22516 72ND PL W.PDF111111111111
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22516 72ND PL W
Ac�51(a 71kd
L. 6() 0,
TAX ACCOUNT/PARCEL
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
C . RITICAL AREAS:64— q DETERMINATION: F] Conditional Waiver Ej Study RequiredKWaiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN
SEWER LID FEE $:
LID #:
SHORT PLAT FILE: LOT:— BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S)
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
OTHER:
LAT7EMP\DSrs\Fonns\Strect File Checklist.doc
PLANNING DATA
NAME: P. Q_ DATE: 4 / 5_/Olt
SITE ABDRESS: ZZ51t,- -77--Pi, LJ. PLANCHK#: 04-a9s-
PROJECT DESCRIPTION: N"
REDUCED SITE PLAN PROVIDED?: (Yes / No
MAP PAGE: t 0 7 CORNER LOT: (Yes / I FLAG LOT:
ZONING: A-�-g —CRITICAL AREAS DETERMINATION #:2M4--b4-)
UStudv Reaulred:
@�Walver
DConditional Waiver
SEPA DETERMINATION:
Fee
Checklist
APO list w/ notarized form
(Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
Exempt
SETBACKS:
Required Setbacks:
Street: 09' Left Side: 7 5' Right Side: -75, Rear:
Actual Setbacks: i-a S
Street: -4 8" Left Side: Right Side: 1"01 Rear:
Street map chocked for additional setback required? 1AW1 DNA
U DETACHED STRUCTURES: AOYXt
U ROCKERIES:
L3 FENCES/TRELLISES:
U BAY WINDOWS / PROJECTING MODULATION:
STAIRS / DECKS:
PARKING: Required: 21 Actual: 4
LOT AREA: 3 2, d
LOT COVERAGE 17-13 1 1 Z o
Calculations: 3 7 1 1 & "76
a V -_
BUILDING HEIGHT: rtf.'. -If-f
Datum Point: Datum Elevation:
Maximum Allowed: Actual Height: _,,'o
A.b.U. CREATED?: Ado�/ Yes)
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: (Yes /A
OTHER:
Plan Review
NewBPPlamingDataForm.DOC
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CA File. Noi. 41
Critical Areas ',Checklist.
Site Information (soils/topography/hydrology/vegetation)
1. Site A ddress/Locatian: .. -4� cs��a elk
2. Property Tax.Account Number ()tkVVx'\ 014Q�rjn t, qzjo(&� j.qq DDO OD-1 DC).C)cZ
4c
3. Approximate Site Size (Acres or square fed): �B 1A 6 S!q �-.7.
4.. Is this site currently developed?±— yes; no.
tv3
If yes; how is site developed? kM
S. Describe the general site topography. Check all that apply.
Flat less than 5- ieet elevation change over entire site.
Rolling. slopes on 'site generally less fim Mrfeet over a horizontal
rM
distance of 66-feet). r2l; it j,�
�4.L L
Hilly: slopes present on site of more than 15% avrd,1,qq -6WI� 4,40-feet
than 30% (a va
over a horizontal distance of 33 to *I �ijl
Steep: grades of greater than 30% present on site (a verbilrYM bf WWd
distance of less than 33-feet).
Other (please describe):
6. Site contains areas 4 year-rinmd standing water. Approx. Depth:
7. Site contain6 areas of seasonal standing water: Approx DeptiL
What season(s) of the year?
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? c— Mhat time of year?
10. Site is primarily: foresW meadow shrubs mixed
(_-:u__&banj9i��Wn,s �etc�
11. Obvious wetland is present on site.
For Gly Staff Use Oidy —
1. Plan Check Number, if applicable?
Z Site is Zoned?
