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19308 94TH AVE W
CITY OF EDMONDS
�V/NEW
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ITY of E D M 0 N DS �--P'E R,M I T
C S I D E S EW E R'
For Inspection Call 771 PERMIT NO.
aNEET FILE
Address of I Construction: 1013ca q4 '-'4 MWE
Property Legal Description (Include all'easements):
L:;e /V%7',-, C�)
Owner and/or Builder:
A-, e--, H 0 P, IJ E_k) 7-1-= Z Pk 5E NC_
Contractor & License�No: EC? AAQ _Z /a (_7'
Single Family Residence L 0 N D�S
"E' T P
I LTREALTMENT PLANT
Multi -Family (No. of Units
Commercial (No; of fixture Units
Invasion into City Right -of -Way: No V /.Yes (If Yes,,Right-of-Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Froperty: Ko Yes (If Yes,.easeme'nt required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS -1-S-T E D THE BACK
RECEIVED
AUG 15 1989
I cer ify that I h and shall comply Date
dve r ff
!e ,
with the items listed on the back. PUBLIC WORKS
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Assessment Fee: Receipt No.
Partial Inspection:
i Comments Initial
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Na- t �e Initial
00
Rejected:
CD -T—nitial
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1 1 The City of Edmonds
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OWNER------------------------------------------------------------------------------------------------ CONTRACTOR G- ' G ' CL --------- v'J -,S " % . ..................... PERMIT NO.
JOB ADDRESS -19.3-bl ---- - ---- ql-� 14 LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
--- --- --- --- - ------------------------------------------------
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---- -------------------------------------------
STREET FILE
(OTfpI ERICHO. TIETZE AND AssocIATES, INC.
Engineers and Consultants
144 Railroad Avenue Edmonds, WA 98020 206-771-6212
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GEOTECH
CONSULTANTS
13-954N.E. 20th St. (Northup Way), Suite I&
Bellevue, WA 98005
(206) 747-5618
(206) 343-7959
STREET FIL E
64�'91#
Du I L,-,M, #0
APR 19 1989
April 17, 1989
JN 89127
Howard Schroeder
Drawer Z
Lynnwood, Washington 98046
Subject: Addendum Number One
Slope Instability Risk Statement
Schroeder Single -Family Residence
19308 - 94th Avenue West
Edmonds, Washington
Dear Mr. Schroeder:
In our judgment, the plans which we have reviewed generally
conform to the recommendations in the geotechnical report and
the risk of damage to the proposed development or to adjacent
properties from soil instability will be minimal subject to
the conditions set forth in the report. Minimal risk does not
imply no risk but rather that the risk is low as there is
always some risk involved with construction on, or close to, a
slope.
If there are any questions,
service, please contact us.
MKD: cw
d
or if we can be of further
Respectfully submitted,
GEOTECH CONSULTANTS, INC.
z5.
S
Mark K. Dodds, P.E.
senior Engineer
GEOTECH APR 14 RM
CONSULTANTS
133% N.E. 20th St. (Northup Way), Suite I G pEwIT COURTM
Bellevue, WA 98005
(206) 747-5618
(206) 343-7959
ST-REET _ILE
Howard Schroeder
Drawer Z
Lynnwood, Washington 98046
Subject: Geotechnical Engineering Study
Schroeder Single -Family Residence
19308 - 94th Avenue West
Edmonds, Washington
Dear Mr. Schroeder:
April 12, 1989
JN 89127
We are pleased to present this geotechnical engineering report
for your residence to be constructed at 19308 - 94th Avenue
West in Edmonds, Washington. The purpose of our work was to
e . xplore site conditions and provide earthwork and foundation
design criteria.
The subsurface conditions of the proposed building site were
explored with four test pits. We found the site to be
underlain by one to six feet organic and medium -dense silty
gravelly sandy fill soils. Below these fill soils all test
pits encountered dense to very dense glacial till. It is our
opinion that the structure can be designed with conventional
foundations bearing on this till soils. Some over -excavation
on the downslope side of the structure may be required,
depending on the design of the structure.
The attached report contains a more detailed discussion of the
study and recommendations. If there are any questions, or if
we can be of further service, please contact us.
Respectfully submitted,
GEOTECH CONSULTANTS, INC.
Mark K. Dodds, P.E.
Senior Engineer
GEOTECHNICAL ENGINEERING STUDY
SCHROEDER SINGLE FAMILY RESIDENCE
19308 - 94TH AVENUE WEST
EDMONDS, WASHINGTON
This report represents the results of our geotechnical
engineering study for the site of the proposed single-family
residence in Edmonds, Washington. The site is located at
19308 - 94th Avenue West. The general location of the site is
illustrated on the Vicinity Map, Plate 1. Based on
preliminary plans furnished to us, we anticipate that the
building will consist of a daylight rambler with an
overhanging deck. Development of the property is in the
design and planning stage. The site plan given to us included
the footprint of the proposed structure and provided
topographic information.
