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HomeMy WebLinkAboutSEPA E06-003 - WALTON TODD / CLEARWIRE- STAND-ALONE MONOPOLEE06 -003 CLEARWIRE WA SEA119-113 15000 57TH AVE SO • Ciiy of Tukwila Steven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director February 14, 2006 Mr. Todd Walton 5808 Lake Washington Blvd Ste 300 Kirkland, WA 98033 RE: Notice of Incomplete Application Conditional Use Permit (L06 -012) and SEPA Application (E06 -003) City of Tukwila ROW, adjacent to 15000 57th Avenue South Dear Mr. Walton: The City of Tukwila's Planning Department received your application for a Conditional Use Permit and SEPA application for Clearwire to locate a monopole near 15000 57th Avenue South. The application was submitted on February 2, 2006. As of February 14, 2006 the application has been deemed to be incomplete. The following item(s) need to be submitted for the City 1. As I noted on the phone, an Owner's Affidavit (attached) needs to be submitted. Once the above - mentioned information is provided, City staff can begin to review the application. Please note that the Department shall cancel an incomplete application if the applicant fails to submit the requested information within 90 -days following notification from the Department that the application is incomplete. The Department may extend up to 120 days if the applicant submits a written request for an extension prior to cancellation. The request must clearly demonstrate that the delay is due to circumstances beyond the applicant's control (such as the need for seasonal wetland data) or unusual circumstance not typically faced by other applicants, and that a good faith effort has been made to provide the requested materials (TMC 18.104.070). If you have any questions, please feel free to call me at (206) 431 -3684 or you can email me at bmiles@ci.tukwila.wa.us. 'randon J. Miles Assistant Planner cc. Nora Gierloff, Planning Supervisor Files (L06 -012 and E06 -0003) 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 • CITY OF TUKWILA Department of Community Development 6300 Southcenter Boulevard, Tukwila, WA 98188 Telephone: (206) 431 -3670 FAX (206) 431 -3665 E -mail: tukplan@.ci.tukwila.wa.us • SEPA ENVIRONMENTAL REVIEW APPLICATION NAME OF PROJECT/DEVELOPMENT: apa i•v &44 -se/9 //9- 5 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. el ?y - rati.414 1661,-r-‘ OF key AQj /—fa /5000 . 9''"' AvE s, p4gCEt -t /157 700310 Quarter: NW Section: z3 Township: 13 Range: 7 (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. 24zr6 Al • s ro Lake- L' I -s /I "o 13/tot S Sob /0/a /A kW wR go3) Name: Address: Phone: 204 339 9 //b FAX: lob 36/ 964% Signature: -11 C: \homepage \tukwila \dcd \apps \sepaApp.DOC, 08/19/05 Date: 2- 2-- Looms FOR STAFF USE ONLY SIERRA TYPE P-SEPA A� Planner: File Number: Eo / p -0D3 "� -1 C / Application Complete (Date: ) Project File Number: `� 0 Application Incomplete (Date: ) Other File Numbers: O gi FZ'Fi M(I NAME OF PROJECT/DEVELOPMENT: apa i•v &44 -se/9 //9- 5 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. el ?y - rati.414 1661,-r-‘ OF key AQj /—fa /5000 . 9''"' AvE s, p4gCEt -t /157 700310 Quarter: NW Section: z3 Township: 13 Range: 7 (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. 24zr6 Al • s ro Lake- L' I -s /I "o 13/tot S Sob /0/a /A kW wR go3) Name: Address: Phone: 204 339 9 //b FAX: lob 36/ 964% Signature: -11 C: \homepage \tukwila \dcd \apps \sepaApp.DOC, 08/19/05 Date: 2- 2-- Looms City of Tukwila • 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 RECEIPT Parcel No.: Address: Suite No: Applicant: TODD WALTON Permit Number: E06-003 Status: PENDING Applied Date: 02/02/2006 Issue Date: Receipt No.: R06 -00161 Payment Amount: 500.00 Initials: BM Payment Date: 02/02/2006 03:03 PM User ID: 1684 Balance: $0.00 Payee: CLEARWIRE TRANSACTION LIST: Type Method Description Amount Payment Check 5038 500.00 ACCOUNT ITEM LIST: Description Account Code Current Pmts SEPA 000/345.831 500.00 Total: 500.00 1971 02/02 9716 TOTAL 500.00 doc: Receipt Printed: 02 -02 -2006 COMPLETE APPLICATION ChECKLIST The materials listed below must be submitted with your application unless specifically waived in writing by the Public Works Department and the Department of Community Development. Please contact each Department if you feel that certain items are not applicable to your project and should be waived, or should be submitted at a later date for use at the public hearing (e.g. colored renderings). Application review will not begin until it is determined to be complete. ADDITIONAL MATERIALS MAY BE REQUIRED. The initial application