715 ELM PL W.PDFIIIIII IIIII IIIII IIIII IIIII IIII IIII11169
715 ELM PL W
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEP�RTIV NT
i
PERMIT ffi
/Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction.`
`Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.,
ADDRESS LOCATION OF CONSTRUCTION .......... 71'5 E*IT-- P1 CP
Lot 39 Elm vic-.T A&.tide C
PROPERTY LEGAL DESCRIPTION ........................•--•----... .----------•--•--••--•--..--..........................•-••-•-•-•-•----........................---.........--..............--................--
.................................................. _................................................................................................ ................ _......................................................................................
................................................................OWNER AND/OR BUILDER ........................................ _.................................. _.......................................................
TRACTOR'S NAME & ADDRESS.......--.........-P� ®NMCsMS
_.......................................................
� ...Permission Is granted ..........- . .............................................. 19... --.... for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmonds ordinances.
ATION IS CALLED TO THE FOLLOWING:
NOTE No. 1—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—Obtaln full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Tap 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.
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to Improper
work which may develop within one year of completion.,
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 Date......../ ------
B Date................— .A........--.. B Date ..............._......-•---........ B
❑ 3 Y.... Y...............
APPROVED ffn Date...;:.:....'.... '.................. B �"�—1............... _.......................................................................................
y..._. .�`
Remarks: ....... _...... _.............................••---..........--............................................ ...........................................................................................................
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection —
I.................................................................................. .... hereby certify that the side sewer installation constructed under this permit
(Owner of Contracting rm Perfcrming Construction)
stalled in accordance with all governing ordinances of the City of Edmonds.
Datedthis............................day of ................................................................. 19.........
�/ Check BEFORE you dig for: Water ❑, Gas ❑, Telephone ❑, Power ❑, Sewer ❑, Other ❑ -V
0 0
ADDRESS: T 5 L
TAX ACCOUNT/PARCEL #: DOC�2z�doDo3�
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: Db -Dol q DETERMINATION: ❑ Conditional Waiver Study Required ❑ Waiver
CRITICAL AREAS #: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER - list permit #'s):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED: �()
SIDE SEWER PERMIT(S) #: 5
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED: 19j f -7 LP
OTHER:
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WATER , SEWER CHECK LIST
CALL AND FIELD CHECK
BEFORE DIGGING
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ADDRESS
NAME
DATE
DISPOSITION
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STREET DEPT.
STORM SEWERS
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A,* City of Edmonds
APPLICATION
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Sim swo Petmff
NEW CONSTRUCTION [I - REPAIRS ❑
EASEMENT NO. ............................. --------------
LID NO. NO. - -----------------
%.0wA'qjV,x% ......
---------------------------------------- ........ -------- ----------- PERMIT NO.
JOB ADDRESS .... .. . . ..... ------------------------ LEGAL DESCRIPTION: LOT NO. ...................................... BLOCK NO. -------- ---------------------------
..................... ------ ................................................................ ............................................................ .......
NAME OF ADDITION .-A--.1-M ... 111,ek-V Jr --------------------------------
A
JUL 13 1976
Public Works wept.
NO
Approved:
DATE............................................ By
A APPLICATION
,.The City of Edmonds for EASEMENT NO . ...........................................
SIDE SEWER PERMIT
NEW CONSTRUCTION ® REPAIRS ❑ LID N�OL.................. ASMT. NO. ..................
OWNER ------- �"T"-----4-IOM--•-----------------------------•-------- CONTRACTOR �--� ' M.....52 iv R rC:----•-- PERMIT NO. SSZL�
JOB ADDRESS--_�i�___ _��--M.---.._�— .................. LEGAL DESCRIPTION: LOT NO. ............................. BLOCK NO. .--.--.-.---.--------.------------_.
0
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-•----------------------•--------_----•-----•----------------------------•----------------.---------------•------------------•----•--------• •----------•----------
NAME OF ADDITION ..... •--- E=— �-- M tiv t St N . .
Approved:
DATE-����J�----•••--
-
By
11/75
#P20 CA IL4
Critical Areas Checklist CAFile No:
Site Information (soils/topography/ 76PAO/0.5,
drology/vegetation)
1. Site Address Location S GIM PL . A 8 G d
2. Property Tax.AccountNumber: A4RC C (. 1# 0 (? 64d),000003 00
3. Approximate Site Size (acres or square feet): N Q i C R B
4. Is this site currently developed? yes; no.
If yes; how is site developed? S I A L CCU I L Y If 6tj SC, tjVyl) YCI-Pr-7)YM D -FRONT f bitCK
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 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):
6. Site contains areas of year-round g water: 1 V ; Approx. Depth:
7. Site contains areas of seasonal standing water: NO ; Approx. Depth: _
What season(s) of the year?
8. Site is in the floodway floodplain NL.f a water course.
9. Site contains creek r an area where water flows across the grounds surface? Flows are year-round?ya
Flows are seasonal? (What time of year? ).
