21116 SHELL VALLEY RD.PDF11111111111111
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21116 SHELL
VALLEY RD
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TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:. 77 DETERMINATION: []Conditional Waiver tudy Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR: -
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED: —
SCALED PLOT PLAN DATED:
SEWER LID FEE $:-
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED-, 17
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
LID #:
LOT: BLOCK:
LATEMP\DS'rs\Forrns\Street File Checklist.doc
C4 FILE NO.
Cr&al Areas ChecAlt' 0
--------------------------------------------------------------
Site Information (soil s/topoaraphy/hydrolo ay/ve getation)
I Site Address/Location: ZZZ A V
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? yes- _no.
If yes; how is site developed? /1�41 e:,-, - ------
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 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 3300"; ( 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 than 33-feet).
Other (please describe):
6. Site contains areas of year-round standinc, water: .61V Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? _ (What time of year?
10. Site is primarily: forested meadow ;shrubs mixed IV
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: U
-------------- --------------------
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DETERMINATION
0 0
City of Edmonds
RECEIVED
MAY 1 1 1999
DEVELOPMENT SERVICES
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 Citv.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, 'or
may be. 0
, present n 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).
A-n applicant, or hisilier 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 devel opment
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 shall include
other pertinent information (e.g.. site plan, topography
map, etc.) or studies in conjunction with this Checldist
to assist staff in completing their preliminary
assessment 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:
Name
Street Address
City S, tate
Telephone
Signature
Applicant Representative:
Name
Street Address
Zip city
State
Zip
Telqphone
Date
c:reception\jana\cac1,doc
Date
(over)
0 0 0 0
City of Edmonds
Critical Areas Determination
Applicant: Judy Howell Determination #: I CA-99-132
Project Name: L I Permit Number: I i
Site Location: 1 21117 Shell Valley Rd. Property Tax Acct #: 3736 005 006 12
Project Description:
Non -Project Specific
Determination: Study Required:
During review and inspection of the subject site, it was found that the site appears to contain
and/or is adjacent to a Steep Slope Hazard Area pursuant to Chapter 20.15B of the Edmonds
Community Development Code (ECDC). To determine if a steep slope does exist, a topographic
survey prepared by a Licensed Land Surveyor delineating the Steep Slope Hazards Area must be
completed. Any slope over 40% with more than 20 feet of rise will be classified as a Steep Slope
Hazard Area. A 50-foot buffer is required from both the top and toe of the slope. A 15-foot
building setback is required for the 50-foot buffer.
For development of any kind which is proposed within the critical area, 50 foot buffer or 15 foot
buffer setback, it must be shown that the development will not adversely impact the Critical Area
or its buffer, by doing one or possible both of the following depending on the outcome of the
study:
I For development proposals which will occur within the 50 foot buffer, but not closer than
10 feet from the top or toe of the slope, the 50 foot buffer requirement may be reduced to
10 feet if a study is completed by a licensed geologist or geotechnical engineer which
clearly demonstrates that the proposed buffer alteration will have no adverse impact upon
the site, the public or any private party. All Critical Area Studies must be completed by a
licensed Geotechnical Engineer (as defined in ECDC 20.15B.020.Y) or under a three
party contract where the City hires the professional required, and the applicant pays for
the study (pursuant to ECDC Section 20.15B. 140).
2. If development must occur within the critical area, buffer, and/or buffer setback, and is
not identified as an exception per ECDC Chapter 20.15B, a Reasonable Use Exception
and Variance must be obtained pursuant to ECDC 20.15B. 107A and 20.15B.040C.
Any development of the site also requires an Environmental Review (SEPA Checklist). The site
is identified on our Environmentally Sensitive Areas Map.
0 0 0 0
If the property owner wishes to apply for a specific development permit which they feel
would not impact the Critical Areas located on the site, they may submit their proposal to
the Planning Division for review. If the planning Division rinds that the proposed
development permit will not adversely impact a Critical Areas or its buffers, a conditional
waiver may be issued on a project by project basis.
Kate Galloway
Name
cc: File CA-99-132
'-��'Oh! '�.
