23702 74TH AVE W.PDFIIIIIIIIIIII
5912
23702 74TH AVE W
CA FILE NO. Z0,6
Critical Areas Checklist
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Site Information (Soils/topography/h dr logy/vegetation)
Y I
1. Site AddressALocation: ;�37&-�L -7t4 14 urz- k=ST
2. Property Tax Account Number: _,!ntOL60 00-9 cn� —6Z-
3. Approximate Site Size (acres or square fe et): Q DM 2aiT
4. Is this site currently developed? v"- yes; — n Y
If yes; how is site developed?
5. Describ e general site topography. Check all that apply.
�� tFlat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (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 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 meadew' ;shrubs mixed
urban landscaped (lawn,shhibs etc) i�
II. Obvious wetland is present on site:
. ................. ............ ...... ....... ........ . .
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City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
Critical Areas File #:
2,67DD '05
Critical Areas Checklist Fee: $45.00
Date Received by Dev. Serv. Dept: 1+ S6 1 OV
City Receipt No: ! 5Z C12-
Date Mailed to Applicant:
CRITICAL AREAS CHECKLIST
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).
0 ner/Applicant:
Name
Street Address
PLEASE PRINT CLEARLY
Applicant Represenal%ce, V, ZO
APR 2 5'XIM
Name "J
VF W4Q'1:s crk
Ds
Street Address
city State zip
Telephone
Signature
L
Date
�411 04,
]A � 11A kRe I arm
I ff'4'�fi-t-'
ook SUREET riOLIE O's
CITY OF EDMONDS
LOT APPROVAL STREET
4
awkq'ti ADDRESS f:>-
ADDRESS OF PROPOSED BUILDING '473 767..Z —
LEGAL DESCRIPTION: LOT ck__5_'LAbDi Ti ON
TYPE OF USE NO-
�PEDROOM
SIZE 'OF LOT
SOURCE OF DRINKING WATERt Public Supply
Private Well
SURFACE DRAINAGE
1. Is disposal field site well drained? '/47
2, Any water course (stream., drainage ditch, etc.) through site?
b. TOPOGRAPHY
1. Any heavy slopes in field, area? JJ 0-
2.. Will present topsoil in field area be removed or gradpd before field tiles
are installed?— M48
3. Will any fill material be used in the disposal field site? 14/0
If year., how much?
SOIL CONDITIONS
1. Has a hole at least 4 feet deep been dug in the disposal field area to deter-
mine the txpe of soil present9 4ss -
2. After hole is dug record the soil condition --- Tat- the following depths. (Re-
cord as sand, graveli clay,, -packed sand, loan,,, etc.,
12 inches1S6.&,iWZ Citk.- 30 inches
YA, inches 1- 6 inches-
24 inches t 148 inches
3. Any ground water encountered before reaching a depth of 4 feet?_=t6l
If so at what depth?
d. WATER TEST
A simple water test will show how well this soil will drain or percolate water.
To perform this test:
1, Dig hole at least 36 inches deep. Use a shovel or post hole digger —
size of hole makes no difference —only depth.
2. Fill hole with water. Now let all water run out of hole. This soaks
the ground and will give a more accurate reading.
3. Again pour water in hole to a height of 12 inches from the bottom.
Let water run out until there is just 6 inches from bottom left in hole.
4. Note how many minutes it takes for this last 6 inches to seep away.
Record this time below.
Number of minutes for last 6 inches to seep away
5. Divide this time by 6 to obtain the rate per inch 7N
6. Date water test was performed
I hereby certify the above information to be correct and the above tests were
performed by me as prescribed.
ed
Sign �,_Cuj
Addre s s t, n� I-% kA *'k I 'T"kA Ae_gk
NOTE: A septic tank permit is issued on the basis of the above information. If
there are any changes or alterations in the above stated soil conditions it may
result in the installation being rejected at the time of inspection.
rM
Percolation Rate and Required Absorption Area. For single Family Dwellings.
Percolation Rate (Time in Lineal feet of 4 inch tile
minutes for water to fall us�ng trench with width of
one inch) two f eet
3
C150 mi
4
5
190
7
225
10
250
12
265
15
285
30
375
Over 30
Soil Unsuitable
C I T Y 0 F E D M 0 N D S
S E P T I C T A N K A F P R 0 V A L
TO WHMM IT MAY CONCERN:
This is to certify that the septic'tank— for
C--, S 0 --/�
70
has been inspected. and are according to City of Edmonds standards
DATE:
Insp-e
APPLICATION CARD No . ........... ..
for
The City of Edmonds SIDE SEWER PERMIT EASEMENT No . ................... ... . . . . ....... .
OUTSIDE 0 INSIDE 0 REPAIRS 0
OWNER ............................................. CONTRACTOR .. . .. .. .................. ... ........ .. PERMIT No.Q�7�13�
;Z 7 o Z- 7 4(.) STREET ZIL
HOUSE No . ............................................................................................................................ AVENUE LOT No ... ....... . .. BLOCK No . .........
.......... * ........ ...... .
NAME ADD ..C&je'c: . ........ . ................ . ........ ........ .... ...... .......
............. ..... .... . ......
to
r
-x-
cm
C.1
rj:)
1p-
7'
APPROVED
4T IV 1962
Date Approved:
BACKFILL WORK ORDER ISSUED ............................................ DEPOSIT, $ ......................................................
SEWERWORK ORDER ISSUED ................................................ DATE ...... . ...................... BY' .... ........ ...............................................