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02318RECEIVED, FES -1 '�7 CITY OF EDNIONDS PLANNIi ' DEPT. EINVIP..0 !' 1T1jTASSE S'1Ei1T 10") PROJECT NAME Residence DATE SUB,'1ITTED_!28/77 In order to meet the requirements of the State Environmental Policy Act of 19711, the responsible official must make a declaration of environmental impact as early as possible in the process of evaluating a o o' t The information in n this form �•;i 11 be -used to determine :;�hether it ti' 11 be necess ary to require an enviror�iiental ic11)ac, satP;;,e,it. if an impact statement is not required, a Staten;ent of �legati ve Decl rai on will be in the. file. placed If an impact statement is required, a draft statement must be filed with this offi ce, pub 1 i c noti ce gi ven and a revi e•.i peri od of* 30 days al 1 oi•red. The final statement and comments rust be filed with the Department of Ecology,Office of ' the Governor and t;ie Ecological Commission. _ The Edmonds Planning.Staff will assist you in any way vie can in accumulating`' t!ii s information and we would appreciate .your cooperation. 1. Land: r j. �r Area in acres .17 approx. (Lot size: 70 x 110) Requires engineered Soils type _ Un-supervised fill Limitations Foundation &"retaining. . Wail 1 Description of topography (% slope) s lone east to west See attachment for section thru bluff. t- { Gradin estimated b' 2 9� cubic _ids. 30 NOTE: If grading or- filling 7i 1 exceed 500 cubic yards Filling: estimated cubic vds. _ 200 a'grading and filling plan 3 must be submitted with the 2. Water: application. Stream - estimated flow second 4 cFs (cubicP feet per P ) $ (apro x) ; ;li l l stream be altered? No To what degree? Impact on storm drainage (i.ncrease in run-off) Nil (approx 0262 CFS) Estimated area to be paved. 24o sq. ft. % 3.1% Es ti mated area in open space 6640 sq. f t. % 85% . Shorelines: wi thi n• 200 ft. of Mean hi gher Hi gh Water No Adjacent to shorelines zone No