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CRA20010092of E°moo City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 1„C. I ggo 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 T1rEXiFYdViE0 maps, or soil surveys). JUN 2 8 2001 PERMIT COUNTER Date Received : LP/ D 8 / o A City Receipt #: 1-1 %rjt Critical Areas File #: C,A—©1— q. p-- Critical Areas Checklist Fee: $45.00 Date Mailed to ADDlicant: 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�' •c,�. DATE �, -- Z 8— v ` PLEASE PRINT CLEARLY Owner/Applicant: ---Ro e r- nrt- Name :5—,� /1 /-!r Street Address E-D 1-f a ry o-, City State Zip Telephone: C— -77 Y — Email address (optional): Applicant Applicant Representative: Name Street Address City State Zip Telephone: Email Address (optional): Critical Areas Checklist.doc/3.19.2001 Critical Areas Checklist CA File No: �_ O -92- Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: / /L ';;7LY"- h jfi v e- 2. Property Tax Account Number: pp 0 — 01610 _ 3. Approximate Site Size (acres or square feet): 2Z S 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: ; Approx. Depth: 7. Site contains areas of seasonal standing water: ; Approx. Depth: What season(s) of the year? 8. Site is in the floodway IV 0— floodplain /V d of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round? ��' - Flows are seasonal? (What time of year? ). 10. Site is primarily: forested ; meadow ;shrubs ;mixed l/ urban landscaped (lawn,shrubs etc) 11. Obvious wetland is present on site: 1. Plan Check Number, if applicable? 2. Site is Zoned? - ->-- c s1_%rPT ? '41 fT It- b For City Staff Use Only 3. SCS mapped soil type(s)? c c' _ a 4. Critical Areas inventory or C.A. map indicates Critical Area on site? C) 5. Site within designated earth subsidence landslide hazard area? t4 O DETERMINATION STUDY REQUIRED _ WAIVER Reviewed by: l " a'_ — ,1AQ. a Q Date: -1/0 In, Critical Areas Checklist.doc/3.19.2001 City of Edmonds Critical Areas Determination Applicant: Robert E. Suchert Determination #: CA-01-92 Project Name: Permit Number: Site Location: 16612 76`h Ave. W. Property Tax Acct #: 5131-000-090-06 Project Description: Non -Project Specific Determination: Study Required: During review and inspection of the subject site, it was found that the site contains critical areas including a stream, a possible wetland, and steep slopes pursuant to Chapter 20.15B of the Edmonds Community Development Code (ECDC). Based on this finding, prior to submission of any development permit, you will be required satisfy the requirements of ECDC 20.15B by completing the following: Stream / Wetland The site investigation has shown that your property contains a stream. The site may also have a natural 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 and identify buffers for the stream and possible wetland. In addition, the study will determinde whether or not salmonids, migrating fish, use the stream. If they do, a 50 foot buffer and a 15 foot building setback is required from the top of the stream bank. If salmonids do not use the stream, a 25 foot buffer and a 15 foot building setback is required from the top of the banks. 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. This part of the required Critical Areas Study shall be performed as a three party agreement with the city selecting the consultant and the property owner or applicant paying the fees as required in ECDC 20.15B.140(D). The applicant may suggest qualified professionals for the City's approval. The qualified critical areas consultant shall perform the following: 1. Classification of the stream pursuant to the criteria established in ECDC Section 20.15B.060(A)(4). 2. Delineate the edge of the stream on the site. 3. State any mitigating measures appropriate to preserving and protecting the stream. 4. Determine whether or not a natural wetland exists on the property. If a wetland does exist, the qualified critical areas consultant shall perform the following evaluation of the wetland. Classify the wetland pursuant to the criteria established in ECDC Section 20.15B.060(A) (5). 2. Delineate the edge of the wetland on the site. 3. State any mitigating measures appropriate to preserving and protecting the wetland. After the qualified critical areas consultant has delineated the stream and wetland boundaries, a surveyor licensed by the State of Washington must perform the following: 1. Delineate the required buffer (see ECDC 20.15B.120.(A) and 20.15B.130.(C)). 2. Delineate the required building setback from the buffer (required setback is 15 feet). 3. Create a map showing the buffer and the building setback. The Land Surveyor is not required to enter into a three party contract. 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. 2. If development must occur within the critical area, buffer, and/or buffer setback, and is not identified as exempt per ECDC Chapter 20.15B, a Reasonable Use Exception and Variance must be obtained pursuant to ECDC 20.15B.170A and 20.15B.040C. 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)). OA 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 Campbell (L-- P July 10, 2001 Name Signature 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. 3 r. 1XI X. 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