materials allow starting project review and vesting the applicant's rights. However, they in no way limit the City's ability to require additional information as needed to establish consistency with development standards. City staff are available to answer questions about application materials at 206 - 431 -3670 (Department of Community Development) and 206 - 433 -0179 (Department of Public Works). Check, items submitted with • application Information Required: May waived 'in. unusual . cases; upon:approval'of both Public °> Works : .. and Plannin g , RECEII APPLICATION MATERIALS: FEB 0 2 COrriMuf 1. Application Checklist (1 copy) indicating items submitted with application. DEVELOP ✓ 2. Completed Application Form and drawings (5 copies). ✓ / 3. One set of all plans reduced to 8 1/2" by 11". One complete set of PMTs of the final drawing set will be required prior to final approval. ✓ 4. Application Fee $2,000. 5. SEPA Environmental Checklist (see SEPA Application Packet). PUBLIC NOTICE MATERIALS: ✓ 6. King County Assessor's map(s) that shows the location of each property within 500 ft. of the subject lot. 7. Two (2) sets of mailing labels for all property owners and tenants (residents or businesses) within 500 feet of the subject property. Note: Each unit in multiple- family buildings - -e.g. apartments, condos, trailer parks - -must be included (see Public Notice Materials section of SEPA Application packet). 8. A 4' x 4' public notice board will be required on site within 14 days of the Department determining that the application is complete (see Public Notice Materials section of SEPA Application packet). PROPERTY INFORMATION: 9. Vicinity Map with site location. 10. If new construction is proposed document sewer and water availability if provided by other than the City of Tukwila. PROJECT DESCRIPTION AND ANALYSIS: 11. A written discussion of project consistency with decision criteria. (See Application) 12. If additional impervious surface is proposed submit a Technical Information Report (TIR) including feasibility analysis per King County Surface Water Design Manual (KCSWDM). For additional guidance contact Public Works. 13. Provide sensitive area studies as needed per Tukwila's Sensitive Areas Ordinance (TMC 18.45). SITE PLAN: / ✓ 14 (a) The site plan must include a graphic scale, north arrow and project name. Maximum size 24" x 36 ". (b) Existing and proposed building footprints. P \Red_Book \CUP APP.DOC, 01/23/03 ED 2006 TY ENT Check items submitted , with application,; Information Req d. May be waived :in unusual cases, upoWpproval of both Public Works, and Planning (c) Dash in required setback distances from all parcel lot lines. (d) Fire access lanes and turn - arounds per Fire Department standards. (e) Parking lots with dimensioned stalls and drive aisles. (f) Loading and service areas. • (g) Fences, rockeries and retaining walls. (h) Pedestrian connections between the building entrance(s) and the sidewalk/public street. LANDSCAPE PLAN: 15 (a) Landscape planting plan by a Washington State licensed landscape architect. One set of all plans and analyses shall have an original Washington State registered Landscape Architect stamp and signature. Plans must include the type, quantity, spacing and location of all plantings. Maximum size 24" x 36 ". (b) Show all existing trees to be retained and any tree protection measures required (for example fencing at drip line). SENSITIVE AREAS PLAN: 16 (a) Location of all sensitive areas (e.g. streams, wetlands, slopes over 20 %, coal mine areas and important geological and archaeological sites). For stream frontage provide existing and proposed top of stream bank, stream bank toe, stream mean high water mark, and base flood elevation (i.e., 100 yr. flood). Maximum size 24" x 36 ". (b) Location of all required sensitive area buffers, setbacks tracts and protection measures. (c) Show all trees over 4" caliper, indicating those to be retained. (d) Proposed lot and tract lines. CIVIL PLANS (If any site changes are proposed): 17 (a) One set of all civil plans and analyses shall be stamped, signed and dated by a licensed professional engineer. Include a graphic scale and north arrow. Maximum size 24" x 36 ". (b) Vertical datum NAVD 1988 and horizontal datum NAD 83/91. Conversion calculations to NGVD 1929, if in a flood zone or flood -prone area. (c) Existing (dashed) and proposed (solid) topography at 2' intervals. (d) Total expected cut and fill. (e) Existing and proposed utility easements and improvements, on site and in street (water, sewer, power, natural gas, telephone, cable). Schematic