Loading...
HomeMy WebLinkAboutSEPA E02-010 - AT&T WIRELESS - TELECOMMUNICATIONS FACILITIES AND ANTENNAAT &T- VILLA NELLE SITE #961503 - 059603 -5619 INSTALLATION OF TELECOMMUNICATIONS FACILITIES & ROOF ANTENNA 3516 S. 146T" ST. E02 -010 Dept. Of Community Development City of Tukwila AFFIDAVIT OF DISTRIBUTION I' \1/47/66- HEREBY DECLARE THAT: Notice of Public Hearing Project Name: 4-7— Determination of Non - Significance (4;;;)2!/' . Mailer's Signature: Notice of Public Meeting Mitigated Determination of Non - Significance Board of Adjustment Agenda Pkt Determination of Significance & Scoping Notice Board of Appeals Agenda Pkt Notice of Action Planning Commission Agenda Pkt Official Notice Short Subdivision Agenda Notice of Application Shoreline Mgmt Permit Notice of Application for Shoreline Mgmt Permit __ __ FAX To Seattle Times Classifieds Mail: Gail Muller Classifieds PO Box 70 - Seattle WA 98111 Other Was mailed to each of the addresses listed on this o7s dda oalb !in the year 20 P:GINAWYNETTA/FORMS /AFFIDAVIT -MAIL 08/29/003:31 PM Project Name: 4-7— Project Number: o 2 0/6 (4;;;)2!/' . Mailer's Signature: Person requesting mailing: 427- P:GINAWYNETTA/FORMS /AFFIDAVIT -MAIL 08/29/003:31 PM • • City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 DETERMINATION OF NON - SIGNIFICANCE (DNS) File Number: E02 -010 Applied: 04/25/2002 Issue Date: 07/25/2002 Status: APPROVED Proponent: AT & T WIRELESS Lead Agency: City of Tukwila Description of Proposal: INSTALLATION OF AN UNSTAFFED TELECOMMUNICATIONS FACILITY CONSISTING OF 2 METROSITE CABINETS AND 6 PANEL ANTENNAE MOUNTED ON THE ROOF PARAPET OF AN APARTMENT BUILDING (3 ANTENNA WILL BE INSTALLED UPON APPROVAL, 3 WILL BE INSTALLED AT A UNDETERMINED FUTURE DATE). THERE IS AN EXISTING TELECOMMUNICATION FACILITY ON THE ROOF. Location of Proposal: Address: 3516 S 146 ST TUKW Parcel Number: 0040000315 Section/Township /Range: The City has determined that the proposal does not have a probable significant adverse impact on the environment. An environmental impact statement (EIS) is not required under RCW 43.21c.030(2) (c). This decision was made after review of a completed environmental checklist and other information on file with the lead agency. This information is available to the public on request. This DNS is issued under WAC 197 -11- 340(2). Comments must be submitted by The lead agency will not act on this proposal for 14 days from the date below. Steve Lancaster, Responsible Official City of Tukwila 6300 Southcenter Blvd Tukwila, WA 98188 (206)431 -3670 7- 2t-t-ot Date Any appeal shall be linked to a specific governmental action. The State Environmental Policy Act is not intended to create a cause of action unrelated to a specific governmental action. Appeals of environmental determinations shall be commenced within the time period to appeal the governmental action that is subject to environmental review. (RCW 43.21C.075) doc: Miscperm E02 -010 Printed: 07 -24 -2002 • • MEMORANDUM To: Steve Lancaster From: Art Pederson Date: July 24, 2002 Re: E02 -010 (SEPA Determination) AT & T Wireless Cellular Facility at the Villa Nelle Apartments 3516 S 146th Street Project Description: This SEPA review is for the proposed construction of a rooftop cellular communication facility on the roof of the Villa Nelle Apartments. The facility will consist of a three - sector antenna array as follows: one sector of two separate antennas will be located along the northern end of the building, two sectors of two antenna each will be located along the southern end of the building. Although applying for six antennas total, the applicant will install only three antennas following approval. These antennas will be in three sectors, one antenna in one sector will be located on the northern end of the building and two antennas in two sectors will be located on the southern end of the building. The remaining three antennas and associated screening will be installed in response to future system demand. All antennas will be screened from view by the use of simulated roof vents / flues that will be painted to match the existing and adjacent roof color. The associated electrical equipment will be located on the roof and be screened by the existing parapet wall. Other Agencies with Jurisdiction: None. Summary of Impacts to Environmental Elements: Earth Concur with Checklist. Air Concur with Checklist. • • E02-010 (SEPA Determination) AT & T Wireless Cellular Facility July 24, 2002 Page 2 • • Water Concur with Checklist. Plants Concur with Checklist. Animals Concur with Checklist. Energy /Natural Resources Concur with Checklist. Environmental Health The Federal Communication Commission (FCC) sets regulations for the environmental health effects from wireless / cellular telecommunication facilities. The Telecommunications Act of 1996 sets allowable levels of emitted radio frequency radiation from wireless telecommunications facilities and prohibits local governments from regulating the location of these facilities based on their potential health effects from emitted radio frequency radiation. All proposed telecommunications facilities must apply for and receive a FCC license before beginning operation. The applicant is responsible for compliance with all FCC regulations. There are no other anticipated