S-06-144 SEPA Environmental Checklist.pdfJ J(
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Purpose OfChecklist: �
The State Envin}DOl8OtB| Policy Act XSEPA>, chapter 4321C F<CVV' requires all gOV8[Onnent8|
agencies to C0DSide[ the eDVinJnOleDt8| impacts Of G prOp0S3| before Dl@kiOQ decisions. An
8Ovin]DDl8Dt@| impact St8h3Dl8Dt (EIS) OlUSt be prepared for all pnJp0S8|S with probable significant
adverse iOlp8CtG on the quality of the eDvi[ODnl8Dt. The purpose of this checklist is to provide
information to help you and the agency identify impacts from your proposal (8Dd to reduce or avoid
iDlpGCtS from the p[OpOS@|' if it can be done) and to help the agency decide whether 8D EIS is required.
Instruction to :
This eOv[VDnneDt@| checklist asks you tO describe some basic information about your proposal.
G0veDlDleDt3| agencies Use this checklist to d8t80OiD8 whether the eDVin3Dnl8Dt8| impacts of your
pnOpO8a| are significant, requiring preparation of an B8. Answer the questions b[iefly, with the most
precise information known, Orgive the best description you can.
You DlUSt answer each qU8Sti0O aCCU[8t8|y and C8[efU||y, to the best 0fyour knowledge. In most
C8Ses' you GhOU|d be 8b|8 to answer the questions from your Ovvn obS8rV3tiODS OF project plans without
the need to hire experts. If you F8@||y do not know the @nsvv8F. or if qU8SU0O dO8S not apply to your
p[0p0S8|. write ''dO not hDOVV" or "does not 8pp|y"Complete answers tOthe qU8StiODS now may avoid
unnecessary delays later.
Some questions ask about governmental regU|@tiVOa' such as zoning, GhO[8|iOe' and |8DdDl8[k
designations. Answer these qVe8bVDS if you can. If you have prOb|8OlS, the governmental 8geDCi8S
can assist you.
The checklist qVHStiUOS apply to all parts of your pn]p0s@|' even if you p/8O to do them over
period of time or on different p@[C8|S of land. Attach any additional iDfO[O08tiOD that will help describe
your proposal O[its environmental effects. The agency tOwhich you submit this checklist may ask you
to HXp|3iO your @OGvve[O DF provide 8ddibOD8/ iDfO[03tiOO F8@GVD8b|y related to d8t8[DliDiOg if there may
b8significant adverse impact.
Use Ofchecklist fornon-project
Complete this checklist for non -project pnDpOS@|S.eVeOthOUghqUeGtioDsDl8ybe3DSVVened"dOeS
not apply". IN A[}0T|(}N. CQ0p|8t8 the SUPPLEMENTAL SHEET FOR NONPR{JJECTACT|ON8
(part D).
For nonproject 8CtiOOS. the [8f9neOcBS in the Ch8CNiGt to the words "project", "applicant", and
11
pnJp8rtyO[Sit9". should [8@d 88 "pnOpVS8|"' "pPDp098/'. and "affected g8Og[8phiC@PS@"' respectively.
Name of proposed project, if applicable:
STEVE MILES
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3. Address and phone number of applicant and contact person:
APPLICANT: STEVE MILES
7005174 th STREET S.W.
EDMONDS, WA 98026
CONTACT: WESTERN ENGINEERS, INC.
13000 HIGHWAY 99 SOUTH
EVERETT, WA 98204
(425) 356-2700.
4. Date checklist prepared:
JANUARY 25, 2010.
5. Agency requesting checklist:
CITY OF EDMONDS PLANNING & DEVELOPMENT SERVICES.
6. Proposed timing or schedule (including phasing, if applicable):
7. Do you have any plans for future additions, expansion, or further activity related to or
connected with this proposal? ..,If yes explain.
CONSTRUCTION OF 2 NEW SINGLE FAMILY UNITS.
8. List any environmental,,,,'information you know about that has been prepared, or will be
prepared, directly relayed to this proposal.
9. Do you know wliether applications are pending for governmental approvals of other
proposals directly affecting the property covered by your proposal? If yes explain.
