HomeMy WebLinkAbout20251105_PJA25-0059_Critical Area Form LAND USE APPLICATION
CRITICAL AREA EVALUATION
`;4 COMMUNITY & ECONOMIC DEVELOPMENT
18204 5911 Avenue NE .Arlington, WA 98223 . Main Line 360.403.3551
SITE INFORMATION
Project Name eil 14 1 14 -b r �-) dei't"
Site Address -Tax Parcel ID Number(s) C7n H;,f g Z 0 D00 Z?ti.
(Use block#if no bldg.#)
Acreage&Square Footage j y c ,i,s Zoning Classification A ir_
of Property 41 � R05 Use Classification No. Fi"V''fl
OWNER APPLICANT CONTACT
Name h,•+d b;_l i kw ..�.>r b : •d
93$:; i59"" A-1, IvF-
Full Address I k-- 2 va
jQc4 ,14, wA 9g S'L.
Phone Number Z 0 1_ 3 9 6 - 7,11. z
E-mail S }cvLhipSfG � fCs , m /j'1
Relationship of Applicant ❑Owner ❑Contract Purchaser C31'essee ❑Other:
to Pro ert check one
CRITICAL AREAS
Are you aware of any environmental documentation that has been prepared related to critical Yes �lo
areas that includes the subject area?
Are there any surface waters(including year-round and seasonal streams,saltwater,lakes, Yes P?do
ponds,bogs,swamps,marshes)?
Is there vegetation that is associated with wetlands on the property? U Yes Lfftl o
Have any wetlands been identified on the property? I U Yes o
Are there any known areas where the ground is consistently inundated or saturated with water? Yes E2ho
Are there any State or Federally listed sensitive,endangered,or threatened species or habitats Yes E No
known on the property?
Are there slopes of 15%or greater on the property? 1:1 Yes 130
Are there any landslide hazard areas? U Yes L�No
Is the property located within a Flood Plain or Flood Way? Yes 00
IF YOU ANSWERED YES TO ANY OF THE ABOVE QUESTIONS THEN A CRITICAL AREA STUDY IS REQUIRED
I grant permission to the City of Arlington to enter the property to determine the presence or absence of critical areas.
—
I understand that if the information on this form is later determined to be incorrect,the project or activity may be
subject to conditions or denial as necessary to meet the requirements of AMC 20.93,Arlington Critical Areas Ordinance.
LApplicant's Signature:_ �G _ — _ Date: I d, Z" �s
City of Arlington
Critical Areas Evaluation
Page 1 of I
Rev 11/2021
e
WATER AND SEWER AVAILABILITY REQUEST
Community and Economic Development
City of Arlington•18204 591h Avenue NE •Arlington,WA 98223 •Phone(360)403-3551
Submittal Requirements:
1. Complete Application
2. 8-1/2"x 11"Site Plan/Sketch of the Proposal
Type of Request: ❑ Water Only ❑ Sewer Only Water and Sewer
Location/Legal Property Address: i S 7 C 4 5 1— A v g Ni�
Lot#: Parcel ID No(s): 0 d g Y g Z yCi o O 2 3 o i Subdivision:
Project Scope of Work: c fr a�-v h 4,, -v r
Owner Name: Office No.: "1ZS 2 V 3 - S Y So
Email Address: •}c -/.L•h s h � n p '� z c �'� Cell No.: *-'1-'-0 3 cJ L- 7 `I�
Mailing Address: $38 •rK A v, 4 tz12 a <� js%1 State: W72 zip: S, C
Owners Agent: Office No.:
Email Address: Cell No.:
Mailing Address: City: State: Zip:
RESIDENTIAL INFORMATION
❑ Proposed Single Family Residence ❑Existing Single Family Residence ❑Accessory Dwelling Unit
❑Proposed Multi-Family Residence:#of Units #of Buildings ❑Residential Plat:#of Lots
COMMERCIAL INFORMATION
❑Binding Site Plan/Plat:#of Lots #of Phases d x 2 #of Buildings Total Square Footage
TYPE OF COMMERCIAL USE
❑Hotel/Motel ❑Food Service ❑ Medical/Dental ❑Office ❑ Retail
❑Vehicle Service ❑Warehouse/Storage ❑ Industrial ]i Other(specify): F y ����•�,
Commercial Water Usage:Monthly Estimation: i b 0 Gallons
WATER,SEPTIC SYSTEM AND FIRE
Is there an existing Well on the property? ❑Yes [21qo Is there an existing Septic System on-site? ❑Yes pNo
Water Meter Size Requested? ERR/8" ❑ 1" ❑ 1.5" ❑2" ❑3" ❑4" ❑6"
Type of Fire Protection Requested? [rFire Sprinkler System ❑Fire Hydrant ❑Unknown
I,the undersigned,request City ofArlington Utilities Division to certify willingness to provide water and/or sewer as indicated.
The above information is complete and accurate to the best of my knowledge. 1 understand that any changes to the above
information must be reported immediately to the City ofArlington Utilities Division as a condition of Utility Availability approval.
Signature( wner/agent) Print Name Date
Page 1 of 2 REV02.2022
TO BE COMPLETED BY THE CITY OF ARLINGTON
CITY OF ARLINGTON UTILITIES DIVISION — PRELIMINARY INFORMATION / CERTIFICATION
A water main or other capital facility improvement: ❑ is required; ❑ is not required.
(If required, refer to below conditions).
Water is presently available from the City of Arlington to service the above referenced
property and specified number of connections upon payment of applicable connection fees and charges.
Fire Flow Estimation: Static Pressure Residual Pressure Flow gpm
A sanitary sewer main or other capital facility improvement: ❑ is required; ❑ is not required.
(If required, refer to below conditions).
Sanitary sewer is presently available from the City of Arlington to service the above referenced property
and specified number of connections upon payment of applicable connection fees and charges.
Approved By: Date:
EXPIRES 18 MONTHS FROM DATE OF ISSUANCE
Additional Comments/Conditions: