE LEGAL DESCRIP11ON AND LOT /04 Of 0 A, (Y�.SP #Pat name Is Septic Systemi/Drainflold: INSTALLED/EYJSTING* 0 PROPOSED NOTAPPLICA13LE 'if installed/existIng, approximate year of installation. ---a 6 -1� Has a now onsite sewage disposal system application been made to the Snohomish Health District in conjunction with this proposed building projecr7 _ yes —Y_ n o. Indicate source of water: 0 INDIVIDUAL WATER SUPPLY PUBLIC WATER SYSTEM Has an individual water supply 7 rl* �ion been made to the Snohomish Health Dislhct in conjunction with this building project? F yes —�,4� no Explain building project and ite use (SFR, addition, shed, etc.): C� 92 of e- /0 Is plumbing for any smjcftm-. Os=NG 0 PROPOSED "THEXISnNC-4PROPOSED/V0 Indicate total number of bedmome before and after construction: _3 / A ATTACH A COPY PE PLOT PLAN - 8 1/2* x 11' minimum showIng: 1. Dimensions of Property Lines. 4. Location of Septic Tank and Drainfield, If known. 2. Dimensions of. Existing Structures and 5. Roads, Easements. Driveways, Parking and Pavement Areas. their distances from Lot Lines. 6. Location of Water Well. 3. Dimensions & Description of Proposed Construction. 7. North A"ow' NOTICE; A Review F 9 May Be Payable Upon Issuance of the Building Permit ,7 SIGNATURE OF APPLICANT: DATE: k, Af 7 FOR HEALTH DISTRICT USE ONLY WATER SUPPLY INFORMATION! (if Required By Building Department) Appears to be consistent with recommendations contained in "Guidelines for Determining Water Availability for Now Buildings', issued April. 1993 as per Section 63 of Growth Management Act (GMA). E] Does not appear to be consistent with recommendations contained In 'Guidelines for Determining Water Availability for Now Buildings'. issued April. 1993 as per Section 63 Growth Management Act (see attached sheet for deficiencies). ONSITE �gWAGE DISP F In Fleld C3 $40 Office -Review [_-] APPROVED: El CONDITIONAL APPROVAL: 0 DISAPPROVED: FIEVIEWNG SANITARIAN: DATE: 0 BUILDING CLEARANCE APPRQVED: BASED UPON REVIEW OF THE ONSITE SEWAGE DISPOSAL SYSTEM INFORMATION AND, WHEN APPLICABLE, THE WATER SUPPLY INFORMATION. REVIEWING SANITARIAN: DATE: rcv03J497ie JUN 12 -'97 11: 24 339 5254 - PAGE.01 UZ/Ul MUN UU:21 FAA.339.5254 EN VIRON ELTH DIV lao0i SNOHOMISH ENVIRONMENTAL HEALTH DISTRICT HEALTH DIVISION 3020 RUCKER, *102 EVERM, WA 9a201 (206) 339-8250/339-5270 FAX NUMBER (206) 339-5254 The Facsimile you are receiving was sent on a Canon Laser Class 6500. THE EqrORMATION CONTAINED IN THIS COMMUN�CATION IS INTENDED ONLY FOR THE USE OF TNE ADDRESSEE AND MAY BE CONFIX)ENTIAL, MAY BE PROFESSIONAL -APPLICANT PRIVILEGED AND MAY CONSTITUTE INSIDE INFORMATION. UNAUTHORIZED USE, DISCLOSURE OR COPYING IS STRICTLY PROHIBITED, AND KAY BE UNLAWFM IF YOU HAVE RECEMD THIS COMMUNICAT3[ON IN ERROR, PLEASE DeSMI)LATELY NOTIFY US AT (206) 339-S210. q7 NUMBER OF PAGES- induding this cover sheet TO, FAX NUMBER:a26d&_/-0/<// j , - e �—=? 0 = 0 = e F==*%, V FF,CM jo/ water and wastewater Section/Enviro=ental Realth Division DS"'T.- Snohomish Health District PHONE NUMBER/EXT: (206) 339-5270 ME!35AGE. Property Tax Account No.: Site Address- , F ?/- Y , 4t /4-7 Year House Built: SP # / Lot #: - 420a Aj requested the following items are faxed: JZJ Copy of the existing drainfield 'as -built' on file Copy of the approved (proposed) septic design on file Copy of the current certified septic designers/initallers/pumpers Other. C:1 With the information provided above. we have searched our records and were unab to locate a drainfield as-buitt that you requested. Please contact a certified septic designer (list enclosed) if you need to locate your septic system. . LONG DISTANCE TRANSMISSIONS REQUIRE SUPERVISOR SIC -NATURE Supervisor Signature rev 082895le JUN 02 '9? 10:21 339 5254 ' PAGE.01 1(40/UZ/97 MON 09:22 FAIL 339 5254 ENVIRON HLTH DIV SNOriOMISH HEALTH DISTRICT DIVISION OF SANITATION 3011 Rockefeller Avenue, Everett, WashilIBIOn APPLICATi�,-!'J FOR A SEWAGE DISPOSAL SYSTEM PERMIT - (Submit 3 CoPi*4 Permit to be i%ucd to ......... /-.'. 4 - - ..... . ... ............. ..... - ... ....... .............. ........... For installation at% (street address) .............................. . ........ ... i�? ........ ......... ........... . .................... . Add'..tion or Subxilvision ........ 1;%r,#46P1Z ............. . .. . ....................... Lot Block ....... :7= ... Type of Building: '.slew ..... 4,1' adsting ........... Single family residence ....... 4<... Number or bedrooms ...... ;n� ............. Other: (specify type or we) .......................................................................................................... ... V ......... ......... . .............. V. d6% xv, —, . .Builder .... A.. ... 2—.42.4-1 ........................ Address ... .... .. � . ........ Designer..- . .................. . Addrefis. I Log Hole No. 1 ..... ... .................................... ....... . . . .. ............. .... ............... ... . SoL D- ........................................... . . ............................. ...... .. ... SoilLog Hole No. 2 ....... . ..................................... . .. . ........................................................ ........ ....................... . ........................................ . .......... .......................................................................................... . ........... . Elevation of Water Table, if encountered. (Distance from ground surfacc) .... ......... . ............................ water if needed ..................... --SAZ--D . ........ ................ ...... ....... Corrections to control surface . ............. . ........... ..................... .. I .... ... ........ ... ......... ................ . ... 11 ...... . ......... ............................................................... .................. Specify if any removing or grading of topsoil in field area ......... � . . ..... . .......... .................... ...... . ............. . ...................... ........... . ....... I ................ . ......................................................................................... Percolation: (Fall in minutes/irich-bottan; 6" test hole) Test Hole No. I —Average Rate ........ 0'-:5,7 x? .......... - . . Test Hole No. 2—Average Rate ...... ........ . ............... .. .. (Fall in ininutLs/inch-bottoin 6" test halo) Test Hole No. 3—Average Rate ...... /-0, e ....(Fall in minutcs/inch-bottont 6" -e3t holc) min- field d Averap percolation rate an which to base d esign Date Tiken.4 Scptic tank requirr-mcnU based an present rults and regulatim": Septic Tank Size ...... 11 .. C� .... gallons. Amc-.int of Square Feet of Disposal Signature — Designer.::�� ........ . ...... .......... .... . Date ..... C- Do NOT WRITE BLLO V T-HIS LINE-!!Ta,.�e completed b- Issuing Agency) ...................... Pet -mix Ntmber ........... /--7 ... Permit issued (dmte)...7- Remaiks: ......... . .... .... ......................................................................... ........... ............. . . ... .. ...... . .............. ........ . ............ ............ . ............. — .... . ... . ...... ......................................... ...................................... I ............. ......................... . ..... stalls JTUN 02 '97 10:21 339 5254 PAGE.02 N MON 09:22 FAX 339 5254 ENVIRON HLTH DIV Z003 low'. lmw, NNW& A SNOHOMISH HEALTH DISTRICT DIVISION OF SANITATION 3*311 Rock0eller Avanue, 2verefl, Washington '4EPTIC TANK INSTALLATION PLAN to 61111111110001 (Submit in Triplicalej ADDRESS OF PROrr.11-n- Owner..... Address 1730JO. p hone ... elf1_1778 10 Builder... ... .. ..... . .. ... .... .. ..... . . ....................... Phone ............... Dejignex. q5'.A,?iP_nrz- ..�.Ass.oc. Address . Box... 1.6—OMPIRE Fh=c..tl..O I .. &..=044 Installer ...... k 1 r_t4 MP N D.. _ Co mc ap—TrAddr...24 ... 1.7 I hereby certify the ICLOnlpanying drawing ir an accurate %presentation of the system insta*Ilad at the listed address. I Aso certify all recnini-nendafe'ons and restrictions (comccrining plumbing stub clevatiom, m2intenance -.)f g"acics, fills, Atirfarc 4rains, ctc.) listed by itie on jjiy sem-age disposal wswin Permit applicatic-i dated ................ 4,nr—lowc bv:n crionIticd %vith. ne::: . . . ........ ..... ... ............... le TO BE FILLED IN 131" HE/uU1*H DEPAIVI'MENT ONLY Accepted...: . . ...... ........ ... 46'** .. ....... . .. ....... Datc... Not Accepted ......... ....... D.Ite .............. ... . ....... ...... .. Signature of Salikarian .............. e _. kemarks: .............................................................. ...... ................ ................... ....................... ........................................................ I ......... ................ ...... . I ................................................................................... ....................................................................... STRUCTIONS: Use the i-evcr.%c side of this orm foi- the ditwing. Usc n 1c;%le %vilicl, will Permit the greatest detail and still conwi_ f�e entire situ on one page. ATrLNTION HOME OWNER: Your septic tank Las lindt-1ons! It was designed and installed to cam for an a%,cragc_si),.c family. Over� loadio., the .1eptic Lank or d1swr6alicc of thc drain -field juay suriously ittip-tir satisfactory operation. Points to 1. Have ,,r tank checked periodically to see it pulliping is ncce=ry (2Y2-3 years). 2. Do not rhinnal ground water, surtaCL Water, looting drains or downspouts into the tank or drainf'icld. 3. Do not xc2vatL, fill, Pl=c a structure, driveway or patio in, on, or over the drainfield. 4. Limit toilti, fixture disposal to Unftary wList" knd toilet tiMic. 5. U04--rip-IlLs and bleachLi tisrd in norinal liotiAeljola tIti-,1111ities %vill not (Ile action of tile Septic tank and disposal field. -now% JUN 02 197 10:22 339 5254 PAGE.03 UA/01 MUIN UV:Z4 rAA JJU 0204 ENViRON HUH DIV 16004 14 I I V Ke -0 1* Wow JUN 02 '97 10:23 339 5-254 PAGE.04 LO I Sharpe 21911 88th Ave. W. Edmonds Proposed New Bath 00 Hot Wtr Htr 22" x 22" 3011 C\l 7- x CV) 4211 3411 11911 30" 3211 X (D > C CO a) #P20 Critical Areas Checklist CA File No:O Y —00 q S Site Information (soils/ topography/ hydrology/vegetation) 1. Site Address/ Location: 2jT1j qr9/11 e"'/ Z '7� 4r 2. Property Tax Account Number: oo a; 0 0 2- If 51 0 3. Approximate Site Size (acres or square feet): go -1, 4. Is this site currently developed? X yes; — no. -kj C'ri- 6 If yes; how is site developed? 5. Describe the general site topography. Check all that apply. XFlat: 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: 0 Approx. Depth: What season(s) of the year? 1 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) X 11. Obvious wetland is present on site: 1. Plan Check Number, ff applicable? 2. Site is Zoned? E6 3. SCS mapped soil type(s)? For City Staff Use Only 0% 4. Critical Areas inventory or Ct map dicatetnitical Area on site? "J 5. Site within designated earth subsidence landslide hazard area? DETERMINATION S L--� WAIVER STUDY REQ Reviewed #P20 �'o C. 1%9V City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 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 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 potenfial 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 (Crifical areas inventories, maps, or soil surveys). Date Received: City Receipt#: 0 c0q? 5— Critical Areas File #: CA —7- Critical Areas Checklist FZ,,.-- L$13§.00 Date Mailed to Applicant: 1 -0 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 Ep!er�mit a �lication. Please submit a vicinity map, along with the signed copy of this form to assist City staff in fmding 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. 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 oFAPPLIcANT/AGENT C, - DATE 9 / -?, - "? -j -7 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 postTg. attendant to this application. SIGNATURE OF OWNER DATE PLEASE PRINT CLEARLY Owner/Applicant: Name Street Address L��o :-,-c city State Zip Applicant Representative: Name Street Address City State Zip . " ", if:, Telephone: Z 72 Telephone: Email address (optional): Lo c -�; A,4 fi Pe- &,) i y AJc). Email Address (optional): e__ C 147 "AILL 88" Ave W (Cntr) Private Drive C�... . .. . .. . .. . .. — —Street Edge . .. . .. 0 Ln 16-3" CL LU > cl-i 0 V== 0 w Z 0 bij E APPROVED FIRY> DFWA�� RECEOVED SEP - 2 2000 BUILDING DEPT. 5""TREET FILE