SITE CONDITIONS
SURFACE
The site is a rectangular lot which lies atop a bluff in
Edmonds, Washington. There are two large trees on the flat
portion of the lot next to 94th Avenue West. The rest of the
property was either grassy or had had the brush cleared at the
time of our fieldwork. No obvious fill piles or substantial
debris were noted from surface observations.
K0tMQ__z4
The subsurface conditions were explored by four test pits at
the approximate locations shown on the Test Pit Location Plan,
Plate 2. The field exploration program was determined based
upon the proposed construction, site topography, the required
design criteria, subsurface conditions revealed during
excavation, the scope of work outlined in our proposal, and
time and budget constraints.
The test -pits were excavated on April 6, 1989 with a rubber -
tired backhoe owned and operated by Evans Brothers Excavating.
"Grab" samples of selected subsurface soils were collected
from the backhoe bucket. A geotechnical engineer from our
staff observed the excavation process, logged the test pits,
GEOTECH CONSULTANTS, INC.
Howard Schroeder JN 89127
April 12, 1989 Page 3
FOUNDATIONS
The proposed structure may be supported on conventional
continuous and spread footings bearing on the dense to very
dense ' glacial till soils underlying the topsoil.
Overexcavation of soil below the footing may be required
depending on final site grades. Fill placed under footings
should extend outwards from the edge of the footings at least
a distance equal to the depth of fill underneath the footings.
Exterior footings should be bottomed at a minimum depth of
twelve (12) inches below the lowest adjacent outside finish
grade. Footings founded on competent native till soils should
be designed for an allowable soil bearing capacity of two
thousand (2000) pounds per square foot (psf). Continuous and
individual spread footings should have minimum widths of
twelve (12) and eighteen (18) inches, respectively. A one-
third increase in the above bearing pressures may be used when
considering short term wind or seismic loads. For the above
design criteria, it is anticipated that total settlement of
footings founded on glacial till soils be about one-half inch.
Almost all settlement due to dead loads from the building
structure should occur during construction.
The deck may be founded on drilled piers socketed into the
glacial till. we recommend a minimum embedment of sixteen -
inch diameter drilled piers into the till of five feet.
Lateral loads due to wind or seismic forces may be resisted by
friction between the foundations and the (bearing soils or
compacted fill subgrade), or by passive earth pressure on the
foundations. For the latter— the foundations must be either
be poured "neat" against the existing soil or the wall
backfill must be compacted structural fill. A coefficient of
friction of 0.45 may be used between the structural foundation
concrete and the supporting subgrade. The passive resistance
of undisturbed till native soils and well compacted fill may
be taken as equal to the pressure of a fluid having a density
of four hundred (400) pounds per cubit foot (pcf).
Slab -on -grade floors may be supported on undisturbed competent
native soils or on structural fill. The slab should also be
provided with a minimum of four (4) inches of free draining
sand or gravel. In areas where moisture is undesirable, a
vapor barrier such as a 6-mil plastic membrane should be
placed beneath the slab.
GEOTECH CONSULTANTS, INC.
Howard Schroeder
April 12, 1989
FOUNDATION WALLS
JN 89127
Page 4
Foundation walls should be designed to resist lateral earth
pressures imposed by the soils retained by these structures.
The following recommendations are for walls less than twelve
feet high which restrain level backfill. If higher walls are
desired, or if the backfill is sloping uphill, then we will
need to be given the wall dimensions and slope of the backfill
in order to provide the appropriate design earth pressures.
If walls are to be restrained at the top from free movement,
such as is the case in basement walls, at -rest earth pressure
conditions are met and the walls should be designed to resist
an equivalent fluid pressure with a unit weight of sixty (60)
pcf. Cantilevered walls or walls that can deflect at least an
amount equal ' to .002 times the height of the wall can be
designed for an equivalent act ' ive fluid pressure coefficient
of 35 pcf. For calculating the base resistance to sliding, we
recommend using a passive pressure equivalent to that exerted
by a fluid having a density of four hundred (400) pcf and a
coefficient of friction of 0.45. These values assume that no
hydrostatic pressures act behind the wall and that no
surcharge slopes or loads will be placed abovethe walls. if
these conditions exist, then those pressures should be added
to the above lateral pressures.
Foundation walls should be backfilled with compacted free -
draining granular soils containing no organics. The wall
backfill should contain no more than 5 percent silt or clay
and no particles greater than four inches in diameter. The
percentage of particles passing the No. 4 sieve should be
between 25 and 70 percent. Alternatively, a geotextile
drainage product such as Miradrain or Enkadrain may be used.
