23104 99TH AVE W.PDFiiiiiiii lill 11
15573
23104 99TH AVE W
CA File Nei:
Critical Areas Checklist
ogy
Site Informaticliji (soils/ topography/ hydrol '' /vegetation).
Wk R12400
1. Site Address/ 1,6catior� 0
2. Tropeirty Tax AcceiuntNumbdr: i=�6�CI14C(5 V-1160 OQ
Size , (a , cres orsquare �feet): AA
3. Appr6kfiii�te �Ii�
4. is this site currently developed? _2� yes; —no.
If yes;,how is site developed? VCLS t C> IF-*_Yf Wk L_
'Describe the generaf site.topography. Check ali t�at 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: ..s . lopes. present on site of more than 15% and less than 30% a vertical rise of 10-feet
over a horizontal distance of 33 to 664eet).
Steep: grades of greater than 301/6 present on site (a vertical rise of 10-feet over a horizontal
distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water. NLO Approx. Depth:
What season(s) of, the year?
At> floodphain LLO of -a."'.
Site is in the floodway water course.
Site contains a creek or an area wbere water flows' across the grounds surface? Flows are year-round?
Flows are seasonal! ft6 — (What tim6-of year?
site is primaril : forested --,-; meadow ;shrubs mixed
y X _0
urbanland�cviped (lawrishrubs etc) A-'C E�Ae_t< oF V.0'&
11. obvipus wetland is present on site: t'A d>
M
Critical Areas Checidistdoc/3.19.2601
Cfty of Edmon,-ds.,.;.'_,
Development -Services Department
Planning Divisiow
,-J?hope: -425.77,1.02,210.
Fax: 425.771.0221
11 1
,Date Received:
City Receipt
Critical Areas- File:#-'-
, . I( �i 7 , - *—
Critica Areas � Checklist Fee: $45.00
cini:
.-Date Malie:d,t6Ap�ll,! ii
The Critical Areas Checklist coxitained'on this form ig A pro' �perty owner, or his/her. authorized repre�entative,
. , "r , �� 1�' .; ' date t,
be filled out by any person preparing. a Develdpinent.� 'musi: 'hif c�ut the" checklist,', gl' - i
igri'and. and "Submit it
Permit Application for the City of Edmonds prior to to the City. The, City.will; review -the checklist, make a
his/her submittal of the application to the City precursory site visi an a determination of the
sequent steps necessary-to-complett a development
The purpose of the Checklist is to enable'City ��sub it application.
p�rm
determine whether any potential Critical Areas ar6,J or,,.
may be, present on the subject property. The information Please submit, a vicinity -map,- along with the signed copy
needed to complet� the Checklist should be, easily of this form to assist City staff in firiding and locating the
available from observations of'the site or- data -available: at s'p"ie"'cific piece of piopir,ty-de'sc�hibe& on this -form.
In
City Hall (Critical areas inventories, maps, 6r�:so'ill addition the applicanf`ihill' *include other pertinent
surveys). ,...,JnfbrQon (e.g. site plan,,j9pography map, etc.) or
studies in conjunction with this Checklist to assistant staff
r ""'. I
in completing their prelimi�fiary assessment of the site.
Tbe I undersigned applicant, and his/hcr/its heirs, and ai�'Igiii, in consideration on the processing of the application agre�s
, , j,., . - 6 '
to release, indemnify, defend and hold the City of Edftionds harmless'froni'any and aff , I including -reasonable
attomey's fees, arising from any action or infraction based in whole or, part. upop.,ftilsel, misleading, inaccurate or
incomplete information furnished by the applicant, his/hcr/its agents or employees.
By my signature, I cer* that the information and e*xhibits.h6rewith submittedare true an�'correcfto 'tih,6- of my
knowledge and that I am authorized to5fil;A�s applibAti6n on" the b h If o'fthefowneris listed belowi'
SIGNATURE OF APPLICANT/AGENI( DATE
Property Owner's Authorization
By my signature, I cer* that I have authorized the above.-Applicant/A or the subject land'use application,
gent to,apply f
and grant my peimission for the public officials and the. itad of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER
Owner/AppUcant:
01. KA R L. e SD. KA L KLZ� A PLC
Name
a IS � 0 4 Ckck _Voi* Awf- WeiErl"
Street Address
WA
city Stafe Z'
Telephone: 4Z6 77A- 2'�8-5
.7
DATE,,.
0-4-
F_
Applicant RepresentAtife:,
Name
Street Address'
City State zip
Telephone:
Email address (optional): Email Address�(optio
nal)
Critical Areas Checklist.doc/3.19.2001