23627 74TH AVE W.PDFiiiiiiiiiiii
5911
23627 74TH AVE W
0':
USE
ZONE PERMIT
CITY OF EDMONDS NUMBER
CONSTRUCTION PERMIT APPLICATION oa .SUITEIAPT #
OWNER NAME/NAME OF BUSINESS ADDRESS
IX 45 LEGAL DESCRIPTION CHECKI SUBDIVISION NO. LID NO.
W MAiLfING"ADDR�SS
Z
o Z TESCP Approved 11
.1:7 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
CITY- ZIP TELEPHONE NUMBER RW Permit Required 0'
EXISTING — REQUIRED DEDICATION Street Use Permit Req'd 0
F_J MOM,4 1AA Inspection Required 0
AAME PROPOSED Sidewalk Required 0
a:
W
METER SIZE LINE SIZE NO. OF FIXTURES FRV REQUIRED
<
Ltd ADDRESS YES 0 NO C3
REMARKS
CITY ZIP TELEPHONE NUMBER E5
< tu
Z
Z
NAME
Luek*&
cc ADDRESS re7 er_
0 ENGINEERING MEMO DATED
I'_
1! 2 REVIEWED BY
R CITT _ZIP_ TELEPHONE NUMBER
t- IRE MEMO DATED REVIEWED BY
OZ 114 ze%r :4r 7a r -0 A� -7 C.
W
cr
ShTE LFCkN91E'NUMdER Ex0iFirTidN DATE
VARIANCE OR CU ADB# SHORELINE #
Legal Description of Property - include all easements ft__Mmw� j
SEPA REVIEW SIGN AREA
COMPLETE I EXEMPT ALL:��PROPOSED ALLOWED ID
__JPROPOSE
_w
COT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
Lu
ALL OSED FRONT SIDE REAR FRONT UR SIDE REAR
Z
Z
Property LOT AREA
T x Account W BY VATE/
P:rcel No.
REMA&S 7711
NEW RESIDENTIAL PLUMBINGIMECH Ap
COMPLIANCE OR
ADDITION 1:1 COMMERCIAL Ej CHANGE OF USE
EIREMODEL 1:1 APT. BLDG. SIGN
HECKED BY TYPE OF CONSTRUCTION
GRADING FENCE CODE OCCUPANT
1:1 REPAIR El - CYDS`. D x —FT) GROUP
1 9-9--
WOODSTOVE SWIM POOL OCCUPANT
INSERT HOT TUB/SPA REQUIRED LOAD
DEMOLISH SPECIAL INSPECTOR
[3 q4GARAGE RETAINING WALL/ �562j:a:�
F-1 C EIROCKERY El RENEWAL REMARKS I
Z
0 (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 108
M Vir
0-
U) NUMBER -95MBER OF CRITICAL
W
0 OF DWELLING AREAS
STORIES UNITS ____ I NUMBER
- DESCRIBETWORK TO BE DONE (ATTACH PLOT PLAN)
SPECTION REOUIRED
b -&5iee� I.
VALUATION FEE
r V r 1_— r— r V FEE
Jt;� V 14,"-7'7 A) c-
Nfxf'sbuF('c9: r I 'JILE[AfING
% IF
PLUMBING
Plan Check No. MECHANICAL
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (cufts, sidewalks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE
successors in interest, agrees to indemnity, defend and hold
'Un, harmless the City of Edmonds, Washington, its officials,
j
m employees, and agents from any and all claims for damages of
cc whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this, permit shall not be deemed to PLAN CHECK DEPOSIT
_j I ive or reduce any requirement of any city ordinance
0
nor limit in any way the City s ability to enforce any ordinance TOTAL,;AMOUNT DUE
provision.
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and THIS PERMIT
state laws regulating construction; and in doing the work authoriz- AUTHORIZES This application is not a permit until
ed thereby, no person will be employed in violation of the Labor . ONLY THE signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
tion Insurance aria RCW 18.27. INSPECTION acknowledged in space provided.