environmental health effects from this proposal. Construction of the facility will occur during daytime hours and will occur on a short-term basis. The hours of construction and levels of noise will comply with the City's noise ordinance. Land /Shoreline Use Concur with Checklist. Housing Concur with Checklist. • E02 -010 (SEPA Determination) AT & T Wireless Cellular Facility July 24, 2002 Page 3 • • Aesthetics The proposed antennas will be mounted to the building roof and parapet. All mounting structures will be hidden from view by the parapet. The antennas will be screened by four simulated roof vent / flues. The vent / flues will be painted to match the existing roof color. The one north facing sector will contain two antennas in two separate vent / flues, only one of which will be installed immediately after project approval. The two south facing sectors will contain four antennas located in two separate vent / flues (two antennas in two sectors per vent / flue); only one vent / flue containing two antennas will be installed immediately after project approval. The associated electronic equipment will be located adjacent to the northern antenna sector on the roof and below the existing roof parapet. Therefore, there will are no anticipated aesthetic impacts. Light and Glare Concur with Checklist. Recreation Concur with Checklist. Historic and Cultural Preservation Concur with Checklist. Transportation Concur with Checklist. Public Services Concur with Checklist. Utilities Concur with Checklist. Recommendation: Determination of Non - Significance. STATE OF WASHINGTON CITY OF TUKWILA Department of Community Development 6300 Southcenter Boulevard, Tukwila, WA 98188 Telephone: (206) 431 -3670 FAX (206) 431 -3665 E -mail: tukplanna,ci.tukwila.wa.us C/7)OFT� APR 2 5 20p Pep,-4 C�T� AFFIDAVIT OF OWNERSHIP AND HOLD HARMLESS PERMISSION TO ENTER PROPERTY ss COUNTY OF KING The undersigned being duly sworn and upon oath states as follows: 1. I am the current owner of the property which is the subject of this application. 2. All statements contained in the applications have been prepared by me or my agents and are true and correct to the best of my knowledge. 3. The application is being submitted with my knowledge and consent. 4. Owner grants the City, its employees, agents, eng. eers, contractors or other representatives the right to enter upon Owner's real property, located at for the purpose of application review, for the limited time necessary to complete that purpose. 5. Owner agrees to hold the City harmless for any loss or damage to persons or property occurring on the private property during the City's entry upon the property, unless the loss or damage is the result of the sole negligence of the City. 6. The City shall, at its discretion , cancel the application without refund of fees, if the applicant does not respond to specific requests for items on the "Complete Application Checklist" within ninety (90) days. Atk 7. Non - responsiveness to a City information request for ninety (90) or more days, shall be cause to cancel the application(s) without refund of fees. EXECUTED at V(X `� \.�, (city), `/ _(state), on ,� I 0 , / a� (PrintNamere (C< J I D /d ieL- fizz (Address) / 6 7 1t15 1 L 44d, 0401,/n/l) Zs'. c(1/ (Phone Number) 30-6 24-- a/6 S (Signature) On this day personally appeared before me i -t1/� G f` _ J . O ['I ai/�-to me known to be the individual who executed the foregoing instrument and acknowle that he/she signed the same as his/her voluntary act and deed for the uses and purposes mentioned therein. jj SUBSCRIBED AND SWORN TO BEFORE ME ON THIS jl h DAY OF vt�NOTARY P BLIC in and for the State o hington residing at My Commission expires on 9/2_4v. /0 / City of fukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 RECEIPT Parcel No.: 0040000315 Permit Number: [02-010 Address: 3516 S 146 ST TUKW Status: PENDING Suite No: Applied Date: 04/25/2002 Applicant: AT &T WIRELESS Issue Date: Receipt No.: R020000549 Payment Amount: 325.00 Initials: CPL Payment Date: 04/25/2002 01:30 PM User ID: 1661 Balance: $0.00 Payee: TRANSACTION LIST: Amount Type Method Description Payment Check 7071009 325.00 ACCOUNT ITEM LIST: Description Account Code Current Pmts SEPA 000/345.831 325.00 Total: 325.00 6182 04/26 9716 TOTAL 11.75.00 doc: Receipt Printed: 04 -25 -2002 ENVIRONMENTAL (SEPA) CHECKLIST A. BACKGROUND 1. Name of proposed project, if applicable: Villa Nelle site # 961 S03- 059803 -SG 19 3 2. Name of applicant: 0063 AT&T Wireless Services Inc. 3. Address and phone number of applicant and contact • erson: Applicant ntact Person 617 Eastlake Ave E ynthia Beme Seattle, WA 98109 4742 42rtd Ave SW #629, Seattle, WA 98116 (206) 937 -9536 FOR OFFICIAL USE ONLY Received by: Receipt #: Date checklist prepared: 04/23/02 5. Agency requesting checklist: City of Tukwila Department of Community Development 6. Proposed timing or schedule: Construction will commence immediately upon issuance of building permit, with completion of project within one month. 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. Yes, one set of future antennas as show on plans EVALUATION FOR AGENCY USE ONLY ajvu Environmental (SEPA) Cht•ist • Page 2 of 13 8. List any environmental information you know about that has been prepared, or will be prepared, directly relating to this proposal. 