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23208 75TH AVE W.PDF111111111111 6005 23208 75TH AVE W CITY OF EDMONDS 0 SYNEET FILE ASSET INFORMATION SHEET ASSET NO. 00 - E] ADDITION ADDITION TO ASSET NO. 1:1 RETIREMENT 2 NEW DESCRIPTION ,5/feu, SERIAL NO. LOCATION DEPT. NO. 232 c v 6 0 Li "PURCHASE ORDER NO. - PURCHASE ORDER DATE COST B.A.R.S. ACCOUNT NO. 4 ESTIMATED LIFE *PROJECT NUMBER (-j .3 57r Ig -2 9 PROJECT COMPLETION DATE /c- -3' -rr"-3 COST / � / - V 6 INITIATED BY DATE APPROVED BY "SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST *SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY 1E DEPRECIATE MONTHLY DEPRECIATION AMOUNT ANNUAL DEPRECIATION AMOUNT - 0 G.L. ENTRY REFERENCE DATE VERIFIED BY PROCESSED BATCH NO. - f 72,�Nl rz:v u INITIAL t.�np DEPARTMENT FILE J$ %% 03.0 c A VE GRA0E-:)0,5-a � C T, ,4 3 7,5 qaA /PC*- -Z RE:-CEI'vED APR 0 d 1993 - IL' PERMIT COUNTER _vT & ll� WA I,-L. tp iS C�d AV w. IF Jr_� I rl [A I r Q-.1 jig- 0 V011- 1XZj Cl %J ciates April LSA F1 1983 CECAI- 1)- 63-980 FOR FCC - Lot 4. Ing to tBl-ek 4 4e record, of plat thereof, nger Land Solohoml3h Courecorded In j.( 3 Plat S n ty, ),'d3h.1r.qtOlume 9 �'bdivf,jon The no on. P1 at.: Pzg's .5 1, acco.-d. call I rt 81. 7 and 58, nqCr Feet of hereof .. Land Co. . 3 PI the We., Ina Snoho.1 3 corded In V , "t S'Utdivis, 450 teat PAJ?CEL oun t.V, wj S O"Iffo 9 of P, On %. , . Lot 4 hlngt0n. 'at'l, on -0 JccGruj ' -Ock 4 Pages 57 ",9 to C,� I ak, That nd 5,,,, 1.12 plat. no. 1portiOn ccoc.j, G r a 0 r of Lot 4, a, a n to th Ock 4 01 1OW3: recorL Plat , take Cher L'alling, S c n n 3 Of S cor a �r Land C t at th nohoml.h "Grded I O..S Once On t a nort � Co pj 3out a eazt I, heazt tnty, ,r, 9 41 alon co�, 9 Sal a P a di -ne of , er .'ash'ington of PI-1 SAOn ne 0 t ts th r Stance 0. Said L ' -'ald descrl,� I a') a east t 81.00 5 at 4, a Lot 4. cd as , thence along 34 Ina 0 th ne, a dl3t feet of 6-14 fact , distance of 1.�7.32 the 0113 C I I e *Ost I drce of Said L ..) an Int.rSectio feet; nort li Ot 4. distanc ne, of ne a 108-50 f 113.41 F - thence n a jj Sq,4 e of 3 nce of 81 3did Lot " an int 5130,, 5 d�ld dlzta eet of eel: t ?with the 53 Lot 41 the; .00 the Irsectl w PARCEL feet to on wl int cc t to -an , ne' N 01 14, the 0 Ce S jo,, E, allifte, . 3(),, th 0 �Cctj E That beotnnlng. ng an *It, No. Portion of Page I , dccordl� Lot 4, 31,� foils 57 9 to 1w 4 0 and , the plat I Lake Balli w 58 record .1. S 3-51s: aeg' ' .,.-,r,o 4-ger to th 30" W Inning at 3 Of Snoh r reoj,, '. La.1d C the no Oml-h C Vd I., �-31 01. P1 a e Tru ' 'long th rthea ourr .., at dista e poi e St y Ume .9 Subd nt of 0, east I. CO." I 4a3hi of plat north TcO Of 56.14 f 9Jnnj ne of I Or Of, _. ngtOn Ivl3lOn r said 1.0 Said L I dl2scri � so on line .00 feet ea 19 of thl t 4 Ot 4. ed . a diata Of 3 de3cri I d di-C I tha.1c, 43 West I., nce t to an inter. -Cc dt�ojj. 4 ance of the Said 11 5 or 11.3 Lot 4. CIO ne, .41 Fee' thenc n W,th t: thence .1 3,ol, Said L d di ' 0 feet t to a N 89.46, ..a . '32 fe G. Stance or ­ 36, at 143 ".9 41 the said an int 5,30,, W Guth 11 57,, V, of 81.00 f Lot 4; th epiectl , alo, ne of 3arjeet to Incee S 89@45,3coe"t to an ence S �on Yll th 9 Said Lhe d zouthea inte Do 14,33'. th south ;1. n I nning east lin a t E, along rsect. a Last 11 ne e, Corner said ""' with 'lang of PA.qCEt a di stance 01, Of 311d' ,soutl' line t",e Said ea. sout"' line 0' 4 35.()o ' Ot 4; ,eet to zh cn ' a Crluonce of "",a the ce tr ). 