1050 ROBBERS ROOST RD.PDF1050 ROBBERS ROOST RD
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location
CA File No: C�'
R-®, /23t5`� MIGW�
2. Property Tax Account Number:
3. Approximate Site -Size (acres.or.square:feet): `.:'off SAU(q j,`'S 5G C4 . .
4. Is this site currently developed? yes; no.
If yes; how is site developed? !�1 ncAi_ l2QS. Vvo-r1 .e. or, `/� l O-A-
5. Des ' e the general site topography. Check all that apply.
Flat: less than 5-feet elevation chang a 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.lWand--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: NO ; Approx. Depth:
7. Site contains areas of seasonalstanding water:: ;Approx. Depth:
What season(s) of the year?
...........
8. Site is in the floodway -' NQ' 166;dplain ` N n of a water course.'
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
T�(o Flows are seasonal? (What time of year? ).
10. Site is primarily: forested meadow shrubs ; mixed
urban landscaped (lawri,shrubs etc)
11. Obvious wetland is present on site: N C)
Critical Areas Checklist.doe/3.19.2001
City Of Edmonds... Date Received: /
Development Services Department City Receipt #: 9 S S" L/
Planning Division Critical Areas file.
Phone: 425.771.0220 Y , Critical Areas Checklist Fee: • $45.00
Fax: ``425.771`0221 ��_4 . Date Mailed to Annlicant
The Critical Areas Checklist contained on this form is .to -. A property owner, or his/her authorized representative,
be filled out by any person preparing_ a Development_,-, must fill out.the. checklist, sign and, date it, and submit it
Permit Application for the' City of Edmonds prior' to • 'to the' City , The' City• will review the checklist,, make a
his/her submittal of the application to the City. precursory site • visit"' and.. make a determination: of the
The purpose of the Checklist is to enable City staff, to.: subsequent .ill -1 ,necessary ;to„complete ...4 ,development
determine whether any potential Critical Areas are„ ,or. penmt application
may be, present on the subject property. The information ' 'Please submit'a vicinity map, :along with the signed copy
needed to complete the Checklist should be easily of this form to `assist City staff � `i " riding 'and locating the
available from observations of the site or:data.available.at_,__. specific piece.. of: property,, described on this form.., In
City Hall (Critical areas inventories, maps, or soil addition, ,the. , applicant shall include other pertinent
surveys). 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 hanmlessxfrom ariy.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 information and exhibits herewith submitted are true- and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF APPLICANT/AGENT ���i -� DATE /o - 3c) -0
Property Owner's Authorization
By my signature; 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 inspection and posting attendant to this application.
SIGNATURE OF OWNER i DATE
PLEASE PRINT CLEARLY
Owner/Applicant:
Zf /erg C atJa 1�
Name `PL
Street Address
,dimrv�r05� C4.
City State Zip
Telephone: ;OU - 5W - S3q/
Email address (optional):
Applicant Representative:
Name"
Street Address
City State Zip
Telephone:
Email Address (optional):.
Critical Areas Checklist.doc/3.19.2001