Signa'tu'Te
5/24/99
Date
41 '1 C. 1 S911
May 24, 1999
Judy Howell
8825 Shell Place
Edmonds, WA 98026
0 0 0 0
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
Subject: Determination regarding Critical Areas Checklist # 99-132
Dear Applicant:
BARBARA FAHEY
MAYOR
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
It is very important for you to retain a copy of this Critical Areas Cherklist "DETERMINATION" for your records.
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS OR CRITICAL AREAS STU Y
D ,
The IDETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
mo, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL .41111111
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Enc: Critical Areas Determination
* Architectural Design Board
Thank you.
Shada Graham
Planning Secretary
C:ReceptIonWna\CRLTR.doc
Incorporated August 11, 1890
Sister City - Hekinan, Japan
or APPLICATION
Ilk
The City of Edmonds for EASEMENT NO . .........................................
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS LID NO. .......... .- ASMT. NO . ...................
OWNER ....... P:::,
....................... I ----------- ------------------------------------------ .......... CONTRACTOR
--------------------- ................ PERMIT NO.
iLLJADDRESS 2-A I\ 6c> — ZA k R-L;LEGAL DESCRIPTION: LOT NO - ------------- E- ................. BLOCK NO. - ------------- .................
-------------------------------------------------------------------------------------
u— ---------------------------------------------------------------------------- I -------------------------------------------------------------------------------------
F— "'J
NAME OF A DDITION ------ ......... Dk -------
�'j
0
F7
�q
21
---- By
10
M
CITY OF EDMONDS SIDE SEWER
PERMIT
WATER-SEVV= jDxrARTAjE"
PERMIT
5767
for "do sewer inspections Runma *QVft*,g say Portion of the construction,
be Provided within 24 hours &nor re"A. *0 set., ftn�, or hclide'y inspection,.)
ADDRESS LOCATION OF CO.W"RU(MON ..... 2_1_116 & 12-1118 Shell valley Road
.............. . ..............
PROPERTY ILEGAL DESCRIMON ---------------------
--- - ------ - -- - ----- 11 --------- ... ........
....... . .................. . ................................... OWN= A"/On
CONMUCTOWS NAME & ADDRESS.lyn agK
n ....... . .... . ................ . ...... . .. . .. . ...
1"o-Vissim Is granted ............ ..... AP ---- - ---
A-1 ... 2 . ........... 119-71, for mpm& swo, ..,.U. of . dde sewer to me dv awwy amw
r . -a,,
f j!n In accordance with Cfty of FAMOU& W&MMMV&
ATTFJMON IS CALIZI) TO THE FOLLOWING:
NOTIC No. 1--Irh! owners of the property may obtain & permit to construct newer irsd"
NO= No, 2—All work performed in city right-of-w^,
Bide sewer in street ares. Do not cover 4W Portion of sewer before it has b— cted. , "I aid* sewer coat -at- =WA be I lie a to
requires an Invasion of Right-of-W&y permit Obtainable from the City ]Cn a
NOTE No' 3--fttaln full information regarding Ordinance 11.16.030 and Regulations gavegsdng sku sewere when you get permit gnew Office,
NOTE NO. 4—Top of side sewer must have at 1 30 lac
sharper than % win be permittodeast beg coversge at Property It" &Ad IS inches inside VWPUty line; Iniftimuss gas" at S%. 'a areas
NOTE No 5--Trenches in street Mug be water watled and surface of street restored to o"Zinal eftdunc. Coutracto" Shan be reffaepook
work which may develop within one year of completion. * W ass *W, to wor-po
NOT" No. 6--It is unlawful to &'ter or do any other work than Is provided for In the p t, or to wo the
sert the Pipe into the wye. aruld 40 4U1Y rk on main sewer er
40109t to Ss-
D119"PROVED [] Date .. . ................................... BY ---------------- D&
APPBOVM
.. . .... .......................
. .. . ...........
....... ... ..... . ....................................
BY.........