51,30" Su *,eat Olnoap,050 fe * at or TrUe Point of to di 'I., n ;)4ge� I a'cor Lot 4, ajocr .S; and rr 4 ' L k, Q to the P" Land CO r'kCrPT the eaOld S �.r _ north 00 feet t f nt., _,I.h C 'r�ore 3 plat hereof. nty, ad in WaSAJ �'Olume 9 or n9ton. 10(1427010 Div. 961 0 ' �-W fps. loor" ED`jO`4OS-WAS"-"O2. YCL A APR 5 1993 PERiwIT COUIVT.0 E j tl* : L S or icies f the NOTICE OF EASEWJJT AND MAINTEIANCE ACREEP.-FlIT TO ALL WHOM ThESE PRESENTS CONCERN: Notice 13 hereby given that ALTAMAE hEfaiA;�NS, a3 ter separate estate, owner Of the following described properties, Situated In the County or Snoho.11s,, State of Washington, to ttits !ARCEL I The north 81.00 feet of the west 108-50 feet of Let 4, 8lock 4, Lake Ballinger Land CO-'s Plat Subdivision No. 1 thereof recorded in Volume 9 of , according to t.%c plat of Snohomish County, Washington. Plats, on pages 57 and 56, records PARCEL 2 That Portion of Lot 40 Block 4 Lake Ballinger Lard CO.'s Plat Subdivision "0- 1, according to the plat thereof recorded Pages 57 and 56, records of Snohomish County, In Volume 9 Of Plats, on follows: f)cginning at the northeast Washinqton, de!;cribcd as Lorner of Said Lot 4. jilcric4. t 5 3*5"30" W, d10119 the C-13L litic of Said Lut rl, dj�,' ' hence N 34,36157" W, a distaijcc of 56.14.rl ta-,v o r 1.'7. J., rt,,- 'et South line of the north 61.00 I'vet a S.'(d Lot tIjrn,-c ,j along said south 1111c, a distince of 113.41 the cast line of the west 108.50 feet Of said rect to all i"tcl-section wittl Lut 4; thence 14 0* 1413C11 E dlong said east line, a distance of 81.00 feet to an intersection with the north line Of said Lot 4; thence S 39*45,301, [9 alon(I So a distance of 153 . 53 feet to the point of bcginailiq. id north line, PARCEL 3 That portion of Lot 4, Block 4, L:ke Ballinger Land CO-'s Plat Subdivision NO- 1, according to the Plat ther Of reco:Jud In Voluj3c 9 OF plats, Pages 57 and 58, records of Snohomish County, on follows: Beginning at the northeast corner of WdsWngtrn doscrIbed as '.3fd Lot 4; thence S 31511301, W, along the east line of said Lot 4, a di-It--ce of 127.)2 feet to the True Point Of Beginning of this description; thence t4 34*361571, a distance of 56. 14 - feet to an Intersection with the South line of the north 81.00 feet of said Lot 4; thence N E9*451301, w, along said South line, a distance of 113.41 feet to an Intersection with tile east linc o� the west 108.50 feet Of Said Lot 4; thence S C*14'30" W, along said east line, a distance of 81.00 feet to an intersect:3n wItjj the south line of said Lot 4; thence S 89045'30" E, along said south line, a distance ef 143-29 feet to the southeast corner of said Lot 4; thence N 3'51130" El along said east line, a distance of 35.CD feet to the True Point of Beginning. EARCEL 1, The west 108.50 feet of Lot 4, Block 4. Lake Ballinger Land Co..13 Plat Subdivision No. It according to the Plat thereof recorded In volume 9 of Plats. on pages 57 and 58, records of Snohomish County, Washington. EXCEPi the north 81.00 feet thereof. does hereby reserve and convey unto the ow . neC3p their heirs, successors, and assigns, Of the her6lnabove described Parcels 1 and 4, and unto THC CITY OF Er'MONDS and unto PUBLIC UTILITY DISTRICT No. I OF SnOHcmISH COUNTY, and unto CENERAL TELE- PHONE COMPANY OF THE NORTHWEST, INC., a permanent ea5cmcnt for ingress and. egress and for the Installations operatLong and maintenance of utilities, across, through, and u' over, under, of Snohomish, Pon the fOl lowing. de.3cri bed property, *Situated In the County State Of Washington, to Wits CITY OF FMIONOS P- W- r- .......... R;NG DIV 8804270ing L, 14�. 1 /- - - , page I of 2 paj,., / IV, �e ele 7 19 4' 7 7- 7 J 71 . j The south . 