NONE KNOWN.
10. List any, overnmental approvals or permits that will be needed for your proposal, if known.
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11. Give brief, complete description of your proposal, including the proposed uses and the
size of the project and site. There are several questions later in this checklist that ask you
to describe certain aspects of your proposal. You do not need to repeat those answers on
this page. (Lead agencies may modify this form to include additional specific information
on project description.)
DEVELOP 2.15 ACRES INTO A 4 LOT SHORT PLAT WITH ASSOCIATED SITE
AMENITIES. SAC -
12. Location of the proposal. Give sufficient information for a person to understand the
precise location of your proposed project, including a street address, if any, and section,
township, and range, if known. If proposal would occur over a range of area, provide the
range or boundaries of the site(s). Provide a legal description, site plan, vicinity map, and
topographic map, if reasonably available. While you should submit any plans required by
the agency, you are not required to duplicate maps or detailed plans submitted with any
permit applications related to this checklist.
SITE IS LOCATED IN THE NE 1/4, SW 1/4, SEC.8J.27N.,RAE., W.M., 7005 &
7027 174th STREET S.W..; EDMONDS, WA 98026. TAX # 00513100013806,
00513100013808, 00513100013812. Al
TO BE COMPLETED BY APPLICANT EVALUATION FOR
AGENCY USE ONLY
B. ENVIRONMENTAL ELEMENTS
1. Earth
a_.f3ePRxat description of the site (circle one): Flat, rolling( Illy,
steep �)
eep slope ountainous, other: ------ Uv
-n
b. What is the steepest slope on the site (approximate percent
slope)? 0 ' 2"
c. What general types of soils are found on the site (for example,
clay, sand, gravel, peat, muck)? If you know the classification of
agricultural soils, specify them and note any prime farmland.
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EVALLJ
d. Are there surface indications or history of unstable soils in the
immediate vicinity? If so, describe.
NONE KNOWN.
e. Describe the purpose, type, and approximate quantit7isof any filling or
grading proposed. Indicate source of fill.
E OTS FOR HOUSES.
V AND 1,100 CY FILL.
f. Could erosion occur as a result of cle I ring, construction, or use?
If so, generally describe.
g. About what percent of the
surfaces after project con,
buildings)? /
11-TAMMIC111111
e will be covered with impervious
ction (for example, asphalt or
h. Proposed measu s to reduce or control erosion, or other
impacts to the earZif any:
a 1 2 0 LOA
NMI
1777"- •UIREMENTS.
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2. Air
EVALUATION FOR
AGENCY USE ONLY
a. What types of emissions to the air would result from the proposal
(i.e., dust, automobile, odors, industrial wood smoke) during
construction and when the project is completed? If any, generally
describe and give approximate quantities if known.
DUST AND EQUIPMENT DURING CONSTRUCTION:
DELIVERY TRUCKS, AUTOS, ELECTRIC SAW AND RELATED
CONSTRUCTION EQUIPMENT. AFTER CONSTRUCTION:
AUTOS, TRUCKS, LAWN MOVERS, WEEDEATERS AND
RELATED RESIDENTIAL EQUIPMENT (I.E. LEAF BLOWERS
CHARCOAL BARBECUES, ETC.).
b. Are there any off-site sources of emissions or odor that may
affect your proposal? If so, generally describe.
NONE KNOWN.
c. Proposed measures to reduce or control emissions or other
impacts to air, if any:
CONFORM TO CITY OF EDMONDS AND STATE OF
WASHINGTON STATUTORY REQUIREMENTS.
3. Water
a. Surface
1) Is there any surface water body on or in the immediate vicinity of
the site (including year-round and seasonal streams, saltwater,
lakes, ponds, wetlands)? If yes, describe type and provide names. If
appropriate, state what stream or river it flows into.
NONE KNOWN.
2) Will the project require any work over, in, or adjacent to (within
200 feet) the described waters? If yes, please describe and attach
available plans.
IN
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EVALUATION FOR
AGENCY USE ONLY
3) Estimate the amount of fill and dredge material that would be
placed in or removed from surface water or wetlands and indicate
the area of the site that would be affected. Indicate the source of fill
material.
