21417 90TH AVE W.PDFlill 11111111
8766
21417 90TH AVE W
CAFILENO.
Critical Areas Checklist
----------------------------- ------------------------------- 7
Site Information (soils/topography/hydrology/vegetation)
I I qi 90'�` A � E7
Site Address/Location:
2. Property Tax Account Number: '5-609 C000 16 00ce
/o,150
Approximate Site Size (acres or square feet):
4. Is this site currently developed? X yes; no.
If yes; how is site developed? P, DOSE j 00 V6wA--?., PA, !-)c5 i L,� Urwpt-, 14-A)D 4f,4)N-'A0M6
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
r-1
7
8
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 3 ) 0% ( a vertical rise of
10-feet over a horizontal distance of '33 to 66-feet).
Steep: . grades of greater than 3 ) 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
Site contains areas of year-round standing water: N Approx. Depth:
Site contains areas of seasonal standincr water: N
M. — _;Approx. Depth:
What season(s) of the year? m 14
Site is in the floodway OVIP floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? d /A Flows are seasonal? N 1,4 (What time of year? /\) M
10. Site is primarily: forested 0 4 � meadow ij 14- shrubs W/A mixed JVA
urban landscaped (lawn,shrubs etc) UPA&V fIQID'Se-805�
11. Obvious wetland is present on site: P)D
bt-TtkMINATION
lca_chk.doc� Rev 10/03197
City of Edmonds
T�W 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 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,
mdps, or soil surveys).
An applicant, or his/her 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 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 shall include
other pertinent infon-nation (e.g., site plan, topography
map, etc.) or studies in conjunction with this Checklist
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
?/,Y/ -7 �(O -�vk �- V E-- 0-)
Street Address
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ICAM 6)1 A,
city State Zip
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Telephone
re
Date
Applicant Representative:
Name
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Street Address
Z4'�IVI&WD 2-,UA
City State Zip
7'7,!1:) -
hone
Telep
Signature
Date
(over)
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Anthony Collins
1920464 th Avenue W
Lynnwood, WA 98036
Subject:
Dear Applicant:
CITY OF EDMONDS BARBARA FAHEY
M AYO R
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works - Planning/Building * Parks and Recreation o Engineering o Wastewater Treatment Plant
November 10, 1998
Determination regarding Critical Areas Checklist # 98-266
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 Checklist "DETERMINATION" for your records.
IMPORTANT INFORMATION TO BE NOTED:
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS OR CRITICAL AREAS STUDY.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL .4111111
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
cc: Don Kinney
Enc: Determination
*Architectural Design Board
C:ReceptionQana\CRLTR.doc
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you.
Planning Secretary
Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
PLANNING DATA
NAME: Law
SITE ADDRESS T-6- Alle W DATE: H LOSM
ZONING: PLAN CHK#:
PROJECT DESCRIPTION:
CORNER LO (Yes/No) FLAG LOT _____(Yes/No)
SETBACKS:
Required Setbacks:
Front: 21-'�, Left Side: Right Side.-7. cO Rear:
Actual Setbacks:
Front: Left Side: Right Slde:71�/ Rear:
Street map checked for additional setback required? Ve-n-&q�nw-;AWeslNo)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE:
Maximum Allowed: ------ 0 7 /cell --.Actual:—
BUILDING HEIGHT: 7, Z,; / 11 ) 7
Maxlmum'All owed:-- Actual Height: -
Datum PoInt:!SW 9bff2Z#C0W9/r Datum Elevation: /W
A.D.U. CREATED?: q4'1
SUBDIVISION:
CRITICAL AREAS #: qz6-Z�a
SEPA DETERMINATION:
LOT AREA: . /0
j
------- 7—
OTHER:
Plan Review By:
c\f11cApaTni"hwdudm
'PC. 1 S 9,3
Anthony Collins
1920464 th Avenue W
Lynnwood, WA 98036
Subject:
Dear Applicant:
CITY OF EDMONDS BARBARA FAHEY
MAYOR
121 5TH AVENUE NORTH - EDMONDS. WA 98020 - (425) 771-0220 - FAX (425) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works - Planning/ Building e Parks and Recreation * Engineering * Wastewater Treatment Plant
November 10, 1998
Determination regarding Critical Areas Checklist # 98-266
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 Checklist "DETERMINATION" for your records.
.............. ...... .............. I ............. - ........... ............... ......................
................... .............................................. .......... -IMPORTANTINFORMATION.TO: BE NOTED
............. ... ....... .
.............. ............... ............ .......... ........ .. .... - .... .. . . ... .. .... ......... .......... ....................... .......... ......... ..........