SIGNATURE (OWNER OR AGENT) DATE SIGNED DEPARTMENT
CITY OF OFFICIAL GNAT DATE
A 'L —JJ I IA4 EDMONDS
xM // //.// / ;�
CALL FOR FIE . �EA��CrB'r,. DATE
TION INSPECTION & Z
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE '77 1 --- f
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 1-0220 ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109 PINK — Owner GOLD — Assessor
10247
STREET
00
r%-
� rl Em E 'T i k L �
�1
11�-N
Plot Plan
of
House Location
for
DOUGLAS ROGERS
I C-
F-7.-,
%A
N
23t
A Portion of Gov't. Lot 6 See. 32-27-4
See Attached Legal Description
September 1977
CITY OF
EDMONDS
rz*,WzD�PT.JF,�GINEERING
DIV,
. I h
DAT415rff7
LXF% I'A 1 N L
By
REMARK9
7-0 N E
%J
S A C!", S:
tu
R R
OTHER
HEIGHT
191-EDIKO
SEP 2 5 1998
,NMYWNG &'ASSOC, INC.
-23423 Highway
Edmonds, WA 98020
Box 32 Lynnwood, WA 98036
'1778-3101
C fiElvo
*ex
tA
ol
"-L
Cr-
'5'r
ANNI
O"TREE I T FIL E
pw; r..:"417
Plot
f ion of Govt.'Lot 6 Sec, 32-27-4
of 9. Por
-;�o -C'Zl — -Att iched Leg
HousqLocation Sie a al Description
S
ept"er 1977
DOUGLAS ROGM CIV�OF EDMONDS
-Wz.DEPT. GINEERING DIV,
LXAMIN __T
BY
REMARK9.
7717
ZONE
SET E3A'!!'S:
-IN
DWI
4. F
N OTHER
4
HEIGHT3L,
j
CH40
IWC
:MEY-R1NG*A'-.ASSvC,
S
�-3423 Hig�wai.
Edmonds, WA, 98020
%
32 lynn;*64 VA 98036 0
AL
�STREET FILE P, 0. ]Box
-.3101
778
. A. -7.
CITY,��,O.F'_EDOONDS_ 0.
PUBLIC WORXS DEPARTMENTj ENG.1 NEER I NG__RVI SION
-OF- - C
,PPLJ ATION �FOR. RIGHT WAY QNSTRUCTION PERMIT
REET. FILF
'THIS PERMIT MU,ST BE !VAILA`BLE AT THE JOB SITE FOR INSPECTION PURPO'SES
Appli-cant.to Complete-P.arts-A and.B
A. Permi.t to be issued to.: Snohomish Cou'nfy PX.D. #1
72�_
.For Vork at:(,address -or vicinity) _7�
Type of Work to be done:
(attach drawing when applicable)
Time Required Start: I -day Finish:
Owner: Snohomish County VU.D� #1
Name
21018 Hwy 99
Mailing.Address
Lynnwood, WA 98036 774-2112
City State Zip Telephone Number
Contractor: �same.as above
Name State License Number
Mailing Address
,.City, State Zip Telephone Number
B, INDEMNITY.: Applicant understands and by his�signature to this �pplication, agrees
to hold the.City of Edmonds harmless:from any injuries, damages, or claims of�any`
kind or description -whatsoever, foreseen or unforeseen, that may�be.made against
the.applicant or the City of Edmonds, or any of its departments or-employe6s,
-including or not limited to the defense of any legal proceedings including defense
-costs, court costs, and attorney fees by:reason of granting this permit,.
Upon issuance of this permit, the contractor is responsible for workma * nship and
mate , rials for a period of one ye ' ar following the final inspection.and acceptance
.of the restoration by the Engineering Division.
Funds held from the SecurityDeposit (estimated restoration fee) will be 'held until
the final street patch -is completed, at which time, a debit or credit, will be
processed for issuance�to the applicant.
Work is subject to inspectionland restoration in acco ' rdance vith-City Code. A
..24-hour notice is required for inspection by Engineering. Call 775-.2525, ext. 220.
I?understand �that this permit must be availab at the job site for inspection
pprposes at all times.
Signature..�� %N\kk\�k Date:
Own-er or ng nt___D
C, TO BE -COMPLETED BY. -ISSUING AGENCY:
Date Issued: 7-.7,9. Permit No.: Fee: J,/.:r
Security Bond: zt,/ ,oy
Time Authorize:d:
APPROVED By D. a t e
lj\-
'1400
PUBLIC WORKS DEPARnW CHECKLIST
tUILDING PERMIT RE= E
(address) (date)
0
1 . , ..
