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1428 OLYMPIC AVE.PDF1111111111111114287 1428 OLYMPIC AVE CA FILE NO. q I w� Critical Areas Checklist -=................................................... Site Information (soils/topography/hydrology/vegetation) UCT 10 1997 1. Site Address/Location: &Aj12 1Z /Jsi1 t JiJ S 2. Property Tax Account Number: 6 .,3/ j --0 e�269 j-- G'eW 3. Approximate Site Size (acres or square feet): �.� �i+7±!k 4. Is this site currently developed? yes; t/ no. If yes; how is site developed? 5. Describe the general site topography. Check all that apply. V""*" 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): ^ca chk.doc; Rev 10/03/97 City of Edmonds Critical Areas Checklist 'nC. 1 g9v 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 Applicant Representative: Name Street Address City, State, ZIP Phone City, State, ZIP Phone Signature Date Signature Date City of Edmonds Critical Areas Determination Applicant: Terrance G. Marcell Determination #: CA-97-202 Project Name: Permit Number: Site Location: 1428 Olympic View Dr. Property Tax Acct #: 5319-045-001-0009 Project Description: Non -Project Specific Determination: Study Required: During review and inspection of the subject site, it was found that the site appears to contain and/or is adjacent to a Class 2A Stream(with salmonoids) pursuant to Chapter 20.15B of the Edmonds Community Development Code (ECDC). Based on these findings, prior to submission of any development permit, you will be required to submit the following for review by the Planning Department: Submit a survey prepared by a Licensed Land Surveyor delineating the top of the stream bank, required 25-foot buffer, and 15-foot setback to any proposed development. This stream flows into Puget Sound, therefore, the applicant must contact the Department of Fish & Wildlife, have them review the site and submit a letter determining the impacts of development on this site and, if necessary, recommend mitigation measures to ensure protection of the habitat/stream. If culverting or redirecting the stream is proposed for development of the site, please have Department of Fish & Wildlife address this matter as well. If the property owner wishes to apply for a specific development permit which they feel would not impact the Critical Areas located on the site, they may submit their proposal to the Planning Department for review. If the Planning Department finds that the proposed development permit will not adversely impact a Critical Areas or its buffers, a conditional waiver may be issued on a project by project basis. Name Signature Date T 4 ON N (n \ l0 \ \ \ CT7 tTj n O H %% ri•i d .. ON F v 0 O `17 (D CD(� (CD 00 O O ND �o � ST ET FILE�.� V�� r• z n' 4 a � ~i n FJ• ty � n WH cD (On(D ,(D(D n r+ r+ H- (D O FJ• P.'� a¢ H �-n P: O! ((D' D 00 �' ((D' D a \ (D oa a �0 (D rh V (D O r+ r+ rF N PSI & p� C O (V rF F� �07 � O F� P- O CN �J C)N a\ W O (n 0 00 rh N (n r+ Cn N- O V N (n � r r (D cD r+ rf r+ rt (D cD C n (D H n n (D H H z H a yy try tri � y RECEIPT zFOR CERTIFIED TAIL 70:j P s Pq�tge t —,".--POSTMARK , : . Z 19-02500 1 `-OR`DATV1\ ST- LUKES EPISCOPAL CH /j P r 5710 22ND AVE. N.W. SEATTLEt-WASHINGTON 98107 ".7 CD OPTIONAL SERVICES,4FOR"ADDITIONAL, FEES:, RETURN 5 11OWS 10 Wh=:Bnd�,da'o delivered 150 ' With delivery,.to , cld,�!.,e only 1 RECEIPT IP Shows to 4holm,' dato -incl 'where delivere d 65 I,,: SERVICES With deliver' to':addresseetonly .:"885 5 # '..'DELIVER TOF 'ADDRESSEE,ONLY 50d V il�l �E SPECIAL p L DELIVERY L;L VERY (extra fee required).... ••.• ............... I ............ RECEIPT FOR CERTIFIED MAIL.7-3 pstage) VI(Plps,p SENT TOPOSTMARK , '' OR DATE -A 1�n `Stk&'ANDINO: Z2 P;O STATE AND*ZIP CODE �oWilONALI,SERVICES::FOR,.ADDITIONAL'.FEES: -RETURN 1.111shows to whom And,clato delivered v: With deliver to.addressee only': RECEIPT ttato -eAd where delivered SERVICES With delivery,'L2 only.....:..:::. .to.al r se 7 DELIVER, To . -ADDRESSEE, ONLY ... ................. ........... .... . f SPECIAL DELIVERY (extra fee requirecl):: ..................•............ PS Form NO INSURANCttOVERAGE AQVIDElf-' Apr. 1971 3800 `NOT OR INTERNATIONAL -MAIL (See other side) GPO, 10700-397 -450 �o -el Dsr) yt The one of tr�iat'� .¢ acaor�l�c ;to1_p1�t thereof "s®aord�acn Velum® 3 of B].