8602 OLYMPIC VIEW DR.PDF8602 OLYMPIC
VIEW DR
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TAX ACCOUNT/PARCEL
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS :A `! 4 DETERMINATION: ❑ Conditional Waiver Xstudy Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:—Ibb&�
SEWER LID FEE S: LID #: its
SHORT PLAT FILE: WhAto Vifm Q IhM LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #: ak lbk
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSTs\Fonns\.Street File Checklist.doc
#P20
CA File
Critical Areas Checklist rl°: zoo-7o ��t�
Site Information (soils/ topography/ hydrology/vegetation)
1. Site Address/ Location: ! / N
2. Property Tax.Account Number: -�
3. Approximate Site Size (acres or square feet):
e
4. Is this site currently developed? Xyes; no. .
If yes;. how is. site developed?. -
5. Describe the general site topography. Check all that ap ly.
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 standing water: o>1e__ ;Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site co tains a creek or an area where water flows across the grounds surface? Flows are year-round?
e_ Flows are seasonal? (What time of year? ).
10. Site is primarily: forested ; meadow ;shrubs ; mixed IK ;
urban landscaped (lawn, shrubs etc)
11. Obvious wetland is present on site: _,4/_0Q0.
For City Staff Use Only
1. Plan Check Number if applicable? &_
Zoo-% f0 _�
2. Site is Zoned? 2 5 Z
3. SCS mapped soil !1 or I %r4 A a t
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4. Critical invento or C.A.C.A.map indicatesCritic
Area on site?
JJAreas
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5. Site within designated earth subsidence landslide hazard area.
X/
Reviewed by: / /y/ .
DETERMINATION
WAIVER
)ate: a
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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: 1 ° 1 10 -7
City Receipt #:
Critical Areas File #: C2 A zoo-70 I Flu(
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 fmding and locating the
specific piece of property described on this forma 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 APPLICANT/AGENT
DATE
Property Owner's Authorization
By my signature, I certify 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 pstiU attendant #this appKca'on.
SIGNATURE OF OWNER
Owner/Applicant:
Name
Sf�eet Address
City State Zip
Telephone: ;;;�eP 4,
DATE /0 ' / 6o — O
Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Email address (optional): Email Address (optional):
CITY OF EDMONDS
CRITICAL AREAS RECONNAISSANCE REPORT
Site Location: 8602 Olympic View Drive Tax Acct. Number: 00612400000900
Determination: Study Required Determination #: CRA-2007-0144
Applicant: Robert Gustafson Owner: Robert Gustafson
CRITICAL AREAS RECONNAISSANCE REPORT: STUDY REQUIRED
During review and inspection of the subject site, it was found that the site contains and/or is
adjacent to an Erosion Hazard Area, pursuant to Chapters 23.40 and 23.80 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 to submit the entire study with your specific
development application.
• Please review the minimum report requirements for all types of Critical Areas that 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 there is 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.
STUDY REQUIREMENT — EROSION HAZARD AREA
It appears that this property contains or is adjacent to an Erosion Hazard Area. Erosion Hazard
Areas include:
• Those areas with Alderwood and Everett series soils on slopes of 15 percent or greater.
Any area with slopes of 15 percent or greater and impermeable soils interbedded with
granular soils and springs or ground water seepage.
• Areas with significant visible evidence of ground water seepage, and which also include
existing landslide deposits regardless of slope.
DEVELOPMENT PROPOSALS ASSOCIATED WITH EROSION HAZARD AREAS
Development within an Erosion Hazard Area must meet additional criteria.
• For erosion hazard areas with suitable slope stability, the only critical area study needed
is an erosion and sediment control plan prepared in compliance with the requirements
set forth in Chapter 18.30 ECDC as part of the construction documents. This option is
at the director's discretion, per Edmonds Community Development Code section
20.80.050.G.
• In areas where the slope stability is not suitable, projects within Erosion Hazard Areas
will require a report by a licensed Geotechnical Engineer or other qualified professional.
Note that it is important for the report to be prepared by a qualified professional as
defined in the ordinance.
• Report requirements are given in ECDC 23.80.050, and more generally in ECDC
23.40.090. D.
• Development standards are given in ECDC 23.80.060 and 23.80.070.