Street Rig�it-of-Way Exist!t,,Z. I REQD
Z
�I;EQD
Access Easements Existing. f4Ar A
p4
Utility Easement Exist' REQD
Lot Per Subdivision Plat Assessor Map
Site Plan Checked for Accurac�."...
Z
Underground 14iring Reqd.
Check Accuracy of Legal Description,
.Z-
Review by Date
A
Existing Water Main Size 01C
Water Main Required C)
..Service
Line Required '9� -Vk
Hydrant Size Existing
Hydrant Reqd Per Fire Code Size
Detector Check Meter Reqd.
Cross Connection Inspection
Fire Department Conments
Water Meter Charge Reqd._&tq!�� L,,- gi& za�LA�
Review by Date
LK.K.
Septic Tank Design Approved A"JI-11 Date
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Availability Proj.
Drawing No. File No.
Side Sewer Availability
Sanitary Sewer Connection Fee Reqd.
Review by Date
K.K.K.
Op en Ditch Existing__,&,/4re? Reqd.
Culvert Reqd. __Size
c4
Catch Basin Reqd. Indicate on Site Plan
0
V
Shoulder drainage maintain collection on swale open runoff AdZ=
E-4
Manhole reqd. Indicate on Site Plan
Soil Conditions and Ground Water Field Checke
Review by. Date
V-�f�
Revised: 1v10-1977
Page 2
Reqd.
Street Paving AAF
Curb and Gutter Reqd.
Sidewalk Reqd.
Curb Cut for Drivewa; Reqd.
Right-of-WayConstruction Permit Reqd.
Bond Reqd. for Public Irrpravenents
Street*Name Sign Reqd.
Other Signing Reqd.
Pre Permit Site Inspection made an '-'--�Lj 4-jIfe
z
0
H BY:. SEWER
E-4
WATER
P-4
U)
z STREET
ENGINEERING
Special* Requirements listed in memo to CoTmunity. Development Departnmt,
Building Division
> BY 41�) -f\j Date A
o All item filled in an Building Permit Application
r4 BY t22 Date AR
Drawings Stairped and Notations Made
P4 BY Date
<4
Approved �y Public Works Department
(y
4
t �
Fzvised: 1v 10-1977..
If
qTRF,;=.ET FILE*
780471
FILE #
FORM FOR [PWWn/F1T\;ALj DECLAMTION OF f9IMPOWMINONSIGNIFICYONCE]
Tescription of proposal Remodel -of existing single family dwelling
Proponent Doug I as E.- Roger's
Location of Proposal 23627 74th Avenue West
Lead Agency City of Edmonds
1his pro-posal has bccn cicte-ml.ned to [imm/not haNe] a signi.f-icant ad-
verse iT .�pcct upon -&.e ei Aii EIS Wis not] requIred u-nder
101 43.21C.030(2) ((�) . -Fni.s dc.-ci.-Jon i..-as r-..adc after rcviei..,. b), tl,,c lead
aaenl-), of a completcd envirou-,icnta1 checklist *
C, L and other inforriat'Lan. on
file with Uic Icad agency.
Responsible Offici.,il Mary Lou Block
Position/Title Associate City Plann"er
Date August 14, 1978 Signaturem
780471
ENVIRONMENTAL ASSESSMENT FILE #
DESCRIPTION OF PROPOSAL: I�Ose-
-7
44 k--
PROPONENT: 4,1-C V067 eR-5,
EXISTING USE:
ENVIRONMENTAL IMPACTS FROM PROPOSAL:
SOILS/TOPOGRAPHY 2-014 7-VMe 6-Row6t�14/ ��Olq Adogoti)
WATER/DRAINAGE - A147-6,Q
XIW6- Z—,,-MU,40 Zoe
W11-1, e-VCA1h14-t61q R041- -11WT )ez'5;'0.3
AIR QUALITY M0 CY114A14e� 6)(IS77AIf 4&M66S1-.'.
1141MAIT 41& PrX4V"0A1- rMe-$11-9e-6- SY1'FW
/A/ *u'7v 794--A�,6-
CIRCULATION - - 46C-es,!� To I*Tt Vo q4P177Pv4'-
VEGETATION - ff0'g'6-'1j0t141-
ECON014IC
CITY SERV ICES - AV'41441366-- 7-V "15-1-7A1,6
ENVIRONMENTAL FINDINGS:
There will be certain environmental impacts but they do not constitute a signif-
Tcant adverse impact on the environment and no environmental impact statement
will be.required.
