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CRA20030155.PDFCritical Areas Checklist CA File No. Site Information (soils/topography/ hydrolo /vegetatiion) Site Address/Location: �5� P� �Iv 2. Property Tax Account Number: eV7 060 f3VI W 3. Approximate Site Size (acres or square feet): 4. Is this site currently developed? _ yes; no If yes; how is site developed? 5. Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. C1 0 91 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 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): Site contains areas of year-round standing water: /16 ; Approx. Depth: Site contains areas of seasonal standing water: ; Approx. Depth: _ What season(s) of the year? Site is in the floodway floodplain of a water course. 9. Site co�jtains a creek or an area where water flows across the grounds surface? Flows are year-round? N 6 Flows are seasonal? (What time of year? ). 10. Site is primarily: forested ; meadow ;shrubs ; mixed urban landscaped (lawn, shrubs etc) - 11. Obvious wetland is present on site: D W/-- For City Staff Use Only 1. 2. 3. 4. 5. Plan Check Number, if applicable? Site is Zoned? 1s - V /I- SCS mapped soil tvpe(s)? 441dt Critical Areas inventory or C.A. map indicates Critical -Area on site? /Ve_6Li)­`13t 0IPe-S W UL— Site within designated STUDY REQUIRED %*__1 WAIVER Reviewed by: dy Date: Critical Areas Checklist.doc/4.22.2003 SI-OfF-S In/ I-17A F—P.OS IOC% l/VI LLB. V I P-jF— COMPL.1,41VCF—= w1TH F.-_DC, 19. 0S'. of ED City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 sac 1 gqo Fax: 425.771.0221 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 the application to the City. The purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas 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). Date Received: -" AO City Receipt #: 2,31 Critical Areas File #: Critical Areas Checklist Fee: $135.00 Date Mailed to Applicant: A property owner, or his/her authorized representative, must fill out the checklist, sign and date it, and submit it to the City. The City will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. Please submit a vicinity map, along with the signed copy of this form to assist City staff in finding and locating the specific piece of property described on this form. In addition, the applicant shall include other pertinent 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 harmless from any 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 f DMI'V i 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 paling attendant to this applicaon. SIGNATURE OF Owner/Applicant: OIA/l%1-f-2 all/ Name -;7 yi 3 .7/- Street Address City State Zip Telephone: ©2!;7- - l Email address (optional): -nSo �/ �y -16a DATE / / 271 Applicant Representative: Name Street Address City State Zip Telephone: , Email Address (optional): Critical Areas Check] ist.doc/4.22.2003 W c t7t03 7v $sV 7035 I 17024 Is w 7529 17110 3 7311 170r12 I) 7029 614 17114 17105 w�0 7120 7001 17118 S Q 7317 17104 7009 - 17128 �7� 7527 = 1710 �l� I 171. 7517 17129 ^ } n 7321 7305 17110 17122 7005 m d« 7112 8 17207 � N 1"1y o n g 7220 7202 17201 70e2 7010 ...,. ,,. e 17217 O3 �EMA ^ 6azo nzos 7z10 17206 17215 7062 6917 17228 9 17231 7507 s W 7510 7305 17218 n 17223 7020 6915 17208 �9 Q rBw76oa R R 7012 6907 7403 17229 7002 Y m 7529 7511 173RDSTSW nzlo ; f0 7508 $ ^ 17303 6905 »> 7220 7210 7402 7401 ^ ^ ^ w 173119 7107 Q o I v 6803 a 17329 17318 Qco m m m a ^ m m MEADOW 17337 17336 n n n m m g m 17411 n % m m m mm 3 I. n ^ 7215 7211 7118 g 17q 6909 6907 $ 17425 TJ15 7311 Cj��05 ^o m N > o 17513 17417 6908 6802 N� 7403 7107 m e h 17500 7108 17 ^ PL ^ m 7007 17421 o 'y $ 1743 1. 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