-rermIt COPles XVST Be Signed By owner of Mrzn
Perfornting Construction IMUOR To Request Iror IIIalwaft
ed wher side sewer lndt�atlon constructed undw this perndt
x hereby certify that the
�t�l��Llng �.rLd --- I
in accordance with all governing ordinances of the City of ZdniondgL
Dated this ...... Q)�
of .... ................................... . .... 19 ......
V V Check BEFORE you dig for: Water 0, Clas 0, TeAWkwe a power 0, Smw a Other
E
I
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
EASEMENT NO . ............................................
NEW CONSTRUCTION El REPAIRS F� LID NO - ------------------ ASMT. NO . ..................
OWNER --------------------------------- -------------------------------- CONTRACTOR z:�Z. V-1 jrm �^ ------ -7
PERMIT NO.,!!�i7( ---- -----
JOB ADDRESS ------- ----- - LEGAL DESCRIPTION: LOT NO . ........ . �1 --------------------- BLOCK NO. — ------------------------------
*jVr
L ... P.4A-K ......... ... ... ... . ------------------------------------------------------------------
------------ - --- ------ .......... ru
0
0
4a
NAME OF ADDITION .............
D
RECEIVro
APR Z 8 1977
Public Works Ugpl.
Approved:
DATE............................................ By ------------------------------------------------------------
11/75
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of ED 4f 0
fp
L , &��
ls-t. Wg,91
MEMORANDUM
Date: July 31, 2003
To: Street File for 21116 Shell Valley Road
From: Meg Gruwell, Senior Planner
Subject: Emergency Tree Cutting
On July 17, 2003, 1 visited the duplex of 21116 and 21118 Shell Valley Road. To the
south of that building is a rockery, and at the southwest comer of that building one of the
rocks fell out last year. The tenant in 21116 was concerned that the tree growing on the
rockery was going to fall and harm her building, or the adjacent duplex at 21112.
The tree roots of the tree in question are right where the rock fell out. The tree is leaning
out over the two buildings, between 21116 and 21112 Shell Valley Road. Though the
approximately 12-inch alder appeared healthy, because its roots were undermined and it
was already leaning towards the buildings, I gave them permission to cut the tree as an
emergency, per Edmonds Community Development Code Section 18.45.030.G.
The tree appears to be in the greenbelt, so I directed the tenant and landlord to obtain
permission from the party in charge of the greenbelt. The landlord, Dealther Taylor, had
informed me that the homeowners' association had been dissolved, so I checked
Snohomish County records on the intemet and let him know that Washington Mututal
[sic] Pioneer Properties was listed as the owner.
I
M
RAC-t"
T
-ty-a I'll OF- P-6M---f-0
�;TAEET F1�77
ENVIROMIENTAL CHECKLI%T
RE rt�:y FILE
Purposc of Chccklisi:
-ironmental Policy Act (SEPA), chapter 43.21C RCIA'. requires all govcrnmc*nt3l`agcncics to consider
The Siatc En%
the cnvironmcnial impacts of a proposal b--forc making decisions. An cnvironmcnial impact..Statcmcni (EIS) must be
Fcp3rcd for all proposals with probable significant adverse impacts on the quality of the cnvironmcni. The purpose of
this chccklist is to provide information to �clp 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!!*Cnc)- decide whether an EIS is required.
Instructions for Applicants:
-li't ask's vou to describe some basic information about your proposal. Governmental agen-
This cnvironmcntal check s
icant., requiring
cies use this checklist to detcrminc %k,hcth r the environmental impacts of your proposal arc signir
preparation of an EIS. Answer the questions briefly. with th-- most precise information known. or give the best dc-
scription you can.
-led-c. In most cases, you should
You must answer each question accurately.and carefully, to the bestor your knou
be able to answer the questions from your own obscrvations or project plans,withOUt Lhc need to hire experts. If you
really do not know the ans'Wer, or if a question does not apply to your proposal, write *do not know" or 'does not ap-
ply". CompItte answers to the quesLions now may avoid unncc_-ssary delays latcr.
Some questions ask about governmental regulaions. such as zoning. shoreline'. and landmark designations. Answer
these questions if you can. If you have problems, the governmental agencies can assist vou.
