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CRA20010071Critical Areas Checklist M6 Lauol � 0 7/ Site Information (soils/topography/hydrology/vegetation) 1. Site Address/ Location: (2 Z Lf — 0 (y 1,,,1 p i L Ave , E O, vyx o v\ A S WA . 2. Property Tax Account Number: O G L 00000 21 O o 1 3. Approximate Site Size (acres or square feet): 4. Is this site currently developed? yes; If yes; how is site developed? 51Ila le 5 6. 7. 8. 9. Describe the general site topography. Check all thatlapply. 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 664eet). 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): Site contains areas of year-round standing water: _ O Approx. Depth: Site contains areas of seasonal standing water: _ �� (� ; Approx. Depth: _ What season(s) of the year? Site is in the floodway - NO floodplain NO of a water course. ''(Af &A7 In o rose . Site contains a creek or an area where water flow across the grounds surface? Flows are year-round? N© Flows are seasonal? s) I A— (What time of year? ). 10. Site is primarily: forested ; meadow ;shrubs ; mixed ; urban landscaped (lawn,shrubs etc) '�Fs 11. Obvious wetland is present on site: NO ��__���--------- For City Staff Use Only —-_----_ � ' 2, 1. Plan Check Number, if applicable? 2. Site is Zoned? RS — 12. 3. SCS mapped soil type(s)? Al -DERV O bD URE,At 4 LAND Cca M pLje,:G 4. Critical Areas inventory or C.A. map indicates Critical Area on site? "D . 5. Site within designated earth subsidence landslide hazard area?. DETERMINATION Y 'M WAIVER Reviewed Date: �✓- 23 " 61. Critical Areas Checklist.doc/3.19.2001 of Eo�o� City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 1 g90 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: City Receipt#:_ 17 59 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 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. 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 by the applicant, his/her/its agents or employees. By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge and that I am authorized to file this application on the behalf of the owner as listed 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 permission for the public officials and the staff of the City of Edmonds to enter the subject property for the purposes of inspection and posting attendant to this application. SIGNATURE OF OWNER u .� � �' 41!✓7.s- l %Yh r _ /0 DATE cS — b PLEASE PRINT CLEARLY Owner/Applicant: �P�VI� I"1,01�"1"lSov� Name 1�8D6— (o pl wec Street Address Lyr,nvJ000l WA City State Zip Telephone: q 2-5 7 g S— Z 2- �? 3 Email address (optional): Applicant Representative: 5 ,q rnE Name Street Address City State Zip Telephone: Email Address (optional): Critical Areas Checklist.doc/3.19.2001 City of Edmonds Critical Areas Determination Applicant: Melvin Mattison Determination #: CA-01-071 Project Name: Permit Number: Site Location: 1224 Olympic Ave Property Tax Acct #: 6066 000 004 00 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 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 20.1513 by completing the following: Steep Slope Hazard Area Delineation Requirements: To determine if a 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- foot 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 buffer 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: 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 engineer 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 20.1513, a Reasonable Use Exception and Variance must be obtained pursuant to ECDC 20.15B.170A and 20.1513.040C. 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 X CITY OF EDMONDS DEVELOPMENT SERVICES i Received of: f' Address: Project Loci i 175796 DATE: Check No. 14 'i' Cash Total Received $ ! cg . Water Meter Size: Amount Water Connection Fee Street Cut/Restoration Fee (620 Fund) Sewer Permit/Repair Trunk Charge Sewer Connection/LID Fee R/W Constuction Permit Fee Street Disruption Fee (ill Fund) Engineering Inspection Fee Engineering Specs & Plans Fee Storm Drainage Fee Street Use Permit Building Permit Fee -Type Plan Check Fee # State Surcharge (622 Fund) Zoning Application Fee - Tye Landscape Inspection Fee _ Shoreline Permit Fee SEPA Review Fee Recording Fee Maps/Books Photocopies Traffic Mitigation Fee Sidewalk Contribution Received by: Permit No.