22319 76TH AVE W.PDF111111111111
6365
22319 76TH AVE W
ADDRESS: 0,-V � 7 711w
-7 A
TAX ACCOUNTIPARCEL NUMBER: S /0
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: q�?- q
RMINATION: E] Conditional Waiver E] Study Require aiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DA
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DA
SIDE SEWER PERMIT(S).fi: 115Y
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT 4:
WATER METER TAP CARD DATED:
LID #:
LOT: BLOCK:
76' Y- �Plj,,17c�
LATEMP\D.Srs\Fomis\Strcci File Checklist.doc
STREET FILE
a Z
C -tical Areas C
ri hecklist'
site Information
Project Name: Permit Number -
Site Location,: ygy2j,, Property Tax Account Number- 247.2-704-3-o6q-oc,611
ApproximAte Site Size (acres or square feet):
11ave you filled out a Critical Areas Checklist for a projea on this site before? 1410
General Site Conditions
1. Has the site been cleared or logged? Y,(f-..4 Date of most recent action:
Soils / Topography 6",", & 1 4W
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)?
3. Describe the general site topography. Check all that apply.
X Flat les's than 5 feet elevation change over entire site.
Rolling: slopes on site
generally less than 15% (a verticalrise of 10 feet over a
horizontal distance of 66 feet.)
)Mlly: slopes prc�mt on site of more than 15% and less than 30% a vertical rise
of 10 feet of horizontal distance_)
Steep: grades. of greaXer than 30% present on site.
comments
Hydrology/Vegetation.
4. Site contains areas of year-round standing water: A/0
5. Site contains areas of seasonal standing water- /V0 ---Approx. Depth:
6- Site is in the floodway floodplain X� of a water course-
7. Site contains a creek or an, area where water flows across the grounds surface? flows.
are year-round?' Flows are seasonal?
8. Site is primarily: forested meadow ;shrubs ;mixed la�,Ijrca�k 0
9.1 Obvious wetland is present on site: /t/O
10. Wetland inventory or map, indicates, wetland present on site: No,
11. Critical Areas inventory or map indicates any Critical Area on site: Kc,
--c-ity:p4e
-Arins tud I t d
-4--ff��WAIVER: Critkal S : yjs no requ.ire
Determination Number — VAt ---9 3 Reviewec!
Planner " - our.
Rey 3127n2
to
City of Edmon&
Critical Areas Checklist
The- Critical Areas chmust co, ntained on
d& form is to be filled out by any person
PrqMing a Development permit
APP"cadon for the MY Of Edmon& prior
tO hisfticr submittal ofa development permit
to the City.
The Purpose of the Cheddist is to enable
City staff to determine whether any potential
Ckitical Areas am or may be present on the
subject PrOPMLY. The infbrmation. needed to
coruPletc the ChOMist should be easily
a 'lable from observations of the site or
V=
data available at City Hall (Critical Areas
inventories, maps, or soil survcys).
An applicant. or his/her represcritativc. must
fill out the checklist, sign and date it, and
submit it to the City. The City win review
the cheddist. make a precursory site visit�
and make a determination of the subsequent
steps necessary to complete a development
permit application.
With a s4med copy of this form, the
applicant should also submit a vicinity map
Of the Parcel with enough dctail that City
staff can f ind and identify the, subject
parcel(s)- In addition, the applicant IS'
cncoumgcd to include any other pertinent
information or sttidics; 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
fachW,. to the best of my knowledge (fill out the appropriate column below) -
Owner / Applicant: Applicant Representative:
Name
Narne
Title
Title
--2�3 13 -7K 25'1(-14le
SOW Address
Street Address
City, State, ZW— hone City. State, Zip
Phone
-it;gnatur'
Date
Signature Date
--------------------------- ----- -
EXIST.
BLDG.