There will be significant adverse impacts on the environment and an environmental
impact statement will be required.
There will be certain impacts on the environment however it is necessary to obtain
more information before a declaration of significance or no6-significance.is made.
/all- -� 9114-17?
CITY PLANNER / DATE
CITY ENGINEER DATE
E/A '76
7
PROJECT NAME V
DATE SUBMITTED
Ell V IBUNMENTAL ASSESSMENT 780471
In order to meet the requirements of the State Environmental Policy Act of 1971,
the responsible official must make a declaration of environmental impact as early
as possible in the process of evaluating a project.
The information in this form will be used to determine whether it will be necess-
.�.nL t
_�o require an environmental impact s atement. If an impact statement is
not required, a Statement of Negative Declaration will be placed in the file.
If an impact statement is required, a draft statement must be filed with this
office, public notice given and a review period of 30 days allowed. The final
statement and comments must be filed with the Department of Ecology, Office of
L
the Governor and the Ecological Commission.
The Edmonds Planning Staff will assist' you in any i-,iay we can in accumulating
this information and we would appreciateyour cooperation.
1. Land:
Area in acres
Soils type Lfini tati ons
Description of topography ('/0 sl'ope)
Grading:
estimated cubic yds.
NOTE: If grading or filling
Filling:
estimated cubic yds.
wil exceed 500 cubic yards
grading and filling plan
—a
must be submitted with the
2. Water:
application.
Stream -
estimated flow (cubic
feet per second)
Will stream be altered?
6:�9v
To what
degree? - ,
/;XV,
Impact on storm drainage (increase in run-off)
Estimated area Ao be paved %
Estimated area in open space
Shorelines: within 200 ft. of Mean Higher High Water
101,
Adjacent to shorel i nes zone
Environmental Assessment, page 2
3. Vegetation:
Type of trees o be removed- Z
Minimum diameter of trees to remain _4
Ground cover % to be removed
Proposed landscaping, if any
4. Existing Land Use within-300 Irt. radius of proposed development,:
Vacant
Single
Family
Multi -
Family
Comm.
Other
North
South
East
West
.5. Circulation:
Estimated increase in auto trips daily C"�
Est imat ed demand for public transportation eu C)
Degree of change on adjacent streets _10CA-)e
6. Area of impact:
neighborhood 99&—L
city-wide /v/
.regional A
MO
7. Effect on air quality
8. dhanges in noise generation: CI AX_:'
.2
3.
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
.22
23
24
25
27
28
29
30
31
32
33
34
35
36
37
38
39
40
.41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
DATE:
A $25 fee will be collected by the City of Edmonds for analysis
of the Environmental Checklist and the preparation of a Threshold
Determination. No -fee will be charged for proposals which would
be categorically exempt if they were not located in an environ-
mentally sensitive area.
ENVIRONKENTAL CHECKLIST FORM
1. BACKGROU14D
I . Name of Proponent:
2. Address and Phone N=b-al ot 1) -oponent:
L__V 67 57 k (7 2- 0
3. Date cjjeckIist7'SGVr,.iitted 4+ — -72Y
4. Agency Requiring Checkli-St .47, 44-6'N )eVIOP, 7
5. Name of Proposal, if applicablc?�- (S , I
6. Nature and Brio�f DescripLiol-I of tie I'roposaF_T_i7_n_cTu_U_-
ing but not lftiited to its size- �,eneral design ele-
ments, and other factors that will rive an accurate
uni standi its scope and, nature):
7. Lb'(fati6n ot Proposal (oes7cribe the Ohysical tettiilg of
the proposal, as well as the extent ok the land area
affected by aiiy environmental impacts, including any
other information needed to give in accura�_, understand-
ing of the environmenra settin�k of the pro, a
-4e -- .
4Z�
ef
8. E st y1la L e d ",ompletion of --Chu Proposed Action:
4 4-t'e
9. U. s L of all Permits, Licenses or Government Approvals.
Required for the Proposal .(federal, state and local —
including rezoiies)
-31-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
10. Do you have any plans for future additions, expansion..
or further activity related to or connected with this
proposal7 If xplain:
11. Do you know of any plans by others which may affect —
the property covered by your proposal? If yes, explain:
-(2.
