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652 DAYTON.pdf------------- Amw I 4m w EXHIBIT 2 CITY OF EDMONDS EDMONDS. WASHINGTON APPLICATION TO HEARING EXAMINER FOR CONDITIONAL USE PERMIT File No Lu 4V -?I * Date Fee t7 APO I S Rect. No. HEARING DATE APPL1 CANT: C� G;Ili V V-06�1 ADDRESS (,P52- _PHONE_ I-75-ISL tk-c? Indicate type or degree of interest in the property: OWNER: I I - A , ,L,� ADDRESS(PS'7� Dcc-aj4b-� PHONE . 1'75-1417 VICINITY SKETCH: Example: 10 PLEASE SH014 BELOW A VICINITY SKETCH AS PER EM-1PLE, INUIUATING NORTH. 61 /"- 410Z-67 �,� A Representative RELEASENOLD HARMLESS AGREEMENT The undersigned applicant, his heirs and assigns, in consideration for the City processing.the application agrees to release, indemnifv, defend and hold the City of Edmonds harmless from anv and all damages and/or claims for damages, including reasonable attorneys' fees, arising from anv action or inaction of the City whenever such action or inaction is based in whole or in part upon false, misleading or incomplete information furnished by the applicant, his agents or employees. PERMISSION TO ENTER SUBJECT PROPERTY The undersigned applicant grants his, her or its permission for public officials and the staff of the City of Edmonds to enter the subject property for the purpose of*inSDection and posting attendant to this application. / 6 -Ad ;nc �-h h 4 /1 Signatfure ot Applicant, owner or Representative m "s a 4 .1 E X H I B I T 3 I EXHIBIT 4 Feb 20, 1987 To whom it may concern: We, Patsy A. and Willard G. McGillivray, owners of the property located at 652 Dayton, Edmonds, WA. (Lot 17 & 18, Blk 96, City of Edmonds, according to the plat thereof recorded in Vol 2, page 39, records of Snohomish County, State of Washington) agree to reside at the above property in either the accessory dwelling unit or the primary unit as long as we own the property e� �' �&r for as long as the accessory dwelling unit is used as such. -4— CA, Lt-d A- 7 //"'� , � '-Q) Patsy A. McGillivray Willard G. McGillivray State of Washington County of Snohomish On this day personally appeared before me Patsy A. and Willard G. McGillivray to me known to be the individuals described in and who executed this document and acknowledged that they signed the same as their free and voluntary act and deed, for the uses and purposes needed. Given under my hand and official seal this,1?0*day of 9�7- Notary Public in and for the.State of Washington, residing at-,F��� MY COMMISSION EXPIRES 6,16-89. EXHIBIT 5 STATEMENT OF RESIDENCY Feb 9, 1987 To whom it may concern: I purchased the property at 652 Dayton, Edmonds, WA in May 1983 and have resided there continually since that time. On my oath, I certify the above statement to be true. 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ENVIRONMENTAL CHECKLIST Purpose or Checklist: The State Environmental Policy Act (SEPA), chapter 43.21C RCW. requires 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 ation to help you and tile agency identify impacts from your proposal (and to reduce this checklist is to provide inform thcr an EIS is required. or avoid impacts from the'proposal, if it can be done) and to help the agency decide whc ants: Instructions ror Applic. This environmental checklist asks \ou 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 brien\, with the most precise information known, or give the best de- scription you can. r vour knowledge. In most cases, you should You must answer each question accurately and carefully, to the best o be able to answer -the questions from your own observations or project plans without the need to hire experts. If you reallv 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"' Complete answers to the qUeSLions now may avoid unnecessary delays later. e Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. AnsN% r these questions if you can. If you have problems, the governmental agencies can assist you. The checklist questions apply to all Darts of your proposal, even if you plan to do them over a period of time or on 4 ibe your proposal or its environmenLal diffti-lent. parcels of land. Atta�h any additionaf information that will 'help descr effects. The agency to which you submit Lhis checklist may ask vou to explain you� answers or provide additional in formation reasonably related to deLermining if there may �e significant adverse impact. U'se or checklist for non.project proposals: Complete this checklist for nonproject proposals, even though questions may be answered "does not apply." IN AD- DITION, COMPICLC theSUrPLEE,\tU1X:T.kL SHEZT FOR NON -PROJECT ACTIONS (part D). For nonproject actions, the references in Lhe checklist to Lhe words "project," "applicant," and "property or site" should be read as "proposal," "propos-�r." and "affected geographic area." respectively. A. BACKGROUND 1. Name of proposed project.. if applicable: 2. Name of applicant: Ta'J'sj t) Address and phone number of applicant and contact person: 5-2- 4. Date checklist prepared: 5. Agency requesting checklist: 6. Proposed timing or schedule (including phasing. if applicable): 7. Do you have any plans for future additions If yes, explain. expansion, or further activity related to or connected %vith this proposal? S. List anv environmental information you knov� about that has been prepared. or will be prepared, directly related to this proposal. 