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---------------------
SITE PLAN
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L.�A- N , -
LFr.AL DESrMPTION
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CA *E NO. 93
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
Riz, I ver)
1. Site Address/Location: P��&c 4).
2. Property Tax Account Number: Zft,104:1 A foo(94 MAR 2 7 -1999
3. Approximate Site Size (acres or -square feet): 0, WO
coum
4. Is this site currently developed? V/ yes; --no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
V/ Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than f5% (a vertical rise of I 0-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
horiz6ntal'distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing Water: 140 Approi. Depth:
7. Site contains areas of seasonal standing water: ?�o ;Approx. Depth:
0�
10.
II.
What season(s) of the year?
Site is, in the floodway 00
floodplain 4,o of a water course.
Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? * 4 0 Flows are seasonal? 4o (What time of year?
Site is primarily:, forested meadow ;shrubs
mixed
urban landscaped (lawn,shrubs etc)
Obvious wetland is present on site: 00
_-P
fJ0 7
---For City Staff Use Only
1. Site is Zoned?
2.._.......SCS mapped soil type(s)? Al &Uwm A —4,�V6" lam— tayn R k, 2 8 '-Z s
3. Wetland inventory or C.A. map indicates wetland present on site?. KIX)
4.. Critical Areas inventory or C.A. map indicates Critical Area on site?
5. Site within designated earth subsidence landslide hazard area? NO
6.. Site designated on the Environmentally Sensitive' Areas Map? N-5
DETERNfINATION
STUDY REQUIRED CONDITIONAL WAIVER
WAIVER
R evi
ewed by:..�
lanner Date
R.� 0 1/04/94
a, 9 0 - 199 -
City of Edmon&
Critical Areas Checklist
The Critical Areas Checklist contained on
this form is to be fi.11ed 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,
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:
�%Ue- F�LLCo4tf-
Name
1"Q pf "C- .
Street Address
1EDrAvJbq' OR
City, State, ZIP Phone
�kl J, --t 6A.11i
Signature I Date
Applicant Representative:
Name
Street Address
City, State, ZIP Phone
Signature Date
4/17 C. 18 () �3
April 6, 1998
Rick Fulcher
1040 A Avenue.
Edmonds, WA 98020
Subject:
Dear Applicant:
CITYPT EDMONDS BA,RBARA FAHEY
121 5TH AVENUE NORTH - EDMONDS, WA 98020*- (425) 771-0220 - FAX (425) 771-0221 M AYO R
COMMUNITY SERVICES DEPARTMENT
Public Works e Planning/Building * Parks and Recreation o Engineering o Wastewater Treatment Plant
Determination regarding Critical Areas Checklist # 98-93
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.
IMPORTANT INFORMATION TO BE NOTED:
PLEASE EXAMINE THIS" DETERMINATIOW FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENWRONMENTAL CHEC�S ORCRITICALA
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination, not a
project -specific determination.
You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH 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.
Thank you.
Shada Graham
Acting Planning Secretary
Eric: Critical Areas Determination
Architectural Design Board
C:ReceptionUana\CRLTR.doc
Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
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).
APPLICATION
in
Jty of Edmonds for
SIDE SEWER PERMIT EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION N REPAIRS E] LID NO . ...... ----------- - ASMT. NO - ---------------
L-W epm%_ c V� a
OWNER ---------- L-r—F=AL--t�h ....... V-i ------- PERMIT NO.
------ --------------------------- . ............ CONTRACTOR .............................................................................. I ..............
JOB ADDRESS LEGAL DESCRIPTION: LOT NO.—`�-�. ........ FE3RM_t_r BLOCK NO - ---------------------------_--
..................................................................................................................................................................
Approved:
?41/
. .. . ......
DATE.. ............... By .. .. .....................
V
SIDE"ISE 'E
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:`AW!
ATER9SEW.!ER:,DEFA M,EN,9
T
8
PERMIT
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Cal)l.'*,77'5'l2'5M;' for -.l'd,*n:j.1e.wel- 60 �.ring
v portiorif ?of: the, Nconstr uc
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isy,,steni-��inuaccordEiifc,o,,'With,iCity-l�f'�Edm(in or inances.,,.