The purpose of the backfill requirements is to assure that the
design criteria for the retaining wall is not exceeded because
of a build-up of hydrostatic pressure behind the wall. The
top foot to eighteen inches of the backfill should consist of
a relatively impermeable soil or topsoil, or the surface
should be paved.
We recommend the use of footing drains at the base of all
footings and earth retaining walls. Roof and surface water
drains must be kept separate from the foundation drain system.
The footing drains should be surrounded by at least six inches
of one -inch -minus washed rock. The rock should be wrapped
with non -woven geotextile filter fabric (Mirafi 140N, Supac
4NP, or similar materials). At the highest point, the
perforated pipe invert should be at least as low as the bottom
GEOTECH CONSULTANTS, INC.
Howard Schroeder
April 12, 1989
JN 89127
Page 5
of the footing and/or crawl space and it should be sloped for
drainage. A typical footing drain detail is attached to this
report as Plate 5.
The excavation and site should be graded so that surface water
is directed off the site and away from the tops of slopes.
Water should not be allowed to stand in any area where
buildings, slabs, or pavements are to be constructed. During
constructio ' n, loose surfaces should be sealed at niqht by
compacting the surface soils to reduce the infiltration of
rain into the soils. The slopes should be covered with
plastic. Final site grading in areas adjacent to buildings
should be sloped at least two percent away from the building,
except where the area adjacent to the building is paved.
No groundwater was observed during our field work. However,
seepage into the planned excavation is possible, and if
encountered, the water should be drained away from the site by
use of drainage ditches, perforated pipe or French drains, or
by pumping from sumps interconnected by shallow connector
trenches at*the bottom of the excavation.
EXCAVATIONS AND SLOPES
In no case should excavation slopes be steeper or greater than
the limits specified in local, state, and national government
safety regulations. Temporary cuts up to a height of four
feet deep in unsaturated soils may be made vertical. For
slopes having a height greater than four (4) feet, the cut
should have an inclination no steeper than 1.5:1
(Horizontal:Vertical) from the top of the slope to the bottom
of the excavation. It should be noted that the sands do cave
suddenly and without warning. Utility contractors should be
made especially aware of this potential danger.
All permanent cut slopes into native dense soils should be
inclined no steeper than 2:1 (H:V). Fill slopes also should
not exceed 2:1 (H:V). Water should not be allowed to flow
uncontrolled over the top of any slope. Also, all permanently
exposed slopes should be seeded with an appropriate species of
vegetation to reduce erosion and improve stability of the
surficial layer of soil.
SITE PREPARATION AND GENERAL EARTHWORK
We recommend that the building and pavement areas be stripped
and cleared of all surface vegetation, all organic matter, and
any other deleterious material. Stripped materials should be
removed from the site or, if desired, stockpiled for later use
GEOTECH CONSULTANTS, INC.
Howard Schroeder JN 89127
April 12, 1989 Page 6
in landscaping. The stripped materials should not be mixed
with any materials to be used as structural fill. structural
fill is defined as any fill placed under buildings, pavements,
walkways, or other areas where the underlying soils need to
support loads. Geotech Consultants, Inc. should observe site
conditions prior to fill placement. The surficial site soils
are moisture -sensitive and can become very soft when wet and
disturbed.
Structural fill under floor slabs should be placed in
horizontal lifts and compacted to a density equal to or
greater than 95 percent of the maximum dry density in
accordance with ASTM Test Designation D-1557-78 (modified
Proctor). The fill materials should be placed at or near the
optimum moisture content. Fill under pavements and walks and
behind retaining walls should also be placed in horizontal
lifts and compacted to 90 percent of the maximum density
except for the top twelve (12) inches which should be
compacted to 95 percent of maximum density. The allowable
thickness of the fill lift will depend on the material type,
compaction equipment and the number of passes made to compact
the lift. In no case should the lifts exceed twelve (12)
inches in loose thickness.
Ideally, structural fill which is to be placed in wet weather
should consist of a granular soil having no more than 5
percent material passing the No. 200 sieve. The percentage of
particles passing the 200 sieve should be measured on that
portion of the soil passing the three-quarter inch sieve.
LIMITATIONS
The analyses, conclusions and recommendations contained in the
report are based on site conditions as they existed at the
time of our exploration and assume that the soils encountered
in the test pits are representative of the subsurface
conditions of the site. During construction, if subsurface
conditions are found which are significantly different from
those observed in the test pits, or assumed to exist in the
excavations, we should be advised at once so that we can
review these conditions and reconsider our recommendations
where necessary. unanticipated soil conditions are commonly
encountered on construction sites and cannot be fully
anticipated by merely taking soil samples in test pits. Such
unexpected conditions frequently require that additional
expenditures be made to attain a properly constructed project.
