6525 170TH PL SW.PDF956
6525 170TH PL SW
CA FILE NO.
Critical Areas Checklist
---------------- ---------------------------------------------
Site Information (soil s/topography/hydrology/ve getation)
I . Site Address[Location: (o -'> 2- S7 I --? 0 ' 12 L S L,1U
2. Property Tax Account Number: —,5R'35 000 0/3 C2)
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? �( yes; _no.
If yes; how is site developed? / �201 Ci !�� F r UC., U &-f-
5. 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 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: A(a ; Approx. Depth:
7. Site contains areas of seasonal standing water: �( a _;Approx. Depth: _
What season(s) of the year?
8. Site is in the floodway &C 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?
.shrubs mixed
10. Site is primarily: forested meadow I
urban landscaped (lawn,shrubs etc) )4 1- 1,cw, 'Tre-e-.5
ll. Obvious wetland is present on site: 13
. DEMMINATION
�m.�chk.doc� R� 10/03/97
City.of Edmonds
RECEIVED
APR 2 8 1999
CRITICAL AREAS CHECKL18
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 infor rn-ation (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:
I A4�er-�e-rfq
Z r,,4 c ka-
Name ( I
a 5- t 0 1"'� P L S L-J
Street Address
city State Zip
Y
Telephone
3 -
Signatu/fre
((— 2,5— ct I
Applicant Representative:
Name
Street Address
city State
Telephone
Signature
Zip
Date
creception�ana\cad.doc
Date
(over)
�(p C. is () \3
Bryon Afterberry
6525 170" Place SW
Edmonds, WA 98026
Subject
Dear Applicant:
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
June 3, 1999
Determination regarding Critical Areas Checklist # 99-120
BARBARA FAHEY
MAYOR
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.
.............. - ......... .... I ........
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 -specific determination not a
project -specific determination.
You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Enc: 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.
Planning Secretary
Incorporated August 11, 1890
Sister City - Hekinan, Japan
APPLICATION
for
The City of Edmonds
EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS 0 1--ILZ) lc�>j 6.'44—').
TE Z) 14.47!5
OWNER Fk=*F:e FT ....... Ph ......... ".e-1 . ..... ........ CONTRACTORLit4l .......... X ....... ................. PERMIT No . ......................
....... LEGAL DESCRIPTION: LOT No . .........
ADDRESS 1774D' ............ ------ %5 ................ ....... BI.A)CK No . ........................... .. . .. ........
NAME OF ADDITION L—"4v= Sbl
....................
.....................................................................................................
Ll
Approved: 4/4
DATI ------ By . ............
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 map(s), nor for any one representation
provided based upon said map(s).
SIDE SEWER PERMIT
CITY OF EDMONDS
WATER -SEWER DEPARTMENT
Tl�
PERMIT 4475
Call 7.76-1107 for side sewer inspections BEFORE covering any portion of the c4DnStruCtlon-
(Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspection.)
5525 - 170th Pl. SW'
ADDRESS LOCATION OF CONSTRUCTION --------------------------------------------------------------------------------------------------------------
aneNo. 5 ..............................................................
PROPERTY LEGAL DESCRIPTION ---------------------- ........................... ............................. ..................................
.. .......................... ..................... . ... ...... . .......... . ........................................................................................ . ...................................................
tA. Mel son .... . .......................................................
m -------------------- - -----------------------------
OWNER AND/OR BUILDER
eschhacker, United Plmbg Swr Const., 21607 Second Ave.
CONTRACTOR'S NAME ADDRESS ------ ....................................... .... 965 e I ....... Wa . s . h ......... 9bu I T
tember 19 for repair and/or connection of a side sewer to the city sanitary sewer
Permission is granted -------- ��P ------------------------- . . . ............ 19.
t
system in accordance with Cit)r of Edmonds ordinances.
A't TION IS CALI D TO THE FOLLOWING: y line. A licensed Side Sewer Contractor must be employed to construct
- ,To. I —The o ners of the property may obtain a permit to construct sewer inside propert
NL __ w has been Inspected.
side sewer in street area. Do not cover any portion of sewer before it
NOTE No. 2—All work performed in city right-of-way requires an Invasion of Right-of-W&Y 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 inside property line; minimum grade of 2%. No bends in grade
sharper than % will be permitted. roper
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for fa4lure due to imp
work which may develop within one year of completion. work on the maln sewer or its appurtenances except to in -
NOTE) No. 6--It is unlawful to alter or do any other work than is provided for in the permit, or to do any
sert the pipe into the wye.
DISAPPROVEDEj Date .... ......... i ...................... By ................ Date ----------- �! .................. By Date ---------------- ------------------- 'BY ................
P, A zw ......................................................................
.;; ....... /q.7/f.77.3 _. By.- if�?5�2 2
APPROVED Date-e�/?/�� 7
................................................ . ....................................... ...................................................................
Remarks: ------- - --------------------------------------- ----------
..................................................................... . ........................................................................................ ................................... . ..........................................
Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
BOTH P:ermit Co 'e ST ig
edo r .... .... hereby certify that the side sewer installation constructed under this permit
s�ru t
I .................... -------
wner of Contracting Firm, orming C stru tion) S
W" �stalled in accordance with all governing ordinances of the City of Edmond
19
Dated this ..... 19 ................ day of ------- ..................................
Check BEFORE you dig for: Water C], Gas [-], Telephone E], Power E], Sewer C], Other 3 V J
The City of Edmonds
APPLICATION
for
slEDE SEVVER PERMT EASX;MENT No . ..........................................
NEW CONSTRUCTION X REPAIRS 0
OWNERA.,6.177 ------------------- --------------
ADDREss6 7-1-7-0 ........ ..................
.... 5�2-6 .....
/--/U 1-71
...9lS44.V.t-;lPERMIT No.
CONTRACTOR
LEGAL DESCRIPTION: LOT No - ----- ..................... ......... BLOCK No . ............................................
....................................................................
NAME OF ADDITION -%8
SEP 1$ 1973
Al>pwved:
DATE------------------------------------------------ By ----------------------------------------------------------------------