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121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
ONLINE CRITICAL AREAS CHECKLIST
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).
By submitting this online application, the applicant/owner grants permission for the public officals and staff of the City of
Edmonds to enter the subject property for the purposes of inspection and posting attendant to this application.
OWNER; APPLICANT . : ,
KYLE+KAELYN MITCHELL KYLE MITCHELL
7017 165TH PL SW 7017 165TH PL SW
EDMONDS, WA 98026-4926 EDMONDS, WA 98026
Site Information (soils/topography/hydrology/vegetation):
1. Site Address / Location: 7017 SW 165th PL, Edmonds WA 98026
2. Property Tax Account Number: 006550000009000
3, Approximate Site Size (acres or square feet): .28 Acres
4. Is this site currently developed? YES
If yes; how is site developed? Average residential lot
5, Describe the general site topography. Check all that apply:
YES 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).
O 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).
O Steep: grades of greater than 30% present on site (a vertical rise of 10 -feet over a horizontal distance of less than 33 -feet).
O Other (please describe):
6. Site contains areas of year-round standing water: NO Approximate Depth:
7. Site contains areas of seasonal standing water: NO Approximate Depth:
What season(s) of the year?
8. Site is in a floodway? NO
Site is in a floodplain? NO
9. Site contains a creek or an area where water flows across the grounds surface? NO
Flows are year-round? NO Flows are seasonal? NO What time of year?
10. Site is primarily: Urban Landscaped (lawn, shrubs, etc..)
11. Obvious wetland is present on site: NO
Plan Check Number, if applicable?
Site is Zoned?
SCS mapped soil type(s)?
Critical Areas inventory or C.A. map
indicates Critical Area on site?
Site within designated earth subsidence
landslide hazard area?
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SITE DETERMINATION
STUDFQUIR�D WAIVER
Reviewed by �` = Date:
SZ7-R-