It is recommended that the owner consider providing a
contingency fund to accommodate such potential extra costs and
risks.
GEOTECH CONSULTANTS, INC.
Howard Schroeder
April 12, 1989
JN 89127
. Page 7
This report has been prepared for specific application to
this pr03ect and for the exclusive use of Howard Schroeder and
his representatives. Our recommendations and conclusions are
based on the site materials observed, selective laboratory
testing and engineering analyses. The conclusions and recom-
mendations are professional opinions derived in accordance
with current standards of practice within the scope of our
services and within budget and time constraints. No warranty
is expressed or implied. The scope of our of our services
does not include services related to construction safety
precautions and our recommendations are not intended to direct
the contractor's methods, techniques, sequences or procedures,
except as specifically described in our report for considera-
tion in design. We recommend that this report, in its
entirety, be included in the project contract documents for
the information of the contractor.
ADDITIONAL SERVICES
It is recommended that Geotech Consultants, Inc. provide a
general review of the geotechnical aspects of the final
design and specifications to verify that -the earthwork and
foundation recommendations have been properly interpreted and
implemented in the design and project specifications.
It is also recommended that Geotech Consultants, Inc. be
retained to provide geotechnical consultation, testing, and
observation services during construction. This is to confirm
that subsurface conditions are consistent with those indicated
by our exploration, to evaluate whether earthwork and founda-
tion construction activities comply with the intent of con-
tract plans and specifications, and to provide recommendations
for design changes in the event subsurface conditions differ
from those anticipated prior to the start of construction.
The following plates are attached and complete this report:
Plate I Vicinity Map
Plate 2 Test Pit Location Plan
Plates 3 & 4 Test Pit Logs
GEOTECH CONSULTANTS, INC.
Howard Schroeder JN 89127
April 12, 1989 Page 2
and obtained representative samples of the soils encountered.
The Test Pit Logs are attached to this report as Plates 3 and
4. The subsurface conditions of the site generally con-
sisted of medium -dense silty sandy fill soils lying atop
glacial till. The following table presents the test pit
number and the depth to dense till soils:
TEST PIT NUMBER DEPTH TO TILL (FEET)
1 3.5
2 6.0
3 2.5
4 3.0
The final logs represent our interpretations of the field logs
and laboratory tests. The stratification lines on the logs
represent the approximate boundary between soil types. In
actuality, the transition may be gradual. The relative
densities and moisture descriptions indicated on the test pit
logs are interpretative descriptions based on the conditions
observed during the excavation.
CONCLUSIONS AND RECOMMENDATIONS
GENERAL
The project appears feasible from a geotechnical engineering
standpoint. The dense to very dense till soils will provide
suitable bearing for the single-family residence. Foundation
elements, both conventional continuous and spread footings,
and drilled piers for the deck, will need to extend through
the surficial soil and fills to the till. It is our opinion
that the underlying glacial till is very stable and that there
is a very low risk of instability involving the house.
Drainage design is always very important when developing
property on a slope. We recommend footing drains at the base
of all footings. In addition, roof and surface water from
impermeable surfaces should be collected into a tight -line
drain. These drains should discharge into a storm drain, if
one is available, or at the base of the slope; or in a manner
as not to increase the concentration of water that normally
flows over the slope.
GEOTECH CONSULTANTS, INC.
Howard Schroeder JN 89127
April 12, 1989 Page 8
Plate 5 Footing Drain Detail
Respectfully submitted,
GEOTECH CONSULTANTS, INC.
b
of , ee ex:% a 6
Of Mark K. Dodds, P.E.
Senior Geologist
J$�% -STE%
X, * 0 0*..6-00
%b*A L James R. Finley, Jr. P.E.
Principal
Attachments
MKD/JRF:cw
GEOTECH
CONSULTANTS
VICINITY MAP
SCHROEDER RESIDENCE
EDMONDS, WASHINGTON
Job No. Dote., p/al
8 APRIL 89 N.T.S. 1 1 71
N
'k%'00 TEST PIT I
4' 0
.\ t 267±
uscs Description
0 Organic Topsoil, roots
SM: Brown gravelly silty SAND, very moist, medium dense (FILL)
fill,
siltier lenses
5 S
Brown gravelly silty SAND, very moist, medium dense to
dense
becomes dense to very dense (TILL)
Test Pit terminated at 8 feet below existing grade.
10 No groundwater seepage encountered during excavation.
15
TEST PIT 2
10 Elevotion-267±
uscs Description
0
H1 tnn.-,m I
Brown gravelly silty SAND, very moist, medium dense
M:
ML- Dark brown sandy SILT to silty SAND with some gravel,
5 ISM wood, roots
Brown gravelly silty SAND, moist, dense with some cobbles
SM: and boulders, dense to very dense (TILL)
10 Test Pit terminated at 912 feet below existing grade.
No groundwater seepage encountered during excavation.
