1044 DALEY ST.PDFiiiiii 1111111110723
1044 DALEY ST
TAX ACCOUNT/PARCEL NUMBER: qz oq--sot - -0
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS : I —141 DETERMINATION: ❑ Conditional Waiver ❑ Study Required Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DA
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PLANNING DATA CHECKLIST DATED: Iy�/�IT
SCALED PLOT PLAN DATED: J �1a Y vf/ 1�2M O
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: 15 BLOCK: �TJ
SIDE SEWER AS BUILT DATED: jj j j ks- l q /
SIDE SEWER PERMIT(S)
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER
ME7TE1R.1TAP CARD C/DATErD:
OTHER: 6uj n-1 Ob 1 ( I
LATEMPOSTsTorms\.Street File Checklist.doc
• •
PLANNING DATA
NAME:
Vv
SITE ADDRESS: DATE:
ZONING:_C6 —1h PLAN CHK#:
PROJECT DESCRIPTION: 7i 401 A _ 1V J
CORNER LOT � (Yes/No) FLAG LOT
(Yes/No)
SETBACKS:
Required Setbacks•
Front:-9 Left Side: _Right Side:_ S'. Rear:_ &—
Actual Setbacks•
Front: Left Side: /2 Right Side: Rear:
Street map checked for additional setback required? (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE:
Maximum Allowed: Xo' % Actual:
BUILDING HEIGHT:
Maximum Allowed: - Actual Height:_ API
Datum Point: Datum Elevation:_
A.D.U. CREATED?:
SUBDIVISION:
CRITICAL AREAS #:_ 47bL
SEPA DETERMINATION:
LOT AREA: g4to
Plan Review By
C �Q � 0/�ORl1IS�I W ESL EDO
P' 25 Soo
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N /v2 $ OLC. rc;._.�.- rid v2.�6 �`
Wsr!:.CTION REQUIRED
RECE VED
MAY 0 2000 OWNEWCONTPACTOR IS RESPONSIBLE FOR
DEVELOPMENT S�RVICES CTR. EROSION CONTROL AND DRAINAGE
CITY OF E MONDS
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PLANNING DATA
NAME: M411044L"�
SITE ADDRESS:11)LA 4 DATE: 7 2 c ?f
ZONING: �PLAN CHK#:��.,
PROJECT DESCRIPTION: yyO'er ZLxZy
CORNER LOT No (Yes/No) FLAG LOT '4"1 (Yes/No)
SETBACKS:
Required Setbacks: S
Front: V1 Left Side: S Right Side: S Rear:
Actual Setbacks:
Front: 9 Left Side: S Right Side: 3-7 Rear: S
Street map checked for additional setback required? (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION �tSS EDus ` ,yam.. (Y/N)
LOT COVERAGE:
Maximum Allowe �Actual: 7 �d
BUILDING HEIGHT: l i,
Maximum Allowed: i 5 Actual Height: Z
Datum Point: " �"°?' Datum Elevation: ) 6
A.D.U. CREATED?: A107,
SUBDIVISION:
CRITICAL AREAS #: ' C 4 - 9 ? -1117 -
SEPA DETERMINATION: L` Yvn- �.
LOT AREA: f, qovlllr,
OTHER:
Plan Review By: wu 7
cArtles\permid^plandat.doc
CITY OF EDMONDS 1W
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
1044 Daley Street
• Owner: Washington Natural Gas
Name
805 156 Av NE
Mailing Address
Bellevue, Wa 984907
City, State, Zip Code
• Contractor: Same as Above
Name
Mailing Address
City, State, Zip Code
Perroo. go- " l oa
Issue Date %' 7 _ fQ
• Permit Issued To:
• Type of Work to be Done:
Install New Service
• Work in Connection With:
El Sub or Plat ❑ Single Family
❑ Comml. / Ind. ❑ Apt. Condo.
• Pavement Cut: ❑ Yes ❑ No
sTaFF-7-
State License Number
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
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 p 4rit must be
Signature: �'.. f..
C�L.- V ,
site for inspection purposes at all times.
Owner or gent ......i
* * THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: &�-1/J
Time Authorized: Void after 3D days
Special Conditions:
Ammendments:
Permit Fee:
Security Deposit:
Receipt No.:
Fund 111 Fee:
Street Cut Dimensions
X=
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
&90.199-
City of Edmonds
Critical Areas Checklist
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
inveritories, maps, or soil surveys).
S C',
RECEIVED -
Jul 2 7 1992
PERMIT COUNTER
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.
With a signed copy of this form, the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conjunction with
this Checklist to assist staff in completing
their preliminary assessment of the site.
I have- completed the attached tical Area Checklist and attest that the answers provided are
factual, to the best of my kno ledge (fill out the appropriate column below).
Owner / Applicant:
Do�6 N�trF3�2�
Name
.
Title
Applicant Representative:
Sc�Lk ZFE
Name
Q���GNc�iL
Title
-r—
Street Address Street Address
[pMo�1Ds w �(�S�2o 7-7( 335Z-- c,�q c,.,9%(o`j
City, State, ZIP
Signature
Phone City State, ZIP
Date Signature
5zt-7 -2- 4,,-:,
Phone
Date
Critical Areas Checklist
Site Information
Project Name: ( (3 Permit Number:
Site Location: toga DAt V j:�Y Property Tax Account Number: 4 � 2J
Approximate Site Size (acres or square feet): S F�
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged? tJ c> Date of most recent action:
Soils / Topography
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)?
3. Describythe 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 of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments FL-A-T CD
Hydrology/Vegetation
M
4. Site contains areas of year-round standing water: T' I"lii
5. Site contains areas of seasonal standing water: N Approx. Depth:
6. Site is in the floodway "` floodplain of a water course.
1�
7. Site contains a creek or an area where water flows across the grounds surface? flows
are year-round? Flows are seasonal?
8. Site is primarily: forested : meadow ; s rubs ;mixed
9. Obvious wetland is present on site: �'J 9
10. Wetland inventory or map indicates wetland present on site: N°
APPLICATION
for
The City of Edmonds SIDE SEWER PERMT EASEMENT No ...........................................
NEW CONSTRUCTION [] REPAIRS
118-03600
OWNER ...........AnthA1ly ..S..--.R............................................................... PERMIT No.......................
O.CCO......--••---------------•---•---••----•--.......------. CONTRACTOR....---....-...................-----..........-.............-----...----••--•
ADDRESS ....... 1044_--Ddley...St.!.....- .... .................. LEGAL DESCRIPTION: LOT No............................................... BLOCK No.............................................
•
•
NAMEOF ADDITION....----•--•...........................•---..............................................................................................
Dye Tested On Sewer 1972
Approved:
DATE................................................ By.................--...................................................
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