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.
Name Sig
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.
F]
EET FILE
C
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RECEIVED
OCT 1.6 2007
BUILDING DEPARTMENT
WY' OF EDMONDS
0 PLANNING DATA
• STREET FILE
11
SINGLE FAMILY RESIDENTIAL
Name: �U
Site Address: 40 2-. , iC
Date 1 o1 —
Plan Check it : ZOO '7 -- (Q
_I,
Project Description: OcC4- "If g61f 4kt
- -
Reduced Site Plan Provided: 4ES NO)
Zoning: �-
Map Page: �Q S�
Corner Lot: (YES
/ O
Flag Lot: (YES /
Critical Areas Determination f SO 0 -7 01 N
Study Required ef`pSjO,\ 64ZW4
❑ Waiver
SEPA etermination:
19-Exempt
❑ Needed (for over 500 cubic yards of grading)
❑ Fee ❑ Checklist
❑ APO List with notarized form
Required Setbacks
Street: z S
Side: C�
----�
Side:
l 0
Rear:
2
- - -
Actual Setbacks
-
Street: � z S � Side: I �
Side _ --I
Rear:
� Z S�
❑ Detached Structures:
❑ Rockeries:
❑ Fences/Trellises:
❑ Bay Windows/Projecting Modulation:
❑ Stairs/Deck:
Buildin Height
Datum Point:
Datum Elevation:
Maximum Height Allowed:
Actual Height:
Other
Parking Required:
Parking Provided:
Lot Area:
Maximum Lot Coverage: 35% Proposed: �.
Lot Coverage Calculations:
ADU Created: (YES
Subdivision: --
Legal Nonconforming Land Use Determination Issued: (YES / QO
Qec k- cy �a c f v'o s,, 6
rQ-r- RC Z 3, L{D.220. C, 3
Comments _
Glgz cvd ovlc , /t/d ALI
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Plan Review By: 4
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MEMORANDUM
Date: October 18, 2007
To: Street File
From: Mike Clugston, Planner
Subject: Permitted Alteration to Structures Existing Within Critical Areas or
Buffers
As part of the City's review of the Gustafson deck replacement at 8602 Olympic View
Drive (BLD20071054), it was noticed that there was a critical area (erosion hazard) on
the subject parcel. As a result, a study was required pursuant to Edmonds Community
Development Code (ECDC) Chapters 23.40 and 23.90.
However, according to Edmonds Community Development Code (ECDC) Section
23.40.220.C.3 — Permitted Alteration to Structures Existing Within Critical Areas or
Buffers — alteration of legally constructed structures is permitted within critical areas or
buffers as long as the action does not increase the impact to the critical area or buffer and
there is no increased risk to life or property as a result of the proposed modification or
replacement. The proposed action will not result in negative impacts to the critical area
or buffer; as a result, no further critical area studies are needed in support of this building
permit.
µte1r�.
.•=w.G.^Z.JL::'.2.Itu�....�'...«..3.!��1u�.L.ii
CITY OF E M ®N ®S HARVE H. HARRISON
200 DAYTON ST. • EDMONDS, WASHINGTON 98020 • (206) 771.3202 MAYOR
DEPARTMENT OF PUBLIC WORKS
REGISTERED MAIL
March 9, 1983
Mr. Robert E. Gustafson
8602 Olympic View Drive
Edmonds, WA 98020
Dear Mr. Gustafson:
SUBJECT: CROSS CONNNECTION/IRRIGATION SYSTEMS
An irrigation system located on your property may be
in violation of State of Washington and City of Edmonds
ordinances related to backflow prevention. To protect
the potable, or drinking water supply, an approved back -
flow device is mandatory on all irrigation systems.
1
Please call the Water Department Cross Connection
Inspector, Lee Willeiksen, at 771-3202, extension 294,
for information or an appointment for inspection of your
irrigation system.
Requirements to meet State and City Codes need to be
completed within thirty days from receipt of this notifi-
cation.