9. Do you know whether applications are pending for governmental approvals of other proposals directly affecting the property covered by your proposal? If yes, explain. None known. 10. List any governmental approvals or permits that will be needed for your proposal, if known. City of Tukwila Endangered Species Act Screening Checklist, Conditional Use Permit and Building Permit 11. Give a brief, complete description of your proposal, including the proposed uses and the size of the project and site. There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not need to repeat those answers on this page. (Lead agencies may modify this form to include additional specific information on project description.) An unstaffed communications facility consisting of 2 metrosite cabinets an . panel antennas mounted on the roof parapet of an existing apart t building. 12. Location of the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street address, if any, and section, township, and range, if known. If a proposal would occur over a range of area, provide the range or boundaries of the site(s). Provide a legal description, site plan, vicinity map, and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications related to this checklist. 3516 S 146"' Street APN 0040000315 -02 EVALUATION FOR AGENCY USE ONLY Environmental (SEPA) Cheist B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (check one): El flat ❑rolling ❑hilly ❑steep slopes ❑mountainous ❑ other • Page 3 of 13 b. What is the steepest slope on the site (approximate percent slope)? The project area is basically level, less than 1% slope estimated c. What general types of soils are found on the site (for example: clay, sand, gravel, peat, muck)? If you know the classification of agricultural soils, specify them and note any prime farmland. Native soil unknown. Site has been fully developed and building, parking lot, and non - native landscaping cover entire site. No earth will be disturbed during this project. d. Are there any surface indications or history of unstable soils in the immediate vicinity? If so, describe. None observed. e. Describe the purpose, type, and approximate quantities of any filling or grading proposed. Indicate source of fill. No earth disturbance will take place during this project. f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. g- No. About what percent of the site will be covered with impervious surfaces after project construction (for example: asphalt or buildings)? This project does not increase impervious surface on the site. h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any. None needed - none proposed. EVALUATION FOR AGENCY USE ONLY Environmental (SEPA) Chest 2. AIR • Page 4 of 13 a. What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities if known. Small quantities of dust and vehicular emissions may be produced during the one -month construction period. No emissions will be produced after construction completed. b. Are there any off -site sources of emissions or odor that may affect your proposal? If so, generally describe. No. c. Proposed measures to reduce or control emissions or other impacts to air, if any. None anticipated. 3. Water a. Surface: 1) Is there any surface water body on or in the immediate vicinity of the site (including year -round and seasonal stream, saltwater lakes, ponds, wetlands)? If yes, describe type and provide names. If appropriate, state what stream or river it flows into. None noted. 2) Will the project require any work over, in, or adjacent to (within 200 feet) the described waters? If yes, please describe and attach available plans. No. 3) Estimate the amount of fill and dredge material that would be placed in or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicate the source of fill material. None. Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. No. EVALUATION FOR AGENCY USE ONLY V ' Environmental (SEPA) Chest 110 Page 5 of 13 5) Does the proposal lie within a 100 -year floodplain? If so, note location on the site plan. No. 6) Does the proposal involve any discharges of waste materials to surface waters? If so, describe the type of waste and anticipated volume of discharge. No. b. Ground 1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, purpose, and approximate quantities if known. No. 2) Describe waste material that will be discharged into the ground from septic tanks or other sources, if any (for example: domestic sewage; industrial, containing the following chemicals ....; agricultural; etc.). Describe the general size of the system, the number of houses to be served (if applicable), or the number of animals or humans the system(s) are expected to serve. None. c. Water Runoff (including storm water): 1) Describe the source of runoff (including storm water) and method of collection and disposal, if any (include quantities, if known). Where will this water flow? Will this water flow into other waters? If so, describe. No runoff is anticipated. d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any. None proposed. EVALUATION FOR AGENCY USE ONLY Z Environmental (SEPA) Chest . Page 6 of 13 EVALUATION FOR AGENCY USE ONLY 4. Plants a. Check or circle types of vegetation found on the site: deciduous tree: ❑ alder ❑ maple El X evergreen tree: aspen ❑ other fir ❑ cedar pine ❑ other ❑ X shrubs ❑ X grass ❑ pasture ❑ crop or grain wet soil plants: ❑cattail ❑buttercup, ❑bullrush ❑skunk cabbage ❑ other water plants: El water lily ❑eelgrass ❑ milfoil ❑other other types of vegetation: b. What kind and amount of vegetation will be removed or altered? None. c. List threatened or endangered species known to be on or near the site. None known. Proposed landscaping, use of native plants, or other measures to d. preserve or enhance vegetation on the site, if any. None proposed. • Environmental (SEPA) Chelst • Page 7 of 13 5. Animals a. Circle any birds and animals that have been observed on or near the site or are known to be on or near the site. Birds: ❑ hawk ❑ heron ❑ eagle El songbirds CI other Mammals: ❑ deer ❑ bear ❑ elk ❑ beaver ❑ other Fish: ❑ bass ❑ salmon ❑ trout ❑ herring ❑ other b. List any threatened or endangered species known to be on or near the site. None known. c. Is the site part of a migration route? If so, explain. Unknown. d. Proposed measures to preserve or enhance wildlife, if any. None. 6. Energy and Natural Resources a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet the completed project's energy needs? Describe whether it will be used for heating, manufacturing, etc. The facility will require 200 Amps of single -phase electrical service that will be used to run electronic equipment. Telephone service will also be required. b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. c. No. What kinds of energy conservation features are included in the plans of this proposal? List other proposed measures to reduce or control energy impacts, if any. All equipment shall conform to applicable energy codes. EVALUATION FOR AGENCY USE ONLY ' Environmental (SEPA) Chest 7. Environmental Health • Page 8 of 13 a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and explosion, spill, or hazardous waste that could occur as a result of this proposal? If so, describe. b. There are no known environmental health hazards that occur because o wireless communications facilities. The Federal Communications Commission (FCC) regulates all radio fwqui nr y emissions. 1) Describe special emergency services that might be required. None. 2) Proposed measures to reduce or control environmental health hazards, if any. EVALUATION FOR AGENCY USE ONLY None anticipated. Noise 1) What types of noise exist in the area that may affect your project (for example: traffic, equipment, operation, other)? None. 2) What types and levels of noise would be created by or associated with the project on a short-term or a long -term basis (for example: traffic, construction, operation, other)? Indicate what hours noise would come from the site. Construction- related noise would be generated during normal business hours for the one -month construction period only. 3) Proposed measures to reduce or control noise impacts, if any. Construction will be limited to business hours requested by landlord to minimize impact. r 8. Land and Shoreline Use a. What is the current use of the site and adjacent properties? The site is currently use as an apartment building with an existing telecommunications facility on the roof. North: Multi - Family East: Multi - Family South: Commercial West: Multi- Family Environmental (SEPA) Checet b. Has the site been used for agriculture? If so, describe. Unknown. Site is not currently used for agriculture. c. Describe any structures on the site. A 35- unit apartment building and an equipment cabinet. d. Will any structures be demolished? If so, what? No. e. What is the current zoning classification of the site? High Density Residential f. What is the current comprehensive plan designation of the site? High Density Residential If applicable, what is the current shoreline master program designation of the site? N /A. h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. Unknown. • g. Page 9 of 13 EVALUATION FOR AGENCY USE ONLY i. Approximately how many people would reside or work completed project? None. The site will not be staffed. One field engineer will visit once a month to perform routine safety check and maintenance. Approximately how may people would the completed displace? j• None. in the the site project k. Proposed measures to avoid or reduce displacement impacts, if any. None necessary. I. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any. The existing use is a communication facility. The antennas and Metrosite Cabinets will be mounted on the roofs parapet. Environmental (SEPA) Chest • Page 10 of 13 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low- income housing. None. b. Approximately how many units, if any, would be eliminate? Indicate whether high, middle, or low - income housing. None. c. Proposed measures to reduce or control housing impacts, if any. None. 10. Aesthetics a. What is the tallest height of any proposed structure(s), not including antennas; what is the principal exterior building material(s) proposed. No new structure is proposed. b. What views in the immediate vicinity would be altered or obstructed? None c. Proposed measures to reduce or control aesthetic impacts, if any. Narrow panel antennas are proposed for this p consistent in form with the existing Sprint antennas already on the roof. EVALUATION FOR AGENCY USE ONLY Stmtatit KA-tiff.te rvt:t • Environmental (SEPA) Cheiist • Page 11 of 13 EVALUATION FOR AGENCY USE ONLY 11. Light and Glare a. What type of light or glare will the proposal produce? What time of day would it mainly occur? None. b. Could light or glare from the finished project be a safety hazard or interfere with views? No. c. What existing off -site sources of light or glare may affect your proposal? None. d. Proposed measures to reduce or control light and glare impacts, if any. None. 