12. Attach any other application form that has been coM__
pleted regarding the proposal; if none has been com-
pleted, but is expected to.be filed at some future
date, describe the nature of such application form:
II. ENVIRONMENTAL IMPACTS
(Explanations of all "yes" and "maybe" answers are
required)
Yes Maybe
No
(1) Earth. Will the proposal result in:
(a) Unstable earth conditions or in
changes in geologic substructures?
(b) Disruptions, displacements, com-
paction or overcovering of the �oil?
(c) Change in topography or ground
surface relief features?
(d) The destruction, covering or
modification of'any unique geologic
or physical features?
(e) Any increase in wind or water
erosion of soils, either on or off
the site?
(f) Changes in deposition or ero-
sion of beach sands, or changes
in siltation, deposition or . erosion
which may modify the channel 'of a
river or stream or the bed'of the
ocean bay, inlet lake?
or any or
Explanation:.
(2) Air. Will the proposal result in:
(a) Air emissions or deterioration
of ambient air quality?
(b) The creation of objectionable
odors.?
(c) Alteration of air movement,
moisture or temperature, or any
change in c'intate, either locally
or regionally?
Explanation:
-32-
Yes Maybe No
(3) Water. Will the proposal result in:
2;
3';
(a) Changes in currents, or the
4:
course or directIon'of water move-..
5:
ments, in either marine or fresh
61
waters?
71
8!
(b) Changes in absorption rates,
9!
drainage patterns, or the rate and
10
amount of surface water runoff?
12i
(c) Alterations to the course or
13i
flow of flood waters?
141
151
(d) Change in the amount of sur-
161
face water in any water body?
17
181
(e) Discharge into surface waters,
or in any alteration -of surface
20
water quality, including but not
21,11
limited to temperature, dissolved
22
oxygen or turbidity?
231
24!
(f) Alteration of the direction
25
or rate of flow of ground waters?
26!
27
(g) Change in the quantity of
28
-
ground waters, either through
29
direct additions or withdrawals,
30
or through interception of an
31
aquifer by cuts or excavations?
32
33
(h) Deterioration in ground water
34
quality, either through direct in-
35
jection, or through the seepage of
36
leachate, phosphates, detergents,
37
waterborne virus or bacteria-, or
38
other substances into the ground
39
waters?
40
41
(i) Reduction in the amount of
42
water otherwise available for
43
public water supplies?
44
45
Explanation: -(Zu,�jdOj'Ic-),7 pte-elx,�A'
A(o
46
47
48
(4) Flora. Will the proposal result in:
49
50
(a) Change in the diversity of
51
species, or numbers of any species
52
of flora (including trees, shrubs,
53
grass, crops, microflora and
54
aquatic plants)?
.55
56
(b) Reduction of the numbers of
57
any unique, rare or endangered
58
species of flora?
-33-
Yes Maybe No
(c) Introduction of new species
of flora into an area, or in a
barrier to th�e:norinal replenish-
ment of existing species?
(d) Reduction in acreage of any
agricultural crop?
Explanation:
(5) Fauna. Will the proposal result in:
(a) Changes in the diversity of
species, or numbers of any species
of fauna (birds, land animals
including reptiles, fish and shell-
fish, benthic organisms, insects or
microfauna)?
�(b) Reduction of the numbers of
any unique, rare or endangered.
species of fauna?
(c) Introduction of new species
of fauna into.an area, or result
in.a barrier to the migration or
movement of fauna?
Deterioration to existing
fish or wildlife habitat?
Explanation:
(6) Noise. Will the proposal increase
i�-xisting noise levels? L__
Explanation:
(7) Light and Glare. Will the pro-
posal pro--d-uce-new light or
glare?
Explanation:
(8) Land Use. Will the proposal
i7`e�-sut in the alteration of the
present or planned land use of an
area?
Explanation:
-34-
1-N
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34.
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
.58
I
Yes Maybe No
(9)
Natural Resources. Will the pro-
posal result in:
(a) Increase in the rate of use
of any natural resources?
(b) Depletion of any nonrenewable
natural resource?
Explanation:
(10)
Risk of Upset. Does the proposal
involve a risk ot an explosion or
the release of hazardous substances
(including, but not limited to,'
oil. pesticides, chemicals or
radiation) in the event of an acci-
dent or upset conditions?