The checklist questions ap�ly to all parts of your proposal, --vcn. if you plan to do dem over a period of time or on
different parcels or land. Attach any additional infor—mation that will help describe your proposal or its environmental
effects. The aecncy to which you submit Lhis checkiist may ask vou to explain your answers or provide additional in-
formation reasonably related to cl=-rmining -se impact.
if Lhc,.t mav be siznificant advc.
y.
Use of chccklist for nonprojcct pro.posa!s:
estions mav be answ-,r--d *does not apply." IN AD -
Complete this checklist for nonproject proposa!s. though cu,
DITION, complete the SUPPLENIENTIAL SHC�- rOR NON?ROJECT ACTIONS (part D).
--nccs Ln Ehe check -fist to the words 'project," "applicant," and "property or site'
For nonproject actions, the refc—
should be read as "proposal," "propost-r.* and "a[ICVCC scoeraonic area. rescectively.
A.BACKGROUNID
1. Name of proposed project. if U ' ' . 40 ,
S/ r a 0 1 - VACkgic_
4
2. Name of applicant: S- U71r - Srv,� �� 's + S CO VV&T�
3. Address and phone number or applicant and contact acrson:
111tY 79t-%- fit'�_ W. Ljnnwoo� -7 75'-Off 0
4. Date checklist prepared:
5. Agency requcsting checklist: Q)WNo v%3 "s ?\C%V%f%, VCJ
6. Proposed I or s cht:dule (including phasing. if applicabic):
7. Do you have any plans for ruture additions. expansion, or rurthcr activity related to or connected With this proposal?
I f yes. explain.
A10
S. List anv crivironnicnil Rnformailon you kno%A about that has bccn prcparcd. or will bc prepared, directly related to
this proposal.
Mb Ple—
§. Do you kno- %%-hcthcr applications arc pending for governmental approvals of other proposals directly affecting the
property covered by your proposal? If yes. explain.
10. List any government approvals or permits that will bc needed ror your proposal, if known.
11. Give brier, complete description of your proposal, including the proposed uses and the size of th-- project and site.
There are several questions later in this checklist that ask vou to describe certain aspects of your proposal. You do not
need to repeat those answers on this page. (Lead agencies may modifv this form to include additional specific infor-
mation on project description.) Vn I f— Fck VV%" t y C'e 0 V-' I'Z5" MTC-S
L'i -, W J-0 h6o'se, Ve *'ho I J e-
eo n n ectr_d �fO Seu-�e,-.5 a^J 11Cve- a -A afpOved fr_4w�fcvl SYS"
12. Location of the proposal. Give sufricient information for a person to understand the precise location or 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 or area, provide the range or boundarics of the sit.e(s). Provide a legal description. site plan, vicinity map.
and topographic map, if reasonably available. While vou should submit any plans required by the agency, you are not
0
required to duplicate maps or detailed plans submiue� with any permit applications relaLed to this checklist.
'9 11 1� :2>1^0
&�A -I v10 66-A C 5 �U' - t+ IDY
D 1A C, 9� ?Acbrd 41 _170 P 14 r 0 (ecef0c.6) -m
/0 6� m0a. eo. W4-
TO BE COMPLETED BY APPLICANT EVALUATION FOR
ACENCY USE ONLY
B. ENVIRONMENTAL ELEMENTS
1. Earth
a. General description of the site (circle one): Flat. rolling, tcep slopes, mountainous,
0
thcr (Y
b. What is the steepest slope on the site (approximate percent slope)?
A e- 7'e tf P CST skoe- )% m eg /.Me 1,D 0
&,rn.,r +o NE eCYA-1
214 FFT 1�,, 0- 25-�% 5 Ivee Z) 5poh. OV
?YV f !,1 014 +�e_ JV-(XVW-0C fk- /0 r C'_ dZZS&'-
()nJew kevs k
fkcie, sl&p" )Vor Ale4-, �1, I J - V
TO BE CONIPLETED BY APPLICANT
c. What general Iypcs of soils arc round on the site (for example, clay, sand, gravel, pelt.
muck)? If you know the CIZISSifiCalion or agricultural Soils, SpMf)' them and note any prime
farmland. '9"VOI -� 7-W
d. Arc.thcre surf3cc indications or history of unstablc soils in the immediate vicinity? If so.
describe.