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? Thera is none in the immediate vicinity. b. Would the proposed project displace any existing recreational uses? If so, describe. No. c. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any. None. 13. Historic and Cultural Preservation a. Are there any places or objects listed on, or proposed for, national, state, or local preservation registers known to be on or next to the' site? If so, generally describe. None known. b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. None. Environmental (SEPA) ChOst • Page 12 of 13 EVALUATION FOR AGENCY USE ONLY c. Proposed measures to reduce or control impacts, if any. None. 14. Transportation a. Identify public streets and highways serving the site, and describe proposed access to the existing street system. Show on site plan, if any. Access to the site will be via S 146`" Street from the parking lot. b. Is the site currently served by public transit? If not, what is the approximate distance to the nearest transit stop. Yes. c. How many parking spaces would the completed project have? How many would the project eliminate? No additional parking spaces are proposed;, no parking spaces will be eliminated. d. Will the proposal require any new roads or streets, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate whether public or private). No. e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. No. f. How many vehicular trips per day would be generated by the completed project? If known, indicate when peak volumes would occur. One vehicle trip per month would be generated for technician to conduct / safety check and perform routine maintenance. The site visit would occur normal business hours. g. Proposed measures to reduce or control transportation impacts, if any. None anticipated. 15. Public Services a. Would the project result in an increased need for public services (for example: fire protection, police protection, health care, schools, other)? If so, generally describe. No. " Environmental (SEPA) Chi . list b. Proposed measures to reduce or control direct impacts on public services, if any. None proposed, not applicable. 16. Utilities a. Check utilities currently available at the site: b. El Electricity © Telephone ❑ Natural Gas © Sanitary Sewer Refuse Service ❑Septic System Water Other. El El Describe the utilities that are proposed for the project, the utility providing the service, and the general construction activities on the site or in the immediate vicinity that might be needed. Power and Telco lines will be run from the existing equipment room to the Communications Facility on the rooftop. C. SIGNATURE Page 13 of 13 EVALUATION FOR AGENCY USE ONLY The above answers are true and complete to the best of my knowledge. I understand that the lead agency is relying on them to make its decision. Pacific Telecom Services, LLC. By: Cyn is M. Berne Date Submitted: 1� • CITY OF TUKWILA Department of Community Development 6300 Southcenter Boulevard, Tukwila, IVA 98188 Telephone: (206) 431 -3670 FAX (206) 431 -3665 E -mail: tukplan a.ci.tukwila.wa.us • SEPA ENVIRONMENTAL REVIEW ern" OF TUKWILA DT nn,.■•• APPLICATION RMIT NAME OF PROJECT/DEVELOPMENT: i-T - 0 s9 i2)01 - Vella LOCATION OF PROJECT/DEVELOPMENT: (Give street address or, if vacant, indicate lot(s), block and subdivision, access street, and nearest intersection. LIST ALL 10 DIGIT PARCEL NUMBERS. 35 1/ S I )-1L /-\ SAre l uk.�,Vl�� , i� ^J 9$1(2 Quarter:) V W Section: al- Township: (`f Range: 01-/ E (This information may be found on your tax statement.) DEVELOPMENT COORDINATOR : The individual who: • has decision making authority on behalf of the applicant in meetings with City staff, • has full responsibility for identifying and satisfying all relevant and sometimes overlapping development standards, and • is the primary contact with the City, to whom all notices and reports will be sent. Name: `,y i\4 C� r . k X'�y (� ! l 'A 1 Address: /11 +L( �il �lU`�— S \NJ l�c)M y� � t W ' A! `A `IF 1 IL Phone: (DO (v) Ct3 T —95 3La FAX:(LLto) Signature: Date: Li/ 4)N X) G: \APPF AN \LANDUSE.APP\SEPAAPP.DOC,ONIMUO pitij )l�lT� FOR STAFF USE ONLY SIERRA TYPE P-SEPA Planner: File Number: ED."- 0(.0 Application Complete (Date: ) Project File Number: Application Incomplete (Date: ) Other File Numbers: L■o2 _Oiy NAME OF PROJECT/DEVELOPMENT: i-T - 0 s9 i2)01 - Vella LOCATION OF PROJECT/DEVELOPMENT: (Give street address or, if vacant, indicate lot(s), block and subdivision, access street, and nearest intersection. LIST ALL 10 DIGIT PARCEL NUMBERS. 35 1/ S I )-1L /-\ SAre l uk.