24119 76TH AVE W.PDF111111111111
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24119 76TH AVE W
NOTICE:
No warranty of accuracy.
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of Edmonds does not warrant the
accuracy of anything set forth on these
map(s). Any person or entity requesting a
copy should conduct an independent
inquiry regarding the information shown on
the map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
employees or officers shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
for
ThO City of Edmomb, SIDE SEWER PERMIT
OUTSIDE [I INSIDE 0 REPAIRS 0
Of
WTI
OWNER .......... .........
HOUSE No. . ..... 7 tv
... .. �t ......... ... .........................................
1�
CARD No . ........
EASEMENT No . ................
CONTRACTOR.............. . . ........ ............................ ___ ............... PERMIT No.
STREET w 9.3 4
AVENUE LOT .................. ....... d
No. i�Aj ..... t�� ....... BLOCK No. .......................................
NAME ADD .............. ........
.............
7 3 T q
N-I H u r- LO
Date
BACKPILL WORK ORDER ISSUED ............................................ DEPOSIT, s ......
SEWER WORK ORDER ISSUED ............ .........................
VPROVED
30 1902
Approved:
il F
DATE)er ....................... BY ................. .......
STREETFILE . cA FmE No:.
Critical Areas Checklist
Site Information (soils/topography/hydr9l=/ egetation)
1. Site AddressALocation:
2.
3.
4.
Property Tax Account Number g-'-0oC,-o1-2--,-01
Approximate Site Size (acres or smiare feeA: '3 0" 'a'6�
is this site currently developed? �) -
_:-�yes, _ no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation changeover entire site.
RECEIVED
j U N 1 5 1994
PERMIT COUNTER
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-feit over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: IV o Approx. Depth:
7. Site contains areas of seasonal standing water., Approx. Depth:
What season(s) of the year7
8. Site is in the floodway IV 0 lain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? /t) 0 Flows are seasonal? _ (What time of year?.
10. Site is primarily: forested meadow shrubs mixed
urban landscaped Qawn,shrubs etc)
11. Obvious wedand is present on site: IV d
UY011004
&90 .199,-
City of FAImon&
Critical Areas Checklist
'Me Critical Awn 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 submittd 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 av:ailable from
observations of the site or data available at
City Hall (Critical Areas inventories, maps,
or soil surveys).
An applicant, or histher representative,
must fill out the checklist, sign and date it,
and submit it to the City. The City will.
review the checUst, make a precursory site
visit, and maim a n of the
subsequent steps necessaryto complete a
development permit application.
With asiigned copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail, that City staff can find
and identify the subject parcel(s). In
addition, the appficant shall include
other pertinent information (eg. site
plan, topography map, etc.) or studies in
conjunction with this Cheddist to assist
staff in completing their preliminary
a ssment 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*
Name
Street Addn=
city, ZE? Phone
Date,
Applicant Representative:
Nam
Street AMP=
City, State, ZIP Phone
S4nahm Date
City of Edi.iond-s
City Engineer's office
COWLAINT REPORT STREET FILE
Report No.
Referred to for Action*64R 026� Time Date
Received by'9% - M t " . Time Date
Made b LOW Address 2 el
How Received: Letter
Nature of Complaint
Engineering Departm
Tit Rexommendation or Comments
I
I
Time
Date
Describe Action Completed:
Engine
In Pe
11
Time Date Completed by
Location Sketch:
4/- t5
A