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Critical Areas Checklist' 6 1.-
Site Information
Project Name: �� ermit Number:
Site Location: 05!n4: jn: �uWrg& tV- Property Tax Account Number..4344-uoZ•Ol3.00e(o
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Approximate Site Size (acres or square feet): D.(A &49nftomi .
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? b Date of most recent action: L✓b
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 30Yp ( 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: P62
5. Site contains areas of seasonal standing water. WO Approx. Depth:
6. Site is in the floodway _ Ili floodplain—HO of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? flows -
are year-round? Flows are seasonal?
8. Site is primarily: forested ; meadow ;shrubs . ; mixed ... ;
9. Obvious wetfand is present on site:
10. Wetland inventory or map indicates wetland present on site:
11. Critical Area's inventory or map indicates any Critical Area on site:
For City Use.Only
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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:
Title
Applicant Representative:
Street Address Street Address
�8020 �'8 � � 2
77¢:�2- �, .,�,_City, State, ZIP t KEP6�- aN
Phone City, State, ZIP Phone
Signature ` le�/
Date Oignatu,, Date
•