�,Vl�� , i� ^J 9$1(2 Quarter:) V W Section: al- Township: (`f Range: 01-/ E (This information may be found on your tax statement.) DEVELOPMENT COORDINATOR : The individual who: • has decision making authority on behalf of the applicant in meetings with City staff, • has full responsibility for identifying and satisfying all relevant and sometimes overlapping development standards, and • is the primary contact with the City, to whom all notices and reports will be sent. Name: `,y i\4 C� r . k X'�y (� ! l 'A 1 Address: /11 +L( �il �lU`�— S \NJ l�c)M y� � t W ' A! `A `IF 1 IL Phone: (DO (v) Ct3 T —95 3La FAX:(LLto) Signature: Date: Li/ 4)N X) G: \APPF AN \LANDUSE.APP\SEPAAPP.DOC,ONIMUO pitij )l�lT� • City of Tu. ESA Screening Checklist City of Tukwila Endangered Species Act Screening Checklist Date: � 01.)-I Applicant Name: ` rSkik rr� . Y hsz_, -YJ`r A 81— Street Address: 7-"Li - Liahk A &) Stu City, State, Zip: SQAt 1 V\J -1 L, Telephone: (k9 DIRECTIONS This Screening Checklist has been designed to evaluate the potential for your project to result in potential "take" of chinook salmon, coho salmon, or cutthroat trout as defined by Section 9 of the Endangered Species Act. The checklist includes a series of "Yes" or "No" questions about your project, organized into four parts. Starting with Part A on Page 1, read each question carefully, circle "Yes" or "No," and proceed to the next question as directed by the checklist. To answer these questions, you may need to refer to site plans, grading and drainage plans, critical areas studies, or other documents you have prepared for your project. The City will evaluate your responses to determine if "take" is indicated. January 25, 2001 1 • City of Tu S ESA Screening Checklist Part A: Please review and answer each question carefully. Consider all phases of your project including, but not limited to, construction, normal operation, potential emergency operation, and ongoing and scheduled maintenance. Continue to the next question as directed for each No or Yes answer. 1 -0 Will the project require any form of grading? Grading is defined as any excavating, filling, clearing, or creation of impervious surface, or any combination thereof, which alters the existing ground surface of the earth (see Tukwila Municipal Code (TMC) Chapter 18.06, Zoning Code, Page 18 -11). Please circle appropriate response. NO - ontinue to Question 2 -0 YES - Continue to Question 1 -1 (Page 3) 2 -0 Will the project require any form of clearing? Clearing means the removal or causing to be removed, through either direct or indirect actions, any vegetation from a site (see Chapter 18.06, Page 18 -8). Please circle appropriate response. 411Cros- Continue to Question 3 -0 YES - Continue to Question 2 -1 (Page 4) 3 -0 Will the project require work, during any time of the project, below the ordinary high water mark of a watercourse or the Green/Duwamish or Black Rivers or in wetlands? Ordinary high water mark is the mark that is found by examining the bed and banks of a stream and ascertaining where the presence and action of waters are so common and usual as to distinctly mark the soil from that of the abutting upland, in respect to vegetation (see TMC Chapter 18.06, Page 18 -15). Please circle appropriate response. . NO Continue to Question 4 -0 YES - Continue to Question 3 -1 (Page 5) 4-0 Will the project result in the processing or handling, storage, or treatment of hazardous substances? This does not include the proper use of fuel stored in a vehicle's fuel tank. Hazardous substances are any liquid, solid, gas, or sludge, including any material, substance, product, commodity, or waste, regardless of quantity, that exhibits the characteristics or criteria of hazardous waste as defined by Washington Administrative Code 173 -303 (see TMC Chapter 18.06, Tukwila Zoning Code, Page 18 -11). This includes fuel or other chemicals stored on -site during construction. Please circle appropriate response. NO - ontinue to Question 5 -0 YES - Continue to Question 5 -0 5 -0 Will the project result in the withdrawal, injection, or interception of groundwater? Examples of projects that may affect groundwater include, but are not limited to: construction of a new well, change in water withdrawals from an existing well, projects involving prolonged construction dewatering, projects installing French drains or interceptor trenches, and sewer lines. For the purpose of this analysis, projects that require a geotechnical report pursuant to the requirements of TMC 18.45.060 and 18.45.080E.4, or would require a geotechnical report if not exempt under TMC 18.45.080A, should answer Yes. Please circle appropriate response. NO) Continue to Question 6 -0 YES - Continue to Question 6 -0 January 25, 2001 7 Part A (continued) • City of Tula ESA Screening Checklist 6 -0 Will the project involve landscaping or re- occurring outdoor maintenance that includes the regular use of fertilizers, pesticides, or herbicides? This does not include the one -time use of transplant fertilizers. Landscaping means natural vegetation such as trees, shrubs, groundcover, and other landscape materials arranged in a manner to produce an aesthetic effect appropriate for the use of the land (see TMC Chapter 18.06, Tukwila Zoning Code, Page 18- 13). For the purpose of this analysis, this includes the establishment of new lawn or grass. Please circle appropriate response. Checklist Complete YES — Checklist Complete Part B: Please answer each question below for projects that include grading. Review each question carefully, considering all phases of your project including, but not limited to construction, normal operation, potential emergency operation, and ongoing and scheduled maintenance. Continue to the next question as directed for each No or Yes answer. 