15700 75TH PL W.PDFi 1111111111111114845i
15700 75TH PL W
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ADDRESS: 'JS�DD T� L [�V •
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS(RECORDED)FOR:
CRITICAL AREAS: �(J Z3S DETERMINATION: ❑ Conditional Waiver Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DA
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DA'
OTHER:
LATEMP\DSTs\Forms\Street File Checklist.doc
LID #:
BLOCK:
.~ 0 •
City of Edmonds
Critical Areas Determination
Applicant: J. Patrick Ford Determination #: CA -96-235
Project Name: Permit Number:
Site Location: 15700 75th PI W Property Tax Acct. #: 5131-028-003-00
Project Description:
Non -Project Specific
Determination: Study May Be Required
Due to the slopes on the subject property, a study may be required. The purpose of this study would
be to identify the extents and steepness of the slope and analyze the impact of development on the
slope. With the information submitted and the site inspection conducted, it is as yet, impossible to
determine if the slope is significant enough to require a study.
With the submittal of your building permit, you will need to submit a topography map that indicates
where slopes of more than 40% exist on or adjacent to the property and delineates the top of the
slope. If their are no slopes greater than 40% on or adjacent to the property, your only obligation
will be to comply with whatever requirements the Building Official applies to the project from
ECDC Chapter 19.05. If there are slopes with an inclination of 40% or greater you must maintain a
50 foot buffer and a 15 building setback unless a geotechnical consultant submits a report which
states how far the 50 foot buffer may be safely reduced down to a minimum of 10 feet.
Stephen Bullock November 27, 1996
Name 1g ture . Date
NOV-21-96 THU 4:51 PM
EAIOQNSULTANTS, 1NC. FAX h0, 20616 0860
ai.y ofEataaa,
Critical Areas Checklist.
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NOV-21-36 THU 4:52 PIA EARTH CONSULTANTS, IK FAX N0. 206 46 0860 P. .,3
Critical Areas Checklist
,,Site Infa mafiIon (s dVtopogragby/hydrology/veget tion) �' t
2. Prey * Tax Ac==
3. llpprozi� Site :+� Eater � 4 erase Z" ' l
4. Is this Sita O=mdy &Y*o 7 ___-yes-, 2o.
If yes: hvw is ahs &Itloped7
3, Deacr U the gWAV sive mpogrophy. A shat
FLOC tela lase 54M devadw caaw aver euke dw.
2611hw gop" as Sk.ft pomady Im thea 15'X. (t vertical rias of 1f3 & ovbr ,
hwiaar+tat 4EMS of m4mo_
N' Y- + Ca fila of atm Om 1594 rad ICU dAa 30% (a verded tine
of 10 -to oyer a i~oei DWA Hca of 33 to W -feet).
.S": 'PIWIS ofSMtW tP "prf M oa siu (s wrtirsl rsec of i0-fiV aver a
bmUcO 3t Qls=a of W &a 3"".
Odw-(per derrib# .
6. aft t slzn V= ufY=-mnd nmdwg waft: J3,n_ : App=. ihp&.
7. Site arata "arm of Somal s"Vg V=r AWox. ;
wi a "*an($) Of ft ym?.
8.; ,Site $ m ihd gaily► T .� of f wztr souse.
9. s
S10,000" j 4W& W aq arae wMa v W Ww atm the gMeaft nrbfS? Fift" am ym.
Mae Ejo FW= are aeas=R time.of ye4r7r� ).
14. Sits b priurgr. [mod ; nwdow �; Snubs !—, m;yod ;
utb,M IandseVed tlawn,ibmbR etc)
11. Qbvim wood is vmm on Site; _ .
..T�o 'Use esti
1. Ste ie 2aar�? J
2. 3t5 Mappod abit
I 'IYNIUA ffiviatory or CA mop bdluam wc&W prearoac 04 40
Af:'•^,C�;tt d Areae lrt+wlm of C.A. MV iadicatae C ilial Am ae dt11 j'Te�Y PES
,S. Site wrtliin tiai�ted eortlt ru�ideace ldadatida areal Y� �P - . C..{1 AEU'-�.t ST
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