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23700 Edmonds Way-Areas checklist#P20 Critical Areas File M C11 Initial Determination - $110pO ❑ Subsequent Determination - $50,°o Date Received: Date.Malled to Applicant: The purpose of this checklist is to enable City staff to determine whether any critical areas and/or buffers are located on or adjacent to the subject property. Critical areas, such as wetlands, streams and steep slopes, are ecologically sensitive or hazardous areas that are regulated to protect their functions and values. The City's critical area regulations are contained within Edmonds Community Development Code (ECDC) Chapters 23.40 through 23.90. Property Owner's Authorization City of Edmonds -. Development Services`Department Planning Division Phone: 425.771.0220 www.edmondswa.gov°`• t g90 A property owner, or an authorized representative, must fill out the checklist, sign and date it, and submit it to the City. Staff will review the checklist, conduct a site visit, and make a determination of whether there are critical areas and/or critical area buffers on or near the site. 1f a "Critical Area Present" determination is issued, a report addressing the applicable critical area requirements of ECDC Chapters 23.40 through 23.90 may be required depending on the scope of the proposed activity. By my signature,) certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge 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 attendant to this application. The undersigned owner, and his/herrits 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, nisleading, inaccurate or incomplete information furnished by the applicant, his/hertits agents or employees. � ,� , — ,, -11 SIGNATURE OF OWNER Owner: Name ,13-7 Ob 6rl w,ny\e c J a,1 Street AddressAga �j h / lAA&)�N S' fn2 OL7-G? City State zip Telephone: y -,C— :J'S'n —S,13 a Email address: CA-) Coo DATE Applicant/Agent: r- rIco t_oe-r►lC Name 3 190 .Srt-one A- 16 Street Address City State zip Telephone:_ o�Ooo �V7- % Email Address: _IO%&AV,, d en VbW . C o117 Revised on 114117 P20 - Critical Areas Checklist Page I of 2 CA File No: #P20 Critical Areas Checklist Site Information y�� /, ,dNronG�S��% 1. Site Address/Location: ; 37CO Ed rwl)�S 0,l1 9 �0�6 2. Property Tax Account Number: / 7 a 3. Approximate Site Size (acres or square feet): d AST d G2C5 4. Is this site currently developed? Ayes ❑ No If yes, how is the site developed? l) ed 1' n f o__ O r-%',e 5. Describe the general site topography. Check all that apply. Flat to Rolling: No slope on/adjacent to the site or slopes generally less than 15 (a vertical rise of 10-feet over a horizontal -distance of 66-feet). ❑ Moderate: Slopes present on/ to site of more than 15 % and less than 40% (a vertical rise of 10-feet over a horizontal distance of 25 to 66-feet). ❑ Steep: Slopes of greater than 40% present on/ to site (a vertical rise of 10-feet over a horizontal distance of less than 2.5-feet): 6. Have there been landslides on or near the site in the past? ❑ Yes K No If yes, please describe: 7. Site contains areas of year-round standing water? ❑ Yes (approx. depth: ) kA No 8. Site contains areas of seasonal standing water? ❑ Yes (approx. depth: ) ONo If yes, what season(s) of the year? 9. Site is in the floodway or floodplain of a water course? ❑ Floodway ❑ Floodplain 10. Site contains a creek or an area where water flows across the grounds surface? ❑ Yes LITLV o If yes, are flows year-round or seasonal? ❑ Year-round ❑ Seasonal (time of year: ) 11. Obvious wetland is present on site? ❑ Yes Rk ,No For City Staff Use Only 1. Zoning. 3. SCS mapped soil type(s): 3. Critical Areas inventory or C.A. map indicates Critical Area on site: 4. Site within designated North Edmonds Earth Subsidence and Landslide Hazard Area (ESHLA)? DFTERMI NATION CRITICAL AREAS PRESENT Reviewed by: Date: ►0 Revised on 114117 P20 - Critical Areas Checklist Page 2 of 2