15
GEOTECH
CONSULTANTS
A
TEST PIT LOGS
SCHROEDER RESIDENCE
EDMONDS, WASHINGTON
dob No.:
D04te/..6/89
Logoed BY:
pm�
89127
1
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2-110
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216
LEGEND
TP-2
12 APIPROMAM TEST PIT LOCATION
0 DECK OJERHANGS
GEOTECH
CONSULTANTS
a
250
TEST PIT LOCATION PLAN
19308 - 94th AVENUE WEST
EDMONDS, WASHINGTON
sco If Note:
11 — 101
J. /NoD 8*90 12 7 1 0Av Pf*R: I L 19 8 9 1 1 7- 2
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uscs
SM
uscs
TEST PIT 3
Ele Vgfioft � 75±
Description
Orgnni r tnp qnj 1
Br6wn gravblly silty SAND, medium to coarse grained, moist,
loose to medium dense (FILL)
Cray gravelly silty SAND, moist, dense to very dense
Test Pit terminated at 5 feet below existing grade.
No groundwater seepage encountered during excavation.
TEST PIT
Description
M
Elevation, 279±
,-Brown gravelly silty SAND, very moist, loose
Gray gravelly silty SAND, moist, medium dense
SM wood encountered at 2'
becomes dense at 3'
5
very dense
OR
15
Test Pit terminated at 6-2- feet below existing grade.
No groundwater seepage encountered during excavation.
- A
GEOTECH
CONSULTANTS
TEST PIT LOGS
SCHROEDER RESIDENCE
EDMONDS, WASHINGTON
dob No., oote. Logged By: Plote
89127 1 4/6/89 1 MD 1 4
S/Ope bockfill ow0y from
foundation.
BACKFILL
See text for
requh,ements.
WASHED ROCK
6 �7.
NONWOVEN GEOTEXTILE
FILTER FABRIC
GEOTECH
CONSULTANTS
11
TIGHTLINE ROOF DRAIN
Do not connect to foofh7q droin.
VAPOR BARRIER
SLAB I I
4 "Min.
x
FREE - DRAINING
SANDI GRA VEL
4"PERFoRArED HARD Pvc PIPE
Invert at least as low as foo/Mg andlor
crawl space. Slope to draln. Place
weepholes downward.
FOOTING DRAIN DETAIL
SCHROEDER RESIDENCE
EDMONDS, WASHINGTON
Job No., Dote:
/a
189129 4/6/89 77 N.T.S. I p5t':
STRE.ET_F1_L..,,',1.:
FILE
DETERMINATION OF NONSIGNIFICANCE
Description of proposal, Construction of.a now single family.residence
Proponent Howard Schroeder
Location of proposal, including street address, if any
19308 94th Ave. W.
Lead agency Edmonds Planning Division
The lead agency for this proposal has determined that it does not have a prob�
able significant adverse impact on the environment. An environmental impact
statement (EIS) is not required under RCW 43.21C.030(2)(c). This decision was
made after review of a completed environmental checklist and other information
on file with the lead agency. This information is available to the'public on
request.
2E/- There is no comment period for this DNS.
This DNS is issued under 197-11-340(2); the lead agency will not act on
this proposal for 15 days from the date below. Comments must be submitted
by
Responsible official Richard Schipanski
Position/title Code Enforcement Technician -Phone 771-3202
Address 250 5th Ave. N.. Edmonds, WA 98020
Date April 12, 1989 Signature
.[X-7 You may appeal this determination of nonsignificance
to Hearing Examiner
at 250 5th Ave. N., Edmonds, WA 98020
no later than 5:00 P.M. April 24, 1989
by filing a written appeal siting reasons
You should be prepared to make specific factual objections. Contact
Rich Schipanski to read or ask about the procedures for SEPA appeals.
/L7 There is no agency appeal.
STREET FILE
ENVIRONMENTAL CHECKLIST
Purposc of Checklist:
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ek,
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The State Environmental Policy Act (SEPA), chapter 43.21C RC\\', require-, all governmental agencies to consider
the environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be
prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of
this checklist is to provide information to help you and the agency identify impacts from your proposal (and to reduce
or avoid impacts from theproposal, if it can be done) and to help the a-cncy decide whether an EIS is required.
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instructions for Applicants:
This environmental checklist asks you to describe some basic Information about your proposal. Governmental agen-
cies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring
preparation of an EIS. Answer the questions briefly. with the most precise information known, oi give the best de-
scription you can.