designs to be provided regardless of purveyor (e.g. site line size, location, and size of public main). No capacity calcs, invert depth, valve locations or the like are needed. (f) If additional impervious surface is proposed provide a storm drainage design at least 90% complete, which meets the TIR and KCSWDM. Include all storm drainage maintenance access and safety features. Call out total existing and proposed impervious surface in square feet. (g) Locate the nearest existing hydrant and all proposed hydrants. (h) Show the 100 yr. flood plain boundary and elevation as shown on FEMA maps. (i) Plan, profile and cross - section for any right -of -way improvements. (j) Show planned access to lots, driveways, fire access lanes and turn- arounds. OTHER: 18. If new construction is proposed provide dimensioned and scalable building elevations with keyed colors and materials. Show mechanical equipment and /or any proposed screening. 19. If site lighting changes are proposed provide a luminaire plan including location and type of street and site lighting. Include proposed fixture cut sheets, site light levels (foot - candles), and measures to shield adjacent properties from glare. 20. All existing and proposed signage with sign designs and locations. 21. Any other drawings or materials needed to explain your proposal. 1' \Red_Book \CUP_APP.DOC, 01 /23/03 COMPLETE APPLICATION ChECKLIST The materials listed below must be submitted with your application unless specifically waived in writing by the Public Works Department and the Department of Community Development. Please contact each Department if you feel that certain items are not applicable to your project and should be waived, or should be submitted at a later date for use at the public hearing (e.g. colored renderings). Application review will not begin until it is determined to be complete. ADDITIONAL MATERIALS MAY BE REQUIRED. The initial application materials allow starting project review and vesting the applicant's rights. However, they in no way limit the City's ability to require additional information as needed to establish consistency with development standards. City staff are available to answer questions about application materials at 206 -431 -3670 (Department of Community Development) and 206 -433 -0179 (Department of Public Works). Check`` "items submitted r yr : , wlthr, °.• aPPhcation. '��Information Required: Maybe waived yin unusual cases, upon approval of both Public Works and•Planning . ,. ". APPLICATION MATERIALS: f 1. Application Checklist (1 copy) indicating items submitted with application. ✓ 2. Completed Application Form and drawings (5 copies). / 3. One set of all plans reduced to 8 1/2" by 11 ". One complete set of PMTs of the final drawing set will be required prior to final approval. 4. Application Fee $2,000. 1 5. SEPA Environmental Checklist (see SEPA Application Packet). PUBLIC NOTICE MATERIALS: ✓ 6. King County Assessor's map(s) that shows the location of each property within 500 ft. of the subject lot. •:. 7. Two (2) sets of mailing labels for all property owners and tenants (residents or businesses) within 500 feet of the subject property. Note: Each unit in multiple - family buildings —e.g. apartments, condos, trailer parks- -must be included (see Public Notice Materials section of SEPA Application packet). 8. A 4' x 4' public notice board will be required on site within 14 days of the Department determining that the application is complete (see Public Notice Materials section of SEPA Application packet). PROPERTY INFORMATION: / 9. Vicinity Map with site location.. 10. If new construction is proposed document sewer and water availability if provided by other than the City of Tukwila. PROJECT DESCRIPTION AND ANALYSIS: " 11. A written discussion of project consistency with decision criteria. (See Application) 12. If additional impervious surface is proposed submit a.Technical Information Report (TIR) including feasibility analysis per King County Surface Water Design Manual (KCSWDM). For additional guidance contact Public Works. . 