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22014 99TH PL W.PDF9769 22014 99TH PL W 'Y 9 0 - 19 " - City of Edmon& Critical Areas Checklist The Critical Areas Checklist contained on this form is to be fil.led out by any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of a development permit 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). An applicant, or his/her representative, must fill out the checklist, sign and date it, R � -'7"' - � , E F�' I " D JUL 07 1999 INEPT. 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. With a signed copy of this form, the applicant should also submit a vicinity map or plot plan for individual lots of the parcel with enough detail that City staff can find and identify the subject parcel(s). In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) 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: Applicant Representative: . &g'FeE:�J L'4 fst4 Name Name f�&e -Street Address StrejAddress &IDS I -le,[_ o 5Ed City, State, ZIP Phone City, S Phone Ignature Date SignYaure Vate CA FILE NO. qq- I (q / Critical Areas Checklist Site Information (soils/topography/hydrology/veget2tion) I Site Address/Location: -Z2-0164 — PLI ail 2. Property Tax Account Number: �g,(5 7-1 - M1 - WZ - 00off 3. Approximate Site Size (acres or square feet): !7400 5�F= 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 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: /\/0 ; Approx. Depth: 7. Site contains areas of seasonal sta:nding water: /,/0 ;Approx. Depth: _ What season(s) of the year? 8. Site is in the floodway A16 floodplain A,� of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year- round? /Va Flows are seasonal? (What time of year? Rev 0 1/04/94 �/ "? C. 1 B 01 July 12, 1999 Warren La Fon 546 Paradise Lane Edmonds, WA 98020 CITY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221 DEVELOPMENT SERVICES DEPARTMENT Planning - Building - Engineering Subject: Determination regarding Critical Areas Checklist # 99-191 BARBARA FAHEY MAYOR Dear Applicant: Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City is located on the reverse side of the form (bottom of page). It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records. .............. ....... .............. TANT INFORMATION TO BE NOTED: PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT ADDITIONAL INFORMATION SUCH AS AN ENV IRONMENTAL CHECKLtS OR CRITICAL AREAS Swi2y. The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not'a project -specific determination. M10. You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION KITH ALL PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED. Permit applications include the following: Building Permits Conditional Use Permits Subdivisions Variances Applications to the ADB* Land Use Applications Any other development permit applications. Enc: Critical Areas Determination *Architectural Design Board C:ReceptionUana\CRLTR.doc Thank you. Sharla Graham Planning Secretary Incorporated August 11, 1890 Sister City - Hekinan, Japan PLANNING DATA NAME: 2 zZ SITE ADDRESS:- �DJATE: ;09' ZONING: E6 PLAN CHK#: 99 - Z11,15" PROJECT DESCRIPTION: 770/�-' L 6:�� _jPC1 CORNERLOT -(Yes/No) FLAG LOT Yes/No) SETBACKS: Required Setbacks: Front: '�� * Left Side'. 75� Right Side: 7,6� Rear: 15 Actual Setbacks: -16 4- Right Side: .5' Rear: Front, ell 6. Left Side: 7 Street map checked for additional setback required? (Yes/No) LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED _(Y/N LOT COVERAGE: Maximum Allowed:. �2'� —Actual: BUILDING HEIGHT: z 6 Maximum Allowed:- Actual Helght:_ DatumPoint: t_Ut_f1A0LAF_ LftD —Daturn Elevation: A.D.U. CREATED?: Tyh-n A L­ SUBDIVISION: CRITICAL AREAS 9: - 19 SEPA DETERMINATION: LOT OTHER: lz� Plan Review By: c%fi1=%perfnij%^p1&n&Ld= & 9 0 . 19 4 - City of Ed�non& Critical Areas Checklist 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 a development permit 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). An applicant, or his/her representative, must fill out the checklist, sign and date it, RECEIVED 9-% J U L 0 7 1999 DEPT. 