CRA20130102_21607-81stAveW.pdf'4e. 1 S91
CITY
Ixa OF EDuONDS
121 5"' Avenue North, Edmonds WA 98020
Phone: 425.77}.0220°Fax: 425.77l.027l°Web: `9vvp/.EdmoudoW/\.guv
DEVELOPMENT SERVICES DEPARTMENT ° PLANNING DIVISION
Date: September 23, 2013
To: Jill Cartwright — 21607 81st Avenue West, Edmonds WA 98026
Eagle Creek Builders —D39Margie AnnDr,[anoano|s.\NA9D282
Subject: Critical Areas Checklist Determination
Address: 21607 u
Ave W, Edmonds
File Number: CRA ]Ol3OlO2
Comment: Enclosed, please find acopy ofthe Critical Areas Checklist that you
submitted. You will find staff's determination atthe bottom ofthe
second page ofthe checklist. |fyou have any questions, please contact a
Planner for more information.
Sincerely,
Gina Janiceb :AssociatePkxnner
City of Edmonds Development Services Department
121 6'hAvenue North, Edmonds VVA98O2O
425771.0220x1778 1
1111 , Ill
V1111 I I (f! I III[ I CII
TTITHI, "11 �01
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*
City Receipt
Critical Areas File 1 0
Critical Areas Checklist Fee: $155.00
Date Mailed to Applicant: 2.,b - !�- 0 1 ';� _
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 informati and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file t application on the behalf of the owner as listed below.
SIGNATURE OF APPLICANT/AGENT DATE D
Property Owner's Authorization
By my signature, I certify that I have authorized the above Applicant/ I 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 inspec�tion-and-pwtiiig, attendaiiVo this application,,,
Owner/Applicant:
Name
AN
Street Address
�A
City State Zip
DATE
Applicant Representative:
Name
Street Address
Ga K �Yl a k �C)
City State Zip
Telephone: 2
�C*? Telepbone.-41',�,5
Email address:
Email Address:uklt (,t ��t�-"-TUX,j
Revised on 12118112 P20 - Critical Areas Checklist. doe Page 1 of 2
4P2 0 'CA File No: to ('60 1
Critical Areas Checklist
site informa tion (s oiis/ topography/ hy*ology/ vegetation)
i. Site Address/Locaiian: IV(Pui q)�eDt- b&� )� —
2. Property Tax Account Number: _0t 0 ®® 53
01
3. Approximate Site Size (acres or square feet):
4, is this site currently developed? X yes; —'no.
If yea; how is site developed?
5. Describe the general site topography. Check all that apply.
Flbt: 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)... . V
Hilly: slopes present on site of more than 15% and, less than 30% (a vertical rise of 110 -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
distan'ce of less than 33 -feet)
Other (please describe)
6. Site contains areas -Approx. Depth: of year-round standing water:
7, Site contains areas of seasonal standing water: _Z_a_; 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-ro-und?
(What time of year?
–Flows are seasonal?
dow shrubs r
mca M, ed
10. Site is primarily: forested
urban landscaped (lawn,) etc)
44
4. Critical Areas inventory or C.A. map indicates Critical Area on site?
5. Site wjthin designated earth subsidence landslide hazard area?
SITE DETERMIN—ATION WAIVER
_5TUDY REQUIRED
ewed Date-,
Revi
Revised on 12118112 P20 - Critical Areas Checklisr.doc I Page 2 of 2