3. SCS mapped soil M*s)? LIS Si,�
critical Areas inventory or CA. map indicates Critical Area on site? No
Site within deshmated earth -subsidence landslide hazard area?. 1140
DO E MINATION
STUDYREQUIRED TER
_WAA
-7
Reviewed bv. Date:
City.tEdmond-s
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 potential Critical Areas we, or
may be, present on the sul:ject property. 11he information
needed to complete the Checklist should be easily
available from observations of the site or data available at
Im (critical,ml,
city 'aru inven
Date Received: 4--44
City R eceipt#-._��
Critical Areas File #-. "
Critical Areas Checklist
Date Mailed to ADDlican
A property owner, or his/her authorized representative,
must'fill out the checklist, sign and date it, and submit it
to the City. 7be City will review the checklist maim a
precursory site,visit and nuke a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form.- In
addition, the applicant shall include other
DrInation (4- site plan. topography map, etc.) or
tudies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
[VWd#W WCW ahMNEe—dits heirs, and assigns, in consideration -on the processing of the application
release, i
felease, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
Attorm fees, arising from any action or infiraction based in whole or part upon false,' misleading, inaccumte.or.
incomplete information furnished by the applicant, his/herfits 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 oF Appju&?(j�;4 DATE . VA 01�4
Property Owner*s Authorization Ts. t>A&J\-S
By my signature, I certify that I have authorized the above ApplicantlAgent 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 posting attendant to this application.
SIGNATURE OF OWNER DATE
PLEASE PRINT CLEARLY
Owner/Appli oft
Ndme
ddress
city state zip
Telephone: (J2 (0
Email address (optional):
Applicant Representative:
Name
Street Address
city State zip
Telephone -
Email Address (optional):
0i
--4
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c
j Sck V-7.
RECEIVED
10 4.8 3' lb-61 REET E MAR 2 4'2004
PERMIT COUNTER
00
14-
0i
24' Existing
Residence 75
1,D
,,6
n
hew unrocm 10
r) c
10n,) w DecUu,", Drivewav k9sq-1
12'�
ZONE
SETBACKS:
FRON
SIDE
clz�o
REAR
12'
OTHER
I
0 OQ 0 a ��-1 C) 0
HEIGHT ?,5 ' —
Parrott Residence APPROVED BY PLANNiNG
22516 72nol Pt. W.
Eclmoncls, Wa, 98026
Scale: 1'=20'
orthwest Sunrooms
PO. Box 1332
-4fKent, Washington 98035
Gr
0
APPLICATION CARD No . ...................... ... ...............
x for
The City of Edmonds E SIDE SEWER PERMff EASEMENT No . .................. .. .................
OUTSIDE 0 INSIDE 0 REPAIRS 0
OWNER :��z -Pyez� S .......... .................... CONTRACTOR PERMIT No.
STREET
HOUSE No. .................... )."52 ..... AVENUE LOT No. ......................... 3� .......................... .............. . BLOCK No . .....
......................... -;�z ........ ... ....... ....
NAMEADD .......... Al . .......... .... .. . ..................................... ............ ...............
jt
Lot=
AppROVED
1963
f
L
Date Approved:
BACKFILL WORK ORDER ISSUED ............................................ DEPOSIT, $ ......................................................
SEWER WORK ORDER ISSUED ................................................ ........ By ...................
I
C)
CU
m,*
'Scl S-1.
�1%04utc-\- X-L,4
Copy RECEIVED
104.83'
8. MAR 2 4 2004
PERMIT COUNTER
OD
24' Existing
Residence 75
,,6
0'i
New unro I r*--
On w De 10,
Driveway k%T-1
ZONE
2'— SETBACKS:
FRON
SIDE
REAR
OTHER
HEIG 4T
911) Parrott Residence
22516 72nd., Pt, W. APPROVED. BY. PLANi,m,l,%,b
Eclmoncls, wa, 98026
�—n� 4-
Scate: 1'=20" z
orthwest Sunrooms,
P.O. Box 1332
0%-\ cl\ ck'�:N cy3 a 0 Q�-1 0 0 AcKent, Washington 98035