13. Provide sensitive area studies as needed per Tukwila's Sensitive Areas Ordinance (TMC 18.45). .. . \ SITE PLAN: j 14 (a) The site plan must include a graphic scale, north arrow and project name. Maximum size 24" x 36 ". (b) Existing and proposed building footprints. \CUP APP.DOC, 01/23/03 Cfieck 'items submitted ... with . .. . application.: Information Re d. May be waived in unusual cases, upon approval of both Public Works . and Planning (c) Dash in required setback distances from all parcel lot lines. (d) Fire access lanes and turn - arounds per Fire Department standards. • (e) Parking lots with dimensioned stalls and drive aisles. (f) Loading and service areas. . (g) Fences, rockeries and retaining walls. (h) Pedestrian connections between the building entrance(s) and the sidewalk/public street. LANDSCAPE PLAN: 15 (a) Landscape planting plan by a Washington State licensed landscape architect. One set of all plans and analyses shall have an original Washington State registered Landscape Architect stamp and signature. Plans must include the type, quantity, spacing and location of all plantings. Maximum size 24" x 36 ". (b) Show all existing trees to be retained and any tree protection measures required (for example fencing at drip line). SENSITIVE AREAS PLAN: 16 (a) Location of all sensitive areas (e.g. streams, wetlands, slopes over 20 %, coal mine areas and important geological and archaeological sites). For stream frontage provide existing and proposed top of stream bank, stream bank toe, stream mean high water mark, and base flood elevation (i.e., 100 yr. flood). Maximum size 24" x 36". (b) Location of all required sensitive area buffers, setbacks tracts and protection measures. (c) Show all trees over 4" caliper, indicating those to be retained. (d) Proposed lot and tract lines. CIVIL. PLANS (If any site changes are proposed): 17 (a) One set of all civil plans and analyses shall be stamped, signed and dated by a licensed professional engineer. Include a graphic scale and north arrow. Maximum size 24" x 36 ". (b) Vertical datum NAVD 1988 and horizontal datum NAD 83/91. Conversion calculations to NGVD 1929, if in a flood zone or flood -prone area. (c) Existing (dashed) and proposed (solid) topography at 2' intervals. (d) Total expected cut and fill. . (e) Existing and proposed utility easements and improvements, on site and in street (water, sewer, power, natural gas, telephone, cable). Schematic designs to be provided regardless of purveyor (e.g. site line size, location, and size of public main). No capacity calcs, invert depth, valve locations or the like are needed. • (f) If additional impervious surface is proposed provide a storm drainage design at least 90% complete, which meets,the TIR and KCSWDM. Include all storm drainage maintenance access and safety features. Call out total existing and proposed impervious surface in square feet. (g) Locate the nearest existing hydrant and all proposed hydrants. (h) Show the 100 yr. flood plain boundary and elevation as shown on FEMA maps. (i) Plan, profile and cross - section for any right -of -way improvements. • (j) Show planned access to lots, driveways, fire access lanes and turn - arounds. OTHER: 18. If new construction is proposed provide dimensioned and scalable building elevations with keyed colors and materials. Show mechanical equipment and /or any proposed screening. 19. If site lighting changes are proposed provide a luminaire plan including location and type of street and site lighting. Include proposed fixture cut sheets, site light levels (foot - candles), and measures to shield adjacent properties from glare. 20. All existing and proposed signage with sign designs and locations. 21. Any other drawings or materials needed to explain your proposal. P: \Red_Book \CUP APP.DOC 01/23/03 COMPLETE APPLICATION CIECKLIST The materials listed below must be submitted with your application unless specifically waived in writing by the Public Works Department and the Department of Community Development. Please contact each Department if you feel that certain items are not applicable to your project and should be waived, or should be submitted at a later date for use at the public hearing (e.g. colored renderings). Application review will not begin until it is determined to be complete. ADDITIONAL MATERIALS MAY BE REQUIRED. The initial application materials allow starting project review and vesting the applicant's rights. However, they in no way limit the City's ability to require additional information as needed to establish consistency with development standards. City staff are available to answer questions about application materials at 206 - 431 -3670 (Department of Community Development) and 206 - 433 -0179 (Department of Public Works). Check • ,'items.; submitted with application.. ''Information Required. Maybe waived;in unusual cases; upon approval ofboth Public :Works:' and:Planning . ... APPLICATION MATERIALS: f 1. Application Checklist (1 copy) indicating items submitted with application. 