S-61-21.pdf'
#P20
CA File No:. 65
Critical Areas Checklist
Site Informaftion (soils/topography/hydrology/vegetation)
1. , Site Address/ Location: 'd 31 vy tv
2. Property TaxAccount Number: i ! f o o Z,
3. Approximate Site Size (acres or square feet): E]► Z . 06 c UlC
4. Is this site currently developed?v' yes; no.
if yes; how is site developed? (Vt
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: t b ; Approx. Depth:
7. Site contains areas of seasonal standing water: ND ; 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? ).
10. Site is primarily: forested ; meadow shrubs ; mixed _- -- -
urban landscaped (lawn, shrubs etc),
11. Obvious wetland is present on site: A)b
4. Critical Areas inventory or C.A. snap indicates Critical Area on site? N b nf., 5h bW YZ .
S. Site within designated earth subsidence landslide .hazard area? O. 8 Ul i i d i V1 G1 of- l C- Gt f fiD .
maVe, ffnal d-twm.inU-hQn -
DETERMINATION
STUDY REQUIRED - WAIVER
Reviewed b Date: (01 A
r
City of Edmonds
Development Services
Planning Division V E
Phone: 425.771.0220
JA J 12005
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: () (0 114- i 0 15 --
City ReoeiPt #: Q, (a 5 J.:aL— -
)Critical Areas Filii#-: G A I ?,Vt)1�5 * 0 9 (0
Critical Areas Checklist Fee: $135.06
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 comp their preliminary assessment of the site.
woy(4111AO
The undersigned applicant, and bis/her/its heirs, and assigns, in consid on 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 infonnation and exhibits herewith.. submitted are true. and. correct to the best of my
knowledge and that I am authorize
file this tion oehalf o e owner as listed below.
SIGNATURE OF APPLwANTI-.�15� .
Property Owner's. Authorization
By my . signa . ture, 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 M'specti n. d posting attendant to this application.
SIGNATiIUJI�<OF OWNER DATE
Owndr/Applicant: Applicant Representative:
Name Name
qtrpet Address Street Address
City State.. City State zip
-4 7
Telephone: ;�Vj Telephone -
Email address (optional): 12 C4,q 5 -Y -5-V 0- V e 07 -bYA, Email Address (optional):
PLANNING DATA
NAME: H lh Vl tf-' r d d ��lm Dd �,1�DATE:O!R I I q [ 2D v 5
SITE ADDRESS: T PLAN CHK#:
PROJECT DESCRIPTION: IZPelvl n rl,s,l 2. P vy 1 n ,-?2-p- !'YI /) A4 --p -&- k at�,
REDUCED SITE PLAN PROVIDED?: es I No}
MAP PAGE. b d � CORNER LOT: (Yes I No) *-FLAG LOT:es)f No}
ZONING: P-Gj • }'J. CRITICAL AREAS DETERMINATION #--05 • S (o
❑ Study Re uired_
® Waiver
❑ Conditional Waiver
SEPA DETERMINATION: �ii{-P/INt
❑ Fee
❑ Checklist
❑ APO list wf notarized form
❑ (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft_ of Puget Sound or Lake Ballinger)
® Exempt
ifC SETBACKS: alt 15 &I, GjQ*b&l LIGE
Required Setbacks:\A/
N tet:;. LQ Side:_.... 1R;gf%.t Side - --Lu U ftar:j b
Actual Setbacks:
N Suet: 4i` Left de:�0 0 _R49W Side: r f ("tU CL d dI` t1 ZiY1
Street map checked for additional setback required? (Yes I No I NA)
® DETACHED STRUCTURES: Q f>( ('cj-h rj G1 (ODD g a, -A 16, 4 '3-11 +Yom
ROCKERIES: 4 flj� Y15
00✓✓
FENCES/TRELLISES: R
❑: BAY WINDOWS I PROJECTING MODULATION:
❑ STAIRS/ DECKS: ,
PARKING: Required: 2- Actual: 10
LOT AREA: 13! q 3q
LOT COVERAGE:
3Zz�J [�VTitrGi
Calculations: %i�"�•
BUILDING HEIGHT_
Datum Point: ' Datum Elevation: �#
Maximum Allowed-�/ 'rJ I Actual Height:_N(Al A- N & E
A_D_U. CREATED?: No Yes
SUBDIVISION: 5 "" q (V I~ 7A dIr, CXA-Ab-.v I Ci to I Q e
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: (Yes No)
Plan Review BY _ ((�-
NewB PP ialingDataform _DOC
-5y
December 26, 1961
Louie B. May
P. 0. Box 67
Edmondso Washington
Dear Mr. May:
The Planning Commission of the City of Edmonds wishes to advise yoU
.that your request for sub -division of your property as described in
your File #S-21-610 has been approved.
Yours very truly,
PLANNING COMMISSION
CITY OF EDMONDS
(secretary)
Mh
7,7
.7777T777'
December 26, 1961
Louie B. May
P. 0. Box 67
Edmondso Washington
Dear Mr. May:
The Planning Commission of the City of Edmonds wishes to advise yoU
.that your request for sub -division of your property as described in
your File #S-21-610 has been approved.
Yours very truly,
PLANNING COMMISSION
CITY OF EDMONDS
(secretary)
Mh
REZONING - FEE $10.00
SUBDIVISION- RECEIPT Ido
DATE
WIE LOU E E B. MAY
ADDRESS 19117 OLYMPIC VIEW DR., EDMONDS, WASH.
PHO Mi PR 8-5646
REQUEST SUBDIVISION OF PORTION OF GOVERNMENT LOT 3 SECTION 13
T27N, R3E, W.M.
PROPERTY DESCRIPTION
COMMENCING AT THE NORTHEAST CORNER OF SAID Gov. LOT 3; THENCE 58.8°33'00"W
ALONG THE NORTH LINE THEREOF 43ZV. FEET; THENCE'4 ET
TO THE TPB.• THENCE CONTINUING S37°17'00"W,363.55 FEET; THENCE N88°33'00"E
341.63 FEET; THENCE N1°52100"W 25 FEET;THENCE N32 00'00 E 125,24 FEET;
THENC N51°21'10"W 239.25 FEET To TPB.
SKETCH: (Sketch of property to be rezoned or subdivided showing streets,,
property lines,, etc.)
ATTACHED