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TAX ACCOUNT/PARCEL NUM13ER:
BUILDING PERMIT (NEW
COVENANTS (RECORDED) FOR:
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CRITICAL AREAS: ��LDETERMINATION: E] Conditional Waiver [] Study R
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DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED: 1 -0
SEWER LID FEE $:
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
LID #:
BLOCK:
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/ INSOECTIONS REQ'D.
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H 40 OCT 19 2004
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DFR COUNTER
d- o3, TS4 OR PERMIT COUNTER
OWN ER/CON TRACTOR SCALE : 1"=20'
\AKING PROPERTIES, INC. W
P.O. BOX 1034 0' lo' 20' 40'
LYNNWOOD, WASHINGTON 98046
S
PHONE : 425-670-2711 PLOT PLAN
BENCH MARK FOR
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT THE LOT 11., VIKING HEIGHTS
CENTERLINE OF 238TH STREET S.W. AT
APPROXIMATELY THE MIDPOINT OF 11-iE IN SE1/4, SECTION 31, T.27N., R.4E., W.M.
PROPERTY. CITY OF EDMONDS
ELEVATION : 200.00 SNOHOMISH COUNTY, WASHINGTON
DATUM : ASSUMED
APPROVED AS NOTED
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— — — — — — — — — — — — — — — — — — — — — — — — — — — — —
HIGA-BURKHOLDER
NWASSOCIATES, LLC
LAND USE PLANNING I CIVIL ENGINERRINO
1721 Havdtt Avenue m Sulte 401 0 11 WA 90201
phone (425)252-28" 11 (425)252-9531
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City of Edmonds
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 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).
Date Received: 0-72
City Receipt#:_ (a '?> 0
Critical Areas File #: --2 cx)*37W�20
Critical Areas Checklist Fee: $45.00
Date Mailed to App licant: 41—//-03
A property owner, or his/her authorized 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 assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds ham-dess from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information fumished by the applicant, his/her/its 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 t is plication "e behal e owner as listed below.
SIGNATURE oF APPLicANT1A7G--- DATE z Zo --,r
Property Owner's Authlo"A ad
By my signature, I certify I authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for e 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
Owner/Applicant:
Name
1Z i; C -3 Z
Street Address
4;bvajvz�
city State zip
Telephone: 6/' C�l
I Email address (optional):
Applicant Representative:
C>f T
Name
1-77,1
Street Address
. Zf-4&Y M—
city State zip
Telephone: 1Y Z 5' - 7-5-9 - 2,e50
Email Address (optional): )o4v,) okp-bt
U W
Critical Amas Checklist.doe/3.19.2001
0
0
City of Edmonds
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 are, or
may be, present on the subject property. The information
needed to comple te the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps,' or soil
surveys).
Date Received: 311 V 1 0-*�2
City Receipt#:_ 1 1 11p,5 0
Critical Areas File M -700-3 -60ai
Critical Areas Checklist Fe!��45-00
Date Mailed to Applicant 3
A property owner, or his/her authorized 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
pennit application.
Please submit a vicinity map, along with the.signed copy
of this form to assist City staff in firiding 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 assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in considerution on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attomey's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information fiirnished by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file )plicatio b h I
owner as listed below.
SIGNATURE oF APPLicANT/AG DATE
Property Owner's Auth7olr*ati
By my signature, I cer* I e authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for ie 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
Owner/Applicant:
I —
"Ow 1J
14ame I
/-Z -2
Street Address
4;6w0iV4?5
city State zip
Telephone: L/' 4f
Email address (optional):
Applicant Representadve:
Name
-77, / Hc;cvt 77— 461-;;-
Street Address
city State zip
Telephone: 1Y
Email Address (optional): -Iohj��P ok---bt
U W
Critical Areas Checklist.doet3.192001