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Critical Areas Checklist �
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/ Location: ice-_,
2. Property Tax Account Number: O og ; q (o - noo - O cp (-
3. Approximate Site Size (acres or square feet): _ 11,000 t]
4. Is this site currently developed? _ yes; I no.
If yes; how is site developed?
S. 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 104eet over a horizontal
distance of 66 -feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of 104eet
over a horizontal distance of 33 to 66 -feet).
Steep: grades of greater than 30°x6 resent on site a vertical rise of 10 -feet over P ( 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: ;Approx. Depth:
What season(s) of the year?.
B. 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?
q 0 Flows are seasonal? (What time ofear? ),
10. Site is primarily: forested ; meadow ;shrubs • mixed
urban landscaped (lawn♦shrubs etc) �L �6
11. Obvious wetland is present on site: o
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Critical Areas Checklist.doc/3.19.2001
IC. lb -7 -
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax:. 425.771.0221
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 the application 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, maps, or soil
surveys).
Date Received: ? - =z0- 0 2—
City
City Receipt #: Q-cDL-1 O 3
Critical Areas File #:
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant:
A property owner, or his/her authorized 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 completea 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 assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished bthe applicant, his/her/its agents or employees.
By my signature, I certify that the i fo tion and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to le is application n the behalf of the owner as list below.
SIGNATURE OF APPLICANT/AGENT DATE
Property Owner's Authorization
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permissionfo the blic officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and p stin attendant to this pplication. Q
SIGNATURE OF OWNER , DATE U 6'2,
Owner/Applicant: �-To
W I 1, (,. I A &A . �i
Name
Street Address
City State Zip
Telephone: H l"5- 1 Z l
Email address (optional):
Critical Areas Checklist.doc/3.19.2001
Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Email Address (optional):
City of Edmonds
Critical Areas Determination
Applicant: William Linton Determination #: CA -02-176
Project Name: Permit Number:
Site Location: 19106 94`b Ave. W Property Tax Acct #: 00 4346 000 06104
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 number of critical areas, including a possible Steep Slope Hazard Area
pursuant to Chapter 20.15B of the Edmonds Community Development Code (ECDC).
Based on these findings, prior to submission of any development permit, you will be required
satisfy the requirements of ECDC 20.15B by completing the following:
Steep Slone Hazard Area Delineation Requirements:
To determine if `.;Steep Slope Hazard Area does exist, a topographic survey prepared by a
Licensed Land Surveyor delineating Steep Slope Hazard Areas must be completed. Any slope of
40% or more with at least 20 feet of rise will be classified as a Steep Slope Hazard Area. A'50 -
toot buffer is required from both the top and toe of the slope. A 15 -foot building setback is
required from the',50-foot buffer.
For development of any kind which is proposed within the critical area, 50 -foot buf er 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 possibly both of the following depending on the outcome of the
study:
1. For development proposals which will occur within the 50 -foot buffer, but no 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,enginoer 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, except those done by a
licensed geotechnical engineer, must be completed 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. I MA and 20.15B.040C.
- ,. , ' "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 Department for review. If the Planning Department finds 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.
Name
Signature
Date
2