EVALUATION FOR
AGL,4cN, usr. ONLY
e. Describe the purpose, type, and approximate quantities of any filling or grading pro-
posed. Indicate source of rill.
, 6 z ,,, — -) - -f -ec, 4, yte�tf 0-0
.0 M.0, L ik OVYV)4��do a,
Low' C4 140-o'-se- -+-
Drvve_ %J-" ?L-f V —IVU )S—Oyes,
J
f. Could erosion occur as. a result of clearinfi, construction. or use'? If so. generaltv describe.
At,
-4v
Ac-r+
**�L, V
4�-� Vvziik k7e, CL se -A. 'A_ tcxw rk
About what percent or the site will be covered with impervious surfaces after project
construction (for example. asphalt. or building '
0s)? 41,-e Onlye 6 7'/0 19
3 3C
C- 1z. )S
h. Proposed measures to reduce or control erosion. or other impacts to the earth. if any:
If necessary, filter cloth
fences, hay bales'and/or
dr ainage culverts will be
installed to channel storm-
2. Air water and to prevent erosion.
a. What types of emissions to the air would result from the proposal (i.e.. dust. automobile,
odors. industrial wood smo ' kc) during construction and when the prujcct is completed? If
any, generally describe and give approximate quantities if known.
NO JV3.-I i-� A.of_ -il" luo
c0biz - fet-1 V1 ir- 61 Vic " -s-
b. Are therc any'orr-iiie sources or emissions or odor that May affect your proposal*, If so,
gencrall y describe. A10 J
c. Proposed measures to reduce or control emissions or other impacts to air, if any:
-3-
TO III: COMPLETED BY APPLICANT EVALUATION FOR
3. �Vaicr AGENCN' USE ONLY
a. Surface:
I) Is there an), Surface waict body on or in the immediate vicinky of the site (including
N-car—round and seasonal streams, sahwatcr, l3kcs, ponds, wolands)? If ycs, describe type
and provide names. If appropriate, state what stream or ri\,cr it nows into.
50-Y vv�
14 6 oe- e'vey � A W4+r-r 1 VX 601 V
2) NVill the project require any work over. in, or adjacent to (within 200 feet) the described
watcrs? If ycs, please des.cribe and attach available plans. (A) �to t, Cd M",
3) Btimate the amount of fill and dred2c 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.
Nofi e--
4) Will the proposal require surface water withdrawals or diversions? Give general de-
scription, purpose, and approximate quantities if known.
A ji e
5) Does the proposal lie within a 100—year floodplain? If so, note location on the site
plan.
6) Does the proposal involve.any discharges of waste materials to surface waters? If so,
describe the t pe of waste and anticipated volume of discharge.
Y
A(6
.'b. Ground:
1) Will ground water be withdrawn, or will water be discharged to ground water? Give
general description, purpose, and approximate quantities ir known.
V_Z'�Cy- + (Z) PC,
kek-lf-�c"X sys�em'a av e- -f- CYjr '0+ Omwnas
2) Describe waste material that will be discharged into the ground from septic tanks or
other sources, if any (ror example: Domestic sewage-, industrial, containing the Following
hcmic3ls agricultural; cLc.). Describe the general size or the system, the number or
Such systems , the number of houses to be served (if applicable). or the number or animals or
h u m
ans the system
(s) arc expected to serve.
YMC
-4-
0
0
4. Plants
a heck.or circle ty�Re of vegetation found on the site:
d
eciduous tree: (I e.0, maple, aspen, ocher
3 pine, other
41(everarecri treeSr(7_da
Z.
Zshrubs
grass
pasture
crop or grain
wdt soil plants: caEtail. buttercup, buttrush. skunk cabbage, other
water plants: water lily, celtyrass. milfoil, oche: -
other types of vegetacion
b. What kind and amount of vc2eEaE;on will be,;e-moved or alter-0
brvtj o, v,6qvvyve4 t,,W );,c Nv% -jj�� or
c. List threatened or endangered species known to. be an or near the site.