NONE.
4) Will the proposal require surface water withdrawals or diversions?
Give general description, purpose, and approximate quantities if known.
NOT APPLICABLE.
5) Does the proposal lie within a 100 -year floodplain? If so, note
location on the site plan.
NO. DOES NOT APPLY.
6) Does the proposal involve any discharges of waste materials to surface
waters? If so, describe the type of waste and anticipated volume of
discharge.
NO, DOES NOT APPLY.
b. Ground
1) Will ground water be withdrawn, or will water be discharged to
ground water? Give general description, purpose, and approximate
quantities if known.
NONE KNOWN.
2) Describe waste material that will be discharged into the ground from
septic tanks or other sources, if any (for example: Domestic sewage,
industrial, containing the following chemicals: agricultural: etc.)
Describe the general size of the system, the number of such systems, the
number of houses to be served (if applicable), or the number of animals or
humans the system(s) are expected to serve.
NONE KNOWN.
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c. Water Runoff (including storm water):
1) Describe the source of runoff (including storm water) and method
of collection and disposal, if any (include quantities, if known).
Where will this water flow? Will this water flow into other waters? If
so, describe.
SURFACERUNOFF FORDEVELOPED
SITE WILL DRAIN • INDIVIDUAL DETENTION
STRUCTURES LOCATED ON EACH LOT. STORM
WATER RELEASE FROM EACH DETENTION
STRUCTURE TO DRAIN TO THE NORTHEAST CORNER
*F THE SITE WHICH THEN TRAVELS NORTHAND
ENTERS • THE •
SYSTEM LOCATION ON • OF
MEADOWDALE BEACH ROAD. SEE DRAINAGE
REPORT.
2) Could waste materials enter ground or surface waters? If so,
generally describe.
IN
d. Proposed measures to reduce or control surface, ground, and
runoff water impacts, if any:
Plants
I. - •� •
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a. Check or circle types of vegetation found on the site:
_XX deciduous tree: alder, maple, aspen, other: COTTONWOOD, POPLAR
XX evergreen tree: fir, cedar, pine, other: Hemlock
_XX_ shrubs, EVERGREEN BLACKBERRIES
®XX® grass
pasture
crop or grain
wet soil plants, buttercup, bulrush, skunk
cabbage, SOFT RUSH, VELVET GRASS
water plants: water lily, eelgrass, milfoil, other
other types of vegetation
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b. What kind and amount of vegetation will be removed or altered?
Mr.1111910 0101006311104CM
c. List threatened or endangered species known to be on or near
the site.
NONE KNOWN.
d. Proposed landscaping, use of native plants, or other measures to
preserve or enhance vegetation on the site, if any:
PIA 011611 _ _ jQA I M04011MOF-Al
5. Animals
a. Circle any birds and animals which have been observed on or
near the site or are known to be on or near the site:
birds: hawk, heron, eagle, songbirds, other: CROW, ROBIN, SPARROW
mammals: deer, bear, elk, beaver, other: RO
fish: salmon, trout, herring, shellfish, other: NONE
b. List any threatened or endangered species known to be on or
near the site.
NONE KNOWN.
c. Is the site part of a migration route? If so, explain.
NONE KNOWN.
d. Proposed measures to preserve or enhance wildlife, if any: �n e,,:
NONE. J
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EVALUATION FOR
AGENCY USE ONLY
6 Energy and Natural Resources
a. What kinds of energy (electric, natural gas, oil, wood stove, solar)
will be used to meet the completed project's energy needs?
Describe whether it will be used for heating, manufacturing, etc.
ELECTRIC AND NATURAL GAS FOR EATING/COOKING
AND POSSIBLE WOOD STOVES OR FIREPLACES.
b. Would your project affect the potential use of solar energy by
adjacent properties? If so, generally describe.
NO EFFECT.
c. What kinds of energy conservation features are included in the
plans of this proposal? List other proposed measures to reduce or
control energy impacts, if any:
INSULATION OF HOUSES IN ACCORDANCE WITH
APPLICABLE CODES.
7. Environmental Health
a. Are there any environmental health hazards, including exposure
to toxic chemicals, risk of fire and explosion, spill, or hazardous
waste, that could occur as a result of this proposal? If so, describe.