9. Do you kno\,%, whether applications are pending for governmental approvals of other proposals directly affecting the property covered by your proposal? If yes, explain. 7+-0. 10. List an), 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 pane. (Lead agencies may modify this form to include additional specific infor- mation on project description.) 12. Location of the proposaf. 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 ran2e of area. provide the ranne or boundaries of the site(s). Provide a legal description. site plan, vicinity map. and topographic map, if rcasonably available. Nk'hile you should submit an% plans required by the agency, you are not required Z to duplicate maps or detailed plans submitted with any permit app�lications related to this checklist. A6:'� I q4- cl 4� ll, TO BE COMPLETED BY APPLICANT B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (circle onc)a rolling, hilly, stcep slopes, mountainous, other b. What is the steepest slope on the site (approximate percent slope)? EVALUATION FOR AGENCY USE ONLY d : I TO BE COMPLETED BY APPLICANT EVALUATION FOR AGENCY USE ONLY 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 any prime farmland. d. Are there surface indications or history or unstable soils in the immediate vicinity? If so, describe. c. Describe the purpose, type, and approximate quantities of any filling or aradino pro- posed. Indicate source or Flil. F. Could erosion occur as a result of clearin2, construction. or use" If so. 2enerally describe. About what percent of the site will be covered with impervious surfaces aftei project construction (for example, asphalt or buildings)" h. Proposed measures to reduce or control erosion. or other impacts to the earth, if any: 2. Air a. What types of emissions to the air would result from the proposal (i.e.. dust. automobile. odors. industrial wood smoke) during construction and when the project is completed'! If any. generally describe and give approximate quantities ir known. b. Are there any off —site sources of emissions or odor thaL may arfect. your proposal" If so. generaliv describe. c. Proposed measures to reduce or control emissions or other impacts to air, if any: I I TO BE COMPLETED BY APPLICANT EVALUATION FOR AGENCY USE ONLY 3. NX-ater a. Surface: 1) Is there an), surface water bod\ on or in the immediate vicinit)' of the site (including vear—round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe lype and provide names. If appropriate, state what stream or river it flows into. 9�A 2) \Vill the project require any work over, in, or adjacent to (within 200 feet) the described waters? If yes, please describe and attach available plans. 3) Btimate 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. IRA 5) Does the proposal lie within a 100—year floodplain? If so, note location on the site plan. PAA 6) Does the proposal involve any discharges of w.aste materials to surface waters? If so, describe the type of waste and anticipated volume of discharge. TU b. Ground: 0 Will ground water be withdrawn, or will water be discharged to ground water?. Give Pencral description. purpose, and approximate quantities if known. I ' RA 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 tile system, the number of such systems, the number of houses to be served (if applicable), or tile number or animals or humans the system(s) are expected to serve. QAJO_� M 14, TO BE COMPLETED BY APPLICANT EVALUATION FOR AGENCY USE ONLY c. Water Runoff (including storm water): 1) Describe the Source or runoff (including storm water) and method of collection and disposal, if any (include quantities, if known). Where will this water flow? Will this water nowinto other waters? If so, describe. 2) Could waste materials enter ground or surface waters? If so, generally describe. P-0 d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: 4. Plants a. Check or circle types of vegetation found on the site: deciduous tree: alder, maple, aspen, other -7 everareen tree: Fir, cedar, pine, other V shrubs grass pasture crop or grain wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other water plants: water lily, eelgrass, milfoil, other other types of ve,getation b. What kind and amount of ve-etation will be removed or altered? c. List threatened or endangered species known to be on or near the site. d. Proposed landscaping, use of native plants, 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. Mtl� .3% TO BE COMPLETED BY APPLICANT EVALUATION FOR AGENCY USE ONLY c. Is the site part of a migration route? If so, explain. d. Proposed measures to preserve or enhance wildlife, if any: 6. Encrov and Natural Resources a. What kinds of energ� (electric, natural vas, oil, wood stove, solar) will be used to meet r-' the completed project's energy needs? Describe whether it will be used for heating.. manu- facturing, etc. b. Would your project affect the potential use of solar energy by adjacent properties? If so, 0 C.enerally describe. 