632 MAPLE ST.PDFIIIIIIIIIIIIII
12141
632 MAPLE ST
TAX ACCOUNT/PARCEL
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: 61 C;� DETERMINATION: E] Conditional Waiver E] Study Required aiver
pq�
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DA'
EASEMENT(S) RECORDED
V I
=:0 VI/
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DA'
SEWER LID FEE $: LID
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
LATEMP\DS'rs\Fomis\Street File Checklist.doc
0 , 9
PLANNING DATA
NAME: '.?t,�o- Z-LtA4, —DATE: lo3
SITE ADDRESS: (' 2, 2- MAPI, 5,.-. PLANCHK#: c73-10)3
PROJECT DESCRIPTION: 4AA +&.-s��
REDUCED SITE PLAN PROVIDED?: O��e) No)
I
MAP PAGE: 00 3 CORNER LOT: (Yes \Ij ) FLAG LOT: ffes
ZONING: PS -& CRITICAL AREAS DETERMINATIONM
Ll Studv Reouired:
LXWaiver
L1Conditional Waiver
SEPA DETERMINATION:
Ll Fee
L1 Checklist
Ll APO list w/ notarized form '9
U (Needed for 500 cubic yards of grading, Shoreline Area. site within 200 ft. of Puget Sound or Lake Ballinger)
El Exempt
SETBACKS:
Required Setbacks: �u- V-0n - It;&
Street: Z-o- Left Side: 5 Right Side: 5' Rear:
Actual Setbacks: tb
Street: �7-5 Left Side: 7-3.5' Right Side: 5' Rear:
Street map checked for additional setback required? (Yes ta/ DNA)
Ll DETACHED STRUCTURES: rl� I k.
Ll ROCKERIES:
El FENCES/TRELLISES:
O'BAY WINDOWS / PROJECTING MODULATION: JOS
LJ STAIRS/ DECKS: t-- � �--
PARKING: Required: 7- Actual:. 3
LOT AREA: GO -110 1 6.6 6Z
LOT COVERAGE 5 - '1-5,
Calculations: :�2 �' -3 +.
BUILDING HEIGHT:
Datum Point:— W.&s f-,w 4-� 'n LE& 4)-. Datum Elevation:
Maximum Aflowed: ;7-5,
Actual Height: '2-4
A.D.U. CREATED?: *LYes
AW- Z- 164Z41tAi
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED:
OTHER:
Plan Review By:
NewBPP1anningDataForm.D0C
0 0
Critical Areas Checklist
Site rination
ct Name: a) .1 p5ov
A)l Permit Number:
L
ite Location: 1110 Ne 5 Property Tax Accoui
(ANumber:
Approximate Site Size (acres or square feet):
Have you filled out a Critical Areas Checklist for a project on this site before?
. X)o
General Site Conditions
1. Has the site been cleared or logged? Date of most recent action:
Soils Topography
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)?
3. Describe' the general site topography. Check all that apply. D
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 feei of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
Hydrology/Vegetation
4. Site contains areas of year-round standing water: //�/o
5. Site contains areas of season I standing water: —Approx. Depth:
6. Site is in the floodway floodplain_.L�,/ Oof a water course.
7. Site contains a creek or an area where water flows across the grounds surface.? ows
are year-round? / 1JZ0 Flows are seasonal?
8. Site i . s primarily: forested meadow shr'ubs mixed
9. Obvious wetland is present on site:
10. Wetland inventory or map indicates wetland present on site:
11. Critical Areas inventory or map indicates any Critical Area on site:
-------------- -—For City Use:Only---
STUDY REQUIRED: Critical areas study is required.
CONDITIONAL WAIVER: Critical areas study not required if sp�_cified conditions satisfied.
WAIVER: Critical areas study is not required. . \ /9-1 /1
Determination Number.- Reviewer I., I/ __� I / / I �
Rev M27/92 (4 Co. Planner t-ff-T z—, Date
9 0
�i CL
690 -194-
Ciq of Edmonds
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.
With a signed copy of this form, the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conjunction with
this Checklist to assist staff in completing
their preliminary assessment 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:
Natne
Title
2 L,,2Z E
Street Address,
City, State, ZIP Phone'
Signature Date
Applicant Representative:
Narne
Title
Street Address
City, State, ZIP Phone
Signature Date
STREET FILfl
Critical Areas Checklist
MAY 7 199
�SitC h&rtnation
ct Name: -f I P5,-vtl �f 0 'Al Permit.Number: ow�
--) I? 1A / <f-
ite Location: Property Tax Accoui
A.Number:
Approximate Site Size (acres or square feet):
C,
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged? Date of most recent action:
Soils / Topography
2. In the Snohomish County Soil Survey, what is the mapped soi I type(s)? e V-t0000 b1114XA)
3. Describe the general site topography. Check all that apply.
M 1"P5
X —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 feei of horizontal distance.)
—Steep: grades of greater than. 30% present on site.
Comments
HydrologyfVegetation
4. Site contains areas of year-round standing water: //�/o
5. Site contains areas of seas I tanding water: //'U—Approx. Depth:
6. Site is in the floodway floodplain Itl Oof a water course.
7. Site contains a creek or an area where water flows across the grounds surface? /i/qows
are* year-round? XZO V L)
�__Flows are seasonal?
8. Site 1 s primarily: forested meadow shrubs /Vo mixed
9. Obvious wetland is present on site:
10. Wetland inventory or map indicates wetland present on site:
11. Critical Areas inventory or map indicates any Critical Area on site:
...... ......