POSSIBLE FUEL SPILLAGE DURING CONSTRUCTION.
1) Describe special emergency services that might be required.
HAZARDOUS WASTE CLEAN-UP.
2) Proposed measures to reduce or control environmental health
hazards, if any:
•► C_G •: � ':• `ill
b. Noise
1) What type of noise exist in the area which may affect your project
(for example: traffic, equipment, operation, aircraft, other)?
RESIDENTIAL EQUIPMENT: LAWN MOWERS, CHAINSAWS, ETC..
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2) What types and levels of noise would be created by or
associated with the project on a short-term or a long-term basis (for
example: traffic, construction, operation, other)? Indicate what
hours noise would come from the site.
SHORT TERM: SAWS, BACKHOES, TRUCKS,
COMPRESSORS, STAPLERS,
00A TO 700 P.M.
LONG TERM: AUTO, TRUCKS, WEEDEATERS, LAWN
MOWERS, ETC.
3) Proposed measure to reduce or control noise impacts, if any:
8. Land and Shoreline Use
a. What is the current use of the site and adjacent properties?
SITE = RESIDENTIAL (RS -20).
ADJACENT = RESIDENTIAL (RS -20).
b. Has the site been used for agriculture? If so describe.
K91
c. Describe any structures on the site.
2 EXISTING HOUSES.
d. Will any structures be demolished? If so, what?
Kel
e. What is the current zoning classification of the site?
f. What is the current comprehensive plan designation of the site?
SINGLE FAMILY - URBAN 1.
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PAGE 10 OF 15
g. If applicable, what is the current shoreline master program
designation of the site?
h. Has any part of the site been classified as an "environmentally
sensitive" area? If so, specify.
NONE KNOWN
I. Approximately how many people would reside or work in the
completed project?
4 SINGLE FAMILY UNITS:
2.7 PER RESIDENCE = 2.7 X 4 = 10.8.
j. Approximately how many people would the completed project
displace?
NONE,
k. Proposed measures to avoid or reduce displacement impacts, if any:
I. Proposed measure to ensure the proposal is compatible with
existing and projected land uses and plans, if any:
9. Housing
a. Approximately how many units would be provided, if any?
Indicate whether high, middle, or low-income housing.
b. Approximately how many units, if any, would be eliminated?
Indicate whether high, middle, or low-income housing.
c. Proposed measures to reduce or control housing impacts, if any:
STORM WATER DETENTION. EXISTING TREE AND
VEGETATION RETENTION.
RAI DSERVER\2006\06802\E NG I NEERI NG\ SEPA 01-25-10
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PAGE 11 OF 15
EVALUATION FOR
AGENCY USE ONLY
10. Aesthetics
a. What is the tallest height of any proposed structure(s), not
including antennas; what is the principal exterior building material(s)
proposed?
25 -FEET, MAXIMUM HEIGHT PER CITY CODE.
MATERIAL: WOOD.
b. What views in the immediate vicinity would be altered or
obstructed?
c. Proposed measures to reduce or control aesthetic impacts, if
any:
EXSITING TREE AND VEGETATION RETENTION.
11. Light and Glare
a. What type of light or glare will the proposal produce? What time
of day would it mainly occur?
RESIDENTIAL LIGHTING — EARLY MORNING AND
EVENING HOURS.
b. Could light or glare from the finished project be a safety hazard
or interfere with views?
NO.
c. What existing off-site sources of light or glare may affect your
proposal?
NONE KNOWN.
d. Proposed measures to reduce or control light and glare impacts,
if any:
PERIMETER TREE AND VEGETATION RETENTION.
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EVALUATION FOR
AGENCY USE ONLY
12. Recreation
a. What designated and informal recreational opportunities are in
the immediate vicinity?