You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you should
be able to answer the questions from your own observations or project plans without the need to hire experts. If you
real]v do not know the ans-wer, or if a I question does not apply to your proposal, write "do not know. or "does not ap-
ply". Complete answers to the questions no\,%, may avoid unnecessary delays later.
Some questions ask about governmental rieguLions, such as zoning', shoreline, and landmark designations. Answer
these questions if you can. If you have problems, the governmental acencies can assist vou.
The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time or on
different parcels of land. Attach any additional information that will help describe your proposal or its environmental
effects. The agency to which you submit this checklist may ask you to explain your answers or provide additional in-
formation reasonably related to determining if there may be significant adverse impact.
Use ofchecklist for nonproject proposals:
Complete this checklist for nonproject proposals, even though questions may be answered "does not apply." IN AD-
DITION, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D).
For nonproject actions, the references in the checklist to the words "project," "applicant," and "property or site"
should be read as "proposal," "proposer." and "affected geographic area," respectively.
A.BACKGROUND
1. Name of proposed project. if applicable:
2. Name of applicant: 4,3-wk-fZ b
3. Address and phone number of applicant and contact person: (5 qz
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4. Date checklist prepared:
S. Agency requesting checklist: (f t -1—/,/ 0 1�1 0 a E> -5
6. Proposed timing or schedule (including phasing, if applicable): lyktpell 0,:::77. /f.C7
7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal?
If yes, explain. A10
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8. List any environmental Information you know about that has been prepared. or will be prepared, direct]), related to
this proposal.
9. Do vou know whether applications are pending for governmental approv'als of other proposals directly affecting the
property covered by your proposal' If yes, explain.
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W. List any government 'approvals or permits that will be needed for your proposal, if known.
11. Give brief, complete description of your proposal, including the proposed uses and the size of the project and site.
There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not
need to repeat those answers on this page. (Lead agencies may modify this form to include additional specific infor-
mation on project description.)
12. Location of the proposal. Give sufficient information for a person to understand the precise location of your pro-
posed project, including a street address, if any, and section, township, and range, if known. If a proposal would occur
over a range of area, provide the range or boundaries of the site(s). Provide a legal description, site plan, vicinity map,
and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not
required to duplicate maps or detailed plans submitted with any permit applications related to this checklist.
TO BE COMPLETED BY APPLICANT
B. ENVIRONMENTAL ELEMENTS
1. Earth
a. General description of the site (circle one): Flat, rolling, hilly, steep slopes, mountainous,
other
b. What is the steepest slope on the site (approximate percent slope)?
EVALUATION FOR
AGENCY USE ONLY
TO BE COMPLETED BY APPLICANT
c. What general types of soils arc found on the site (for example, clay, sand, gravel, peat,
muck)? If you know the classification of agricultural soils, specify them and note anv prime
farmland.
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d. Are there surface indications or history of unstable soils in the immediate vicinity? If so.
describe.
c. Describe the purpose, type, and approximate quantities of any filling or grading pro-
posed.. Indicate source of fifi.
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f. Could erosion occur as a result of clearing, construction. or use'? If so. generaliv describe.
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g. About i what percent of the site will be covered with impervious surfaces after project
construction (for example, asphalt or buildings)?
h. Proposed measures to reduce or control erosion. or other impacts to the earth, if any:
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2. Air
a. What types of emissions to the air would result from the proposal (i.e., dust, automobile,
odors. industrial wood smokc) during construction and when the project is completed? If
anv. acnerallv describe and give approximate quantities if known.
b. Are there any off —site sources of emissions or odor that may affect your proposal? If so,
generally describe.
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c. Proposed measures to reduce or control emissions or other impacts to air, if any:
EVALUATION FOR
AGENCN' USE ONLY
TO BE COMPLETED BY APPLICANT EVALUATION FOR
AGENCY USE ONLY
c. Is the site part of a migration route? If so, explain.
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d. Proposed measures to preserve or enhance wildlife, Iif any:
6. Enerav and Natural Resources
a. What kinds of energy (electric, natural -as, oil, wood stove, solar) will be used to meet
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the completed project's energy needs? Describe whether it will be used for heating, manu-
facturing, etc. A 5� 14 -r-1 A/ C---
(T L 1-5 e 7-1c)
b. Would VOUT project affect the potential use of solar energy by adjacent properties? If so,
generally i1scribe.
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c. What kinds of energy conservation features are included in the plans of this proposal?
List other proposed measures to reduce or control energy impacts, if any:
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7. Em-ironmental Health
a. Are there an), environmental health hazards, including exposure to toxic chemicals, risk
of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal?
If so, describe.
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1) Describe special emergency services that might be required.
2) Proposed measures to reduce or control environmental health hazards, if any:
b. Noise
1) What types of noise exist in the area which may affect your project (for example:
traffic, equipment, operation, other)?