Sincerely,
A —9, "7?�
ARCHIE BRENA
Water/Sewer Division Supervisor
LEW/ml
Enclosures: Ordinance No. 1711
Edmonds City Code -Chapter 7.20
lo
44 / Z-4-5 DT WILLEIKSEN DT MARCH DT
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1
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ORDWAtiCB H0. 1711 is:..,::;
AN ORDINANCE OF THE CITY Of HDJ=DB, WABHINGTON,
AMMDING CHAPTER 6.16 OF THE ETlHMS CITY CODE,
DECLARING CRASS OOM ICTIONS MICR ENDANGER WATER
QUALITY UMLAN?m MD =QUIp_=G THB INSTALLATION OF
BACRTL04I PR$VMrTZCN reWCE$t REQUIRIMG PRIVATE
WATER SUPPLY SYST AS TO CC!NpppX VM APPLICABLE
ORDINANCES OF THE CITY OP ED1 OUW I ADOPTING STATE
STANDARDS FOR KATHA SUPPLIES AND CROSS CONVIECTION
CONTROL YZGULATIOni DSCI.ARIMG RXISTING LA1UY IFUL
CROSS ='UP-CTIONS TO B: PUBLIC btUISANC38 AmD
PRESCRIBING A PROCEDURE FOR ABATnXM" OF SAID
NUISANCES.
WHEREAS, th®.City Council of tho City of F.dnonds, Washington,
has date mined that certain cross connections in the public water
supply POGO a potential hazard to water quality within maid city,
and
WHEREAS, the installation of backflow prevention devices
to counteract back pressure or prevent back siphonage into the
Public water system are necessary for the public health, welfare
and safety, now, therefore,
THE CITY COUNCIL OF THE CITY OF ED1,YJNDS, WASHINGTON, DO 1
ORDAIN AS FOLLOWS:
Section 1. Chapter 6.16 of the Edmonds City Code is
hereby amended by adding to said chapter, the following sections:
Section 6.16.200 Definitions:
1. Backflow: A flow, other than the intended direc-
t1on of flow, of any foreign liquids, gases, or
substances into the distribution system of a
public water supply.
2. Backflow Prevention Device: A device approved
Y Fe ate o ns ng on, Department of Social
and Health Services or such other sta'te'depart-
ment as shall have jurisdiction over the subject
matter, and by the American Water Works
Association, used to counteract back pressure or
prevent back siphonage .into the distribution
System of a public water supply.
t� d -m ^ "#'�''�'e�?? s¢ ` rr wad � . A a���� it
3. Cross -Co ctioni Any phYAipa1 azrangcatant
Vher yy a p Yid water sv$ply is connected,
dirOctly or indirectly, with any other dater
supply system, se r, drain, conduit, pool,
storage reservoir, plumbing fixture, or other
device which contains or spay contain contaminated
water, savage, or other wastes or liquids of
unknown or =sasfe quality, which may be capable
of
suppllyaras agresult ofabaaakflod. ilia water
Sectionine 6.16.210 Cross-connectionshe-
a on or Declared Unlace h 1s
Er —
which in this opinion Of the DSa or ®a ecrosa,connoc on,
nistrativa
Amsictasnt or any staff mar that he shall designate
who is qualified in protection Of municipal water
water supplyaliofthe gCity ofr the wEdmonds, ater is hereby declared
to be unlawful.
Section 6-16.220 Backf low Prevention Devices to be
Insta s ac oar prevon on v ces
o e natalled in thm opinion of the Kayoree Admin s-
n rQI1
trative Assistant or his designated representative
shall be installed and maintained by the service
customer on any service connection to tho City of Edmonds
water supply system where said baokflow prevention
devices are necessary for the protection of the City
Of Edmonds water supply.
Section 6.16.230 Re lation of Private WateLL_Eupplies,
Use or operat ono a pr vote wa r supp y aye em,
contrary to the provisions of the ordinances of the
City of Edmonds, or the Laws of the State of Washington
or the rules and regulations of the State Board of
Health regarding public water supplies whore said
private system is served by the City public water
supply are hereby declared to be unlawful.
Section 6.16.240 Ado tion of State Re lationes Rules
an regu a gone o e a e oar UL nealtn
public water supplies, entitled •Cross-Connectionrding
Control Regulation in Washington State" WAC 248-54-250
through WAC 248-54-500, and the American Water Works
Association, Pacific Northwest Section's Second Edition
of 'Accepted Procedure and Practice in Cross -Connection
Manual' as they presently exist and as they may, from
time to time, be amended in the future, are hereby
adopted by this reference as if set forth in full.