�34.n:, t.. . x Pa���: aw reaord� :of 3nohomish.,Co�urity; Wa hington, .desc:ribed follows : f (1):' East 140 feat .of TracC !88, Js-xcz T the North 15 fet©t Che -77 (2) North lg . fe0.t of ,5out3i '1'7 Ee® .of Tract 89:, BXCF" thQ ti.;;.• East •140 feet. thereof'. 5 r (�) Nortii 12 feet of.x�a©t 100 f�pet of -Tract '89. a�stat® descriyti:on in sarici°;:f:axnest Money. Rec p,t and` 4,tYjjj Agreement be 'and hereby is ai i nded ';to read as above s®t f,orth. :G• The, Company has not surveyed the premises described in l is t q a'1 w"is;: furnished without charge solely for the purpose. of assisting in locating said prertii es and the J: „z i dWnes".no liability for inaccuracies therein. ft does :not purport to show ALL highways, roadse'and ease f pert L, inertts �Cdjo(nri-'or, effecting said premises.' • b •F r q, ' S11• ' toe jLL o c • V . V I A 13'7z kic Map 'Dept. Reference ............. ......... CITY OF EDMONDS - SIDE SEWER PERMIT WATER -SEWER DEPARTMENT PERMIT K® C2�j�j /Call 776-1107 for side sewer inspections BEFORE covering any portion of the construction.\ `Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspections./ ADDRESS LOCATION OF CONSTRUCTION .........:......................... _......... PROPERTYLEGAL DESCRIPTION ............................ :...... :.:.......... ..... :............ :...................................................... :................................................................. .........................................•-•----...._......----_OWNER AND/OR BUILDER---- ------ :...'..::::•----_._.._.........__..--•-------------•------......_....--•-----.._..........................._....... CONTRACTOR'S NAME & ADDRESS ----------------•--- .... -•------------! ----••-•_.••••a--,-'-.-,-•--------.--a--------•------..,..•-----_............................................ Permission is granted ......_.___ . ............................................... 19.....:... for repair and/or connection of a side sewer to the city sanitary sewer systems in accordance with City of Edmonds ordinances. IENTION IS CALLED TO THE FOLLOWING: TTE 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—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 4—Top 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 1,¢ will be permitted. NOTE No. &--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 ...................... ......... By ............. Date-- ------ ............... B . �. ...., --b--...`.._ ...........----•--• By ..... - •• ----- Date ................ APPROVEDDate.- .._ ............................... By_ • ..... 4..... �...._.......---......---....................---..... Remarks. m:. ......................................................................-....----..._......._..._.............------...'........................................................ .................................................••------•--•------------•---•------.............................-------••---..................------..._....•......._..••---.._-----------------... .---------....................................._....... — BOTH Permit Copies MUST Be Signeq- instItIled r of Firm Performing Construction PRIOR To Request For Inspection -- I,..%-�C"' 5-�. - ------------------ hereby certify that the side sewer installation constructed under this permit (Owner of Contracting Firm Perfcrming in accordance with all governing rdinances of the City of Edmonds. Dated this..;Z.�,1or--------------- day of ---�G!:"---I- %'�. 19 -----Z V Check BEFORE you dig for: Water p, Gas p, Telephone [j, Power [], Sewer E], Other ❑ V V 1 y • SEWAGE DISPOSAL P Septic Tank .......... rQ�.......gals. &" E CITY OF E D M O N D 1 �'Lo 1� Disp. Field ........... I� -sq. ft. Department of Public Works Other----- --............................... -.......... Name------------------------- A. ........ ......................................... ----------- is hereby authorized to install/ repair sewage disposal system at Date issued 'on.---..--.. ------------- Permit expires one year from date of issue DO NOT COVER BEFORE AP&OVED BY DESIGNER OR SANITARIAN I hereby certify this system was installed under my supervision and control and complies with all provisions of the City of Edmonds Resolutions. Signatureof Installer ............................................................................. Date .................................. Approved ] isapproved F1 Date----------c Z. 4. ........................... By......... .. -------------------------- Remarks:------•----•------------------•----------•---..........