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CRA20010033.PDFw Critical Areas Checklist Oite Information (soils/topography/hydrology/vegetation) File No: ' 1. Site Address/Location: _642U 01tAmpi / Viod 'DEW\JL �wlovA ,wA �gbOl4p 2. Property Tax Account Number: (Q coo - 0Q 1, ' $�s� © 1 3. Approximate Site Size (acres or square feet): k2 , 77 47W 4. Is this site currently developed? _K yes; no. 1 If yes; how is site developed? G,�V161� - , hi tl VI YlJb1,&(/ tt- 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): ?7,AZV- C4N ~ e)_NAk*A 10 Site contains areas of year-round standing water: ; Approx. Depth: Site contains areas of seasonal standingwater: Approx. Depth: What season(s) of the year? �1 6 V\L 8. Site is in the floodway NO floodplain 0 of a water course. 9. Site con ams a creek or an area where water flows across the grounds surface? Flows are year-round? d Flows are seasonal? N 0 (What time of year? iJ 0MG ). 10. Site is primarily: forested ; meadow ; shrubs ; mixed urban landscaped (lawn,shrubs etc) 11. Obvious wetland is present on site: N 0 -For Ci 'Staff Use Oil - - ------------------ ---------------- 1. Plan Check Number,'if applicable? 2. Site is Zoned? 3. SCS,mapped soil types)?, y " 4. Critical Areas inventory or,C.A.,map.indicates CriticatArea-,on R:pc,6;i*1�i 5. Site within designated earth subsidence -landslide hazard area? 6.-,Site- designated on the Environmentally Sensitive Areas Map?� " DETERMINATION STURDY REQUIRED WAIVER Reviewed by: r- a Or .. \- �s>A Date: v c Planners L. G:\Share\Library\Planning\Forms\Public Handouts\ Critical Areas Checklist Doc/1-16-2001 ,ac. I s90 City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 Fax: 425.771.0221 DATED RECEIVED:_ 3Ici /OI CITY RECEIPT #:_ 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. L J 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). �*. J �Pwp lican �M fi P(s eA u l C.d f )Y-A vA Name Name -161� P�GNGVLAt AV& Est Street Address 4eAA\t/ City State Zip Telenlaa �e(P), -;V" 21 WO Signature Date: -2cv © LAM Vw Street Address (P'AWWW)4 WA q $O?J'v City State Zip Telephone: 642--11 " Sign re • Date: G:\Share\Library\Planning\1:orms\Public Handouts\ Critical Areas Checklist Doc/]-16-2001 • r� L • tt1 -1 a O L m YMP VIpR� is EW _ o rl_ 12 99.14'HUGH COWARDO SSG (NET) W J1 w� ,r-z tn RIGHARO D. CUPP 10 WARREN L. WILSO J GEORGE F. SHERWIK J,JR. V i _ N� � 9 N� O _ I 0 'r w I Q V E HOUSE Io Q E— 12,32440 CHAR. \�9 (DIET) 139.05' . �`- 142.32' EXISTIWG 12' ROAD EASEU EWT O Y G 40, O N T-A Y a • i ` al Land THOMAS B. BERRY H. AWDERSOW 5-20-5<0 : REVISED OlUEIJSIOWS ; KU L Lovell- Sauerland & Associates, Inc. S SURVEYORS • DEVELOPMENT CONSULTANTS • PLANNERS 23106 100TH AVE. W. • EDMONDS WA. 98020 . PHONE 775-1593 DRAWN ICHECKED I GATE I F.B. I SCALE I FILE NO. KM GWL 13-14-OS_1_200A I 1"=SO'� SCj-�323 -_. ~ NV-l6DllS �� .--'--'--�---'--'---o—�msmo----'----'`9 ..' / °' / '.. / ~