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