CRA2017-0141#P2O
Critical Areas File #: rU--t,�b1—+01 L I
Initial Determination - $100
❑ Subsequent Petermination - $50
Date Received: s I 2
Date Mailed to Applica t: 1 $
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
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. If 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, I 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/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, mi�l�ading, inaccurate or incomplete information furnished by the applicant, his/her/its
agents or employees. � )
SIGNATURE OF OWNER DATE VAZ121) 2—
Owner: Applicant/A nt:
Name Name
Street Address 1,Y7 6M000 ,fyk- I r"JZ 1�'N Street Address
City W"-State Zip City State / Zip
Telephone: �"U`I ' ��—aZ� Telephone: G L' o(�
Email address: /Ud� �' W/� �-���' S`�c ,lEmail Address: F94d 6
Revises! on 114117 P20 - Critical Arcas Checklist Page I of 2
1P
CA File No: ck\q 2. b 1 _4 o L A� #P20
Critical Areas Checklist
Site Information l(
1. Site Address/Location: 00 I!: U I✓l e1r�/c J
2. Property Tax Account Number: g 0 0cx-)
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? ,Yes ❑ No
If yes, how is the site developed? S F R
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/adjacent to site (a vertical rise of 10-feet over a
horizontal distance of less than 25-feet).
6. Have there been landslides on or near the site in the past? ❑ Yes No
If yes, please describe:
7. Site contains areas of year-round standing water? ❑ Yes (approx. depth: )J No
8. Site contains areas of seasonal standing water? ❑ Yes (approx. depth: ) f\No
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 No
If yes, are flows year-round or seasonal? ❑ Year-round ❑ Seasonal (time of year: )
11. Obvious wetland is present on site? ❑ Yes V_ No
1. Zoning: S_ i Z
3. SCS mapped soil type(s)
_V
For City Staff Use Only
3. Critical Areas inventory or C.A. map indicates Critical Area on site: X'A
—t J
4. Site within designated North Edmonds Earth Subsidence and Landslide Hazard Area (ESHLA)? P v ✓
DETERMINATION
CRITI!�;AL AREAS PRESENT
Reviewed by ,
/K - WAIVER
Date: 2
Revised on 114117 P20 - Critical Areas Checklist Page 2 of 2