15-00 feet Of the north 63.50 FCC'. of the west 55.DO feet of.Lot 4, Block 4. Lake aalllnger Land Company's Plat Subdivision No 1, according to the Plat thereof rCcordod In Vo lume 9 Of Plats, On Pages 57 and 58, records of Snohomish Co,,.Ity, Washington. and does hereby reserve and convey unto the Owners, thLir heirs, succeSsors, and assigns, Of the hcreinabove described Parcels 2 �,rd 3, and unto THE CITY OF EDMONDS, and unto PUBLIC UTILITY DISTRICT 14. 1 CF SN�-�CMISH COUNTY, and unto GENERAL TELEPHONE COWANY OF THE NORTHIkEST, 111c., a Per,.ianent casement for Ingress and egress and for the Installation, operation, and ,aintenance of utilities, over, under, across* through, and upon thO I`0110%�ng described Property, situated in County of Snohomish, State Of Aashl.1gton, tr the A strip of land, fifteen (15) fec-� wide, the centerlinc of wshich strip - Of land 13 described as beginning at the nortlicast corner OF Lot 4, Block 4o Lake Ballinger Land Company's Plat d 5:, records -, %'Olum according to the plat thereof recoeded Is Subdivision No. 17 an e !� of 1j'at,' .1 g th east line of SnO-"OmI3h County on Par -es on 9 Was:iington; thence S 3*51130" W, Point Of Beginning o Of said Lot 4' a distance of 127 32 feet to the True f the centerl1ne herein described*; hence tj 4036'57'- a distance of 56.14 feet to an Inter3 t north 81.00 feet Of said Lot 4* thencectlon With t"c 5011th line or tj.c Line, a distance of 30.00 reet't e' N S9*45'30" 'N' 'j'OnV 5'"d SOLIth described. 0 the terminus Of LML centerlino herein Maintenance, repalrp and/or reconstruction Of any roadway, or utilities con- structed or Installed upon or within the easement right of we) first he:cinabove reserved and conveyed, shall be the rezponsibility Of and th,� costs of said nainten- ance, repair, and/or reconstruction borne Jointly and equally by the owners, their heirs, succe3sor3v and assigns, of the herelazoova described Parcels I and 4, and maintenancet repair and/or reconstructIrn of any roadway or utilities constructed or Installed upon or within the easement right Of wdY also hereinabove reserved and conveyed, shall be the responsibility of and the Costs of Said n4lntcn4ncc, repalrp and/or reconstruction borne Jointly jn*d equally by t,"c owners, their hc.:rz, successors, and assigns, of the hereinabc,e describea Parcels 2 and 3. In y This Instrument shall be a covenant running with the land and shall be binc- 9 p9V_the Parties hereto, their heirs, successors . in dssign5, forever. ,e hereunto so, our sgnatures and scals this26 '6day 1963. - 7— law __ZrA . .. ... Z 671. �htlzi ';.t" szilllt� INCTON) 'j COUNTY OF SS. % On this day personally appcared before le ALTAMAE HERMANr4S, to me known the Individual described In and who executed and to be the within and foregoing inzZrumcnt, acknowledged that She signed the same as her free A for the uses and voluntary a and PurP03e3 therein mentioned. ct and deed, MEN under my hand and official seal C this ddy of MUD 4 2'1 ..... . CITY OF ED&IONDS P. W. DEPT. ENGINEERING :1 ft�'� DIV. Notary �P.bli In and for the State of By Ir Was hIngton, residing r a REMAnKSg Page 2 Of 2 Pages V0L1786P4cEj630 STREET FILE t UTILITY EASEMENT ffIL*1T,1 r-stf,�Ec roven-sauerrand & W.; E: I E D 7 - 100th A 23106 Edmunds, Washirgon 93020 APR 0 5 1993 mrr and 1n Consideration of PERMIT COUNTER. p benefits to accrue to Grantor by reason the 1n3tallatIon and Operation of HOMES, INC., Of Utility Systems, the Grantor, a Wd3hIngton' BL��QRINT Corporation, Owner of the foll properties, situated In the' Owing described County of Snohomls.