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S7RC-27 FIE
1e9a.1990
City of Edmonds
Critical Areas Checklist.
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 a developmentpermit
to the City.
The purpose of the Checklist is to enable
City staff to determine whether any potential
Critical Arras 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).
An applicant, or his/her representative, must ,
fill out the checklist„ sign and date it, and
submit it to the City. The City will review
the ehocidist, make a precursory site visit,
and make a determination of the subsequent
steps necessary to complete a development
permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the -subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conjunction with
this Checklist to assist staff in completing
their preliminary assessment of the site.
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
Name
Title
Street Address
Cit State, ZIP Phone
Signature Date
Applicant Representative:
Name
Title
Street Address
City, State, ZIP Phone
Signature Date
RECEIVED
Critical Areas Cheddis
J U I. t 3 1992
Site Information
Project Name: !30077Y Permit Number.� PERMIT COUNTER
Site Location: 1N G (�%J / �r �c�! X, Property Tax ccount Number �> 7 3 UI V D�
Approximate Site Size (acres or square feet): 5
Have you filled out a Critical Areas Checklist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged? Date of most recent action:
Soils / Topography
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)?
3. Descnbe the general site topography. Check all that apply.
Flat less than 5 feet elevation change over entice 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 thin 30% ( a vertical rise
of 10 feet of horizontal distance.)
Steep: grades of greater than 300/a present on site.
Comments
Hydrology/Vegetation
4. Site contains areas of year-round standing water.
5. Site contains areas of seasonal standing water. Approx. Depth:
6. Site is in the floodway ( ' (floodplain of a water course.
7. Site contains a creek or an area where water flows across the grounds surface?flows
are year-round? Flows are seasonal?
8. Site is primarily: forested ; meadow ;shrubs I` ; mixed
9. Obvious wetland is present on site: ll�
10. Wetland inventory or map indicates wetland present on site: .
11. Critical Areas inventory or map indicates any Critical Area on site:
for Gty Use :Only