23912 84TH AVE W.PDF111111111111
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23912 84TH AVE W
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ADD RESS:
TAX ACCOUNT/PARCEL #:
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: DETERMINATION: El Conditional Waiver 0 Study Required Waiver
CRITICAL AREAS #: DETERMINATION: f-1 Conditional Waiver El Study Required El Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER — list permit #'s):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:kTEMP\DST'skForms\Jana's Street File Checklist 5-14-08.doc
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#P20
ED
City of Edmonds Date Received:
Development Services Department City Receipt #:
Planning Division Critical Areas #-C IP-A -21k9q-,0011
Phone: 425.771.0220 Critical Areas Checklist Fee: $135.00
Date Mailed to Applicant:
0C. 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).
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 harmless 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 furnished by the applicant, bis/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 fi pli t e e a
,�to�is ap Ica ' h b h If of the owner as listed below. 8
Z:2 DATE
SIGNATURE OF APPLICANVAGENT
Property Owner's Authorizatio
By my signature, I certify that I have authorized the above Applicant/Agent 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/Applicant:
M oxc, X-.1 I
Name
-70tcl N �- A,,IF. OE
Street Address I
SOX46- UJ q8 1, 9
city State Zip
Telephone:
QL,0 6 -- -7 Eq — 6 (,, J--7
Email address (optional):
DATE
Applicant Representative:
Name
1---�C>00 +f,,,:i
Street Address f
City State Zip
Telephone:
Email Address (optional): Owee
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#P20
V ED-Af
0 City of Edmonds Date Received:
Development Services Department City Receipt#:
Planning Division Critical Areas File #:
Phone: 425.771.0220 Critical Areas Checklist Fee: $135.00
Fax: 425.771.0221 Date Mailed to Applicant:
ft"TIZ,
,�. 1 S9
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).
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 forin. 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 beirs, and assigns, in consideration 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
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished 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 etofi � Lisappli�ca nithe behalf of the owner as listedbelow.
-Z
SIGNATURE OF APPLICANVAGENT DATE -11q IL
Property Owner's Authorizatioz
By my signature, I certify that I have authorized the above Applicant/Agent 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
Owner/Applicant:
CAX
Name -
--701cl - ILI �'- Arkg OF -
Street Address
City State Zip
Telephone: -7 84 — 6 61-1
Email address (optional):
DATE
Applicant Representative:
Lae--S+e-r(-N
Name
11000 ++,,:1
Street Address
j5 /,t r- e-�
city State Zip
Telephone:
Email Address (optional): __A LZ we4exn em
-J V%�, S.
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Critical Areas Checklist CA File No: CA2A-*aC0T-00k%
Site Information (soils/ topography/ hydrology/vegetation)
1. Site Address/ Location: 1�1__SchgL 94,01- A14- W.
2. Property Tax Account Number: 00t46'�>7:�0t6(_-jbt0
3. Approximate Site Size (acres or square feet): 1-71 a (0
4. Is this site currently developed? V yes; — no.
If yes; how is site developed? - I e-)(-,% ski(\J
5. Describe the general site topography. Check at 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 10-feet
over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-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 0 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? Y
10. Site is primarily: forested ; meadow ;shrubs mixed
urban landscaped (lawn, shrubs etc)
11. Obvious wetland is present on site: tj 0
-----For City Staff Use Only
1. Plan Check Number, if applicable? N.1 A
2. Site is Zoned? WIM-1 - %
3. SCS mapped soil type(s)? 5-Akdercoccd- UrAayx, 6,,,d cg�,F_x -a Jm -:A:.c,
4. Critical Areas inventory or C.A. map indicates Critical Area on site?
5. Site within designated earth subsidence landslide hazard area?
DETERMINATION
STUDY REQUIRED X WAIVER
Reviewed bv- 1�014���� Date: -3L _q
Critical Areas Checklist.doc/2.171004
CITY OF EDMONDS
121 5TH AVENUE NORTH EDMONDS, WA 98020 (425) 771-0220 FAX (425) 771-0221
Website: www.d.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
April 10, 2009
MEMO TO:
Edmonds School District
Verizon Northwest
SNOCOM Police and Fire Dispatch
SNOPAC
Snohomish County E911
U.S. Post Office
Snohomish County Assessor's Office
Snohomish County Information Services
Snohomish County P.U.D.
Puget Sound Energy
GARY HAAKENSON
MAYOR
IS rRE, e r p,
. 14"
Edmonds Fire Department
Edmonds Police Department
Edmonds Utility Billing
Edmonds Public Works
Edmonds Building/Street File
Edmonds Address Files
Lynnwood Disposal
Comcast Cable
Waste Management Northwest
Please be advised that the attached address has been added to the Edmonds address
system:
2391484 1h Ave W ( Lot 2) Previously I parcel addressed 23912 SO' Ave W
Lot I will remain 23912 84 th Ave W with Existing Home.
Occupancy: R3 Tax ID Number: (for short plat): 00463301600101
File number: S-2008-14 Lots #: I & 2
If you have any questions regarding this letter, please contact a City of Edmonds Pen -nit
Coordinator at 425-771-0220. Please contact our office if you wish to be removed from
future address change notifications.
Sincerely,
Ll
ind Thoniquist
Permit Coordinator
Cc: file
Incorporated August 11, 1890
Sister City - Hekinan, Japan
CITY OF EDMONDS
121 5TH AVENUE NORTH EDMONDS, WA 98020 - (425) 771-0220 FAX (425) 771-0221
Website: www.d.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
April 10, 2009
Margo Henson
7019 14 1h Ave NE
Seattle WA 98119
Re: Addressing for Henson Short Plat
File number: S-2008-14
Dear Ms. Henson,
This letter is to inform you of the addressing for your proposed short plat.
Enclosed you will find a copy of the plat map with the addresses which are:
2391284 th Ave W Lot I with existing Home
2391484 th Ave W Lot 2
Thank you,
�Qh
'"r
Lmda Thomquist
Permit Specialist
City of Edmonds
GARY HAAKENSON
MAYOR
Incorporated August 11, 1890
Sister City - Hekinan, Japan
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Al Margo Henson Attachment 1
2 Lot Short Subdivision Zoning& Vicinity Map
File Number S-2008-14 0 100 200 Feet t
go IqC'QI 23912 84th Avenue West (RS-8 Zone) I