2. Completed Application Form and drawings (5 copies). / 3. One set of all plans reduced to 8 1/2" by 11 ". One complete set of PMTs of the final drawing set will be required prior to final approval. ✓ 4. Application Fee $2,000. J 5. SEPA Environmental Checklist (see SEPA Application Packet). PUBLIC NOTICE MATERIALS: 6. King County Assessor's map(s) that shows the location of each property within 500 ft. of the subject lot. . / ✓ 7. Two (2) sets of mailing labels for all property owners and tenants (residents or businesses) within 500 feet of the subject property. Note: Each unit in multiple - family buildings —e.g. apartments, condos, trailer parks- -must be included (see Public Notice Materials section of SEPA Application packet). 8. A 4' x 4' public notice board will be required on site within 14 days of the Department determining that the application is complete (see Public Notice Materials section of SEPA Application packet). PROPERTY INFORMATION: / 9. Vicinity Map with site location. 10. If new construction is proposed document sewer and water availability if provided by other than the City of Tukwila. PROJECT DESCRIPTION AND ANALYSIS:. 11. A written discussion of project consistency with decision criteria. (See Application) 12. If additional impervious surface is proposed submit a Technical Information Report (TIR) including feasibility analysis per King County Surface Water Design Manual (KCSWDM). For additional guidance contact Public Works. 13. Provide sensitive area studies as needed per Tukwila's Sensitive Areas Ordinance (TMC 18.45). . \ SITE PLAN: / J 14 (a) The site plan must include a graphic scale, north arrow and project name. Maximum size 24 "x36 ". (b) Existing and proposed building footprints. \CUP_APP.DOC, 01/23/03 Check items • submitted' with `:' .: ..application 'InformationRec�ed. May be waived in unusual cases, upo approval of both Public Works and Planning (c) Dash in required setback distances from all parcel lot lines. (d) . Fire access lanes and turn - arounds per Fire Department standards. • (e) Parking lots with dimensioned stalls and drive aisles. (f) Loading and service areas. . (g) Fences, rockeries and retaining walls. (h) Pedestrian connections between the building entrance(s) and the sidewalk/public street. LANDSCAPE PLAN: 15 (a) Landscape planting plan by a Washington State licensed landscape architect. One set of all plans and analyses shall have an original Washington State registered Landscape Architect stamp and signature. Plans must include the type, quantity, spacing and location of all plantings. Maximum size 24" x 36 ". (b) Show all existing trees to be retained and any tree protection measures required (for example fencing at drip line). SENSITIVE AREAS PLAN: 16 (a) Location of all sensitive areas (e.g. streams, wetlands, slopes over 20 %, coal mine areas and important geological and archaeological sites). For stream frontage provide existing and proposed top of stream bank, stream bank toe, stream mean high water mark, and base flood elevation (i.e., 100 yr. flood). Maximum size 24" x 36". (b) Location of all required sensitive area buffers, setbacks tracts and protection measures. (c) Show all trees over 4" caliper, indicating those to be retained. (d) Proposed lot and tract lines. CIVIL PLANS (If any site changes are proposed): 17 (a) One set of all civil plans and analyses shall be stamped, signed and dated by a licensed professional engineer. Include a graphic scale and north arrow. Maximum size 24" x 36 ". (b) Vertical datum NAVD 1988 and horizontal datum NAD. 83/91. Conversion calculations to NGVD 1929, if in a flood zone or flood -prone area. (c) Existing (dashed) and proposed (solid) topography at 2' intervals. (d) Total expected cut and fill. ' (e) Existing and proposed utility easements and improvements, on site and in street (water, sewer, power, natural gas, telephone, cable). Schematic designs to be provided regardless of purveyor (e.g. site line size, location, and size of public main). No capacity calcs, invert depth, valve locations or the like are needed. (f) If additional impervious surface is proposed provide a storm drainage design at least 90% complete, which meets the TIR and KCSWDM. Include all storm drainage maintenance access and safety features. Call out total existing and proposed impervious surface in square feet. (g) Locate the nearest existing hydrant and all proposed hydrants. (h) Show the 100 yr. flood plain boundary and elevation as shown on FEMA maps. (i) Plan, profile and cross- section for any right -of -way improvements. (j) Show planned access to lots, driveways, fire access lanes and turn - arounds. OTHER: 18. If new construction is proposed provide dimensioned and scalable building elevations with keyed colors and materials. Show mechanical equipment and /or any proposed screening. 