Alo n e
TO BE COMPLETED BY APPLICANT
c. Water Runoff (including storm water):
EVALUATION FOR
AGENCY USE ONLY
1) Describe the source of runorf (including storm water) and method of collcction and
disposal, if any (include quantities, if known). Where will this water no%%,? will this %yatcr
flo", into other waters? ir so, describe. b 0-v v% L&) e6yts+yu(,,�rc,�, X� SY S 4-e_�
W'111 tWL !h1jPkMeJ1," 4 �eedc_d ,
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:
If necessary, filter cloth
fences, hay bales and/or
drainage culverts will be
installed -to channel storm
water du.ring construction.
The permanent storm water
system has been approved by
the City of Edmonds Engineer-
ing Division.
S te-
d. Proposed landscaping, use or native plants, or othe.- measures to preserve or enhance
vegetation on the sic�, if any: law Yj
'1n d 3�" n ?h7eJa4,e-
/7 ek 6,1,5e . I .
#0 '1/ be
64 13,;w"5 Oe- C - 04J4
5. Animals
a. Circle any birds and animals whic.h have been obser.,ed on or near the site or are known
to be on or near' the site:
birds: hawk. heran. eagle. songbirds, other: ....
mammals: deer, bear, elk. beaver. other:
fish: bass. salmon, trout herring, shellfish o her: .............. 1VOP.': .........
b.. List. any threatened or endangered species known to be on or near the site.
Yo n c-
-5-
TO BE COMPLETED BY AIIJILICAKT
c. Is the sitc part of a migration routc? If so. cxplain.
EVALUATION FOR
AGENCY USF-. ()NJ.)'
d. Proposed mcasurcs to prcscr%,c or enhance wildlife, if any: NO WTO L I ex&ef+ Ss V114CS
6.- Energy and Natural Resources
a. What kinds or cncrgy (electric, natural -as, oil, wood stovc, solar) will be used to meet
C
the completed project's energy necds? Describe whether it will be used for heating. manu-
0
facturing, etc. &YM C, C Eke4vi e,o_ / 4Y SIP 116a5e-
b. Would your project affect the potential use or solar encray by adjacent properties? lf so.
general]), &scribc.
c. What kinds of energy conservation features arc included in the plans of this proposal?
List other proposed measures to reduce or control energy impacts, if any:
)% 57-0-M "Ge&Y (666
7. Environmental Health
. a. Arc there any environmental health hazards, including exposure Eo- toxic chemicals, risk
.of firc and explosion, spill, or hazardous \vastc, that could7occ'ur as a resuIt of Ehis proposal"
If so, describe. &
1) Describe special emergency services that ml,-hL be required.
2) Proposed measures to reduce or control environmental health hazards, if any:
b. Noise
1) What types or noise exist in the area which may affect your pro*cct (ror examoic:
traffic. equipment, o*peraLion, other)?
None
2) What types and levels or noise would be created by or associaLed wiLh the project an a
..'...Short-term or a long-term basis (for example: traffic, conSLruction, operation. offier)? [ndi-
cate what hours noise would come from the site. br 4&-y fr 4e &rS
7h T- le-er" IraWrr. vM
2
ne 4or
-3 'VWVA S L.O.& V_
TO BE COMPLETED BY APPLICANT EVALUATION FOR
AGENCY USE ONIA
3) Proposed measures to reduce or control noise impacts, if any:
Makie, Ne,:ndeJ
8. Lind and Shoreline Use
a. What is the current use of vhc site and adjacent properii6s?
0 rl om, is a* s-,,faq1v- F*Mi(y afiJ bop1e^.5
b. Has the site been uscd'for aoriculturc? If so, describe.
c. Describe any structures on the site.
d. Will any structures be demolished? If so. what'?
No
6. What is the current zonine classification of the site?
S-1-hile— RS-8
f. What is the current comprehensive plan designation of the site?
g. If applicable, what is the current shoreline master program designation of the site?