SNOHOMISH COUNTY PARK 1/2 MILE SOUTH OF SITE,
AND MEDOWDALE PLAYFIELDS 1/4 MILE NORTHEAST OF
SITE.
b. Would the proposed project displace any existing recreational
uses? If so, describe.
im
c. Proposed measures to reduce or control impacts on recreation,
including recreation opportunities to be provided by the project or
applicant, if any:
fEel ►ICIIIIN, 0[93►IO►/0�
13. Historic and Cultural Preservation
a. Are there any places or objects listed on, or proposed for,
national, state, or local preservation registers known to be on or
next to the site? If so, generally describe.
l61 Eel 01:4:1ki[93►�►104
b. Generally describe any landmarks or evidence of historic,
archeological, scientific, or cultural importance known to be on or
next to the site.
NONE KNOWN.
c. Proposed measures to reduce or control impacts, if any:
NONE PROPOSED.
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File] q 0 LON&K &I a•SO 0 1 WA
14. Transportation
a. Identify public streets and highways serving the site, and
describe proposed access to the existing street system. Show on
site plans, if any.
ACCESS FOR LOTS 1 AND 2 WILL BE VIA AN EXISTING
PRIVATE DRIVEWAY TO 174t' STREET S.W. ACCESS FOR
LOTS 3 AND 4 WILL BE VIA AN EXISTING PRIVATE
DRIVEWAY TO 174th
STREET S.W. SEE SITE PLAN.
b. Is site currently served by public transit? If not, what is the
approximate distance to the nearest transit stop?
NO. PUBLIC TRANSIT HAS STOPS APPROXIMATELY 1/4 MILE
EAST ON OLYMPIC VIEW DRIVE.
c. How many parking spaces would the completed project have? '/ � ',,1 <',
How many would the project eliminate? ""N"
2 PER NEW RESIDENCE, (2 X 2) = 4, NONE ELIMINATED.
d. Will the proposal require any new roads or streets, or NV
improvements to existing roads or streets, not including driveways?
If so, generally describe (indicate whether public or private).
THERE ARE NO PUBLIC ROADS PROPOSED FOR THE SITJ
ACCESS TO BE PROVIDED BY 2 AND 3 LOT PRIVATE
ACCESS EASEMENTS.
e. Will the project use (or occur in the immediate vicinity of) water,
rail, or air transportation? If so, generally describe.
ZIN
f. How many vehicular trips per day would be generated by the completed
project? If known, indicate when peak volumes would occur. C, -X
9.57 ADT PER NEW DWELLING UNIT. 9.57 X 2 = 19.14,
g. Proposed measures to reduce or control transportation impacts, if any:
APPLICABLE FEES PER CITY OF EDMONDS.
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15. Public Services
a. Would the project result in an increased need for public services (for
example: fire protection, police protection, health care, schools, other)?
If so, generally describe.
YES, DUE TO THE ADDITION OF 2 NEW SINGLE FA �`LY
RESIDENCES.
b. Proposed measures to reduce or control direct impact§,'bn public
services, if any.
1. PROPOSAL WILL GENERATE N
REVENUE.
16. Utilities
b. Describe the utilities that are propps " ed for the project, the utility providing
the service, and the genera 1�constru cti on activities on the site or in
the immediate vicinity which might be needed.
P
The ab?ye answers are true and correct to the best of my knowledge. I understand that
the lead agency is relying on them to make its decision.
S'/ 0 /
gnature:
Date Submitted: 12- 1--3 (10
RAI DSERVER\2006\06802\ENG IN EERI NG\ SEPA 01-25-10 PAGE 15 OF 15
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Address and phone number of applicant and contact person:
APPLICANT: STEVE MILES
7005 174th STREET S.W.
EDMONDS, WA 98026
CONTACT: WESTERN ENGINEERS, INC.
13000 HIGHWAY 99 SOUTH
EVERETT, WA 98204
(425) 356-2700.
Date checklist prepared:
JANUARY 25, 2010. Revised March 9, 2011
Agency requesting checklist:
CITY OF EDMONDS PLANNING & DEVELOPMENT SERVICES.
Proposed timing or schedule (including phasing, if applicable):
WITHIN ONE YEAR FOLLOWING CITY APPROVALS.
Do you have any plans for future additions, expansion, or further activity related to or
connected with this proposal? If yes explain.
CONSTRUCTION OF 2 NEW SINGLE FAMILY UNITS.
List any environmental information you know about that has been prepared, or will be
prepared, directly related to this proposal.