7U 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: 6-yo V"L',J 7. Environmental Health a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and explosion, spill, or hazardous waste, that couldoccur as a result of this proposal? If so, describe. 7UC 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)? 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. T: TO BE COMPLETED BY APPLACANT EVALUATION FOR AGENCY USE ONL.Y 3) Proposed measures to reduce or control noise impacts, if any: 8. Land and Shoreline Use a. What is the current use of �he site and adjacent properties? b. Has the site been used'for agriculture? If so, describe. c. Describe any structures on the site. 6 4&�J d. Will anv structures be demolished'? If so, what? /Y) 1 0 L-16 e. What is the current zoning classification of the site? 40 C. What is the current comprehensive plan designation of the site?,Lj�, PL,,�Y If applicable, what is the current shoreline master program designation of the site? h. Has any part of the site been classified as an " erivi ron men Lally sensitive" area'? If so, 10AA specify. i. Approximately how many people would reside or work in the completed project? -1f)q j. Approximately how many people would the completed project displace'? 6' 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: I I t I TO BL COMPLETED BY APPLICANT 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, mid- d1c, or low—inconic 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 or any proposed structure(s), not including antennas; what is the principal exterior building material(s) proposed? b. What views in the immediate vicinitvIld be altered or obstructed? 9LW--,, c. Proposed measures to reduce or control aesthetic impacts, if any: EVALUATION FOR AGENCY USE ONLY a�_) _�- / Liaht and Glare 1� a. What type of light or glare will the proposal produce? What time of day would it mainly 7U_V� occur? b. Could light or glare from the finished project be a safety hazard or interfere with views? Xer�� c. What existing off —site sources of light or glare may affect your proposal? TA_V� d. Proposed measures to reduce or control lip -lit and glare impacts, if any: 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? 11-A b. Would the proposed project displace an), existing recreational uses? if so, describe. P4 M� 'M� 1.11 TO BE COMPLETE) BY APPLICANT c. Proposed measures to reduce or control impacts on recreation, including recreation op- portunitics to be provided by the project or apblicant, if any: 13. Historic and Cultural Preserv'atio n a. Arc there any places or objects listed on, or proposed for, national, state, or local preser- 7,(A vation registers known to be on or next to the site? If so, generally describe. b. Generally dcs'cribe any landmarks or evidence of historic, archaeoloslical. scientiFic, or cultural importance known to be on 'or next to the site. c. Proposed rn-�asures to reduce or control impacts. if any: 14. Transportation a. Identify public streets and highw I ays serving the site. and describe proposed access to the existing st reet system. Show on Site 1-:) iaris. if any. b. Is site currently served by to the public! transit" If riot. what is the approxialate distance nearest transit stop? c. How many park-ing spaces wouid the completed project have'�Ho%v many would the project eliminate'? d. Will the proposL11 require any ne:w ro-adis or stret:,s. or imorovc:menu to existing roads or streets. riot iric'ludinu �r; f weways. dC.SC7ibe (indicate whether public or private). e. Will the project use (or occur in Lhe imi-nedia[c -.,iC;rlitV k)f� WULe-. rail. or air cransporta- T-14 tion? If so. generally describe. I C. How malli VehICUILIr trip.) per ki.1y .vould lot: gencraLed bV the Completed project'! If known. indic:111C When peak volumes w0tild .)ccur. EVALUATION FOR AGENCY USE ONLY 4 1 M .1 TO BE COMPLETED [IN' APPLICANT 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. b. Proposed measures to reduce or control direct impacts on public services, if any. 16. Utilities a. Circle utilities currently available at the site: clectricitv, natural P-as, water, refuse.serv= .............. ice, telephone, sanilary sS�ve 1, 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 0 be needed. C. SIGNATURE The above answers are true and complete to the best of my knowledge. I understand that the lead ao I * h ake its decision. ency re ying on t emig m Signature: .............. f'***''***'**''''***'*''''******* Date Submitted: ............................................ EVALUATION FOR AGENCY USE ONLY 9� -V� I rN�"- ji. -Ij OF EDMONDS,,, City of Edmondaf-Y F 0-19 .1987 Fire M OFFICE COR U.0 WQNS ""'G6ry McComas,. INTER, RESPONDENCE go'bby Mills - P.W. Dan Smith/Jerry Hauth Eng. Dbane Bowman 2/18/87 TO FROM DATE SUBJECT CU-6-87 CONDITIONAL USE -PERMIT -FOR ACCESSORY DWELLING UNIT AT .652 DAYTON STREET CRS-6)' HEARING DATE: MARCH.5, 19-87 PLEASE RESPOND WITH. YO.UR COMMENTS NO LATER THAN FEBRUARY' 24, 19-87. SORRY FOR THE SHORT NOTICE. THANKS.