-------------.......---.........--••------------------------ ••--------------. ---- SANITARIANOR DESIGNER. ......................................................... ...................................... Date .............................. ............................. This permit shall be posted in a reasonably conspicuous place on the job until inspection has been completed. .J+ CITY OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250 Fifth Avenue North, Edmonds, Washington APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT (Submit 3 Copies) Charles Hansen Permitto be issued to: ........................ -•-----•----................................ - .............................. ....... ................................. ........... For installation at: (street address)-.-...-.�. — .......... Addition or Subdivision See Attached Sheet ------ - ------------- - ------ ---------- Lot.---------...... Block ................ -- ---- ---- ---- - -- - -- ---- ---- Type of Building: New ... X...... Existing............ Single family residence ... .x......... Number of bedrooms..... 2................... Other: (specify type or use) ----• --- ••-•-•------------ ---- -- ------------------------------ ----.... ---...... .------- ---........................ ............. Charles Hansen 18627 ------.__.._.___.--Address..--186...........�lst--Ni,. Edmond.. ---Wash:......_..._. Builder .......... ............. M. B. Meyring............... ......... ............ ..--------------- Address......200.19. Hiway. 99..Lynnwood,..Wash...--.--.... Designer. - Soil Log Hole No. 1..........48"---$and gravel with slight traces.of_ clay.._...... ------------------------------------------------------------------------------------------------------- ------------------------ ---............................................................ Soil Log Hole No. 2..... .....same as No. 1 ---------------------•-••------•--------•••----------------•-----........----------......----------...---- ---------------------....-- . -- ....................................................... Elevation of Water Table, if encountered. (Distance from ground surface) ..........no-ne Corrections to control surface water if needed .......... no ne Specify if any removing or grading of topsoil -in field area.... Minimum ... graadi-ng...a.11owed.4n-'.-drainfleld....... ......... P-rea............................. -............................ -•-------•••-----------.....---------................... ---•--........................---:............................---- i'ercolation Test Hole No. 1 —Average Rate......... .................................... (Fall in ininutes/inch-bottom 6" test hole) Test Hole No. 2—Average Rate........................................................... (Fall in minutes/inch-bottom 6" test hole) Test Hole No. 3—Average Rate.......4............................................. (Fall in minutes/inch-bottom 6" test hole) Average percolation rate on which to base drain field design.....0...... ......... .............. . Date Taken.... Septic tank requirements based on present rules and regulations: Septic Tank Size. ------- .... 900 gallons. Amount of Square Feet of Disposal Field ....450 . .. Signature — Designer....--- ........ ,.. Date..... f .Q . 3 A/6..................... DO NOT WRITE BELOW THIS LIN (To be completed by Issuing Agency) Permit issued (date).-.. ...... Permit Number.... .............................. Remarks :........................................ . .... ---------------------------------------- -------------- _-------- . ..........--_-_-------...... ..----------.......------- .... � +ia.auru.amw+i. � � µ' M (�..wsmwww-.•w+a... p� � P✓i Cn"�1�.- Vi T ' { E f(1 } T� r ✓ � p„ ra co 0 CO �• , tie C3 • ca '.a 22 Legal Description for Charles Hansen East yi" V-T et of Tract 88 and South 17 feet of Tract 88, Less the East 140 feet thereof, and Tract 89, Less the West 140.feet of the South 120 feet thereof, and Less the East 160 feet of the South 120 feet thereof, Edmonds Sea View Tracts, as per plat recorded in Volume 3 of Plats on Page 76, Records of Snohomish County, situate in the County of Snohomish, State of Washington. a