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STREET FILE
CITY OF EDMONDS
CIVIC- CENTER— WATER -SEWER DEPARTMENT
_SIPE SEWER PERMIT.
Cail PRospect 6-1107 when work
Is ready for Inspection. (No Inspeca
tions Saturday, Sunday or ho I Ildays.) N2 3022
ADDR,USS ............... 1420 ... Oly ic A
........... ..... . !PP ........... YqTuq
Jack E. Dodd
OWNER------------------------------------........................................ COINTTRACTOR .......... Rqy................Allen
..............................................
Permission is granted ............................ 19-6.8... for ... ...................... days to REPAIR or CONNECT a side sewer
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION 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 d Side Sewer Contractor must
be employed to construct side sewer in street area. Do not cover anyportion of sewer before It hansbeen.Inspected.
NOTE No. 2—Obtain full informa ' tion regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 3—Top of side sewer must have at least 30 Inches coverage at Property line and 12 inches inside property line; minimum grade of 20/0.
No bends In grade sharper than % will be permitted.
NOTE No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible f failure due to improper work which may develop within one year of completion. or
NOTE No. 6—It is unlawful to alter or do say other work than Is provided for In the permit, or to'do any work on the main sewer or its appur-
tenanees except to Insert the pipe Into the wye.
t 'C
CA FILE NO.
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: r�(
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? _ yes; no.
If yes; how is site developed. �
c9 c c.t
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 standing water: IU ; Approx. Depth:
7. Site contains areas of seasonal standing water: ' 0 ; 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? (What time of year? ).
10. Site is primarily: forested ; meadow ; shrubs ; mixed
urban landscaped (lawn,shrubs etc)V .
11. Obvious wetland is present on site: ' 3 C.
Rcv 01/04/94
6190.19"
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 inventories, maps,
or soil surveys).
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
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
other pertinent information (e.g. site
plan, topography map, etc.) or studies in
conjunction with this Checklist to assist
staff in completing their preliminary
assessment of the site.
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
Name
Street Address
City, State, ZIP Phone
Signature Date
Applicant Representative:
TC>ov,,- �0t5L
Name
Street Address
City, State, ZIP Phone
Signature Date
Inc. 1 S911
May 6, 1999
Mr. Jack Dodd
1420 Olympic Avenue
Edmonds, WA 98020
CITY OF EDMONDS
121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771.0221
DEVELOPMENT SERVICES DEPARTMENT
Planning • Building • Engineering
Subject: Determination regarding Critical Areas Checklist # 99-127
Dear Applicant:
BARBARAFAHEY
MAYOR
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIST OR CRITICAL AREAS STUDY.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
y You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL .40
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Enc: Critical Areas Determination
* Architectural Design Board
Thank you.
Sharla Graham
Planning Secretary
C: ReceptiWJana\CRLTR.doc
Incorporated August 11, 1890 °
Sister City - Hekinan, Japan