N,
h. Has any part, of the site becri classified as an "environmentally sensitive' area? If so,
specify. The Environmentally Sensitive
Areas map identifies this site
11 It
.,as a slope y 1 mga �aA
i. Approximately how many people would reside or work in the completed project? A vW-r lrlwe�
j. Approximately how many people would the completed project. displace?
N11W e—
k. Proposed measures to avoid or reduce displacement impacts. if any:
NonC
1. Proposed measures to ensure the proposal is compatible with existing and projected land
uses and plans, if any: a, j9WAcd 741- — Le-v--L w 113cv,--1 S'id-11111 i- CeALY Skuk 404
—7—
0
TO BL COMPLETED 11% APPLICANT EVALUATION FOR
AGENCY USE ONLY
9. Housing
a. Approximately how many units would be provided, if any? Indicate whether high, mid-
d1c, or low-income housing. fkj�6�11e_ �M_OvAe_ ( _(J K Z V-
b. Approximate]), how many units, if any, would be eliminated? Indicate whether high,
middle, or low-income housing.
c. Pr . oposed 'Measures to rcducc or control housing impacts, if any:
/VOW-
10.. Aesthetics
a. What is the tallest height of any proposed structure(s), not includinc, antennas-, what is
the pri a] exterior building material(s) proposed?
(! 141 vjc-%J�%j fe,�, b V%S I ge,\, t-_ L 0, e-Z c ,r
b. What views in the immediate vicinitv would be altered or obstructed?
Ate kle-
c. Proposed measures to reduce or control aesthetic impacts, ir any:
1. Liaht and Clare
0
a. What type of light or glare will the proposal produce? What time of day would it mainly
occur?
b. Could light or glare from the finished project be a safety hazard or interfere With views?
c. What existing off -site sources or light or glare may affect your proposal?
d. Proposed measures to reduce or control light and glare impacts, ir any:
12. Recreation
a. What designated and informal recreational opportunities are in the immediate vicinity?
Y&U- Y05+ bla�
b. Would the proposed project displace any existing recreational uses? Ir so, describe.
—8—
TO BE COMPLETED BY APPLICANT
c. Proposed measures to reduce or control imp3cis on recreation, including recreation op-
portunitics to be provided by the project or applicant, if 3ny:
43
13. Historic and Cultural Preseryation
a. Are there any places or objects listed on. or proposed for, national, state, or local prescr-
vation reoisters known to be on or next to the site? If so. gencrali describe.
y
0
b. Generally des'cribe any landmarks or evidence of historic, archacolo2ical. scientific, or
cultural lmoorzanc.- knc�vn to be on or next to the site.
6 Y'4-
c. Proposed inz:zsures to rzducz or control impacts. *if any:
Transuorracion
a. [denffy public izre::,s and. high-ays se,-;im, the s4e. and describe proposed access to the
scrc=� syszd-n. Sho- on sic'! olarts. if anv.
s��w
"b. Is iicd currently se.ved by public crartslc� If not. what is the approximate diszanc-- to the
nearest transit sEuo*l NO 3 b 6L
c. How many park-ing spac=s would the comple,.cd project have? How many would the
project r!im1nacc'!
3 4 P\aces on
t
d. Wiil the proposal reuuirc any nc-.v rouds or surct-ts. or improvements to CXISE[ng roads or
scrcz,s. not lnc!ud;n,-, driveways" [I' so. gcncrul[v desc,-ibe- (indicate whether public or
privacc.). X0
EVALUATION FOR
AGENCY USE ONLY
5
c. Will chc project use (or occur in the immediate vicinity of) water. rail. or air transporta-
tion? (f so, cencral1v describe.
z
C. How muny vehicular Lrilps per day %vuu!d bt: cie�uted by the completed pru*C'.:t` If
known. indl='LC %vnc.q pcLk '/()Iumcs '.vuuld occur. Wcr
K M -;20 M03
I,—
TO 11E COMPLETED BY APPLICANT
EVALUATION FOR
AGENCY USE ONLY
g. Proposed measures to reduce or control transportation impacts. if any:
)5. Public Scr%-ices
a. Would the project result in an increased need for public services (for example: fire pro-
tection, police protection, health care, schools, other)? If so. generally describe.
b. Proposed measures to reduce or control direct impacts on public services, if any.