19. If site lighting changes are proposed provide a luminaire plan including location and type of street and site lighting. Include proposed fixture cut sheets, site light levels (foot- candles), and measures to shield adjacent properties from glare. 20. All existing and proposed signage with sign designs and locations. 21. Any other drawings or materials needed to explain your proposal. P: \Red_Book \CUP_APP.DOC, 01/23/03 COMPLETE APPLICATION ChECKLIST The materials listed below must be submitted with your application unless specifically waived in writing by the Public Works Department and the Department of Community Development. Please contact each Department if you feel that certain items are not applicable to your project and should be waived, or should be submitted at a later date for use at the public hearing (e.g. colored renderings). Application review will not begin until it is determined to be complete. ADDITIONAL MATERIALS MAY BE REQUIRED. The initial application materials allow starting project review and vesting the applicant's rights. However, they in no way limit the City's ability to require additional information as needed to establish consistency with development standards. City staff are available to answer questions about application materials at 206 -431 -3670 (Department of Community Development) and 206 -433 -0179 (Department of Public Works). Check 'Items: submitted with . application . ' ,Information Required. Maybe Wailiedin unusual cases; zipon approval of both Public Works and Planning. APPLICATION MATERIALS: 1. Application Checklist (1 copy) indicating items submitted with application. ✓ 2. Completed Application Form and drawings (5 copies). 3. One set of all plans reduced to 8 1/2" by 11". One complete set of PMTs of the final drawing set will be required prior to final approval. ✓ 4. Application Fee $2,000. j 5. SEPA Environmental Checklist (see SEPA Application Packet). PUBLIC NOTICE MATERIALS: 6. King County Assessor's map(s) that shows the location of each property within 500 ft. of the subject lot. . 7. Two (2) sets of mailing labels for all property owners and tenants (residents or businesses) within 500 feet of the subject property. Note: Each unit in multiple - family buildings —e.g. apartments, condos, trailer parks- -must be included (see Public Notice Materials section of SEPA Application packet). 8. A 4' x 4' public notice board will be required on site within 14 days of the Department determining that the application is complete (see Public Notice Materials section of SEPA Application packet). PROPERTY INFORMATION: 9. Vicinity Map with site location.. 10. If new construction is proposed document sewer and water availability if provided by other than the City of Tukwila. PROJECT DESCRIPTION AND ANALYSIS: . 0 11. A written discussion of project consistency with decision criteria. (See Application) 12. If additional impervious surface is proposed submit a.Technical Information Report (TIR) including feasibility analysis per King County Surface Water Design Manual (KCSWDM). For additional guidance contact Public Works. 13. Provide sensitive area studies as needed per Tukwila's Sensitive Areas Ordinance (TMC 18.45). • " \ SITE PLAN: 14 (a) The site plan must include a graphic scale, north arrow and project name. Maximum size 24" x 36 ". (b) Existing and proposed building footprints. \CUP APP.DOC, 07/23/03 Check =items submitted with:. • application.. Information-Re ed. May be waived iri unusual cases, upWxpproval.of both Public Works and Planning (c) Dash in required setback distances from all parcel lot lines. (d) Fire access lanes and turn - arounds per Fire Department standards. (e) Parking lots with dimensioned stalls and drive aisles. (f) Loading and service areas. . (g) Fences, rockeries and retaining walls. (h) Pedestrian connections between the building entrance(s) and the sidewalk/public street. LANDSCAPE PLAN: 15 (a) Landscape planting plan by a Washington State licensed landscape architect. One set of all plans and analyses shall have an original Washington State registered Landscape Architect stamp and signature. Plans must include the type, quantity, spacing and location of all plantings. Maximum size 24" x 36 ". (b) Show all existing trees to be retained and any tree protection measures required (for example fencing at drip line). SENSITIVE AREAS PLAN: 16 (a) Location of all sensitive areas (e.g. streams, wetlands, slopes over 20 %, coal mine areas