1 -1 Will the project involve the modification of a watercourse bank or bank of the Green/Duwamish or Black Rivers between the ordinary high water mark and top of bank? This includes any projects that will require grading on any slope leading to a river or stream, but will not require work below the ordinary high water mark. Work below the ordinary high water mark is covered in Part C. Please circle appropriate response. NO - Continue to Question 1 -2 YES - Continue to Question 1 -2 1 -2 Could the construction, operation, or maintenance of the project result in sediment transport off site or increased rates of erosion and/or sedimentation in watercourses, the Green/Duwamish rivers, or the Black River? Most projects that involve grading have the potential to result in increased erosion and/or sedimentation as a result of disturbances to the soil or earth. If your project involves grading and you have not prepared a Temporary Erosion and Sedimentation Control Plan specifically designed to retain 100 percent of the runoff (including during construction) from impervious surface or disturbed soils, answer Yes to this question. If your project is normally exempt under the Tukwila Municipal Code and would not require the preparation of a Temporary Erosion and Sedimentation Control Plan, BUT may still result in erosion or sediment transport off site or beyond the work area, answer Yes to this question. Please circle appropriate response. NO - Continue to Question 1 -3 YES - Continue to Question 1 -3 1 -3 Will the project result in the construction of new impervious surfaces? Impervious surfaces include those hard surfaces which prevent or restrict the entry of water into the soil in the manner that such water entered the soils under natural conditions prior to development; or a hard surface area that causes water to run off the surface in greater quantity or at an increased rate of flow from the flow presented under natural conditions prior to development (see TMC Chapter 18.06, Tukwila Zoning Code, Page 18 -12). Such areas include, but are not limited to, rooftops, asphalt or concrete paving, compacted surfaces, or other surfaces that similarly affect the natural infiltration or runoff patterns existing prior to development. Please circle appropriate response. NO - Continue to Question 2 -0 (Page 2) YES - Continue to Question 1 -4 January 25, 2001 3 City of Tu ESA Screening Checklist Part B (continued) 1 -4 Will your project generate stormwater from the creation of impervious surfaces that will not be infiltrated on site? For the purpose of this analysis, infiltration includes the use of a stormwater treatment and management system intended to contain all stormwater on site by allowing it to seep into pervious surface or through other means to be introduced into the ground. If your project involves the construction of impervious surface and does not include the design of a stormwater management system specifically designed to infiltrate stormwater, answer Yes to this question. Please circle appropriate response. NO - Continue to Question 2 -0 (Page 2) YES - Continue to Question 2 -0 (Page 2) Part C: Please review each question below for projects that include clearing. Review each question carefully, considering all phases of your project including, but not limited to construction, normal operation, potential emergency operation, and ongoing and scheduled maintenance. Continue to the next question as directed for each No or Yes answer. 2 -1 Will the project involve clearing within 200 feet of the ordinary high water mark of a watercourse or the Green/Duwamish or Black Rivers? Please circle appropriate response. NO - Continue to Question 3 -0 (Page 2) YES - Continue to Question 2 -2 2 -2 Will the project involve clearing of any trees within 200 feet of the ordinary high water mark of a watercourse or the Green/Duwamish or Black Rivers? A tree is defined by TMC 18.06.845 as any self - supporting woody plant, characterized by one main trunk, with a potential diameter - breast - height of 2 inches or more and potential minimum height of 10 feet. Please circle appropriate response. NO - Continue to Question 2 -3 YES - Continue to Question 2 -3 2 -3 Will the project involve clearing of any evergreen trees from within 200 feet of the ordinary high water mark of a watercourse or the Green/Duwamish or Black Rivers? For the purpose of this analysis evergreen means any tree that does not regularly lose all its leaves or needles in the fall. Please circle appropriate response. NO - Continue to Question 2 -4 YES - Continue to Question 2 -4 2 -4 Will the project involve clearing within 100 feet of the ordinary high water mark of a watercourse or the Green/Duwamish or Black Rivers? Please circle appropriate response. NO - Continue to Question 3 -0 (Page 1) YES - Continue to Question 2 -5 2 -5 Will the project involve clearing within 40 feet of the ordinary high water mark of a watercourse or the Green/Duwamish or Black Rivers? Please circle appropriate response. NO - Continue to Question 3 -0 (Page 2) YES - Continue to Question 3 -0 (Page 2) January, 33, 2001 4 • City of Tug" ESA Screening Checklist Part D: Please review each question below for projects that include work below the ordinary high water mark of watercourses or the Duwamish /Green or Black Rivers or in wetlands. Review each question carefully, considering all phases of your project including, but not limited to, construction, normal operation, potential emergency operation, and ongoing and scheduled maintenance. Continue to the next question as directed for each No or Yes answer. 