Section A-16.250 Abntement of Unlawful Cross -Connections
an ns a at on o Bac ow raven on Uov ces - Proce urea: roes -conned ens ec are n -
s c apter
� it"-- �VIM*
Lnnn', ram. .,Ir"i {
to be unlawful whether prese.Iily existing or herein-
after installed and/or aesvioos requiring bncktlaw
prevention devices and/or unlawful use or operation
of a private water supply system served by the City
public water supply system are hereby declared to be
Public nuis&nces, and in addition to any other pro-
visions of the Sdmosds City Code ar the ordinan ma of
the City of Edmonds armor° abnt&mtnt of public nuisance::,
shall be subject to abateuasnt in accordance with the following procedural*
1- In the event that the N.A.A. or his designee
dettrninse that a nuisance as heroin provided does
exist, written notice shall be sent to the person in
whose name the water service is established under the
records of the City of Edmonds Water Departxoont, or
alternatively, A copy of such written notice shall be
posted on the premises served.
2. The notice shall provide that the nuisance
described herein shall be corrected within thirty days
(30) of the data said notice is mailedor posted on
the premises.
3. In the event said nuisance is not abated
within the prescribed time, water service to said
Premises shall be dir.continued.
4. In the event that the nuisance, in the opinion
Of the H.A.A., or his designated representative,
presents an imann_diate danger of contamination to the
public water supply, service from the City water supply
System to the promises may be terminated without prior
notice, provided, however, notice will be posted on
the premises in the manner heretofore provided at the ti'
time said service is terminated.
Section 6.16.260 Penalties: In addition to the remedies
set or ere n, any person found guilty of violating
any of the provisions of this chapter shall be subject
to the penalties as set forth in Section 5.12.170 of the
Edmonds City Code.
APPROVED:
H. H. HARRISON
MA
ATTEST:
I R A VAM M(1 .A I
CITY CLERIC
Passed by the City Council: May 21, 1974
Filed with the City Clerk: April 18, 1974
Published: May 29, 1974
._.." _,I.��_! �._-- -_f..��_��,.:� �`�,£-i,�"i��'+::a1'm".t.�..�i.f�..'��.u�'t"�'�"'F`s. �;5�`Hy*fYm,,,a, r`�y a__,'�`<•�°,-�i'+.m�,c'+r'�ifiX�`•?+x",�i'SF°'.+E�i��
7.20
Chapter 7.20
Backflow Prevention
Sections:
7.20.010 Definitions
7.20.020 Cross -connections declared unlawful
7.20.030 Backflow prevention devices to be installed
7.20.040 Reputation of private water supplies
7.20.050 Adoption of state regulations
7.20.060 Abatement of unlawful cross -connections and
installation of backflow prevention devices
- Procedures
7.20.070 Penalties
7.20.010 DEFINITIONS
A. "Backflow" means a flow, other than the intended di-
rection of flow, of any foreign liquids, gases or sub-
stances into the distribution system of a public water
supply.
B. "Backflow prevention device" means a device approved
by the State of Washington, Department of Social and
Health Services or such other state department as has
jurisdiction over the subject matter and'by the American
Water Works Association, used to counteract back pressure
or prevent back siphonage into the distribution system
of a public water supply.
C. "Cross -connection" means any physical arrangement
whereby a public water supply is connected, directly or
indirectly, with any other water supply system, sewer,
drain, conduit, pool, storage reservoir, plumbing
fixture or other device which contains or may contain
contaminated water, sewage or other wastes or liquids
of unknown or unsafe quality, which may be capable of
imparting contamination to a public water supply as a
result of backflow. [Ord. 1711 §1 (part), 1974].
7.20.020 CROSS -CONNECTIONS DECLARED UNLAWFUL
The installation or maintenance of a cross -connection,
which, in the opinion of the director of public works or his
designee, will endanger the water quality of the potable
water supply of the city of Edmonds, is unlawful. [Ord.
1711 §1 (part), 1974].
