CRA20020077.PDFGRA20D2oo'1�
OF EDo� City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
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, . „ _ C)
City Receipt #: I�7
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 au mbzed to file this application on the behalf of the owner as listed below.
SIGNATURE OF
DATE -V 2 3 " O Z
Property Owner's Autho?iizaCion
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
PLEASE PRINT CLEARLY
Owner/Applicant:
Name
Street Address
City State Zip
Telephone:
Email address (optional):
DATE
Applicant Representative:
V7 a, )4 L4d(7 k
Name
71015 SDI c fir' Va /la V-1JY
Street Address
EJV"0VIA wg. 178024
City State Zip
Telephone: C� Z S,' % 7 5- - / 1. ° /
Email Address (optional):
Critical Areas Checklist.doc/3.19.2001
y5 00
Critical Areas Checklist CAFileNo: 0a-17
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/ Location: / 6 2 Z / - 75- ?'y PL . tN, EEo M
2. Property Tax Account Number: OO Si3% 600 06,$- oo
3. Approximate Site Size (acres or square feet): APR 2 3 2002
4. Is this site currently developed? V yes; no.
If yes; how is site developed? 51 r !�
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: No ; 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?
Flows are seasonal? ✓ (What time of year? 'W ► n 4--r ).
10. Site is primarily: forested ; meadow ; shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: /V b
For
:1. J.- Plan Check Number,' if applicable?
2. Site�is'Zoned?
3. SCS mapped soil.type(s)?
Use Only
4. Critical Areas inventory or C.A. map indicates Critical Area on site? _
5. Site within designated earth subsidence landslide hazard area?
DETERMINATION."
Reviewed Daft-_
'WAIVER
Critical Areas Checklist.doc/3.19.2001
City of Edmonds
Critical Areas Determination
Applicant: Steven J. Hudak Determination #: CA-02-77
Project Name: Permit Number:
Site Location: 16221 75`h Pl. W � Property Tax Acct #: 00 5131 000 065 00
Project Description:
Non -Project Specific
Determination: Study Required:
During review and inspection of the subject site, it was found that the site has some potential for steep
slopes on portions of the property and/or adjacent to the property pursuant to Chapter 20.15E of the
Edmonds Community Development Code (ECDC). Based on these findings, prior to submission of any
building permit, you will be required satisfy the requirements of ECDC 20.15B by completing the
following:
THE "STUDY REQUIRED" PROCESS:
1. First Step: In order to determine whether or not a steep slope does in fact exist on your property
and/or is adjacent to your property, you are required to submit a topographic survey. This survey
must be completed by a Licensed Land Surveyor (with a professional stamp on the drawing). The
survey must include the following information:
A. Top of the slope
B. Toe of the slope
Note: If there is not an obvious break in the topography to indicate the
top and toe of the slope, then a Geotechnical Engineer may be required
to locate the top and the toe of the slope. Refer to the City Code section
ECDC Chapter 20.15B.
2. Second Step, if deemed necessary: If you feel that you need to have the proposal located in the
buffer area or in the critical area, then you may apply for a Steep Slope Exemption, Critical Areas
Exemption, or Conditional Waiver. It is important to understand that not every applicant will qualify
for the exemptions and waivers listed above. Only a few applications are issued exemptions and
waivers on a project by project basis.
Please do not submit any new materials, such as Geotech Reports, elevations, soil reports,
unless you have received an official memo from the City requesting additional information and
al.
Name
signature
Date
City of Edmonds
Critical Areas Determination
Applicant: Phyllis Lawson Determination #: CA-02-77
Project Name: Fire - Rebuild Pen -nit Number: PC-03-346
Site Location: 16221 — 75th Place W. Property Tax Acct #: 5131 000 065 00
Project Description:
To reconstruct a two-story house with basement on the existing
foundation of a structure that burned.
Waiver Criteria (all criteria must be found to apply):
X There will be no alteration of the Critical Area or its required buffers;
X The development proposal will not impact the Critical Area in a manner contrary to
the goals, purposes, objectives and requirements of the Critical Areas ordinance;
X The development proposal meets the minimum standards of the Critical Areas
ordinance;
X The above findings are based on the following conditions of approval:
1. This conditional waiver is only for work done within the existing footprint of
the existing house, except the cantilevered floors outside the footprint are
also acceptable.
2. No work shall be done that creates the potential of soil movement or risk of
harm or damage to existing uses or development, or to the public safety
(ECDC 20.15B.040.A.2).
3. This conditional waiver does not include pin walls or retaining walls done
outside of the building footprint.
4. A building permit is required for all work.
Based on the above findings and conditions, the requirement for a Critical Areas Study
associated with this development permit is hereby Waived, as authorized by Chapter 20.15B.040
(A)(1) of the Edmonds Community Development Code.
Meg Gruwell __ _ 10/03/2003