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17901 72ND AVE W
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179th Street SW
CITY
[IF EDMONDS SIDE SEWER AS
BUILT
ADDRESS
Permlt Number 9474
I
17901
72nol Ave W
HOMEOWNER
CONTRACTOR
Cohee
Construction
DATE
4/13/01
DRAWN
BY P. Lemcke
LID
NO.
215
MM-29-2000 16*-28 CITY OF EDMONDS
Critical Areas Checklist
4257710221 P.03/07
CA.-m-'515
--------------------------------------------------------------
Site Information (soils/topography/hydrology/vegetation) 7' , 6PAP
1. Site Address/L*cation: 1 -72 0 -42ml hbf;� IAJ95 Ojvk)5
2. Property Tax Account Number., Q,3t--P601 &00
3. Approximate Site Size (acres or square feet): F 46 1
4. Is this site currently developed? yes; — no.
If yes; how is site developed? AAA
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 IS% (a vertical rise of I 0-feet over a
horizontal distance of 66-feet).
Hilly. slopes present on site of more than 15% and less than 309/6 ( a vertical rise of
I 0-feet over a horizontal distance of 33 to 66-feet).
Steep; grades of greater than 106/o 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 seaqon(s) of the year?
B. Site is in the floodway floodplain-96— of a water course.
9. ' Sitc contains a creek or an area where water flows across the grounds surface? Flows are year -
Flows are seasonal? N 0 (What time of year? -- ).
round?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc) :J-
11. obvious wetland is present on site: AID
1. Site-ij Zoned?
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A-.-
2.: .SCS map,:pcd so),,l vwwl,
W-etlaitd: pieientok s*� t
I Wetland invent0i�--§*..
4. Ctiticat:*�*:i'
.5. "site within
6. Site desigym�ed4n Th
IDETERMIN
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MAR-29-2000 16:27 CITY OF EDMONDS
4257710221 P.02/07
City of Edmonds
V4W CRITICAL AREAS CHECKLIST
The Critical Areas Checklist contained on this form is
to be filled out bY any Person Preparing a
Development Pennit 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).
Oa.,# 1. 4-�
An vplicant, or his/her representative, must fill out
tl* 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.
please submit a vicinity map along with the signed
copy of this form to assist City staff in finding and
locating the specific piece of property described on
this form. In addition, the applicant "I 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
assessmcnt of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant: Pe, '7-Rovi
e--� "-7, (>N� c> 0 2
- Z QA A Jal
Name
Street Address
941, J,
City State Zip
Ttl4hone
signature
Date
C:M=PdDft\J&n2%CW1.d00
Applicant Representative:
Name
Street Address
city Stme zip.
Telephone
Signature
Date
(over)