CRA20010027III I�� ICI CA FILE NO.
Critical Areas Checklist e Rn loo / °pa'I
----------------- --------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: l 7 r,;?- 7— 7 e lAr,
2. Property Tax Account Number: 7610 621!2 d
- 3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? yes; no.
If yes; how is site developed?
5. 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 over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% 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: l 0%iet ; Approx. Depth: ve fo
7. Site contains areas of seasonal standing water: ; Approx. Depth:
What season(s) of the year?
8. 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? e.5 Flows are seasonal? (What time of year? ).
10. S' forested : meadow : shrubs mixed
urban landscaed ( wn,shrubs etc)
11.�vio�uswet�land present on site: i/ e5
4. Critical Areas inventory or. C.A map indreatesCriticaLArea On sit
5. Site within designated earth subsrtlence.landslide .:hazard area? �� S
6. Site designated on the Envrronmentaliy Sensitive Areas Map?
DETERMINATION
^ca chk.doc; Rev 10/03/97
-oc. 1 %9�
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
DATED RECEIVED:
CITY RECEIPT #: / 17)Vy
Critical Areas File #:
Critical Areas Checklist Fee: $45.00
DATE MAILED TO APPLICANT:
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/or 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.
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.
I have completed the attached CRITICAL AREAS CHECKLIST and attest that the answers provided are
factual to the best of my knowledge (fill out the appropriate column below).
PLEASE PRINT CLEARLY
Owner/Applicant:
Name
leg �-�� �6 �'k�� �✓
Street Address
1--) / R
J74 mm /J
City State Zip
Telephone:
Signature
Date:
c:mydocuments/spellman/form+/CACL Form.doc
g:share/temp/jana/formsCACL Formdoc
Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Signature
Date:
City of Edmonds
Critical Areas Determination
Applicant: Pete Troka Determination #: CA-01-27
Project Name: Permit Number:
Site Location: 17527 76th Ave W. Property Tax Acct #: 7009-000-004-00 1
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
critical areas, including a Wetland and Stream 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:
Wetland/Stream
The site investigation has shown that the site has a natural stream and wetland. Based on the
above findings, a Critical Areas Study is required to determine the hydrology of the area and to
delineate the approximate boundaries of any wetland or stream and identify its buffers. The
required qualified critical areas consultant needed to perform the study shall be a specialist in
botany, fisheries, wetland biology, and/or hydrology with a minimum of two years' field
experience with wetlands and/or streams in the Pacific Northwest. All critical areas studies shall
be performed as three party agreements with the city selecting the consultant and the property
owner or applicant paying the fees.
The qualified critical areas consultant shall perform the following:
Classification of the stream and/or wetland pursuant to the criteria established in ECDC
Section 20.15B.060(A)(4) and (5).
2.* Delineate the edge of the stream and/or wetland on the site.
3. State any mitigating measures appropriate to preserving and protecting the stream and/or
wetland.
00•
After the qualified critical areas consultant has delineated the stream and/or wetland boundary, a
surveyor licensed by the State of Washington must perform the following:
1. Physically mark the edge of the wetland.
2. Delineate the required buffer (see ECDC 20.1513.120. (A) and 20.15B.130.(C)).
3. Delineate the required building setback from the buffer (required setback is 15 feet).
4. Create a map showing the wetland, the buffer and the building setback.
Both the qualified critical areas consultant and the Land Surveyor shall enter into a three party
contract with the applicant and the City of Edmonds as required in ECDC 20.15B.140(D), where
the applicant pays for the study. The applicant may suggest qualified professionals for the City's
approval.
If the results of the Critical Areas Study determine that the lot may not be developed, the
applicant may apply for a Reasonable Use Exception and Variance pursuant to ECDC
20.15B.170(A) and 20.15B.040(C)).
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 Area or its buffers, a conditional
waiver may be issued on a project by project basis.
Star C
Name
Date
❑ Cited sections of the Edmonds Community Development Code (ECDC) can be found on the City of Edmonds
website at www.ci.edmonds.wa.us.
2