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011503 4 A 6 7 8 9 10 11 DATE: 13 'A $25 fee will be collected by the City of -Edmonds for analysis 14 of the Environmental Checklist and the preparation of a Threshold Determination. No -fee will be charged for proposals which would 16 17 be catego c H ally exempt if they were not located in an environ- 18 mentally sensitive area. 19 20 21 22 23 4 .2 ENVIRONMENTAL CHECKLIST FORM i5 T 26 27 I. BACKGROUND 28 29 Ij NameProponent Gillesple Construction 30 2. Address and Phone urnber or Proponent: 31 23414 9?Od W_ -Ayta-- 32: 33 34 .3. _Fd le itted Date -a- cFlis-t-3u m 35 4. Agency. Requiring Checklist 36 S. bl Name of Proposal, if applicae.: 37 '38 6. Wispy Willows - I brier roposaT (inclu Ra—ture .2114 vescripLion oT- 39 ing but not limited to its size, gener.al design ele- 40 -ments, and other factors that will give an accurate 41 understanding of its scope and nature): Subdivide 2.14 acres located 2001 N. of 212th S.W. and 42 43 eas of 8Ot into .9' -1 44 45 OT roposal (ZeSeriSe the physi=cl sett"111, Of 46 tile proposal, as well as t lie extent of tile land area 47 affected by any environmental impacts, including any 48 other information needed to give an accurar-- underSLand- setting of the proposal): 49 ing of the environmental 50 51001 north of 7 Qth q W On ths Isa t slde of-Anth 52 8. �IcAction: Estimated Date -For Completion o - thu 'rolose .53 54 Summer 1978 -i—ioverilt—itentAllprov 55 9. List Of al crmits, Liccns� or G als r-1 56 Required for the Proposal(federal, State and.local- 57 58 includin rezones) prelimfnary and final plat building permits and 59 utility PAr itc- 60 -31-