�, State Of Washington, to wit: —PM—T—EL1 The north 81-00 feet of the west 108 * 50 feet of Lot 4, Block 4,. Lake Ballinger Land CO.'s Plat Subdivision the plat thereof r-- No I orwed In Vol . , according to and 58, records of SnohOMI3 ume 9 Of Plats ' on Pages 57 h County, Washington. PARCEL 2 That Portion of Lot 4. Block 4p Lake Ballinger Land CO-13 Plat g Subdivision No. I accordIn to the plat thereof recorded In Volume 9 Of Plats' on Pages 57 and 58, records Of Snohomish County, Wd3hIngtO4, described as follows: northeast corner Of Said Lot 4- Beginning at the thence S 3051130,, W. Ong the east line Of said Lot 4, J distance of 127.3 N 340161571, W, a distance of 56.14 feet to a " feet; thence with the south line of the no n Intersection thence N 89-45-30., rth a-',OO feet of said Lot 4- Wo along said south line, a distance of' 113-41 feet to an Intersection with the e03 t line of the West 108.50 feet Of said Lot 4; thence N 0-14'30" E along said east llnep a distance of 81-00 feet to an Intersection with the north line Of said Lot 4; thence 5 89-45-30" E, a long Said north line, a distance 0 ,of beginning. f 153,53 feet to the Point PARCEL 3 That portion of Lot 4P Block 4 1 Lake Ballinger Land Co.,, Plat Subdivision No. It according to the plat thereof recorded In Volume 9 of Plats, on Pages 57 and 581 records of Snohomish County. Wa3hingtont described as follows. east Beginning at the northeast corner Of Said Lot 4 thence S 3*51,30., W, along the line Of said Lot 4, a dl3t'ance of 127.32 feet Point of Beginning of this de3c to the True riPtlon; thence N 34436-571, W a distance of 56.14 feet to an Intersection Of the north al 00 feet Of said Lot 4; With the 3outh,,Ilne thence N 89045-30,- along said 30Ut� line, a distance of 113.41 feet to an lnte;. section With the east line of the West 108.50 feet of. said Lot 4; thence S 0`14-30- W, along said east line, a distance of 81-00 feet to an Intersection With the south line Of said Ot 4; thence S L 89845'30-1 E along said south line, a distance If 143 29 feet to the 30Uti�a3t corner of said Lot 4; thence N 3051: 30" E, along said east line, a distance of 35.00 t to the True Point of Beginning. fee PARCEL 4 The West 108.50 feet of Lot 4 Block 4, Lake Bal Inger Und CO.'s Plat Subdivision No. In Volume 9-1f Plats, on pages 57 and 58 1 County# Washington. 1, according to the Plat thereof recorded records of Snohomish EXCEPT the north 81-00 feet thereof. does hereby reserve and convey unto SNOHOMISH COUNTY - PUBLIC UTILITY DISTRICT NO-. L OF , and unto GENERAL TELEPHONE COWAN and unto W I ASHINCTON NATURAL GAS C ' ONP4NYP and unto V OF THE NORTMKST, INC., THE CITY OF EDMONDS, and 'Vo SALAM VCL 1789PICE2537 - Al FILE 00 AP 1/0 R 0 5 1993 Cr3 or C4 r0 ALL 114IN No tj C A cor e I Pop, tion, hereb co"CIDN. 7 Coun t�' Of S *ner en th noho Of the . at at or. 0110101, n e d Of Cprs, d P, q'On' opertl take "Ofth to es, 4,741 th 8alli 81.00 WI t. 31tu, ngto, e Plat nger feet ted and 5�9 thep, Land C,*f the the *e' t JOS. re, Of r 3 Plat S OPd, Of eSC0,14d,'d no 0.11" V ol Ubdivi S feet Of that sh CO Ume 9 "on No. Ot 4 of P1 I . ,S(J6djPOrQo Unty' Wdsh at3 deco Ock 4 Oj visto n Of L Ingto;; on P'jg z'dj,q t CO time .9 n No Ot 4 es 0 Un ty Of p * 1, , 82 no Jdta acco Ock 4 earth ' W'33hi ea. t on roing ' take 3 119ton'. Pages to th . N j4 t J, eorner , des, 37 C all, ne 010 - or Plat nger L' Saicirlbed and 5,9 the,e With 'A6'571, said L 43 f and C th the , 4 Ot 4 Ot 01101,, recOPd, or re 0. 3 PI en, out a th 3 . Co4rde a t e jP1, 1 3 t421' enc . a or S d 1 .41 fne 0 e 0 Stance e S .. eq, J70h n west I fee e Of J.? 51—nninq omish said 08.50 to an 4 04 1101, feet 7. 