01135! 3.
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8 9 DATE:
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A $25 fee will be collected by
the City of Edmonds for analysis
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of the Environmental Checklist
and the preparation of a Threshold
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Determination. No will be
charged for proposals which would
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be categorically exempt if they
were not located in an environ-
A
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mentally sensitive area.
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al
s
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s >
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25.
ENVIRONMENTAL CHECKLIST FORM
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t -
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. 1. BACKGROUND
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1.' Name of.
Proponent Gillespie Construction
130'
2. Address
and Phone Number oL Proponent:
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31
23414
92nd Ave_ w_
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3. ate sec
list Su matte
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4.
Agency.Requirinr Checklist.
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5.
Name of Proposal, if applica a:;
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Wispy Willows
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6.
Nature and brier Description oTtlie Proposal inr. uu=
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ing but not limited to its size, general design Ile.-
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ments,.and other factors that .will give an accurate
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understanding of its scope and nature}: .
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Subdivide 2.14 acres located 200' N. of 212th S.M. and
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east of 80th Ave. W., into .9'single family.dwelling
44'
45.
7,
ocatiioon o Proposal uescri e the p hysic�ll sett�of
46'
the proposal, as well as the extent of the land area
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:
affected by any environmental impacts, including any
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other information needed to give an accurar-, understand-
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ing of the environmental setting or the proposal)
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2M I north 2 12th S W the + s i_HA of Anth
of on -ea
Ave, W.
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8.
Estimate -Vate for Completion of tBL. Propose Action:
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Summer 1978
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9,
Li.s-` of a1Z 1'ermiits, LL-'cnses or l;ovcrument Approvals
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Required for the Proposal (federal, state and local--
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including rezones):
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Preliminary and final plat building permits and
utility permits.
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