�0
16. Utilities
a. Circle utilities currently available at the site: 1--ctricitN, atural Ras wat.er efuse serv-
i septic system, other.
b. Describe the utilities that are proposed for the project, the utility providing the service,
and the oeneral construction activities on the site or in the immediate vicinity which mighL
C, 0
be needed. ki vxb e-v q01-0 w"fe-V, 0�o 6't 5
C. SIGNATURE
The above answers are true and complete to the best of my knowledge. I unders-,and that
the lead agency is
Signature: ..
Date Subm ed: ................................
..................
itt'**7
_10-
TO III: HV AIII'LICANT EVALUATION FOR
AGENCY USE ONLY
D. SON-LEMEWIAL S111:11T FOR N0NVR(JJC-CT ACTIONS (Rezones , Code Changes , Annexations etc
(do not use this sheet (or project :IcIIonS)
ljec;iuse Ilicsc questions are very gencral it may be iieiprui to read them in conjunction
with ilic list (if the elements oFthe cliVi"011111c"t.
When answering theNe questions, be aware or oic exient the propos:jl, or thc.types or
aclivilici to result from (lie proposal, would'affecl the item at ;I greater inicrisky or
at -.I faster rate than if the proposal were not implemented. Respond brieny ind in general
terms.
How I would the proposal be likely to incrc;ise discharge to water; emissions to air-, pro-
duction, storage, or itic-ase of' toxic or hazardous substances; or production of noise?
64c4-f- 0#1 CYWWMe47k 00VJ`4x5 eD,-)&V,;CHb ki I- d4er
Proposcd nie.isures to avoid or reduce such increases are:
biq4,��, oil j--be
2. Flow would the proposal be likely to affect plants. animals, Fish, or marine lire?
NO MIJ
Pruposcd me:tsurcs to protect or conserve pkints, animals, fish, or marinc life are:
Woo e-
3. Flow would Lhc proposal be- likely to deplete. energy or nawral resources'?
IV6)qe-
Propos,:d ineasures to protect or conscrve energy and natural resources are:
Iq 8,6 En" I ccde-
4. How would the proposal be likely to use or affect environmentally sensitive arcas or ar-
ens deslunatcd (or �li--Ible or undec study) for -overnmental protection: such as parks. \vIl-
dcrricss, wild and scenic rivers, dircatened or endangered species habitat, historic or cultural
iit,", we-dands, Iluodplains. or prinic rarnilnnds'?
blo
Proposed mcasures to protect such resources or to avoid or reduce impacts are:
Abc ne
Ji. HOW WMIld Lhe proposal be likely to affecL land and shorelitic use, inclu ' ding whether it
WOuld allow or cricutimgt: kirid or shoreline uses Incompatible with existing plans'!
N, 14 , . .
— 1. 1. ..
TO BE CONJI'LITED [IN' APPLICANT
EVALUATION FOR
AGENCY USE ONLY
Proposed measures to avoid or reduce shorclinc and land use impacts arc:
01
6. Ho% . k, would the proposal be likely to increase demands on transportation or public scr-
vice., and utilities?
P-Oa6le_
Propostd measures to reduce or respond to such demand(s) arc:
7. Adentify, if possible, whether the proposal may conflict with local, state, or federal laws
or requirements for the protection of the environMenL.
—1?=
C I T Y 0 F., E D Me D S
PUBLIC WORKS DEPARTH-M -
412-41- 00 P31
77
Routing of Building,-
Perj�it-,
Plat,
or SubdAblim, tai-Aca
Proposed Property Address:
21116 -
21118
Shell Valley
Road
DEPARTIENT
CONZENTS
INITIAL
& DATE
IV A T E R
S E W E R
77
77
r\ Z-9
S T R E E T
�15 '5"
B U I L D I N G
0 R
P L A N N I N G
ADDITIONAL INFOPMATION:
10/11/76