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22505 72ND PL W
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ADDRESS: 2�2-5097 -7�2_1,d pl t�j
TAX ACCOUNT/PARCEL #: C)Oqql?q 0006 12-00
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: DETERMINATION: Conditional Waiver Study Required [] Waiver
CRITICAL AREAS #: DETERMINATION: Conditional Waiver Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE P LAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER — list permit #'s):
lint
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE]ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
04
L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc
ALL EXPOSED SURFACES TO
BE COVFPFD WMIN 2. -DAYS
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Applicant shall repair/replace all damage to
utillfies, or frontage improvenients in City
right-of-way per C4y standards that is caused
or occurs durWV the permitted project.
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CITY OF EDMONDS WATERLINE AS -BUILT
6 ADDRESS HOMEOWNER
22505 72ND PL W BRAD HORTON
CONTRACTOR SCALE
NTS
DATE DRAWN WATERLINE
2/14/06 BY 1. ABILA NO - 2006-0103
0 -ED
City of Edmonds
Site Classification Worksheet
Page 1 of 2 1) C. I so(j
The -project's Site Classification will dictate the specific stormwater management
requirements applicable to your site. Completing this worksheet will help determine the amount of
regulated impervious surface and whether your project falls into the classification of a Small Site
(Category 1 or Category 2), or a Mnor Site. Please reference the Olossary (12p. 10- 11), Figures D and
E, (pp. 8-9), and Examples (pp. 12-13), to assist with completion of this worksheet.
1) Is Permeable Pavement' Proposed For Use on this Site?
Refer to Stormwater Supplement Chapter 5.1 E:1 Ws N07
If YES, the subject area is to be considered impervious for initial site classification purposes. Include total
permeable pavement area in the calculation of Non -Regulated, Replaced and/or New impervious surface
areas in the table below.
2) Determine the Amount and Type of Existing & Proposed Impervious Surface for th e Site
Refer to Stormwater Supplement Chapter 2 and Fig. C
Line 1: Identify the Non -Regulated Impervious Surface Area.
Line 2: Identify the Replaced Impervious Surface Area, dividing the total between Exempt and Regulated; either or both
may be zero. Note: FUr'project classification purposes, Wililaced -Impervious may only be considered exempt
under certain�onditions. Rdfer to the Glossary and Figure D.
Line 3: Identify the New Impervious Surface Area for your project. All impervious dreas created post -July 7, 1977 or
after the date of annexation into the City ge'regiflated & should be included in this total unless they cith be'
categorized separately as a Replaced -Regulated area.
Line 4: Enter the. sum of the total Replaced -Regulated plus. the total New impervious areas.
Line 5: Identify the total area currently'mitigated by an existilij city -approved stormwater management systerp.
Line 6: Enter ifie*,sum of the value in Line 4 less the value in Line 5 to identify the total Regulated area in -which
stormwater c4trols have not yet been ap"plied.
Line 7: Identify the total area proposed to be mitigated through the use of Low Impact Development Techniques.
Line 8: Identify the total area proposed to be mitigated through conventional Stormwater Management Techniques.
Provide a copy of the following table on the drainage plan sheet,for the proposed project
Line
Type
Area (square feet)
1.
Non -Regulated
V
Exempt
Rigulaite'U
2.
Replaced
3.
New (Post 1977)
+
A Spy
4.
Total Regulated Impervious Area
1
Mitigation required if in excess of 2000sf
5.
Total Area Mitigated by Existing Stormwater Management System(s)
6.
Regulated Area Not Yet Mitigated
Area Proposed to be Mitigated by Low Impact Development Techniques
i7.
8.
l
Area Proposed to be Mitigated through Conventional SWM Techniques
(e.g. porous asphalt, porous concrete, paver blocks, concrete open celled paving grids, or plastic lattices Jej ON)
Revised on 4121111 E72-SWM.-EFr 2 ge 5 of 13
AUG 2 20P
tPMUILDING DEPARTMEW
UTY OF EDMONDF
City of Edmonds
Site Classification Worksheet
Page 2 of 2
E
3) Determine the Total'Area of Land Disturbing Activity sf
Refer to Stormwater Supplement Chapter 8
4) Determine . the Quantity of Grading, Fill and/or Excavation _ao—cy
5) Will the pr *ect convert 3/4 Acre or More of Native Vegetation to Lawn or
01 El Yes X No
Landscaped Area?
6) Identify the Watershed the Existing Site Runoff Discharges to
Refer to Stormwater Supplement Chapter 2.3
Based on Site Location and Watershed Map — Figure-C. Check all that apply.
A. F-1 Direct Discharge B. Creek or Lake Basin
[i Edmonds Way Basin
o Puget Sound Basin
ci Puget Sound Piped Basin
DETERMINE PROJECT CLASSIFICATION USING THE INFORMATION ABOVE
AND THE PROJECT CLASSIFICATION CHART (Figure B, pg 4)
0 Small �S ' ite...- Category I El Small Site - Category 2 0 Minor Site
Stormwi2ter'Supplement Stormwater Supplement Stormwater Supplement
Chapter 5 Chapter 5 Chapter 6
Revised on 4/21/11 E72-SWAI�_Erosion_Control--04.21. 11 -FINAL Page 6 of 13
PLANNING DATA
SINGLE FAMILY RESIDENTIAL
/ f
STREET FILE
Name: �oc
Date:
Site Address: OS- -7 Lt,�Z� (-
Plan Check Z0
Project Description: All;, 0-0
Reduced Site Plan Provided: NO) Zoning:
Map Page:
Corner Lot: (YES/ 00
Flag Lot: (YES
Critical Areas Determination ff.,
D Study Required
ISr-Waiver
SEPA Petermination:
V4'Exempt
Needed (for over 500 cubic yards of grading)
0 Fee 0 Checklist 0 APO List with notarized form
Required Setbacks A
Sirtet- 7 S
Sid
Si�a.
ar:
Actual Setbacks
Street:
Side:
Side:
Rear:
9- Detached Structures:
11 Rockeries:
11 FencesfT-rellises:
El Bay Windows/Projecting Modulation:
El Stairs/Deck:
fielght
Daturn Point: Co VJ-J—'
Datum Elevation:
Maximum Height Allowed:
Actual Height:
Other
Parking Required:
Parking Provided:
Lot Area: -7o L
Maximum Lot Coverage: 35% Proposed: 2�315
Lot Coverage Calculations: 5-0 4- 3 2- 0 6 0 0 L Z (-700
ADU Created: (YES
Subdivision: brr4 -Ttcrcce L 10
Legal Nonconforming Land Use Determination Issued: (YES
/, , L , Comments
VwA
-00 N�- q
t 7:- t [ Z � 5 Mk DC
Plan Review By: /e. A,��7 -) / � / (
Marv" Data Form 0441,06,doc