626 GILTNER LN.PDFiiiiiiiiiiiiii
14000
626 GILTNER LN
To Harry Whitcutt
Building Official
FORM 41 - LITTLES
INTER -OFFICE COMMOCATIONS
DATE January 29, 1 c3 L4
FROM Bill Nims
Engineering Department
6�V�ner Ln -
SUBJECT: Permit Application for 626 - M_Avtenue North
The following is a list of Engineering requirements for subject permit:
1. Twenty (20) feet of paving on interior street.
2. Installation of 8" and 4" cast iron water main with blow -off.
39 Sanitary sewer connection required.
4. Underground wiring required.
5. One fire hydrant required.
CP.
The developer has posted with this Department a cashier's check in the amount of
$2,000.00 in lieu of installing the public improvements. The Engineering
Department approved the application.
14JN: rf
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CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
C,
PERMIT - Q' ��l I
Call 775-2525 for side sewer Inspections BEF�RE covering any portion of the construction.
Inspection will be provided within 24 hours,-lafter requst. NO Sat., Sun., or holiday inspections.)
", ",:2 - " -1 5::
ADDRESS LOCATION OF CONSTRUCTION ........... ��, - > — V1, h10—CA0. ...............................................................
.. ................................. _ .............................
Lp-�- - & lins= ......... ............................................................
PROPERTY LEGAL DESCRIPTION ......................................................................I
. .................................................. .................................................................................................. ............... . .................................. . ..................................................
............ * ------------ * ... * .................................. O1VNER,1XDjOK BUILDER ......... L.1 . ......... -------------------_-- - -------------------------------------------------------
CONTRACTOWS NAME & ADDRESS ............... F. ......... ��Wi'n ..................................................................................................................................
Permission Is granted -----_---- V h 1,:;-m .....
. ........................... for repair and/or connection of a side sewer to the city sanitary sewer
S4 In accordance with City of Edmonds ordinances.
ACTION IS CALLED TO THE FOLLOWING: ,
NOTE No. I —The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before it has been Inspected.
NOTE No. 2—All work performed in city right:of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches lrf�lde'prQperty line; minimum grade of 2%. No bends in grade
sharper than % will be permitted. 7"
NOTE No. 5—Trenches in street must be water settled and surface of street restored -�6�originai condition. Contractorvhs��I,be responsible for failure due to improper
work which may develop within one year of completion. 1, 1 . I .. �, --,,
NOTE No. 6—It is unlawful to alter or do any other work than Is provided for in the permit, or to do any work on the main sewer or Its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED E] Date ... ...... ? ............... BY .......
....... Al .......... Dat By ........... Date ................ ................. 'By ................
... .. .......... -----
APPROVED Date .......... ..... ............... .......... BY . ........
............. - ----------- t .................. . ............................................. . .......................................
Remarks: .............................. ...... 7 ...... . ....................................................................................................................... ..................... m� .............................
..................................................................... . ............................................................................................................................................................................. .........
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
I .................................................... ... I hereby certify that the side sewer installation constructed under,,this permit
..... .... ..................
Twner of Contracting Firm Performing Construction)
Womstalled in accordance with all governing ordinances of the City of Edmonds.
Dated this .............. P�7 ....... day of ........................... ....... .................... 1 19.24,
V V Check BEFORE you dig for; Water E], Gas E], Telephone E], Power F], Sewer E], Other. E] V V
APPLICATION
In
TIW City of Edmonds for EASEMENT NO. - -----------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS E LID NO . .................. ASMT. NO . .............
OWNER ------- LJIE�
--------- -------------- ......... -------------------------- CONTRACTOR --- I -------------------------------------------------------------------------------- PERMIT NO.
L-N�llr= . ........ LEGAL DESCRIPTION: LOT NO. -- - ------------------- BLOCK NO . ...........................
JOB ADDRESS
A
-------------------- I ------------------------------------------------------------
-1- -- .--- e--Il -T-t-�IF�P7-
---------------------------------------------------------------------------
.................................................
DATE...... z .. ......... By � ----------------------- ..........
for
The' City of Mmonds EASEMENT NO - --------------------- ----------------------
SIDE SEWER PERM
NEW CONSTRUCTION REPAIRS LID NO . .................. ASMT. NO. --------------
OWNEP . ......... 149-/ ........ 7' Cqk-� ..................... ........................... CONTRACTOR .... 10— A 4 ....... HN/1
........ ---------------------------------------------- � PERMIT NO . ....................
