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22606 96TH AVE W
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CA FILE NO 4�110
Critical Areas Checklist
------------------------ 7 --------------------------------------
Site Information (soil s/topogrziphy/hydrology/vegetati on)
L' Site Address/Location: ��Z,6696,- !a7llt,�e
2. Property Tax Account Number: 1-190 -7 010 :- 0, 0 0 -- /Z 6"
3. Approximate Site Size (acres or square feet): Z/ �"6 .54
4. Is this site currently developed? _.�L yes; no.
If yes; how is site developed? hmllv, 07VLI�_
5. Describe the general site topography. Check all that apply. I VE 0,
Flat: less than 5-feet elevation'change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet
horizontal distance of 66-feet).
4.
f,410 - 'i 1998
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 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe)-
6. Site c� o6tains areas of year-round standing water: KI,4_; Approx. Depth:
7. Site contains areas of seasonal standing water: A� /A _; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site contains a c.reek or an area where water flows across the grounds surface? Flows are year-
round? AZZ
Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc) <
11. Obvious wetland is present on site:
-----------
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DETERMP"TION
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^ca_chk.doc� Rev 10/03/97
City of Edmonds
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NAW 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
permitt.0 the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The
information needed to complete'the Checklist should
be easily available from observations of the site or
data available at City Hall (Critical Areas inventories,
maps, or soil surveys).
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 information (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:
1�
'J J .'
M
Name
4 v, - x-)
Street Address
City State/ Zip
'�"-25'- 77 z�Y,
Telephone
Signature
Date
Applicant Representative:
Name
Street Address
City State
Telephone
Signature .
Date
Zip
(over)
c:reception\jana\cac1.doc
'PC. 18 () 13
May 8, 1998
Jim McCreedy
2260696 th Ave. West
Edmonds, WA 98020
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 a Planning/Building e Parks and Recreation * Engineering e Wastewater Treatment Plant
Subject: Determination regarding Critical Areas Checklist # 98-129
Dear Applicant:
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 CHEr-KLLS-T OR CRITICAL AREAS STUDY,
The 'DETERMINATION' for the Critical Areas Checklist you submifted is a site -specific determination not a
project -specific determination.
moo.. You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL -411111111
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
C:ReceptionUana\CRLTR.doc
Thank you.
Shada Graham
Acting Planning Secretary
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
PLANNING DATA
NAME: tk&&-du
SITE ADDRESS: DATE:
ZONING: PLANCHK#:
PROJECT DESCRIPTION:
CORNER LOT—*—(Yes/No)
WARINEW1510
FLAG LOT- On (Yes/No)
SETBACKS:
Required Setbacks:
Side
Front!gtL��d Right Side:_:�—�r-__�Z�
Actual Setbacks:
Front: Left Side: Right Side: Rear:
Street map checked for additional setback required? (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED I —(Y/N)
LOT COVERAGE: /I ,,-
Maximum Allowed: "�'S � Actual: r��
L
BUILDING HEIGHT:
Maximum Allowed:—,W," Actual Height:
Datum Point: Datum Elevation:
A.D.U. CREATEW:
SUBDIVISION:
CRITICAL AREAS#: '-/� -
SEPA DETERMINATION:
LOT AREA: eyn
OTHER:
Plan Review By:
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