10414 NOTTINGHAM RD.PDF1111111111111112399
0414
NOTTINGHAM RD
#P20
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1.
2.
3.
4.
5.
Site Address/Location:
CA File No:. b CJ - J
Property Tax Account Number:
Approximate Site Size (acres or square feet):
Is this site currently developed? yes; _ no.
If yes; how is. site developed?.
Des jbe the general site topography. Check all that apply.
Flat: less. than 5-feet elevation change over entire sit
e. •
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 than33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: No ; Approx: Depth:
7. Site contains areas of seasonal standing water: N ; Approx.•Depth: .
What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site co4#tins a creek or an area where water flows across the grounds surface? . Flows are year-round?
LM Flows are seasonal? (What time of year? ).
10. Sit is p ' orested ' ; meadow ; shrubs mixed
urban landscaped awn, shrubs etc) n r
11. Obvious wetland is present on site: / V
For City Staff Use Only
1. Plan Check Number, if applicable? u Clete Q f V e41.
2. Site is Zoned?. _ R-5 — g .
3. SCS mapped soil type(s)? (0. A1 A cNWUt d u rlo" L.Dliyt d X , a —15% e, I r3 new
1-+t. C-WXC41- arAXT I!A� _GAN1 dti l oam o --
4. Critical Areas inventory or C.A. map, indicates Critical: Area on site? 157—b0'l • eX'051 Cn 51 tPC I�;-
rm wept e, f d e, of prop"'ot f utim k em -bar, 'y adzGt 5. Site within designated earth subsidence landslide hazard area? N 0 ht ,+ 61,U'1dj-n Gl
nffi'C,4 +D Vna ke. frrl a! z*r, m ri af-)-oyl
DETERMINATION
STUDY REQUIRED WAIVER
Reviewed by: Q�'[/1/1/fjt / ( Date: 0111 7-3 i ?-yoCr
�L��.�tlef%Cd•� —
#P20
`a C: 1 %9 �
City, of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
Date Received: 1111 UD
City Receipt #: Q o 00
Critical Areas File #: 1-005 013 5'
Critical Areas Checklist Fee: 135.00
Date Mailed to Applicant:
The Critical Areas Checklist contained on this form is to A property owner, or his/her r authorized representative,
be . filled out by " any . person preparing a Development must fill out the checklist,. sign and date it, and submit it .
Permit Application. for the City of Edmonds prior to to the City. The City will review the checklist,. make a
his/her submittal of the application to the City. precursory" site _visit, and make a determination of the
The purpose of the Checklist is to enable City staff to subsequent steps necessary to complete a development
determine whether any potential Critical Areas are, or permit application.
may be, present on the subject property. The information "Please submit a vicinity map, along with the signed copy
needed to ,complete, thet Checklist should - be:: easily.. - of this form to -assist City staff in fmding.and locating the
available from observations of the site or data available atspecific piece, of,:property. , described on this form.. In
City .Hall (Critical areas inventories, maps, 'or soil addition, ".the applicant. shall include other pertinent
;
surveys). ` infoimation::(6.g'. site plan' topography map, etc.) or
.studies in conjunction with -this Checklist to assistant staff
in completing their preliminary.assessment of the site.
The undersigned applicant, and his/her/its heirs, and.assigns, in consideration on the, processing of the.application agrees
to release, indemnify, defend and hold the .City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from . any ' action 'or infraction, based in whole or part upon false, misleading, inaccurate or.
incomplete information fiunishe'd'by the applicant,-his/her/its agents or. employees:
By my signature,: I certify that the information and exhibits .herewith =submitted, are true and correct ;to the'best of my
knowledge andahat I am authorized to file this application on the behalf of the owner as listed.below.
SIGNATURE OF APPLICANT/AGENT DATE
Property, Owner's Authorization
By my signature, I certify that I have authorized the:above Applicant/Agent apply for the subject land use application,
and grant my permission for the public.officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and postinattendant to this application.
J
SIGNATURE OF OWNER U!?l!r(/ DATE .:/ -/7�t.J'
Owner/Applicant: Applicant Representative'.
Name (f . Name
/.
O / 4 /�D�/1(n�AQI,
Street Address Street Address
�O 98n
City' State Zip City State Zip
Telephone: �� 6 %a — /0/ 6 Telephone: -r
Em dress (optional): ar /�/S $ Email Address (optional):
�lo�i l C�Y1