GEOTECHNICAL AND DRAINAGE REPORT.
Do you know whether applications are pending for governmental approvals of other
proposals directly affecting the property covered by your proposal? If yes explain.
NONE KNOWN.
List any governmental approvals or permits that will be needed for your proposal, if known.
ALL NECESSARY APPROVALS AND PERMITS REQUIRED BY CITY OF
EDMONDS PLANNING DEV. SERVICES AND/OR STATE AGENCIES
INCLUDING BUT NOT LIMITED TO: CLEARING, DETAILED DRAINAGE,
FRONTAGE IMPROVEMENTS AND BUILDING PERMITS.
RAI DSERVER\2006\06802\ENGINEER] NG\ SEPA 03-28-11 PAGE 2 OF 15
0a" FO
AGENCY USE ONLY
d. Are there surface indications or history of unstable soils in the
immediate vicinity? If so, describe.
NONE KNOWN.
e. Describe the purpose, type, and approximate quantities of any filling or
Y,
grading proposed. Indicate source of fill.
GRADING WILL OCCUR ON SITE FOR PROPOSED DRIVEWAY,
DRAINAGE AND UTILITY CONSTRUCTION. MINIMAL GRADING
TO CREATE DRIVEWAYS AND LEVEL LOTS FOR HOUSES.
QUANTITY: ESTIMATE 1,050 CY CUT AND 1,100 CY FILL.
SOURCE: ON-SITE. c
NOTE: GRADING QUANTITIES SHOWN REPRESENT MINIMAL EXCAVATION
FOR REQUIRED SITE IMPROVMENTS, PRIOR TO BUILDING INSTALLATION.
APPROXIAMTE ADDITIONAL EXCAVATION FOR FUTURE SFR FOUNDATION
IS ESTIMATED AT 200 CY CUT AND 200 CY FILL DEPENDING ON HOUSE
DESIGNS.
f. Could erosion occur as a result of clearing, construction, or use?
If so, generally describe.
YES, HOWEVER MINIMIZED BY THE USE OF BMPS.
g. About what percent of the site will be covered with impervious
surfaces after project construction (for example, asphalt or
buildings)?
APPROXIMATELY 24,78% FOR NEW BUILDINGS,
DRIVEWAYS, AND PRIVATE ROADS ROAD.
h. Proposed measures to reduce or control erosion, or other
impacts to the earth, if any:
PREVENTATIVE MEASURES SUCH AS, BUT NOT LIMITED TO,
STRAW BALES, SILT FENCING, CATCH BASIN PROTECTION,
STAGED CLEARING ETC. WILL BE UTILIZED IN
CONFORMANCE WITH SOUND CONSTRUCTION PRACTICES
AND CITY REQUIREMENTS.
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EVALUATION FOR
AGENCY USE ONLY
15. Public Services
a. Would the project result in an increased need for public services (for
example: fire protection, police protection, health care, schools, other)?
If so, generally describe.
YES, DUE TO THE ADDITION OF 2 NEW SINGLE FAMILY
RESIDENCES.
b. Proposed measures to reduce or control direct impacts on public
services, if any.
1. PROPOSAL WILL GENERATE NEW TAX AND USE
REVENUE.
16. Utilities
a. Ci � 'ti av � t the ria n
gas Ovate , use servic elephone nitary se
system, other.
CABLE TELEVISION.
b. Describe the utilities that are proposed for the project, the utility providing
the service, and the general construction activities on the site or in
the immediate vicinity which might be needed.
ELECTRICITY — SNOHOMISH COUNTY P.U.D. NO. 1
WATER — CITY OF EDMONDS
SANITARY SEWER — CITY OF EDMONDS
TELEPHONE — FRONTIER
CABLE TELEVISION — COMCAST
CIS+y[�7�1_r�11�
I declare under penalty of perjury laws that the above answers are true and correct to the best of my
knowledge. I understand that the lead agency is relying on them to make its decision.
Signatur f Proponent
RAI DSERVER\2006\06802\E NGI NEE RING\ SEPA 03-28-11
Oa l )I
Date Submitted
PAGE 15 OF 15
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