7.20.030 BACKFLOW PREVENTION DEVICES TO BE INSTALLED
Backflow prevention devices, when required to be installed
341
7.20.040 •
in the opinion of the director of public works or his desig-
nated representative, shall be installed and maintained by
the service customer on any service connection to the city
of Edmonds water supply system where the backflow prevention
'devices are necessary for the protection of the city of
Edmonds' water supply. [Ord. 1711 §1 (part), 19741.
7.20.040 REPUTATION OF PRIVATE WATER SUPPLIES
Use or operation of a private water supply system, contrary
to the provisions of the ordinances of the city of Edmonds,
or the laws of the State of Washington
gulations of the State Board of Health
water supplies where the private system
city public water supply is unlawful.
1974)
7.20.050 ADOPTION OF STATE REGULATIONS
or the rules and re -
regarding public
is served by the
[Ord. 1711 §1 (part)
Rules and regulations of the State Board of Health regarding
public water supplies, entitled "Cross -Connection Control
Regulations in Washington State", WAC 248-54-250 through WAC
248-54-500', and the American Water Works Association,
Pacific Northwest Section's Second Edition of "Accepted Pro-
cedure and Practice in Cross -Connection Manual" as they pre-
sently exist, and as they may from time to time, be amended
in the future] are adopted by this reference as if set forth
in full. [Ord. 1711 §1 (part), 19741.
7.20.060 ABATEMENT OF UNLAWFUL CROSS -CONNECTIONS AND IN-
STALLATION OF BACKFLOW PREVENTION DEVICES - PROCEDURES
Cross -connections declared in this chapter to be unlawful
whether presently existing or hereinafter installed and/or
services requiring backflow prevention devices and/or un-
lawful use or operation of a private water supply system
served by the city public water supply are public nuisances,
and, in addition to any other provisions of this code or the
ordinances of the city of Edmonds on abatement of public
nuisances, shall be subject to abatement in accordance with
the following procedure:
A. In the event that the director of public works or his
designee determines that a nuisance as herein provided
does exist, written notice shall be sent to the person
in whose name the water service is established under
the records of the city of Edmonds water division, or
alternatively,a copy of such written notice shall be
posted on the premises served.
342
ip
.�a-os::A:i�i_,_�s�(?��°�'e�°"�iTi1r>��="�.'M ,•���' •ci61-,,Tj:��kO:�s.s-s<,,• ..,:';.`.c'"'°�--: —_
rt,R 9 yam. T(p H. f P I y' S S RY�y isy : ` T+tA� < *aid iFi F j xFv NaC7 �11.. YI
•
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7.20.070
B. The notice shall provide that the nuisance described
herein shall be corrected within thirty days of the
date the notice is mailed or posted on the premises.
C. In the event the nuisance is not abated within the pre-
scribed time, water service to the premises shall be
discontinued.
D. In the event that the nuisance, in the opinion of the
director of public works, or his designated representa-
tive, presents an immediate danger of contamination to
the public water supply, service from the city water
supply system to the premises may be terminated without
prior notice, provided, however, notice will be posted
on the premises in the manner heretofore provided at
the time the service is terminated. [Ord. 1711 §1
(part) , 19741 .
7.20.070 PENALTIES
In addition to the remedies set forth herein, any person
found guilty of violating any of the provisions of this
chapter shall be subject to the penalties as set forth in
Section 5.45.020 of this code. [Ord. 1711 S1 (part), 1974].
343
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Show to whom, date, addressi of delivery.-.-ji;I
RESTRICTED :,,DELIVER y
'hoi-K;an'd,'date c delivered.6501
W
E] RESTRICTED �;DELIVEkY.'
Show to whom, date, and -address of delivery' 8 0
,2. ARTICLE, ADDRESSED -TO:
7 Mr. Robert. Gust.df,sbn
86d.2 'Ojr�yjnpic%! View Dr
adg 98020.
�'Edmbl-
3. ARTICLE DESCRIPTION:'
REGISTERED NO.' CERTIFIED NO 'INSURED, NO
obtain signature of addressee or agentY.
L have rectiived` the.iakiclet,described above.
SIGNATURE 0�.Addresiee�- 0. Authorized"agent:,;
W >,DATE OF,DELIVERY'.',
POSTMARK'�-!