10. Site is primarily: forested ; meadow ; shrubs ; mixed ;
urban landscaped (lawn, shrubs etc)x
11. Obvious wetland is present on site: NO
For City Staff Use Only P . O �j
1. Plan Check Number, if. applicable? N ala-b 6h QW✓1.
2. Site is Zoned? R- 5 (O -
3. SCS mapped soil type(s)? 115: U Y106M I� GL V1 of 8/ 11, i ilt&t4l ' q nyel l U
Critical Areas inventory or C.A. map indicates Critical Area on site? v . \AIL AID W C,(tt* - On or
AdiaGGYt +0 -M& p►"oPt/m Dfr mAp7 VGYi-�i� durinA ln�UGCy'1.
5. Site .within. designated earth subsidence landslide hazard area? M b
DETERMINATION
STUDY REQUIRED WAIVER
Reviewed by: Wyi a/ (A c c/ a,- Date: 01-11 `i' 1 ti 00 (0
-C. 1 B7
#P20
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
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: 0 2. / 0 (v l 200(0
City Receipt#: 1-81 7-0
Critical Areas File #: y 0 0 (a— Oo 1
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, Iin 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 famished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and convect 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 APPLICANT/AGENT A DATE
Property Owner's Authorization
:.. ..lF•r
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and giant 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 application.
SIGNATURE OF OWNERClh&t� DATE TL&L"R/l
PLEASE PRINT CLEARLY
Owner/Applicant:
Lynn, C. AictfARb /V 7`NOaNivN
Name _
LAA PLhCC W tryST
Street Address
� pM Olds w.6 0a0 - 6: 61y.
City 11 State Zip
Telephone:
Email address (optional):
Applicant Representative: .
Name
Street Address
City State
Telephone:
Email Address (optional):
Zip
CITY OF EDMONDS
CRITICAL AREAS RECONNAISSANCE REPORT
Site Location:
715 Elm Place
Tax Acct. Number:
00642200000300
Determination:
Study Required
Determination #:
CA-2006-0014
Applicant:
Lynn & Richard Thornton
Owner:
Lynn & Richard Thornton
CRITICAL AREAS RECONNAISSANCE REPORT: STUDY REQUIRED (CA-2006-0014)
During review and inspection of the subject site, it was found that the site may contain or be adjacent to
critical areas, including a Stream ("Willow Creek") pursuant to Chapter 23.40 of the Edmonds Community
Development Code (ECDC).
GENERAL CRITICAL AREAS REPORT REQUIREMENTS
Critical Areas Reports identify, classify and delineate any areas on or adjacent to the subject property that
may qualify as critical areas. They also assess these areas and identify any potential impacts resulting
from your specific development proposal. If a specific development proposal results in an alteration to a
critical area the critical areas report will also contain a mitigation plan. You have the option of completing
the portion of the study that classifies and delineates the critical areas and waiting until you have a specific
development proposal to complete the study. You may also choose submit the entire study with your
specific development application.
• Please review the minimum report requirements for all types of Critical Areas which are listed in
ECDC 23.40.090.D. There are additional report requirements for different types of critical areas (see
below).
• Note that it is important for the report to be prepared by a qualified professional as defined in the
ordinance. There are.options on how to complete a critical areas study and an approved list of
consultants that you may choose from. You may contact the Planning Division for more information.
• General Mitigation Requirements for all Critical Areas are discussed in ECDC 23.40.110 through
23.40.140.
REPORT REQUIREMENTS — STREAMS
"Willow Creek" or its tributary is on or near the subject property.
• Streams are areas where surface waters produce a defined channel or bed which demonstrates clear
evidence of the passage of water. Streams need not contain water year-round.
• Streams are regulated as types of Fish and Wildlife Habitat Conservation Areas.
• Streams are classified according to whether or not they run year round and whether or not they
support fish populations according to the classification system listed in ECDC 23.90.010.A.1.
• The minimum buffer widths for streams vary depending on the type of stream and are listed in ECDC
23.90.040.D.1.
• In addition to the general requirements for Critical Areas reports referenced above, specific Critical
Areas report requirements for Fish and Wildlife Habitat Conservation Areas are provided in ECDC
23.90.020.A to C and additional technical information requirements for streams are listed in ECDC
23.90.020. D.
• l •
DEVELOPMENT PROPOSALS ON A SITE WITH A STREAM
Development proposals that encroach into streams or their buffers or building setbacks may be allowed
through the approval of certain processes.
• The width of a stream buffer may be reduced through buffer enhancement if through the review of a
Stream Buffer Enhancement Plan that meets the specific requirements referenced in ECDC
23.90.040.D.2. The maximum amount that a buffer can be reduced through buffer enhancement is
50%.
• A buffer may also be modified through a process called buffer averaging. The criteria applied to
buffer averaging are listed in 23.90.040.D.2. The maximum amount that the buffer width can be
reduced at any single location through buffer averaging is 50%.