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. With a signed copy of this form, the applicant should also submit a vicinity map or plot plan for individual lots of the parcel with enough detail that City staff can find and identify the subject parcel(s). In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) 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: Name Street Address City, State, ZIP Signature Phone Date Applicant Representative: 10 IL f�&e FMADI-5t ld� Strea Address ' City, State, ZI Phone 0 ?-, 0 S—ign-16me Efafe CA FILE NO. ?q- 161 / Critical Areas Checklist Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: -Z2.01� Vl— , 0J 2. Property Tax Account Number: 4;�' 0003, 3. Approximate Site Size (acres or square feet): !100 515= 4. Is this site currently developed? X yes; no. If yes; how is site developed? ;5�e_g rAMIL!�� 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 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: A10 _; Approx. Depth: 7. Site contains areas of seasonal standing water: INLo —;Approx. Depth: _ What season(s) of the year? Site is in the floodway 1�16 floodplain A,16 of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year- round? lv(g Flows are seasonal? (What time of year? 10. Site is primarily: forested ; meadow _; shrubs ; mixed urban landscaped (lawn,shrubs etc) X 11. Obvious wettand is present on site: Ve RevOUM4 City of Edmonds RIGHT-OF-WAY CONSTRUCTION 70 V0 PERMIT Permit Number. REET FILE k;sue Date: A. Address or Vicinity of Construction: 22014 98 P1 W 89 0 9C) B. Type of Work (be specific): Renew Service C. Contractor: Washington Natural Gas Company- Contact: Frank Swan MailingAddress: 815 Mercer St. Seattle, WA Phone: 224-2278 State License #: 98111 Liability Insurance: Bond:$ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. F] Commercial F] Subdivision El City Project g Utility (PUD, GTE, WNG, CABLE, WATER) rl Multi -Family EJ Single Family n Other INSPECTOR: INSPECTOR: AL -k b4 F. Pavement or Concrete Cut: 0Yes []No G. Size of Cut: 1 (2 x 4) H. Chargq�_$ APPLICANT TO READ AND GN INDEMNITY. Applicant understands and by his signature to this application, agrees to o the (City ofEdmonds harml wf�41,$rl-s�ddm.ges, or g i claims of any kind or description whatsoever, foreseen or unforeseen, that maybe ade ainst the City of Edmond �,_or any of its departments or employees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason ofgranting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A.PERIOD OF ONE YEAR F6LLOW1NW ,HE FINAL INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. Work and material is to be inspected during progress and at completion. Restorati ' on is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by.t�e City EnWheer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working da.0; NO EXCEPTIONS. Ihave read the above statements and understand thepermit requirements and thepink copyof thepermit willbe available on site at all or ins ec i . on purposes. Signature: Date: January 26, 1994 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK I � FOR-CITrY USE ONLY APPROVED BY: k A-1k RIGHT OF WAY DEPOSIT TIME AUTHORIZED VOID AFTER .4190(- 13DAYS DISRUPTION FEE/FUND Ill: 108 SPECIAL CONDITIONS: 126 RESTORATION FEE: 1PA\1f7NA4FA)J PERMIT FEE: �O Q 0 COMMENTS: TOTAL FEE: RECEIPT FEE: . 9 AP DATE: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Enj . ,rg. Div. 1991 FIELD INSPECTION NOTES Comments: � Diagram.: CONTRACTOR CALLED FOR INSPECTION Partial Work Inspection by P.W.: Work Disapproved By: FINAL APPROVAL BY: (Fund 111 - Route copy to Street Dept.) Date: Date: NO .0 Ww,Nr ton .. - q.