JOB ADDRESS ------ 4.;Z� �el.
--------------------- ------------ --------- ------------- --- ------------- LEGAL DESCRIPTION: LOT NO - ------- ------------------ BLOCK NO - ------------------------------------
........................ -- .................................................................................. ................................. ..........
NAME OF ADDITION .... ��?t --------- ---------------------------------------------------
0
Approved:
DATE............................................ By ------------------------------------------------------------
117 C.. . Jso�3
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number-
Lssue Date:
A. Address or Vicinity of Construction: e4A
B. Type of Work (be specific): 4:4 -g�442C ZZ L2
110,
C. Contractor: '�:4uvaz �f
Mailing Address:
State License #:
Contact:
Phone:
Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. E] Commercial [J Subdivision El City Project )4 Utility (PUD, GTE, WNG, CABLE, WATER)
n Multi -Family E] Single Family n Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut D Yes E]No. G. Size of Cut: x H. Charg4�_$
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds harmlessfrom injuries, damages, or claims ofany
kind or description whatsoever, foreseen or unforeseen, that may he made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legal proceedings including d�fense costs and attorneyfees hy reason of granting this permit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMA NSHIP AND MA TERIA LS FOR A PERIOD OF ONE YEA R FOLLO WING THE FINAL INSPEC-
TIONAND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED
BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT
Two sets of construction drawings of proposed work required with permit application.
A 24 hour notice is required for inspection. Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut trench work shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be
available on site at all timesfor inspection purposes.
Signature: Date:
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY:
TIME AUTHORIZED: VOID AFTER "7 DAYS
SPECIAL CONDITIONS:
RIGHT OF WAY FEE:
DISRUPTION FEFIFUND I 11:
RESTORATION FEE:
T OTAL FEE:
00
RECEIPT NO.:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
TO THE ELECTION BOARD
City of Edmonds.change of addresses.
Old
626-3rd Avenue North
628-3rd Avenue Nort
632-3rd Avenue Nort
642-3rd Avenue North (
These changes due to a new
STREET FILE
may 7, 1975
New
Name
626 Giltner
Lane
vacant
628 Giltner
Lane
G) Itner
632 Giltner
Lane
urpur
631 Giltner
Lane
-,,�Reiser
���e s-i-d —n6-+ i o n
Ann El I in
Building Dept.
co
CA FILE No.
Critical Areas Checklist
--------------------------------------------------------------
Site In -formation (soils/topography/hydrology/vegetation)
I Site Address/Location: �-r,41612 qvL- 419/g&-n A/�� 44,�d
2. Property Tax Account Number: :ZVa763,1— 2-,V7-0001
3. Approximate Site Size (acres or square feet): Lod) o
4. Is this site currently developed? yes; _no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
tl� Flat: 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 3 0% 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: Me Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway V'w floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? lick Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ;shrubs ;rnixed
urban landscaped (lawn,shrubs etc) 6
11. Obvious wetland is present on site: M, —
DE-TERMINAMN
STUDY RE
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^ca,_chk.doc: Re� 10/03/97
City of Edmonds
RECEIVED
JUL 15
... P
COMMUMU
V41W 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).
Owner/Applicant- Applicant Representative:
hviA KfZN-'C'6-'
Name N,
�2-4,
Street Address Street Address
city State Zip city State Zip
Telephone Telephone
Signature 7 Signature
---- 'Y' '�5- -
Date
c:recepdon\jana\cac1.doc
Date
(over)
CITY OF EDMONDS BARBARA FAHEY
MAYOR
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works - Planning/ Building e Parks and Recreation - Engineering * Wastewater Treatment Plant
0C. is
July 20, 1998
Harry and Bernice Schulz
626 Giltner Lane
Edmonds, WA 98020
Subject: Determination regarding Critical Areas Checklist # 98-191
Dear Applicant:
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
IMPORTANT INFORMATION TO BE NOTED:
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS OR CRITICAL AREAS STUDY,
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site-spetific determination not a
project -specific determination.
You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL .40
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Eric: Determination
* Architectural Design Board
C:ReceptIon\Jana\CRLTR.doc
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you.
Shada Graham
Acting Planning Secretary
o Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
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This sketch is provided, without charge, for your information. It is not intended to show
all matters related to the property including, but not limited to, area, dimensions, ease-
ments, encroachments, or location of boundaries. It is not a part of, nor does it modify,
the commitment or policy to which it is attached. The Company assumes NO LIABILITY for any
matter related to this sketch. Reference should be made to an accurate survey for further
information.