• Development proposals that propose encroachments into buffers beyond what is allowed through the
above methods require a Critical Areas Variance or a Reasonable Use Exception., If you think that
you have a proposal that may require one of these processes, please contact a Planner for more
information.
ALLOWED ACTIVITIES
Certain activities are allowed in or near critical area buffers as specified in ECDC 23.40.20. If you have
any questions about whether your proposed development qualifies as an allowed,activity, please contact a
Planner for more information.
EXEMPT DEVELOPMENT PROPOSALS
Certain development proposals may be exempt from Critical Areas Requirements (ECDC 23.40.230). If
you think that a specific development proposal may be exempt, contact a Planner for more information.
Gina Coccia Planner February 28, 2006
Name, Title Q Signature Date
NOTE: Cited sections of the Edmonds Community Development Code (ECDC) can be found on the City
of Edmonds website at www.ci.edmonds.wa.us.
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690 _ 19ci'
C. Contractor:
Mailing Address:
State License #:
I y o mon
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number: 9J - a (�
Issue Date: 3- 0c /_ 3
A. Address or Vicinity of Construction: 7.15ELM PLACE
.)r 40
B. Type of Work (be specific): GTE TO PLACE BURIED SERVICE WIRE WITH
A 21-FT D.W. PUSH, HAND -DIG 15-FEET, SEE ATTACHED SKETCH.
' D. Building Permit # (if applicable):
Contact:
Phone:
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. ❑ Commercial , ❑ Subdivision ❑ City Project [?9 Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other W,O.,II 2100-9Poo1DB 242310
INSPECTOR: INSPECTOR: (/A t+
F. Pavement or Concrete Cut : ❑ Yes ®No G. Size of Cut: x H. Charge $
APPLICANT TO REt'AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agold/ he City of Edmonds harmless from( j(ryuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that may be ma a� he City of Edmonds, or any , us"depar or employ-
ees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by mason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC77ON
AND ACCEPTANCE OF 7HE, WORK _ ES77MA7ED RESTORA77ON FEES WILL BE. HEED UN77L TH_ E FINAL. STREET PATCH__IS ._COMPLE_7ED BY
Y
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT _
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Departme
Work is to be inspected during progress and at completion. ?�,�a®�
Restoration is to be in accordance with City Codes.
Street shall be kept cleair'at all ,tiines�'k T d
Traffic Control and Public Safety shall �be in accordance with City regulations as requirtil by the City Engineer.
All street cut ditches shall be'patched with.asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS. r '
Fhave read the above statements and understand the permit requirements and the pink, copy of the permit will -be available
on site at all tinys for inspection purposes. -
Signature: Date: 2-25-93
(Contractor or A nt)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
;COMMENTS:.... _ _.. _..... _ ... RECEIPT NO:.:,
DATE: -;ISSUED :BY
NO WORK SHALL
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund III - Route copy to Street Dept.)
Comments•
Diagram:
CONTRACTOR CALLED FOR INSPECTION O YES O NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. 1u
DATE: ,Tune 4, 1976
MEV0 TO: ilarry 11h;tctitt STREET FILE
Buildinn official
FROM: Richard 11. Allen
Assistant City Frinineer
SUBJECT: Building Permit Jp2lication for 715 Elm Place
After review of the stih,j Oct hui 1 di nn permit and i cati on , we. have the fol-
lowing comments:,
1. Setback on west line must be 10-.foot so no construction
blocks use of easement.
RH : mj r
it Address
I_eaal Description
r
BUILDING PERMIT P,FVIEI,-I - PIGINFFRING, DF.PARTMFNT
CHECK LIST
Reviewer's
Intials
1. Septic Tank System Design Approved
2. Sanitary Sewer Availahili.ty!(C5 Slit. of Dwn. No..
Project:RATZ1� Side SewerAvailability:
3. Any Sanitary Sewer Co
4. Site Drainage Checked
5. Storm Sewer Availability: Sht:_of Dwg: No. '1
Project: t•wela* Roadside Ditch u�
6. Grading & Final Contours N ON 094A 04:59
7. Sidewalks (Site Inspection shows condition of existing vialks" as follows):
8. Curbs t�iICal 611(�.
9. Curb Cuts�4j�II�IC�t*
10. Underground Miring f, Street LfahtinnTgzvof
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
3/9/76
Street Riaht-of-viav & Bldg. Setbacks:ox�:�� Sht. _12
of Dwg. No. l�� .of, Official Street Map.
.,
Existing Utility Easements L14%
Access Easements
Water Mains A Fire hydrants (Indicate Size !later 14ain)
O 06
Bonds for Site 1,lork_
Special Requirements listed in memo to flj g--pDept.
Commercial & Apt. Requirements form comnleted, _
Drawings stamped & notations made
Si te' Inspecti on made on C'p' 2/70
All items filled in on M dg. Permit Application &
This'Lot included in Subdivision (List any special requirements):
o
N O .59� 3, tam S
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