3 -1 Will the project involve the direct alteration of the channel or bed of a watercourse, the Green/Duwamish rivers, or Black River? For the purpose of this analysis, channel means the area between the ordinary high water mark of both banks of a stream, and bed means the stream bottom substrates, typically within the normal wetted -width of a stream. This includes both temporary and permanent modifications. Please circle appropriate response. NO - Continue to Question 3 -2 YES - Continue to Question 3 -2 3 -2 Will the project involve any physical alteration to a watercourse or wetland connected to the Green/Duwamish River? For the purpose of this analysis, "connected to the river means" flowing into via a surface connection or culvert, or having other physical characteristics that allow for access by salmonids. This includes impacts to areas such as sloughs, side channels, remnant oxbows, ditches formed from channelized portions of natural watercourses or any area that may provide off channel rearing habitat for juvenile fish from the Duwamish River. This includes both temporary construction alterations and permanent modifications. Watercourses or wetlands draining to the Green/Duwamish River that have a hanging culvert, culvert with a flap gate, diversion, or any entirely man -made or artificial structure that precludes fish access should answer Yes to this question. Please circle appropriate response. NO - Continue to Question 3 -3 YES - Continue to Question 3 -3 3 -3 Will the project result in the construction of a new structure or hydraulic condition that could be a barrier to salmonid passage within the watercourse or the Green/Duwamish or Black Rivers? For the purpose of this analysis, a barrier means any artificial or human modified structure or hydraulic condition that inhibits the natural upstream or downstream movement of salmonids, including both juveniles and adults. Please circle appropriate response. NO - Continue to Question 3 -4 YES - Continue to Question 3 -4 3 -4 Will the project involve a temporary or permanent change in the cross - sectional area of a watercourse or the Green/Duwamish or Black Rivers? For the purpose of this analysis, the cross - sectional area is defined as a profile taken from the ordinary high water mark on the right bank to the ordinary high water mark on the left bank. Please circle appropriate response. NO - Continue to Question 3 -5 YES - Continue to Question 3 -5 3 -5 Will the project require the removal of debris from within the ordinary high water mark of a watercourse or the Green/Duwamish or Black Rivers? For the purpose of this analysis, debris includes, but is not limited to fallen trees, logs, shrubs, rocks, piles, rip -rap, submerged metal, and broken concrete or other building materials. Projects that would require debris removal from a watercourse or the Green/Duwamish or Black Rivers as part of a maintenance activity should answer Yes to this question. Please circle appropriate response. NO - Continue to Question 3 -6 YES - Continue to Question 3 -6 January 25, 2001 5 I City of TuI'a ESA Screening Checklist Part D (continued) 3 -6 Will the project result in impacts to watercourses or wetlands that have a surface connection to another watercourse or the Green/Duwamish or Black Rivers but do not contain habitat conditions that support salmonid use? Such areas may include, but not be limited to hillside seeps and wetlands isolated from the watercourse or river that have a surface water connection to the watercourse or river but are not assessable, nor would be assessable to salmonids under natural conditions. Wetlands with a "functions and values" rating for baseflow /groundwater support of 9 and above (or moderate) as described in Cooke (1996) should be included. Please circle appropriate response. NO - Continue to Question 3 -7 YES - Continue to Question 3 -7 3 -7 Will the project include the construction of artificial waterways or wetlands connected to a watercourse containing salmonids? For the purpose of this analysis, the construction of artificial waterways or wetlands includes wetlands, channels, sloughs, or other habitat feature created to enhance wildlife use, particularly waterfowl use, or may be attractive to wildlife, particularly waterfowl. Please circle appropriate response. NO - Continue to Question 3 -8 YES - Continue to Question 3 -8 3 -8 Will the project include bank stabilization? For the purpose of this analysis, bank stabilization includes, but is not limited to, rip -rap, rock, log, soil, or vegetated revetments, concrete structures, or similar structures. Please circle appropriate response. NO - Continue to Question 4 -0 (Page 2) YES - Continue to Question 4 -0 (Page 2) January 25, 2001 6