TOD�, IS!.CA�LLiDI'T61 THE'bi�O N�ING:
A 1—.;NT LLO
"I'—.Tlfie,-� . I . - permit%toi-con�truct,ihewer* Inside- jiroperl YAInle; W �l icensed- -Side S�wc r Con t ra&�r. rnift be��er�. Pioye`&�'t;�)consfruct
NO;11E�.N c�wne��,s,'.,of'Ahei property.,may.;obtain la� 1 1 1 ;-' � .. .. . I . 11, 1.. , '_ ,
-.o':,Do)-not xover'!any-tpcirtidn,�of� sew e r-* be fore' It'rhawibCeniln spedfed'., A'
it
cd�.Inrc . lty*,rIght- '�'y"i'one.-of'.I:d�fit.�'of'-'WiL�,".-Perr�te�obta:lnabl'�'� from,.the,,!� lO"flfIci:,
;�r6TE,--No� 2—Alllllwork,�per�flo of-way,.requi�resiJan't*1 JEnglneer's%
',NOTE;',4q'O; �,Z--. 06tatw ful . 11.4n I olrmat len!,re gaxd I . ng.�Ordinance�-i-l�.-16,030).anat.Regula�ibnst governing �vh*enl�yowgee,perrnit.. -
I . d
T%�,Nosf'4' It ne';, -Min imum, jgrade.,'of�$2'%.� )No� ben
-sharpL N�1111.be -permitted. j
for�fabure;.cftie`� o) I mproper:
N6'TEr��N*&� Trench esym �stre&�4n�ist ib6l �wa�t'eri�eLtl�di,a3iiik',s�urface;,of.',sfreei-*,ie�t8r�dt �t6,;originaJ'tcondition,.�,lCpritract'o a �shail!'be,�responslblei
work whlch,�rnay,.:.�Jeveldp� within,�onc year. -.of � coin PIC
06n,.
er rk:�thirr,l - s? .providdd!'� C)r,.In�.tfiet,i�ermit,,.or.,toedol�any,,N�c�rk-,i4.�the��rii!�in-,,sewerlo,r2,,its�app tenance �,exce�pt';tbjn-;
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,�!(,Own df�,Cont�a rin, -Pirforiyiing,',Constiuction,);.,
peiwl� all--,.g9ve'
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,W,6_JMl, -e 4wd rning;o,rdinancesli djCify"!Orta!non`dS..-..
iih ill cco da
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WiLter -_�6�4 Tble P r 'Sewe
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a
City of Edmonds
EASEMENT NO - ---------------------------
LID NO. � ... PSM
�& T
- -----------
OWNER
-------- - ----------------- CONTRACTOR 40&19RMIT NO.
.g.,0
joB ADDRESS
TH --- A -VAC- ---- LEGAL DESCRIPTION: LOT NO - ----------------------- --------- BLOCK NO - ------------------------------------
T
tO 4 S'4i 4/ 00 r, 7 7,
Yll , '?
NAME OF ADDITION I �
................................... .............. ...................................
APPUCATION
for
SIDE SjWjqt pEltMff
NEW CONSTRUCTION 0 REPAIRS E]
4� V V1,
Approved:
C 0
RECEIVED
FEB 2 8 INS
T u li
DATE
By----------
4011.
Date June 11,1 1974
Memo to: Director of Maintenance & Operation
Public Works
From: City Engineer
Subject: Sewer Connection Charges
Legal Description:
Beg. 30 ft E and 100 ft N of SW Car. NW 14, BW 14
See. 299 T 27 Nq R 4 El th E 156.26 ftl th-K 2;60100"
E, ".10 ft; th W 120.62 ftl th S 70 ft to the T,P,,Il,
NOTES gas attached recomendation for tive extension;
notify awn�r of yourd*cision.
known*as, 22312 "th AVWAN W. Owner: Lialle R. renbe&
Z.F.F. Calculation:
23 Z. F. F. x ( $7.50
Lateral x- (0100000
IL Unit x ( $ 25
cc:
7,
$ 571.73 Connection Fee
$ 100,00 Lateral Charge
s 25,00 Trunk Charge
$ 10.00 Permit
$ 706.73 TOTAL
LEIF R. LARSON,' P.E.
EDMONDS C!TY ENGINEER
Form 6