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� cc',�i stA "'• >1 " S� - » CA FILE NO.-
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Critical Areas.. Checklist ,T: k .
"'':�,�►;:Site_Information'(soils/topography/hydrology/vegetation)
"Site -Add ress/1.4cation
2 Property Tax,`Account Number: 'Tqfflaer 060• o0 mp
3 Approximate Site Size (acres or square feet): '�9-D
4. Is -this site currently developed? yes; �C no. !
_ •. _ .PCs -. .
• ; ' , If yes; how is site developed?
5. Describe the general site topography. Check all that 1 t A'�
Y- apply. k _ �09 , t4b
. Fiat: i - less than 5 feet elevation change over entire site. �• !q
g �i
• y. 9
Rolling:. slopes on site en
g , generally less than 1596 a vertical rise f 1 f P o 0- eel . g over a
y ( ..
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).
St des of eater than 30% r eeP- � .$t' 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: Approx. Depth:
7. Site contains areas of seasonal standing water: _� ; Approx_ Depth:
What season(s) of the year?
8. Site is in the floodway A o floodplain A46 of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? _ N,o Flows are seasonal? N t,_ (What time of year? )_
10. Site is primarily: forested ; meadow ;shrubs ; mixed ;
urban landscaped (lawn,shrubs etc) _
11. Obvious wetland is present on site: wn
For City Staff Use Only
L Site is Zoned? S ' (?.
— JQy9l+ 2. SCS mapped soil type(s)? GY 4_� 2 rok'v6ff c�. 00, 5 Z 5' - 70 yo S roAe
3. Wetland inventory or C.A. map indicates wetland present on site? Ala
4;,;-• -Critical Areas inventory or C.A. map indicates Critical Area on site? Yes - S fre�0 -�y_tis +.6�G S I W e S
t--
5- . 'Site within designated earth subsidence landslide hazard area? A/0
6. • Site designated on the Environmentally Sensitive Areas Map? Yes . 40 S'�goes
.DETERMINATION
REQUIRED
WAIVER Reviewed by: Xj
.
Planner 47
CONDITIONAL WAIVER
.The Critical Areas. Checklist contained on :,and submit it: to the City The City will'-,:
this form is to be filled out by any person :k 'retiriew the checklist;' make a precursory site
Preparing a Development permit, `Ivisit, and make a determination of the
Application for
the Ci of > ty Edrrwrtds rior. .. subsequent p• �,. � steps necessary to complete a
to his/her submittal of a development ' development permit application.
permit to the City.
With a signed copy of this form, the
The purpose of the Checklist is to enable:._- : :. �.. applicant should also submit a vicinity map .
City staff to determine whether any - or plot plan for individual lots of the parcel
potential Critical Areas are or. may be'. •.d :. --; with enough detail that City staff cart :find
present on the subject property. 3'he :� and identify the subject parcel(s). In - `.
information needed to complete the, addition, the applicant shall include
Checklist should be easily available from' other pertinent information '(e.g. site
observations of the site or data available at plan, topography amp, etc-) oc studies' in '
City Ball (Critical Areas inventories,,maps, conjunction with this Checklist to assist
or soil surveys). staff in completing their preliminary
assessment of the site.
An applicant, or his/her representative, --
must fill out the checklist, sign and date it,
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). '
} . - "" .�.� . 1•
owner/ , .
Applicant: Applicant Representative:
1 Aa IF CAL. S.
Name Name
Street Address Street Address
JCiState, P PhoneCity; State, ZIP Phonere Date Signature.. Date .
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„�" •�' ►' =-- r At
City of Edmonds
Conditional Waiver
Applicant: Ian Ellis Determination #: CA-97-3
Project Name: Permit Number:
Site Location: 17002 72nd Pl. West Property Tax Acct. #: 7417 000 005 00
Project Description:
Waiver Criteria (all criteria must be found to apply):
X There will be no alteration of the Critical Area or its required buffers;
X The development proposal will not impact the Critical Area in a manner contrary to
the goals, purposes, objectives and requirements of the Critical Areas ordinance;
X The development proposal meets the minimum standards of the Critical Areas
ordinance;
X The above findings are based on the following conditions of approval:
1. The applicant must follow the requirements of the Building Official for
construction on steep slopes.
2: The applicant must follow the requirements of the Engineering Division for
erosion control.
Based on the above findings and conditions, the requirement for a Critical Areas Study
associated with this development permit is hereby Waived, as authorized by Chapter
20.15B.150 (B) of the Edmonds Community Developme t Code.
Kirk J. Vinish, AICP /'J - January 10, 1997
Name Signatur Date