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2) What types and levels of noise would be created by or associated with the project on a
short-term or a long-term basis (for example: traffic, construction, operation, other)? Indi-
cate what hours noise would come from the site.
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TO III: COMPLETED BY APPLICANT
3. Water
a. Surface:
I ) Is there any surface water body on or in the immediate vicinity of the site (including
vear—round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type
and provide names. If appropriate, state what stream or river it no\,\,s into.,
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2) Will the project require any work over, In, or adjacent to (within 200 feet) the described
waters? If yes, please describe and attach available plans.
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3) Estimate the amount of fill and dredge material that would be placed in or removed
from surface water or wetlands and indicate the area of the site that would be affected. In-
dicate the source of fill material.
4) Will the proposal require surface water withdrawals or diversions? Give general de-
scription, purpose, and approximate quantities if known.
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5) Does the proposal lie within a 100—year floodplain? If so, note location on the site
plan.
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6) Does the proposal involve an), discharges of waste materials to surface waters? If so,
describe the type of waste and anticipated volume of discharge.
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b. Ground:
1) Will ground water be withdrawn, or will water be discharged to ground water? Give
general description, purpose, and approximate quantities if known.
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2) Describe waste material that will be discharged into the ground from septic tanks or
other sources, if any (for example: Domestic sewage; industrial, containing the following
chemicals . . . ; agricultural; etc.). Describe the general size of the system, the number of
such systems, the number of houses to be served (if applicable), or the number of animals or
humans the system(s) are expected to serve.
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EVALUATION FOR
AGENCY USE ONLY
TO BE COMPLETED BY APPLICANT
EVALUATION FOR
AGENCY USE ONLY
c. Water Runoff (including storm water): #
1) Describe the source of runoff (including storm water) and metho d of collection and
disposal, if any (include quantities, if known). Where will this water flow? Will this water
flow into other waters? If so, describe. 5*7-0 5- E: W LS- rz-
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2) Could waste materials enter ground or surface waters? If so, generally describe.
d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if
any:
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4. Plants
a. Check or circle types of vegetation found on the site:
deciduous tree: alder, maple, aspen, other
evergreen treev Pine, other
shrubs
crass
pasture
crop or grain
wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other
water plants: water lily, eelgrass, milfoil, other
other types of vegetation
b. What kind and amount of vegetation will be removed or altered?
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c. List threatened or endangered species known to be on or near the site.
d. Proposed landscaping, use of or other measures to preserve or enhance
vegetation on the site, if any:
5. Animals
a. Circle any birds and animals which have been'observed on or near the site or are known
to be on or near the site:
birds: hawk, heron, eagle, songbirds, other: ..................................
mammals: deer, bear, elk, beaver, other: ..........
Fish: bass, salmon, trout, herring, shellfish, other:
b. List any threatened or endangered species known to be on or near the site.
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TO BE COMPLETED BY APPLICANT
EVALUATION FOR
AGENCY USE ONLY
3) Proposed measures to reduce or control noise Impacts, if any: #
8. Land and Shoreline Use
a. What is the current use of the Site and adjacent properties?
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b. Has the site been used'for agriculture? If so, describe.
c. Describe any structures on the site.
d. Will any structures be demolished? If so, what?
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e. What is the current zoning classification of the site?
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f. What is the current comprehensive plan des], -nation of the site?
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g. If applicable, what is the current shoreline master program designation of the site?
h. Has any part of the site been classified as an "environmentally sensitive" area? If so,
specify.
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i . Approximately how many people would reside or work in the completed project?
j. Approximately how many people would the completed project displace'?
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k. Proposed measures to avoid or reduce displacement impacts, if any:
1. Proposed measures to ensure the proposal is compatible with existing and projected land
uses and plans, if any:
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TO BL COMPLETED BY APPLICANT
9. Housing 0
a. Approximately how many units would be provided, if any? Indicate whether high, mid-
dle, or low—Incomc housing.
b. Approximately how many units, if any, would be eliminated? Indicate whether high,
middle, Or low—income housing.
c. Proposed measures to reduce or control housing impacts, if any:
10. Aesthetics
a. What is the tallest height of any proposed structure(s), not Including antennas; what is
the principal exterior building material(s) proposed?
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b. What views in the immediate vicinity would be altered or obstructed?
c. Proposed measures to reduce or control aesthetic impacts, if any:
11. Liaht and Clare
a. What type of light or glare %&,III the proposal produce' What time of day would it mainly
occur?
b. Could light or glare from the Finished project be a safely hazard or interfere with views?
c. What existing off —site sources of light or glare may affect your proposal?
d. Proposed measures to reduce or control light and glare impacts, if any:
12. Recreation
a. What designated and informal recreational opportunities are in the immediate vicinity?
b. Would the proposed project displace any existing recreational uses? If so, describe.
