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1053 ALDER ST
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ADDRESS: I S J Ay div k,
TAX ACCOUNT/PARCEL NUMBER:f)D 4f2�'2101 DZ 3 dD
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS : �h" J DETERMINATION: ❑ Conditional Waiver ❑ Study Required Waiver
i
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:�LQ'LI
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMITS)
GEOTECH REPORT DA'
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
OTHER:
BLOCK:
Mr,
LATEMP\DSTs\Forms\Street File Checklist.doc
---�------------- -�'REE�" FILE
UHMVELOPED ALLEY
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MAY 1 1 1992
91, PERMIT COUNTER
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Critical Areas Checklist
Site Information
Project Name: 1053 ALDO?, M_> M QIIJ Permit Number:
Site Location: \ E -V Property Tax Account Number:
Approximate Site Size (acres or square feet):
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? _�-5 Date of most recent action:
Soils / Topography
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)?
3. 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 of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
HydrologyNegetation
4. Site contains areas of year-round standing water: Q
5. Site contains areas of seasonal standing water: LEI Approx. Depth:
6. Site is in the floodway V 1 floodplain of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? �P flows
are year-round? Flows are seasonal? /
8. Site is primarily: forested , meadow ; shrubs ✓ , mixed
9. Obvious wetland is present on site:
10. Wetland inventory or map indicates wetland present on site:
11. Critical Areas inventory or map indicates any Critical Area on site:
For::Gty:>Use _Only-» -
STUDY REQUIRED: Critical areas study is required.
CONDITIONAL WAIVER: Critical areas study :not requir..ed..if specified:.conditio..ns.satisfied.....
// WAIVER: Critical areas study is not required. _
Planner
STREET FILO'
r o
890-199
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
inventories, maps, or soil surveys).
(?,�9 - ��W -13 3
APR 2 4 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 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
ty
Title
- I OF)-,) k ucu�
Street Address
Applicant Representative:
Name
Title
Street Address
City, State, ZIP Phone City, State, ZIP
Signature Date Signature
Phone
Date
APPLICATION
The City of Edmonds for SIDE SEWER PERMIT EASEMENT NO. --------------------------------------------
103-04450 NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO. .................. ASMT. NO. --_-..-_-----.--.-
OWNER Thomas -L, Richardson ---------------------------- CONTRACTOR -------------------------------------------------------------------------- PERMIT NO. --------------------
1053 Alder Street
JOB ADDRESS ------ - - LEGAL DESCRIPTION: LOT NO. - ._.
--_-_-._-._--------------------- BLOCK NO. .____ ..---_--..-___-..-__...
- - - ..
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NAMEOF ADDITION---------------------------------------------------------------------------------------------------------------------
DYE TESTED ON SEWER - February 10, 1976
By Jim Jensen
Approved:
DATE-------------------------------------------- By --------------------------------------------------- - --- -/75-
7 1
1TY O�� /
CITY of EDMONDS BUSS LICENSE APPLICA IONN.
aY lt•..-
Civic Center • Edmonds, Washington 98 . DA LICENSE NO.
City Clerk Phone 775-2525 CTQ
INSTRUCTIONS:
• All items must be completed
or application will notbe ac-
cepted.
• Sign and return application
with fee. Renewals received
after February 15 must pay
penalty-in`addition to
—NEW BUSINESSES AFTER
-DULY 31, 1/2 FEE.
NAME OF FIRM
MAILING ADDRESS -
EETEIL TYPE OF BUSINESS ANNUAL FEE AFTRR FEB. 1:
SPEC
(A) HOME OCCUPATION
$ 15.00
$ .50
nNO.
❑
(B) BUSINESSWITH
$20.00
$ 30. 0
1 TO 3 EMPLOYEES
C. BOX
❑
(C) BUSINESS WITH
$22.00
$ 3.
SUE OF
4 TO 9 EMPLOYEES
E C T E D
❑
(0) BUSINESS WITH 10
$ 75.00
112.5
WITH
ION.
OR MORE EMPLOYEES
NEW APPLICATION
(LA)
❑ RENEWAL
(LB)
❑ CHANGE
(LC)
PLEASE MAKE ANY NECESSARY CHANGES) ❑ DELETE (LD)
7 �I, .SN"T. 1:>ES16AJ BUSINESS PHONE70.t�� Fff.OYY/HE5 6bii
NA�URE OF•BUSINESS 1,, S,EP 1 lG8L
—� - EDMONDS FIRS=%r_.
NGQS `JljcL �' � AJ T6 Al 6 R -�PEG O A A 7—
BUSINESS ADDRESS Cm� IND.IVIDUAL PARTNERSHIP CORPORATION
C1 (S) 0 (P) 0 (C)
OWNERS NAME HOME ADDRESS
1z � Q SA
HOME PHONE
-lit
DAT
EMERGENCY NOTIFICATION (1) NAME & TELEPHONE
(PLEASE LIST TWO) (2) NAME & TELEPHONE
WASHINGTON STATE TAX
APPLICANT'S SIGNATURE
DO NOT WRITE BELOW THIS LINE
STAFF REVIEW: - FILL IN LAND USE CODE, UFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR DISAPPROVAL, DATE, AND
SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT" SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT DATE 74 L LAND USE CODE ZONING CODE
APPROVE ❑ DISAPPROVE
SIGNATURE
CONDITIONAL USE PERMIT
COMMENTS
BUILDING DEPARTMENT . DATE GI �I3 -8Z
APPROVE ❑ DISAPPROVE SIGNATURE I4. (ZeeVe5
COMMENTS:
CAPACITY: (NO. UNITS, APTS. OFFICES, SEATS, BEDS, STUDENTS)
FIRE DEPARTMENT DATE
&APPROVE ❑ DISAPPROVE SIGNATURE
COMMENTS:
Building
❑
Hotel/Motel
(L)
Permit
®❑
❑
Apt. Bldg.
Office Bldg.
(A)
(0)
Occupancy
❑
Restaurant
(R)
Group
❑
Hosp/Nuys Home
(H)
❑
School
(S)
�r��� ccw ooni
O�A
E DEPARTMENT
PPROVE ❑ DISAPPROVE DATE SIGNATURE
COMMENTS:
LIC WORKS DEPARTMENT
VAAPPROVE
❑ DISAPPROVE DATE SIGNATURE
COMMENTS:
PI (=A-qF RFTI IRIU Tn (`_ITV r%1 CQLC