and important geological and archaeological sites). For stream frontage provide existing and proposed top of stream bank, stream bank toe, stream mean high water mark, and base flood elevation (i.e., 100 yr. flood). Maximum size 24" x 36". (b) Location of all required sensitive area buffers, setbacks tracts and protection measures. (c) Show all trees over 4" caliper, indicating those to be retained. (d) Proposed lot and tract lines. CIVIL PLANS (If any site changes are proposed): 17 (a) One set of all civil plans and analyses shall be stamped, signed and dated by a licensed professional engineer. Include a graphic scale and north arrow. Maximum size 24" x 36 ". (b) Vertical datum NAVD 1988 and horizontal datum NAD. 83/91. Conversion calculations to NGVD, 1929, if in a flood zone or flood -prone area. (c) Existing (dashed) and proposed (solid) topography at 2' intervals. (d) Total expected cut and fill. (e) Existing and proposed utility easements and improvements, on site and in street (water, sewer, power, natural gas, telephone, cable). Schematic designs to be provided regardless of purveyor (e.g. site line size, location, and size of public main). No capacity calcs, invert depth, valve locations or the like are needed. (f) If additional impervious surface is proposed provide a storm drainage design at least 90% complete, which meets, the TIR and KCSWDM. Include all storm drainage maintenance access and safety features. Call out total existing and proposed impervious surface in square feet. (g) Locate the nearest existing hydrant and all proposed hydrants. (h) Show the 100 yr. flood plain boundary and elevation as shown on FEMA maps. (i) Plan, profile and cross- section for any right -of- way improvements. (j) Show planned access to lots, driveways, fire access lanes and turn - arounds. OTHER: . 18. If new construction is proposed provide dimensioned and scalable building elevations with keyed colors and materials. Show mechanical equipment and /or any proposed screening. 19. If site lighting changes are proposed provide a luminaire plan including location and type of street and site lighting. Include proposed fixture cut sheets, site light levels (foot - candles), and measures to shield adjacent properties from glare. 20. All existing and proposed signage with sign designs and locations. 21. Any other drawings or materials needed to explain your proposal. P: \Red_Book \CUP_APP.DOC, 01/23/03 COMPLETE APPLICATION C}FECKLIST The materials listed below must be submitted with your application unless specifically waived in writing by the Public Works Department and the Department of Community Development. Please contact each Department if you feel that certain items are not applicable to your project and should be waived, or should be submitted at a later date for use at the public hearing (e.g. colored renderings). Application review will not begin until it is determined to be complete. ADDITIONAL MATERIALS MAY BE REQUIRED. The initial application materials allow starting project review and vesting the applicant's rights. However, they in no way limit the City's ability to require additional information as needed to establish consistency with development standards. City staff are available to answer questions about application materials at 206 - 431 -3670 (Department of Community Development) and 206 -433 -0179 (Department of Public Works). Check ' items: submitted with applicarion :Information Required. May be waived in unusual cases, upon approval of both Works, , andPlanning; .. APPLICATION MATERIALS: / 1. Application Checklist (1 copy) indicating items submitted with application. ✓ 2. Completed Application Form and drawings (5 copies). / 3. One set of all plans reduced to 8 1/2" by 11". One complete set of PMTs of the final drawing set will be required prior to final approval. �// 4. Application Fee $2,000. j5. SEPA Environmental Checklist (see SEPA Application Packet). PUBLIC NOTICE MATERIALS: 6. King County Assessor's map(s) that shows the location of each property within 500 ft. of the subject lot. 7. Two (2) sets of mailing labels for all property owners and tenants (residents or businesses) within 500 feet of the subject property. Note: Each unit in multiple - family buildings - -e.g. apartments, condos, trailer parks- -must be included (see Public Notice Materials section of SEPA Application packet). 8. A 4' x 4' public notice board will be required on site within 14 days of the Department determining that the application is complete (see Public Notice Materials section of SEPA Application packet). PROPERTY INFORMATION: 9. Vicinity Map with site location. 