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24227 78TH PL W.PDFIIIIIIIIIIII 6800 24227 78TH PL W ADDRESS: 0,q,2_411 -7 ?"� 0 1 t() TAX ACCOUNT/PARCEL #: OD q 90 0 0 2,00 LIX) BUILDING PERMIT (NEW STRUCTURE) #: COVENANTS (RECORDED) FOR: CRITICAL AREAS #: 01-001C) DETERMINATION: El Conditional Waiver El Study Required Waiver CRITICAL AREAS #: DETERMINATION: 0 Conditional Waiver El Study Required OWaiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORD FOR: PERMITS (OTHER - list permit #'s): PLANNING DATA CHECKLIST DATED: �1!2/0q SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: [BLOCK: SIDE SEWER AS BUILT DATED: 11-1,51w, SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE/ENCROACHMENT PERMIT FOR: WATER METER TAP CARD DATED: OTHER: L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc RANNING DATA SINGLE FAMILY RESIDENTIAL 41 1[—,,W,—,TFILE il Name: Ite 2 Site Address: �cf c e- to Plan Check 00c') L Project Description: C, (6 e Reduced Site Plan Provided: (S)NO) Zoning: Map Page: Corner Lot.- (YES Flag Lot: (YES Critical Areas Determination ff: El Study Required 9CWaiver SEPA Determination: V-Exempt El Needed (for over 500 cubic yards of grading) C1 Fee 1:1 Checklist E3 APO List with notarized form Reqtllte(l tbacks Street- Sid -7.S- Side: Rear: 2- S_ /S Actilil-Setback,,; Street: -31-1 Side: Side,. - El Detached Structures: Rockeries: Fences[Trellises: Bay Windows/Projecting Modulation: Stairs/Deck: MIA In Daturn Point: Datum Elevation: Maximum Height Allowed: Actual Height: Other Parking Required: 2- Parking Provided: Lot Area: Maximum Lot Coverage: 35% Proposed: Lot Coverage Calculations: C AZ_)_,J__St+ Covkr-ed o�qar-�f ADU Created: (YES / NO) Subdivision: ow dd - Legal Nonconforming Land Use Determination Issued: (YES comments A_ Plan Review By:#.. Kau" Data fom 04 -11,06 doc #P20 Critical Areas Checklist Site Information (soils/ topography/ hydrology/ vegetation) 1. Site Address/ Location: 2-42Z-7 —733+k 'PL_ \1\1 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1. 2. 3. CA File No: (,�_A - I D 900 Property Tax Account Number: C-Uo'�'t> /C_Z2:QD ICU Approximate Site Size (acres or s uare feet): Is ffiis site currently developed? T yes; — no. If yes; how is site developed? 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 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): Site contains areas of year-round standing water: ; Approx. Depth: Site contains areas of seasonal standing water: JW Approx. Depth: What se,ason(s) of the year? Site is in the flood�vay floodplai—i)(1 ofawa'tercourse. Site con ' creek or an area where water flows across the grounds surface? Flows are year-round? tazo__ - — Flows are seasonal? (What time of year? Y Site is primarily: —forested meadow shrubs mixed urban landscatd wn, hrubs etc) ^'rr%EET FILE Obvious wetlan p resent on site: —For City Staff Use Only Pfah (Nec*k Numb�r, If Site ' Zoned? tZ Ls SCS mapped soil type(s)? Critical Areas inventory or C.A. map indicates Critical Area on site? 5. Site within designated earth, subsidence landslide hazard area? _A(0 4 1 DETERMINATION S-MDY REQUIRED WAIVER I* #P20 City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 C. 1. Fax: 425.771.0221 'Me 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 ofth�a�bliptai6iilb the,Chy. The purpose of tb�- 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: - v-l.aq City Receipt#: 4914 -1 �2- Critical Areas File #: G�A UCP1 DOI 0 Critical Areas Checklist Fee: Date Mailed to Applicant:_ 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 `precursbry,'siP�.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 prelinuinary 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 fi7om any and all damages, including reasonable attorney's fees, anismig from any action or infraction, based in whole or part upon false, misleading, inaccurate or incomplete information furrushed by the applicant, his/her/its agents or employees. By my signature, 1, certify that the information and exhibits herewith subrm'tted are true and correct to the best of my knowledge and that I am authorized t% on on the behalf of the owner as listed below. SIGNATURE OF APPLICANVAGENT DATE—V ZS� Property Owner's Authorization By my signature, Icertify that I have authorized the above Applicant/Agent to apply for the subject land use a . pplication, and grant my pernussion for the pub)iSofficials and the staff of the City of Edmonds to enter the subject property for the purposes of 'inspection and postinrXit this application. . . . I - - SIGNATURE OF OWNER DATE PLEASE PRINT CLEARLY Owner/Appficant: JP A 'i MDV 0--% rf:, Tuubt) Name 7?4c�Z L k) Street Address eda rroio M? -qa9k City State ZI 4)9 . Telephone: ZN;�­/ Applicant Itepresentative: PIIF�JIAWAO Narne Street Address City State Z1* Telephone: 4-25 - -)e-pl - JA1_ Email address (optional): Email Address (optional): -*ate Approved: BACKFILL WORK ORDER ISSUED .................. ................... DEPOSIT, ......................... .......................... SEWER WORK ORDER ISSUED .......................................... . .. ............ v 0 -7 FILE C I T Y 0 F EDMONDS S E P T I C T A N K APPROVAI TO WME IT MAY CONCERN: This is to certify that the septic tank— for t -.5.1 �7-lz - --2 has been inspected and are according to City of Edmonds standards 10, DATE: Inspected by: /7 74- C 0 /11' 74"l< 41 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 for - th 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 empl-o-yee-s o-r office-rs sh-all be 1--ia-b-l-e for the information given on this map(s), nor for any one representation provided based upon said map(s).