Explanation:
(11)
P lation. Will the proposal
HHH'r Re location, distribution,
density, or growth rate of the
human population of an area?
Explanation:
(12)
Hous ing. I -Jill the proposal affect
existing housing availability, or
create a demand for addi�ional
housing?
Explanation:
(13)
Transportation/Circulation. Will
.the p�oposal res-u—EtEin:
(a) Generation of additional
vehicular movement?
(b) Effects on existing parking
facilivies, or demand for new
parking?
(c) Impact upon existing trans-
portation systems?
(d) Alterations to present
patterns of circulation or move-
menL of people and/or goods?
(e) Alterations to waterborne,
rail or air traffic?
-35-
Yes Maybe
li2
1
.(f) Increase in traffic hazards.
2
to motor vehicles. bicyclists or
3
pedestrians?
4.
5
Explanation:.
6
7
8
(14) Public Services. Will the pro-
9
posal li ve in effect upon, or
result in a need for new govern-
11
mental services in any of the
12
following areas:
13
14
(a Fire protectioni
15
16
(b) Police protection?
17
18
(c) Schools?
19,
20
(d) Parks or other recreational
21
facilities?
22
1
23;
(C) Maintenance of'public facili-
24
ties. including roads?
25
26
(f) Other governmental services?
27
28
Explanation:
29
30
31
(15) �Dfrgy. Will the proposal result in:
32
33
(a) Use of substantial amounts of
34
fuel or energy?
351
361
(b) Demand upon existing sources
37;
of energy, or require the develop-
38
39
ment of new sources of energy?
40
Explanation:
41
42'_
43
(16.) Utilities. Will the proposal
44
re"s-uT—Lin a need for !_ystems,
45
o--r alterations to the following
46
utilities:
47
48
(a) Power or natural gas?
49
50
(b) Corrdilunica t ions systems?
51
52
(c) Water?
53
54
(d) Sewer or septic tanks?
55
56
(e)_ Storm water drainage?
57
58
(f) Solid waste and disposal?
59
60
E.xplanation:
61
-36-
Yes No
1 (17) Human Health. Will the proposal
2 result in r e creation of any
3. health hazard or potential health
41 hazard (excluding mental health)7
5
61 Explanation:
7
8
91 (18) Aesthetics. Will.the proposal
10 result in the obstruction of any
111 scenic vista or view open to the
12: public, or will the proposal re-
13 sult in the creation of an
14 aesthetically offensive site open
15 to public view?
16
17 Explanation:
18
19
20 (19) Recreation. Will the proposal
21 resuTt—itT—an impact upon the
22 quality or quantity of existing
23 recreational opportunities?
24
25 Explanation:
26
27
28 .(20) Archeolopica 3. /His torica 1. Will the
29 proposal result in -a-n--aTteration of
30 a significant archeological . or his-
31 torical. site, structure, object
32 or building?
33
34 Explanation:
35
36
37 111. SIGNATURE
38
39 1, the undersigned, state that to the best of my knowledge
40 the above information is true and complete. It is understood
41 that the lead agency may withdraw any declaration of non-signi-
42 ficance that it might issue in reliance upon this chec'!-list
43 should there be any misrepresentation or lack of full c osur
44 on my part.
45
46 Propon t:-
47
48 WAC 197-10-370 WITHDRAWAL OF -IM%TI%7E THRESHOLD
49 DETERMINTATION. If it any time a�p r the entry of a decl.ra-
50 tion of significance, the propoyrent modifies the proposal
51 so that, in the judgment of the lead agency, all significant
52 adverse environmental impacts resulting therefrom are elimin-
53 ated, the declaration of significance ohall be withdrawn
54 and a declaration of non -significance entered instead. ' The
55 lead agency shall. also revise the registers at its SEPA
56 public information center accordingly. If the pro-
57 ponent of a proposal is a private applicant, the proposal
58 shall not be considered modified until all license applica-
59 tions 'for the proposal are revised to refle'
ct the modification.
