CRA19920116.PDFCritical Areas Checklist �XOlI2c`�l�
Site Information41 /
Project Name: C�r'ijS �iu� /, Permit Number:
Site Location: �'�`�`� - Cs��..,o�c leProperty Tax Account Number: /S7-764Z— l Low
Approximate Site Size (acres or square feet):
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged? le� Date of most recent action:
Soils / Topography
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)?
3. 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 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 of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
Hydrology/Vegetation
4. Site contains areas of year-round standing water. NG
/� A rox
5. Site contains areas of seasonal standing water. pp. Depth:
6. Site is in the floodway floodplain /'lo of a water course.
7. Site contains a cree� or an area where water flows cross the grounds surface? �0 flows
are year-round? Wo Flows are seasonal? M>
8. Site is primarily: forested ; meadow ;shrubs ; mixed
9. Obvious wetland is present on site: �o
10. Wetland inventory or map indicates wetland present on site: /
11. Critical Areas inventory or map indicates any Critical Area on site:
For City Use Only
690-199
City of Edmonds
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, 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.
With a signed copy of this form, the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conjunction with
this Checklist to assist staff in completing
their preliminary assessment of the site.
I have completed the attached. Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant: Applicant Representative:
p'
Name - Name
e::�&)XAr Idjowa Qdsth J G, /-r a ee
Title r Title
. lev
Street Address
City, State, ZIP Phone
Signature
Date
Street Address
City, S e, ZIP/ Phone
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6 ' — 4� . I �7�
Signature Date
0
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