3z Jo" w - at the ea. Fee ntep 3,1 00 to feet , ql,n *I th the ;t III? t 0 ,,',see r, an I nte'fethe, 9 the along no,: e, a on 301th eet 3 .., ce Of b . said th I St t th th Jin 0 egin, n ne an 0, e Said t On In Orth jIn or Ce , t e ed ' d di Ot 4; of SJ ence N st 11 stInc PA.9 e, $aid Lot -00 feet O*J4, ne of e of _14�1 CC " dista, 4; to 30" the 3 Ce 0 thenc an I C' al 'A.t f J5.1 L S �99. j7ter3 Ong PI, t Portio .53 fee 45,3,,, ec CIO, In V, Subdivin Of t to th E C' olume '71 'Ot e ount Dj no y .9 on No. Ock Pol" t rthe , Pi ed, d3t C n dt3 acco Ldk t gton 1 0, I'd.1,9 -. 8.jI POJ,tJJne Orne� , des, Pdges 57 to -the Ing,,. t 4 or or rib .dj Of Be Said L said , ed a. fand 5,9 Plat thand Co or Stan, ginnin Ot 4 Ot 4. OJI0 e"eof 3 the e I a d I th wa .1 reeo4rd or 9 Of 13 Can 3 ree 01) nor th 56-14 this ence S* 8egi, OfSn arded e'tj! Said 81.00 feet de3c Ce Of 3151, 301.ning at Ohomish 4 Wit Of, th re to "J'o tj 0 127.1" IV the )t 40 h, 1, et Of an in te's 1) thene the ne said ' then eet ' 444 ,j a dista Lot . ect,on ce All to t4 9 th .00 e S least 14*,,, e r.. e 4. feet O*J4, 14e nee th Wi th t 57,, e I e 14 then to a h 3. R9 f� ce S a , ,, e *est -41 . -9. 51, e. tnjt0e'r' 4' Of th Of 11, ence , 9-45,3FUth III) w 4 , Se no 10 lee- 1�" 730" t t ' 304 Otio Said 0.50 to a, W e '1 0 the n Irl th f I P, - V along east I eet of A� 've Ong Outh the Ina In tep f 71 ......... POI east east 3out I a distance n t or said 00 Said Guth Ine Said q-4 . tne of 0'3 Said nning 4'".. di.t4 d� a n. to dis Ca 41 Of t 4. the nee 35.'00 nee feet page . J. of Pa le he or and 'licies ent or ligations r policies fault of the PA _RCEL 4 The west 108-50 feet of Lot 4, Block Plat Subdivision No 4. Lake Ballinger Land Co.,s . 1, accardIng to the Pla thereof recorded 9 of Plats on Pages In Volume 57 and 58, rat County, Washington. cards Of Snohomish r. EXCEPT the north 81.0 0 feet thereof. does hereby reserve and convey unto the owners, the Ir heirs, successors, and assigns, Of the hereInabove described Parcels 1, 2, 3, and 4, a permanent Z 'easement for the Installation, operatlonj and maintenance of a sanitary sewer Pipeline, over, under,'acrOUP throughp and upon the following described property situated In the County Of Snohomish. State of Washington, to wIt: The south 10-00 feet of the nor- 116-00 feet of Lot 4, Block 4, 11dlIInger Land Co.'s Plat Subdivision the Plat No. 1, JcCOrdbiq to thereof recorded In Volume 9 or Plats, and 53, records Of Snohomish on pages 57 County, Washington; EXCEOT the west 98.50 feet thereor; 4� together with the further right to remove trees, bushes, undergrowth, 'and other obstructions Interfering with the Installation, operation and/or maintenance Of said sanitary sewer Pipeline. The cost of ma lntenance, repair or reconstruction Of any Portion Of the sanitary sewer Pipeline used In common shall be borne In eqval shares, except that the owners of any lower Parcel shall It not be responsible for maintenance, repair the Cost OF or reconstruction Of any Part of the sanitary sewer Pipeline above their Point Of connection to same. 'When necessary to maintain, repair. clean or recon3 truct the sanItar Y sewer Pipeline, the beneficiaries of this Instrument shall have the right of entry for such Purposes, Provided, when entry 13 made to maintain-, r sewer Pipeline, 31A epalr, clean or reconstruct the sanitary Ch work shall be all Performed In a workmanlike manner with reasonable haste and the Premises shall be Promptly restored to Its Previous condition as soon as 13 reasonably Possible. This Instrument shall be a covenant running with the land and shall be binding upon the Parties hereto, their heirs, success . Or3 and assigns forever. In Witness whereof we hereunto affix our signatures and seals of rn lox this '/"da 1983, A.D. y BLUEPRINT H W S, INC. T. J, * :.