-37-
i I . - " -. - i
C:)
r4,1�
cc
Q
QD
14LIR,
CITY CLEI?K
(.'ivic Co,,(jtor
Urnotitif,,
FILE
COVENANT
WHEREAS, the.Granto.r, Douglas E. Rogers, a single
man, hereafter referred to as "Grantor", has applied for a
Building Permit for property located at,,2362'7-74th Avenue -West
in Edmonds, Washington, which is zoned.RSW-12000; and
.WHEREAS, Grantor's property has a pre-existing non-
conforming dwelling unit in the structure, which existed prior
to the effective date of the.Edmonds Zoning Code; and
WHEREAS Grantor desires to remodel said structure but
desires to agree not toexpand or enlarge said non -conforming
dwelling unit;
NOW THEREFORE, in consideration o'f the Ci.ty of Edmonds
issuing a Building Permit, and for mutual benefits, Grantor
agrees as follows:
Grantor is owner of certain real property located
in Edmonds, Snohomish County, Washington and
legally described as "Exhibit A" attached hereto'
and incorporated in full by this reference;
This covenant and all terms hereof shall be binding
on Grantor, his heirs, assigns, and successors in
interest, and shall be deemed to run with the land
and bind all future owners of the property described
on "Exhibit A" -
Grantor, his heirs and successors, acknowledge that
the -dwelling unit located in.the basement area of
the home on the subject property is a non -conforming
use and in violation of the terms of the Edmonds
Zoning Code and Map. Grantor, his heirs and.successors,
covenant that said non -conforming dwelling unit in
the basement of the structure shall not be enlarged
or expanded. No other non -conforming units shall be
NzO SJftLF_S TAX
�onstructed on the subject property;
REQUE"ZED
AUG, J). 191;3
MR1 d
V01 1371 PAC'E.678
7808300289
CITYCLIkK
civic cenicr
Vii-ishington
E(J111011(is,
4. This covenant sh all be recorded in the Snohomish
County Auditors Office, Grantor to pay al.1 recording
fees;
5. In the event Grantor, his heirs and successors.
violate any of the terms of this covenant, the -
City of Edmonds shall be entitled to enforce the
terms.hereof by specific.performance. In the event
the City is required'to enforce the terms of this
covenant, Grantor, his heirs or successors, shall
pay the City.'s cos.ts, including reasonable attorney's-
fees.
DATED this /3 day of August 1978.
GRANTOR:
STATE OF WASHINGTON
COUNTY OF SNOHOMISH ss
Rogers, q/'s4ngje--man-
On.this day personally appeared before me 979- Al
to me known to be the individual described in and who executed t�e
within and foregoing instrument, and acknowledged that he signed
as his free and voluntary act and deed, for the.uses and
t
herein mentioned. --till
G4vkn-. under my hand and official seal this
`day of August,
_0 tot:
C, P U
f ------
o Notffr' Public�'in and or the State oT
y
Washington, residing inn)rU."W"o-&—
voL1371 P"ITE-679
TRP81300289
Qr
A'
CITY CL11%
Civic. Catil(tr
Edmonds,
i INN
EXHIBIT A
ALL THAT PORTION OF GOVERNMENT LOT 6, SECTION 32, TOWNSHIP 27'NORTH,
RANGE.4., EAST W.M...? DESCRIBED AS FOLLOWS:
COMMENCING AT A POINT WHERE THE NORTH LINE OF MCALEER WAY INT . ERSECTS
THE SHORE LINE OF LAKE BALLINGER; 'THENCE NORTHERLY ALONG 'SAID LAKE
SHORE, A DISTANCE OF 360 FEET, MORE OR LESS,TO THE'SOUTHEAST CORNER -OF
A TRACT CONVEYED TO ALBERT G. HINCKLEY AND WIFE, BY DEED RECORDED
UNDER SNOHOMISH COUNTY AUDITOR'S FILE NO. 376663, THE TRUE POINT OF
BEGINNING; THENCE WEST ALONG THE SOUTH BOUNDARY OF SAID HINCKLEY
TRACT TO A POINT ON THE EAST BOUNDARY OF COUNTY ROAD; THENCE SOUTH-
EASTERLY ALONG SAID, COUNTY ROAD TO A POINT ON A LINE WHICH IS 100 FEET
SOUTH OF AND PARALLEL TO THE SOUTH LINE OF SAID HINCKLEY TRACT; THENCE
EAST ON SAID PARALLEL LINE TO.THE SHORE LINE OF LAKE BALLINGERJ-
THENCE NORTHERLY ALONG SAID SHORE LINE 100 FEET, MORE OR LESS, TO
THE TRUE POINT OF BEGINNING.'