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EVALUATION FOR
AGENCY USE ONLY
to iir COMPLI-TED BY APPLICANT
EVALUATION FOR
AGENCY USE ONLY
c. Proposed measures to reduce or control impacts on recreation, inclucllni� recreation op-
portunities to be provided by the project or applicant, if any:
13. Historic and Cultural Preservation
a. Are there any places or objects listed on. or proposed for, national. state, or local preser-
vation registers �nown to be on or next to the site? If so. generally describe.
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b. GeneralIv describe any landmarks or evideric
e of historic, archaeolo!zical. scientific, or
cultural importance known to be, on or next to the site.
c. Proposed measures to reduce or control impacts. if any:
14. Transportation
a. Identify public stretts and highways serving the site. and describe proposed access to the
existing street system. Show on site
�Jans. if any.
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b. Is site cur i rently served by public transit? If not. what is the approximate distance to the
nearest transit stop"
c., How many parking spaces would the completed project have? How many would the
project eliminate'?
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d. Will the proposal require anv new roads or streets. or improvements to existing roads or
streets, not including drive%vays" If so. generally describe (indicate whether public or
private).
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e * . Will the project use (or occur in the immediate vlclnitv 00 water. rail. or air transporta-
tion' If so, generally describe.
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f. How many vehicular.Lrips per day would be gencrated by the completed project? If
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known. Indicate when peak volumes %%' uld occur.
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TO BE COMPLETED BY APPLICANT EVALUATION FOR
AGENCY USE ONLY
g. Proposed measures to reduce or control transportation 'Impacts, if any:
15. Public Services
a. Would the project result in an increased need for public services (for example: firc pro-
tection, police protection, health care, schools, other)? If so, generally describe.
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b. Proposed measures to reduce or control direct impacts on public services, if any.
16. Utilities
a. CirQ1c_uii I ies I electricitv natural ga
I't* _CmLusenth, available at the site:(iED <�� (e=fuseserv-
ice eleph3on,,4anitary sewer septic system, other.
b. Describe the utilities that are proposed for the project, the utility providing the service,
and the general construction activities on the site or in the immediate vicinity which might
be needed. 4, 1 o F 4-73 OV E
C. SIGNATURE
The above answers are true and complete to the best of my knowledge. I understand that
the lead agency is relying on them to make its decision.
Signature: ..... ......... . .. .......................................
Date Submitted: ........ ?:- / _Z ..............................
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TO BE COMPLETED BY APPLICANT EVALUATION FOR
AGENCY USE ONLY
D. SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (Rezones, Code Changes, Annexati ons, etc.).
(do not use this sheet for project actions)
'Because these questions are very general, it may be helpful to read them in conjunction
with the list of the elements of the environment.
When answering these questions, be aware of the extent the proposal, or the.types of
activities likely to result from the proposal, would affect the item at a greater intensity or
at a faster rate than if the proposal were not implemented. Respond briefly and in general
terms.
1. How would the proposal be likely to increase discharge to water; emissions to air; pro-
duction, storage, or release of toxic or hazardous substances; or production of noise?
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Proposed measures to avoid or reduce such increases are:
2. How would the proposal be likely to affect plants, animals, fish, or marine life?
Proposed measures to protect or conserve plants, animals, Fish, or marine life are:
3. How would the proposal be likely to deplete energy or natural resources?
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Proposed measures to protect or conserve energy and natural resources are:
4. How would the proposal be likely to use or affect environmentally sensitive areas or ar-
eas designated (or eligible or under study) for governmental protection; such as parks, wil-
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derricss, wild and scenic rivers, threatened or endangered species habitat, historic or cultura
sites, wetlands, floodplains, or prime farmlands?
Proposed measures to protect such resources or to avoid or reduce impacts are:
5. How would the proposal be likely to affect land and shoreline use, including whether it
would allow or encourage land or shoreline uses incompatible with existing plans?
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TO BE COMPLETED BY APPLICANT . EVALUATION FOR
AGENCY USE ONLY
Proposed measures to avoid or reduce shoreline and land use impacts are: #
6. How would the proposal be like]) to increase demands on transportation or public ser-
vices and utilities?
Proposed measures to reduce or respond to such demand(s) are:
7. Identify, if possible, whether the proposal may conflict with local, state, or federal laws
or requirements for the protection of the environment.
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I)ESCRIPTION
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X The legal description has beien amended to read as
-follows:
A111 that portion of Lot 60;,EXCEPT the north'3S6.00 feet thereof, in
Edmonds Sea,�Iiew Tracts, according to the plat.thereof recorded in
VoliNe,3 of Plats- page 76, in Snohomish County, Washington,
described As follows.
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