........... ...................... -
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS OR CRITICAL AREAS STUDY.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
mo, You mustsubmit a copy of the CRITICAL AREAS CHECKLISTand DETERMINATION WITH ALL 40
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
cc: Don Kinney
Enc: Determination
* Architectural Design Board
C:Reception\Jana\CRLTR.doc
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you.
Planning Secretary
* Incorporated August 11, 1890 0
Sister Cities International — Helkinan, Japan
CA FILE NO.
Critical Areas Checklist
_rl ---------------------------------------------------------
Site lifformation (soils/topography/hydrology/vegetation)
I . Site Address/Location: '7_1 i� ' -7 A V F ck-� , 6_� P� [-,, ill 0
2. Property Tax Account Number: 5- 6 c 9 cc c, c, c c, c
j Approximate Site Size (acres or square feet):
4. Is this site currentiv developed? ....X _ no.
I ...— yes;
If yes; how is site developed? EX��>7106
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 I 0-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
I 0-feet over a horizontal distance of 3 )3 to 66-feet).
Steep: grades of greater than 3 ) 0% present on site (a vertical rise of 1 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: .44 Approx. Depth:
7. Site contains areas of seasonal standing water: N /P_ Approx. Depth:
What season(s) of the year? h / 4
8. Site is in the flocdwav Ai A floodplain A'1A of a water course.
9. Site contains a creek or an area where water flows across the grounds surface9 Flows are year-
round? �j 1A Flows are seasonal? N' / A
(What time of year? N 1;4
10. Site is primarily: forested 1,4 meadow fj 4 shrubs I Y/ i� mixed A /A
urban landscaped (lawn,shrubs etc) 1_4�AP-,V
11. Obvious wetland is present on site: rj 1�-�
DETERMINATION
Na-chkAoc; Rev 10/03/97
/,7 C. 1 B,413
Anthony Collins
1920464 th Avenue W
Lynnwood, WA 98036
Subject:
Dear Applicant:
CITY OF EDMONDS BARBARA FAHEY
MAYOR
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works * Planning/ Building 9 Parks and Recreation e Engineering e Wastewater Treatment Plant
November 10, 1998
Determination regarding Critical Areas Checklist # 98-266
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 Checklist "DETERMINATION" for your records.
.................... ..........
............................ - ... ............ ........... ................................. I ...........
........... � ................... ............
............. . .............. , ........... ...... .................. IMPORTANTINFORMA TION:TOBE: NOTED.
......... ...... ........ ...... ............ ........................ I .....................
.............. ........ - ..... ..... .... ...... - ..... . ...iii.� ...... .. .... 11 . .................... .................. - .... I .................................
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS OR CRITICAL AREAS STUDY,
The 'DETERMINATION' 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 -4111111111
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
cc: Don Kinney
Enc: Determination
* Architectural Design Board
C:ReceptionUana\CRLTR.doc
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you.
Planning Secretary
* Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
CA FILE NO.
Critical Areas Checklist
----------------- --------------------------------------------
Site. Information (soils/topography/hvdrology/vegetation)
-7 (f)
I Site Address/Location: (.- i � ro
2. Property Tax Account Number: 6 c ci co o c, c, o c) o r__
J. Approximate Site Size (acres or square feet):
4. Is this site currentiv developed? X yes; _ no.
I -
If yes; how is site developed? 6X��*>7in6 P,'D,�SE, (A. V&\--:Pry
rL,r !_ty 7
yap", V
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
R
7.
8
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 than 33-feet).
Other (please describe):
Site contains areas of year-round standing water: IY )Z _; Approx. Depth:
Site contains areas of seasonal standincr water: N Approx. Depth:
What season(s) of the year? 4
Site is in the floodway NIA floodplain NIA of a water course.
9. Site contains a creek or an area where water flows across the grounds surface') Flows are year-
round? ii Flows are seasonal? N' I (What time of year? N M
10. Site is primarily: forested N ;meadow Ji A,- shrubs I Y� PN mixed �"JVA
urban landscaped (lawn,shrubs etc) UPAAW LAiTc�_-PF
11. Obvious wetland is present on site: r') (,-�
DETERMINATION
^ca.�chk.doc: Rev 10/03/97
I
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS 0 EASEMENT No . ..........................................
111-04100
OWNM.......... R...E ...... ............................................................ CONTRACTOR -------------------------------------------------------------------------------------------------- PERMIT No . ......................
ADDRESS ..... 21-417 ---- --- 9Ot4-A-ve..-U . ............................................... LEGAJ, DESCRIPTION: LOT No . .............................................. BLOCK No . ..................... ......................
NAMEOF ADDITION.. .......................................................................................................................................
0
0
Dye Tested On Sevier 1972
Approved:
DATE................................................ By ......................................................................