TOGETHER WITH SHORE LANDS OF 'THE SECOND CLASS AS CONVEYED BY THE STATE
OF WASHINGTON, IN FRONT OF, ADJACENT TO OR ABUTTING THEREON,'SITUATE
IN THE COUNTY OF SNOHOMISH, STATE OF WASHI.NGTON.
voL 1371 PA'GE 680
7008300289
Ale"
't
m
APPLICATION CAR15� rio . ........................
..............
for
'T ............
Ihg City of Edmonds Q
SlIDE SEWER PERMT
Q EASEMENT No . .................
ET VIL OUTSIDE INSIDE F-1 REPAIRS
ol
OWNER' ............................................ CONTRACTOR .................. .. .. ......
STREET
HOUSE No.
-------- . .. . ...................... ........ ............ AVENUE LOT No . ................................
NAME ADD . .............................................
Date
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ ....................
SEWER WORK ORDER ISSUED .................... .....................
Approved:
........... PERMIT No.
.......................... ...... BLOCK No . ...............................................
................
BY .... ..................
DATE ......................
'10
CA FILE NO. I G
Critical Areas Checklist
--------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
I . Site Address/Location: _24C,,2 7 7 Y �"'14 Ve u)
2. Property Tax Account Number: 00 -7 - 000 q
3. Approximate Site Size (acres or squar feet): or�) :�g 44� le
4. Is this site currently developed? 7
yes; no.
If yes; how is site developed? 9(_1 -:1 je, t141 Lle we-
5. Describe the general site topography. Check all that apply.
--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
I 0-feet over a horizontal distance of 3 3 to 66-feet).
Steep: grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
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? (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is resent on site:
p
------------------------------------------------------- For. City Staff Use Only ----------------------------------------------
':/N:
^cn_chk.doc; Rev 10/03/97
RECEIVED
City of Edmonds
JUN 0 5 1998
IMF CRITICAL AREAS CHECKLIST MMMI WilY qERVICES
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, 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.
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 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 Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
Name
,,2 3 & ?, -�
Street Address
city State Zip
'17
Telephone
Signature
Date
C:recepticn\jana\cac1.doc
Applicant Representative:
'ILA L46-k('C-
Name
1-2--10q
Street Address
city State Zip
Tel
Sanature
60
Date
(over)
7S,
.CITY OF EDMONDS BARBARA FAHEY
MAYOR
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works a Planning/Building * Parks and Recreation e Engineering e Wastewater Treatment Plant
June 29, 1998
Douglas Rogers
2362774 th Ave. West
Edmonds, WA 98026
Subject: Determination regarding Critical Areas Checklist # 98-154
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.
..............
IMPORTANT INFORMATION TO BE NOTED.
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL.INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS ORCRITIC AREASSTUDY
AL
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific. determination.
ollo, 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.
Enc: Critical Areas Determination
* Architectural Design Board
Thank you.
Sharla Graham
Acting Planning Secretary
C:Reception\Jana\CRLTR.doc
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
j
,5 qp O-JP
K,o 9 re, S'dem & e
,;L3 (eA7 7�"A A ve- U/
rz:: j vVA- cfSo;'—L)
z
z
0
114 Sea Cor
S.W. I/
City of Edmonds
Critical Areas Determination
Tin
Applicant: John Luckie Determination #: CA-98-154
Project Name: Non -Project Specific Permit Number:
Site Location: 23627'74 Ih Avenue West Property Tax Acct #: 1 322704-3-007-0004 1
Project Description:
New dock
Determination: Study Required:
The subject site is located on the shore of Lake Ballinger, a Class I wetland and wildlife habitat
critical area subject to to the requirements of Chapter 20-15B of the Edmonds Community
Development Code (ECDC). The site is also designated as an Environmentally Sensitive Area
due to water environment.
Prior to submission of any development permit, you will be required to provide the following for
review by the Planning Department:
1. A wetland delineation by a qualified wetland biologist identifing the boundaries of the
wetland and proposed mitigations to show no net loss of function and/or size of the wetland
and its buffer..
2. An Environmental Checklist for SEPA review will be required for any development
proposals and future building permits for this site.
3. A Shoreline Management Permit may be required if the project does not meet one of the
State Shoreline permit exempti(
Karissa Kawarnoto
Name
6/26/98
Date