- NaUX-51 d�� AV,b"Von&WWC-T=rV jZeAtatO 5e1ZVIfX- Z 7- 0 / 4, 9 6 & 0 Addendum to City of Edmonds Right of Way Permit Application Submitted by: Guyla Connors Engineering Aide Washington Natural Gas 521-5248 C� f Z >eer- -6 U 7- WNG to window Water main depth Key: -W- water Unknown -9- gas - gas main -Ss- sewer -19- water hydrant 0 water valve 815 M=cr St. (P.O. Box 1869). Sc&ttk, WA 98111 (206) 622-6767 - - :-A 21TY OF EDMONDS PUBLIC WORKS — oinEtl- FILE ACTION REPORT Date: Time: 4�?, 3D SUBJECT: SUSPENSE DATE: File # Attachments: REQUESTOR: NAME: ADDRESS: A PHONE: REQUEST RECEIVED BY: TELEPHONE CONTACT IN OFFICE RECEIVED BY: Pn11TF Tn- N? 1629 - =Yes =No MM UMMM"M BE All Concerned Notified Action Completed/File - --- - - ------- - - - - - - - - - - - - - - - - - - - - - - - - - - EX15TING HCU5E EL. NEW GARAGE ADC)ITION EL. 51.4' 06LAB EL. 511' - - - - - - - --- ----- - 1;4 ---- - - - - - - --- -- - - - - - - - - EL. S10 e,,41-97Z- PAI x �61 FTG,71 0 NEW 5ETE ED IVEWAY EL. WX N 1* 05' 40" E 90.00, ...... ...... 7;eAe TV/? 161-L RECEIVED JUIL 0 9 1999 DEVELOPMENT SERVICES CTR. CITY OF EDMONDS AlE STI-IFE-T F APPROVED BY PLANNING STREET FJL9x City of Edmonds RIGHT-OF-WAY CONSTRUCTION (Y 9 0 - 1 9 9 - PERMIT Permit Number: Issue Date: A. Address or Vicinity of Construction: /. Z U 114 99 Flace west B. Type of Work (be specific): Install New Service C. Contractor: Washington Natural Gas Company MailingAddress: 815 Mercer Street, State License #: Seattle, WA 98111 D. Building Permit # (if applicable): Contact: Frank Swan Phone: 224-2278 Liability Insurance: Bond: $ Side Sewer Permit # (if applicable): E. E] Commercial E] Subdivision F-1 City Project [)g Utility (PUD, GTE, WNG, CABLE, WATER) F] Multi -Family El Single Family R Other INSPECTOR: INSPECTOR: F. Pavement or Concrete Cut Yes []No $1 ) G. Size of Cut: 3 x 4 H. Charge$ fa Gas APPLICANT T -0 READ KS_ 'IG N C, A INDEMNITY: Applicant understands and by his signature to this application, agrees IN! City of Edmonds hwmlessftont injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeen, that may be made against the City of Edmonds, or any of its departments or employ- ees, including or not limited to the defense of any legal proceedings including defense costs, and attorneyfees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIPAND MA7ERIALS FOR A PERIOD OFONE YF54RFOLLOWING THE FINAL INSPEC17ON AND ACCEPTANCE OF 7HE WORK ES77MAYED RESTORA77ON FEES WILL BE HELD UN77L THE FINAL S7REET PATCH IS COMPLE7ED BY CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE A PPLICANT, Construction drawing of proposed work required with permit application. `/ A 24 hour notice is required for inspection; Please call the Engineering Department-171-3202. Work is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulkiti6its as required by the eify hngin-ee'r. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. I have read the above statements and understand the permit requirements and the pink copy of the permit will be available on site at all timesfor inspection p Signature: _ /V Date: April 20,.1992 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK . . ..... . .. ... FOR CITY USE ONLY .......... . .... .. .... . . ... . ...... . APPROVED BY. . .......... ... -RIGHT . .. .... .. . ... ......... ....... TIME.:AUTHORIZED VOID:: :..JAAY 30_:� AFTER, :DAYS: .,�:DISRUPrION::FEE/FUND:l�1.1:.��,: :'SPECIAL,CONDITIONS:. FAe;e . . .... RESTORATION FEE: .... .... ..... ry . .. . ... . ..... . .... . .. PER.Mr.T.F.EE:.. .......... .. . . . . . ..... .... .. ....... .. ....... - ...... ...::��:::�:7.OTAL: ..... .... .... .. . . .... .. .... ... . . . ....... FEE.: . ... .. ..... . ........ .... ............ ........... :'COMMENTS ..... RECEIPT.NO:.... �_DATE: ......ISSUED BY:: SHALL BEGIN PRIOR TO PERMIT Engrg. Div. 1991 FIELD INSPECTION NOTES (Fund I I I Route copy to Street Dept.) Comments: Diagram: CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng. Div. July 1985 Ai—�— Aw�- Washington=--- Natural Gas — A v-wvxjm Ei ei wy CcmDvw Addendum to City of Edmonds Right of Way Permit Application Submitted by: Kerry Walsh Engineering Aide Washington Natural Gas 622-6767 x2761 14 99 PL, w pager WNG to window P Water main depth unknown 2- 11 gas main � C �,2K 4� 0 rs. 3-�'5- 108"0 C;) OF.-) eVeV-6--AEN)r—Y UEA-Y- 6 WL114 It'i 130 CA-Yc-�, Key: -w- water -g- gas -ss- sewer water hydrant 815 Mercer St. (P.O. Box 1869), SeatUe, WA 98111 (206) 622-6767