_:For:Gty:,Use:0nIy--
........... .......
STUDY REQUIRED: Critical areas study is required.
CONDITIONAL WAIVER: Critical areas study not required if sp�cified conditions satisfied.
WAIVER: Critical areas study is not required.
Determination Number Reviewer
Planner Date
Rev M7192 G—) . <_ —I—
a, go -�199
City of Edmonds
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 dete ' rmine 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 makt a determination of the subsequent
stcps necessary to complete a development
permit application.
With a signed copy of this form, the
applicant should also -submit a vicinity map
of the parcel with enough detail -that City
staff can find and identifythe subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conjunction with
this Checklist to assist staff in completing
their preliminary assessment 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:
Narne
Title
61,22 -E
Street Address
7,75-69 "20
City, State, ZIP Phone
12-
k777
rQz
Signature
Date
Applicant Representative:
Name
Title
Street Address
City, State, ZIP Phone
Signature' Date
APPLICATION
for
The City of Edmonds SME SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS EASEMENT No . ........................... ..............
103-08800
Pauline Brid
OWNER.................................................. gq� .................................................... CONTRACTOR .................................................................................................. PERMIT No . ......................
ss .............. ... (14p
ADDRE ... $.t-reet ...................................... ........... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
.. .........
NAMEOF ADDITION .........................................................................................................
0
DYE TESTED ON SEWER
JULY, 1972
Approved:
DATE................................................ By ......................................................................
-715
V
C== N - --v
ADDRESS-
OWNER -
APPROVED DATU 3 - IL,
By f4- a�ecve.�,
IILDG. Ocr'!OIAL
KHP THESE STAMP
PLANS ON _'OtISITE !
L INSF ECTIONS
1 SHEET
PERMIT N .
820097 Oi
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SET B19ek !1A)c
?0_0 00,
32 GUTTERSDOWNSPOUT-S
TO CONNECT TO EXIST, SYST:
a-- T "OA)
In 30-0*
RIGHT-OF-WAY CONSTRUCTION PERMIT
01
AND INSPECTION REQUIRED
OL
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OP, FY
15 T/ IV
0(7
ARPROVED A� NOHD
".1Ok IS Fit"'PcNSIBLE FbYO 5 E %
BY ENGINEERING
EROSION CONTROL AND DPANAGE
L-7- Eiz-T
Date:'
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\ City of Edmonds Permit No' W I
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date: 6f 0
A. Addr�ks.or Vicinity of Construction: We ftiple-10 SN&
B. Type of Work (be specific): 0QNQWU(.T' Pgfll� I EA)J?AAC8
ontracto
C. C r: -
MailingAddress: 145*2�1'
Sta te License #:
D. Building Permit # (if applicable):
E. Commercial Subdivision
-Family El Single Family
E] Multi
Contact: SC at 5 vvu rN
Phone: :a---r5 — <8,cl
n�
&ibility Insuraice:_ Bond: $ K
Side Sewer Permit # (if applicable):
E] City Project E] . EUC-(Pub, VERIZON, PSE, AT& T, OVWDY
. . I 1k, - `r I I - t.-I, .
F1 Other"'
[NSPECTOR:
__7
F. PAVEMENT CUT: El YES [I NO G. SIZE OF CUT., X,
CONCRETE CUT:, El YES 0 NO
Al'MICANT,ro lZFAI) ANI) SIGN
INDEMNITY. Applicant understands by his/her signature to this application helshe, holds the City of Edmonds harmless ftom
injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may bemade against the City of
Edmonds or any of its departments or employees, including but not limited to the defense of any legal proceedings including defense
costs and attorneyfees by reason ofgranting. this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLL097NG THE FINAL
INSPECTION AND ACCEPTANCE, OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE, FINAL STREET PATCH IS
COMPLETED BYCITYFORCES, AT WHICH TIMEA DEBITOR CREDIT 97LL BEPROCESSED FOR ISSUANCE TO THEAPPLICANT.
* Traffic control and publi c safety shall be in a ccorda nce with City regulations as req uired by the.City Engineer. Every
flagger must be trained as - required by (WACY-29_6455-305 and, must have certification verifying completi on of the
required training in -their possession.
* Restoration is to be in accordance with City codes. All street -cut trench' work shall be patched with asokalt,or City-:
approved material prior to the end of the workday - NO EXCEPTIONS.
* Three sets of construction drawings of proposed work are required with- the permit application.
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNINP WORK
I HA VE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THA TIMUSTMAKE THE PINK COP OF THE PERMITA VAILABLE ON SITE A TALL TIMES FOR INSPECTIONS
Signature: Date: &/o
(Contractor/ or Agent)
Approved by: LA5_�_y FOR CITY USE40 ILY R I ight-of-way Fee:
0
Time Authorized: Void After i 0 Disruption Fee/Fund Ill:
Special Conditions: Mi"ki P)M K)CE U Restoration Fee:
I
Total Foe:' 7
1�
Receipt No:
(JE8L POV— 7H-KLL I M-A EV e-i Issued by: . �
UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING, FINAL
INSPECTIONIS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT CODE (Phone 425-771-0220, Ext. 1326)
FINAL APPROVAL OF PERMITTED WORK. <:1�iQlYfl�-ol-oAA DATE- - .511t
lnspjct�r -s signature
For inspection requirements see Engineering Inspection Information'liandout.
NO WOIZK SHALL Bl,-,(;IN I'MOIZ TO I'EIMIT ISSUANCE
DAMy Documents\Forms\Engnmg\ROWpermit_.dGc