cra20130131.pdf111c. 1S9\)
CITY OF EDMONDS
121 5th Avenue North, Edmonds WA 98020
Phone: 425.771.0220 ® Fax: 425.771.0221 ® Web: www.EdmondsWA.gov
DEVELOPMENT SERVICES DEPARTMENT • PLANNING DIVISION
Date: December 23, 2013
To: Delores Gray — 22306 92nd Avenue West, Edmonds WA 98020
Subject: Critical Areas Checklist Determination
Address: 22306 92nd Avenue West, Edmonds
File Number: CRA 2013 0131
Comment: Enclosed, please find a copy of the Critical Areas Checklist that you
submitted. You will find staff's determination at the bottom of the
second page of the checklist. If you have any questions, please contact a
Planner for more information.
Sincerely,
Gina Janicek :: Associate Planner
City of Edmonds Development Services Department
121 5th Avenue North, Edmonds WA 98020
425.771.0220 x 1778 1 gina.ianicek@edmondswa.gov
OV EDrLl
0% "ty of Edmonds
��
a Development Services Department
Planning Division
Phone: 425.771.0220
5 Z 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:
City p # i 5 q b-
Critical Areas File R
Critical Areas Checklist Fee: 0
Date Mailed to Applicant: J 7
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 fording 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 _w/ Y� 1 v� DATE ZZ -Y— / :7
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 posting attendant to this application.
SIGNATURE OF OWNER �•:>r. lit DATE / a —5--/
Owner]/"A�)pplicant:
Name
92
.3 c�& 9 � `�
Street Address
City State Zip
Telephone: (-9 (c -�, 2Z(tet
Email address:
Applicant Representative:
r
Name
Street Address
City State Zip
Telephone:
Email Address:
Revised on 12/18/12 P20 - Critical Areas Checklist.doc Page 1 of 2
#P20 CA File No: -7013 –0 l_3'
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/ Location: ot' qz4c� mvo
2. Property Tax Account Number: 005 LL�-:o C) co 0 t � Do
3. Approximate Site Size (acres or square feety,' (�l 3
4. Is this site currently developed? 4' yes; — no.
If yes; how is site developed? 'A/j';:j<; 's-
5. Describe the general site topography. Check all that apply. ?
Flat: less than 5 -feet elevation change over entire 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 than 30% (a vertical rise of 1.0 -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):
6. Site contains areas of year-round standing water: &16 Approx. Depth:
7. Site contains areas of seasonal standing water Approx. Depth: 52 /,j X'V0
What season(s) of the year?
8. Site is in the floodwayAA& floodplain AX0 - of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
(tel Flows are seasonal? A (What time of year? &0
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn, shrubs etc)
11. Obvious wetland is present on site:
----------------------------------------------------------
For City Staff Use Only ------------------------------------------------------------------
1.F
Plan Check Number, if applicable? D
2.
Site is Zoned?
3.
SCS mapped soil type(s)? AC -i- Mdfmmud OvIoAVI 1"( WM91CN
4.
Critical Areas inventory or C.A. map indicates Critical Area on site? !Nn,
�IjAyvt eloq� WA
b 0, U, kA OL rds,
5.
Site within designated earth subsidence landslide hazard area? No.
SITE DETERMINATION
STUDY REQUIRED
-WAIVER
Reviewed by: (2ioa TaVA11cv— Date:
Revised on 12118112 P20 - Critical Areas Cheeklist.doc Page 2 of