� �,.` 1:5 17jFq .7 Pdge-Z of 3 Pages vat RECEiv4 Critical Areas Checklist* Site Information MM,3 - 1993 KAMMG OWT., Project Name: - A 9 e 2, A,441,?-JeAl Permit Number SitelLocation: L'MCA ;5,-M Property Tax Account Number. Approximate Site Size (acres or square feet): Z(I�eb Have you filled out a Critical Areas Checklist for a project on this site before? General Site Conditions 1. Has the site been cleared or logged? Ile Date of most recent action: Soils / Topography AWR1e-14~ a"IMI 2- � In the Snohomish County Soil SurvM what is the mapped soil type(s)? 44,V.0 4414,QZ4X 3- Describe the general site topography. Check all that apply. FW-.e Flat less than 5 feet elevation change over entire site. Rolling: slopeson site generally less than IS% (a vertical rise of 10 feet over a horizontal distance of 66 feet.) ffilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of 10 feet of horizontal distance.) I-,- Steep: grades of greater than 30% present on site. Comments *g�- A16,AA6X , 1.4* fle, 19AW AM Hydrology/Vegetatiort 4. Site contains areasof year-round standing water: & 5. Site contains areas of seasonal standing water. AIQ —Approx. Depth: 6. Site is'in the floodway A10 floodplain----&Q—of a water course. 7. Site contains a creek or an area where water flows across the grounds surface? __bV flows are year-round? _ALO - Flows are seasonal? WO 8. Site is primarily: forested meadow shrubs mixed 9- Obvious wetland is present.on site: HAQ 10. Wetland inventory or map indicates wetland present on site: 11. Critical Areas inventory or map indicates any Critical Area on site: MO F-6f�--Gty. Use Only City of Edmonds Critical Areas Checklist' -Me Critical An= Checklist contained an this form is to be filled out by any person prq)anng a Development Permit Application for the City of Edmonds prior to his/her submittal of a development permit to the city. Ile Purposcof 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 Cheeldist should be easily available fiorn observations of the site or data available at City Hall (Critical Areas inventories, maps, or soil surveys). A_u applicant. or his/her representative, must fill out the choc4dist, sign and date it, and submit it to the City. The City will revie-m the cheddist, 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 of the parcel with enough detail that city staff can find and identify the subject parcel(s). In addition, the applicant is encouraged to include any other pertinent information 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: MAN, ""'Marx Title 6 7 SOW Address City, State, Zip 776. ;�4 Phone Signature Date Applicant Representative: I Name Title Street Address ,-Akrizao, x1.4 mle,7 City, State, ZIP' Phone Signature Date The City of Edmonds Side Sewer Drawing EASEMENT NO . ............................................ NEW CONSTRUCTION REPAIRS F� LID NO . .................. . ASMT. NO . .................. -A)rc- 1. - OW-NER ................................................................................................ CONTRACTOR .................................................................................... PERMIT NO. (�W 7- - ......... 14 ----- 4jC—.-..\A/ ------ LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . .................................... JOB ADDRESS ........... . ..... NAMEOF ADDITION ............................................................................. ---------------------- V "I, LL c- �Nz) a- \-3 S j �--. �Z- 0 � PWW.0001-1 1/75 (REV.1 1/78) Approved: ....... By ......................... DATE ...... ........ 0;�: .....