A;
5.. ADDRESS (Complete only if requested)
"[6. UNABLE TO DELIVER BECAUSE:
CLERK'S
INITIALS.._.
Gpo: 1975--(>-568-047,
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CAT OF EDMONDS
200 DAYTON ST. • EDMONDS, WASHINGTON 98020 • (206) 771.3202
DEPARTMENT OF PUBLIC WORKS
January 25, 1983
Mr. Robert E. Gustafson
8602 Olympic View Drive
Edmonds, WA 98020
Dear Mr. Gustafson:
SUBJECT: CROSS CONNECTION/IRRIGATION SYSTEMS
HARVE H. HARRISON
MAYOR
An irrigation system located on your property may be
in violation of State of Washington and City of Edmonds
ordinances related to backflow prevention. To protect
the potable, or drinking water supply, an approved back -
flow device is mandatory on all irrigation systems.
Please call the Water Department Cross Connection
Inspector, Lee Willeiksen, at 771-3202, extension 294, for
information or an appointment for inspection of your irri-
gation system.
Requirements
completed within
cation.
LEW/ml
to meet State and City Codes need to be
thirty days from receipt of this notifi-
Sincerely,
ARCHIE BRENA
Water/Sewer Division Supervisor
"�CDT WILLEIKSEN DT RCH DT
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CITY OF EDMONDS Willa No.
2
PUBLIC WORKS DEPARTMENT STR E E p � � (� L�LC E Issue Date 4" i� Li j ,; �
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction • Permit Issued To: r--, /V
.(��:•,n� ;!�!/ia�t,-�n�r. 1�/P;,oJ %Ira
• Owner: ����T_h// eT�'►-�� / • Type of Work to be Done:
Name d7A/ �"i >�,,2,�1 t� i A /c U t- /,,(J.
• Work in Connection With:
Mailing Address ❑ Sub or Plat ®; Single Family
❑ Comml. / Ind. ❑ Apt. Condo.
City, State, Zip Code • Pavement Cut: ❑ Yes E. No
• Contractor: S Az,'j • 12 . 7:>/A 2
Name
Mailing Address s State License Number
City, ' State, Zip Code Telephone Number
�r NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE �t
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit must be available at the job site for inspection purposes at all times.
1
Signature: �;I/l! /,e%.i��//lam-% Date '
Owner or Agent v
* * THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR .INSPECTION PURPOSES yt
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
1
Time Authorized: Void after days
Special Conditions:
Ammendments:
Permit Fee: /4- •4
Security Deposit:
Receipt No.:
Fund 111 Fee:
Street Cut Dimensions
X =
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
h
FIELD INSPECTION ES (Fund 111 - to cony to Street Dept.]
Comments:
Diagram:
Contractor called for inspection,_ Yes (IcJ
Work Disapproved By: Date: Bv: Date:
Work .Approved By: -` � Date:
Inspector:
Ena. Div. December 1978
CITY OF EDMONDS
CLAIM FOR DAMAGES
Date: July 80 1969
Reid, Middleton & Associates, Inc.
324 Main Street .
Edmonds, Washington 98020
Gentlemen:
Forwarded herewith is a claim from Hugh H. Hopper, Jr.
of 8602 Olympic View Drive Edmonds Nn. for damages in the
amount of a 37.15 to his automobile
resulting from contractual work under L.I.D. No. 161
It is requested that this office be advised of action taken relative
to the claim within fifteen (15) days from receipt of this letter. '
Please use the form below for your reply.
Enclosure
cc: Safeco Insurance Co.
City tngineer
REPLY
L.I.D. No. Date:
Inspector:
Contractor:
Complainant:
Action taken:
Signature
INTER; -OFFICE COMMUN ICI�.,j IONS
o. Sr
STREET FILE DATA 7/1 2/ ,g 83
TO FILE FROM Lee Willeiksen
by M. LeVan
SUBJECT: ROBERT GUSTAFSON - .8602 Olympic View Drive.
Per Lee Willeiksen, Mr. Gustafson indicates his sprinkler system
is an old one and does not -.work., :so..he .refuses to disconnect it.
We, therefore, are not pursuing this any further.
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