702 9TH AVE N.PDF9882
702 9TH AVE N
Critical Areas Checklist CA File No: Oq - MD
Site Information (soils/ topography/hydrology/vegetation)
1. Site Address/ Location: 7— (�7'r'0 -AV,,e W
2. Property Tax Account Number: 00-S-4f!)900000-701
3. Approximate.Site Size (.acres or squarei feet): 4�., ovo
4.1 Is this site currently.developed? -�V yes�_ no. ------
If yes; how is site developed? 4+r)t"S_Z1_
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 10-feet overa 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):
6. Site contains areas of year-round standing water: -Approx. Depth-
7.. Site contains areas of seasonal standing.water: W/P Approx. Depth:
What season(s) of the year?
8. Site is in the floodway 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? 11 (What time of year? LO/
10., Site is primarily: forested meadow ;shrubs V_ mixed v--'-
urban landscaped (lawn, shrubs etc)
11. Obvious wetland is present on site:
For City Staff Use Only
1. Plan Check Number, if applicable?
2. SiteisZoned? 1?5-10-�
3. SCS mappedsoil type(s)? I&Z Mh rwood Urbo,,-, LaJ Cd,-,d X S -15- 0/0 5 10aef
4. Critical Areas inventory or C.A. map indicates Critical Area on site? /VOAe.
5. Site within designated earth subsidence landslide hazard area? A/0'
DETERMINATION
Reviewed
1 1616 't
WAIIVER
Critical Areas Cheeklist.doc/4.22.2003
of, E DAV
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.02M
Fax: 425.771.0221
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 the application 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).
Date Received: '1-J,-20o+
City Receipt#: 2-�4 F?A:0 91+
Critical Areas File #:
Critical Areas Checklist Fee: $135.00
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
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 assistant staff
in completing their preliminary 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, from any and all damages., including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its; agents or employees..
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF APPLI . CANTIAGENT DATE Lv
Y
Property Owner's Authorization
By my signature, I cer* that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this Rplication.
SIGNATURE OF OWNER
Owner/Applicant:
9A,tXAr-- \-J&LPf—
Name
516 2�1 G Lt Ni [-
Street Address
kl�-At kkoA-S- W ter
City State zip
Telephone: L�0(e - 9 *7 q - Z-& 3 4-
Email ad dress (optional):
Applicant Representative:
,A�J
Name
Street Address
City State zip
Telephone:
Email Address (optional):
Critical Areas Checklist.doc/4.22.2003
APPMATICIN
for
a �L-ET SEDE SEWER PERMIT
The City of Edmonds FILE NEW CONSTRUCTION 0 REPAIRS 0 EASEMENT No . ..........................................
116-05100
OWNER........... Dowery....-C ...... G -- ---------------------------------------------------------------- CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS ....... 7.0.2 ... 9.th-Ave....N. . ........................................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAME OF ADDITION ..................................
DYE TESTED ON SEWER, 1972
Approved:
DATE................................................ By .......................................................................
FP_ ',�)
1 9 q
ET FILE City of E.dmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number. !?
ji Issue Date: Cz, - 7
A. Address or Vicinity of Construction: 702 9 Av N (9416046)
B. Type of Work (be specific): 1�stall New Service.
C. Contractor: Washingtc�. Natural Gas Company -
Mailing Address: 815 Me�cer St, Seattle, WA
State License #: 98111
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 224-2278
Liability Insurance: Bond:$
Side. Sewer Permit # �if applicable):
E. EJ Commercial E] Subdivision El City Project K] Utility (PUD, GTE, WNG, CABLE, WATER)
F1 Multi -Family [1] Single Family E] Other
INSPECTOR: INSPECTOR: k
F. Pavement or Concrete Cut: bd Yes []No G. Size of Cut: —2 ( 2 x 4 H. Chargq�_$
APPLICANT TO READ AND SI
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold t " 'yofEdmondsharml z�nQg�mages, or
fits dep
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made again, he City ofEdmonds, or any of its epartments or
employees, including or not limited to the defense of any legalproceedings including e' 'cost , nd attorney fees by reh5ion. rg hi ermit.
Be sp
�v'�o
fen MRIOD OF ONE YEAR FOLLOWING THE FINAL
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RFSTORAT16N-FCES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILKBE F1Vd_t,79S8FD FOR ISSUANCF��OJHE Al!�,' CANT.
Construction drawing of proposed work required with permit application.
A 24 hour notil�e 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 iegulbLtions as required b�_th7eC ity-Eng'iheer.
All streef cutditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above statements and understand thepermit requirements and thepink copy of thepermit will be
available on site at all tiDws-ror inspectipn purposes.
Signature: Date: May 2. 1994
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: Vi i,\ RIGHT OF WAY DEPOSIT
TIME.AUTHORIZED VOID AFTER J DAYS DISRUPTION FEE/FUNDAIL'.
SPECIAL CONDITIONS: Ar RESTORATION FEE:
PERMIT FEE:
TOTAL FEE.
COMMENTS:' RECEIPT FEE:
DATE: ISSUED B
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Mv. 1991
�7
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES 0 NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
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Addendum to City of Edmonds
Right of Way
Permi Application
submitted by: MITCHELL S.-LANKFORD
Engineering Aide
Washington Natural Gas
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""A 111 006) 627- -.767