10. If new construction is proposed document sewer and water availability if provided by other than the City of Tukwila. PROJECT DESCRIPTION AND ANALYSIS: sr 11. A written discussion of project consistency with decision criteria. (See Application) 12. If additional impervious surface is proposed submit a Technical Information Report (TIR) including feasibility analysis per King County Surface Water Design Manual (KCSWDM). For additional guidance contact Public Works. 13. Provide sensitive area studies as needed per Tukwila's Sensitive Areas Ordinance (TMC 18.45). \ SITE PLAN: / ✓ 14 (a) The site plan must include a graphic scale, north arrow and project name. Maximum size 24" x 36 ". (b) Existing and proposed building footprints. \CUP_APP.DOC, 01/23/03 Check,':items' sub 11tted< ' . with ':application:::. . Information Reed. May be Waived iri.unusual cases, upoiapproval of both Public Works and'Planning . (c) Dash in required setback distances from all parcel lot lines. (d) Fire access lanes and turn - arounds per Fire Department standards. • (e) Parking lots with dimensioned stalls and drive aisles. (f) Loading and service areas. . (g) Fences, rockeries and retaining walls. (h) Pedestrian connections between the building entrance(s) and the sidewalk/public street. LANDSCAPE PLAN: 15 (a) Landscape planting plan by a Washington State licensed landscape architect. One set of all plans and analyses shall have an original Washington State registered Landscape Architect stamp and signature. Plans must include the type, quantity, spacing and location of all plantings. Maximum size 24" x 36 ". (b) Show all existing trees to be retained and any tree protection measures required (for example fencing at drip line). SENSITIVE AREAS PLAN: 16 (a) Location of all sensitive areas (e.g. streams, wetlands, slopes over 20 %, coal mine areas and important geological and archaeological sites). For stream frontage provide existing and proposed top of stream bank, stream bank toe, stream mean high water mark, and base flood elevation (i.e., 100 yr. flood). Maximum size 24" x 36 ".. (b) Location of all required sensitive area buffers, setbacks tracts and protection measures. (c) Show all trees over 4" caliper, indicating those to be retained. (d) Proposed lot and tract lines. CIVIL PLANS (If any site changes are proposed): 17 (a) One set of all civil plans and analyses shall be stamped, signed and dated by a licensed professional engineer. Include a graphic scale and north arrow. Maximum size 24" x 36 ". (b) Vertical datum NAVD 1988 and horizontal datum NAD 83/91. Conversion calculations to NGVD 1929, if in a flood zone or flood -prone area. (c) Existing (dashed) and proposed (solid) topography at 2' intervals. (d) Total expected cut and fill. (e) Existing and proposed utility easements and improvements, on site and in street (water, sewer, power, natural gas, telephone, cable). Schematic designs to be provided regardless of • purveyor (e.g. site line size, location, and size of public main). No capacity calcs, invert depth, valve locations or the like are needed. (f) If additional impervious surface is proposed provide a storm drainage design at least 90% complete, which meets, the TIR and KCSWDM. Include all storm drainage maintenance access and safety features. Call out total existing and proposed impervious surface in square feet. (g) Locate the nearest existing hydrant and all proposed hydrants. (h) Show the 100 yr. flood plain boundary and elevation as shown on FEMA maps. (i) Plan, profile and cross - section for any right -of -way improvements. • (j) Show planned access to lots, driveways, fire access lanes and turn - arounds. OTHER: 18. If new construction is proposed provide dimensioned and scalable building elevations with keyed colors and materials. Show mechanical equipment and /or any proposed screening. 19. If site lighting changes are proposed provide a luminaire plan including location and type of street and site lighting. Include proposed fixture cut sheets, site light levels (foot - candles), and measures to shield adjacent properties from glare. 20. All existing and proposed signage with sign designs and locations. 21. Any other drawings or materials needed to explain your proposal. P: \Red_Book \CUP_APP.DOC, 01/23/03 City of l ukWlla II Screening Checklist City of Tukwila Endangered Species Act Screening Checklist Date: 7 — Z ZUG RECEIVED [FEB 0 2 2006 • COMMUNITY DEVELOPMENT Applicant Name: 1 p `A/41 -7bA) /(Lw1w//t& Street Address: Sao( LAkE Mgsvih)1,70A.1 elve`' Sk 30b City, State, Zip: `Cl2 /C/p Nd L✓A 9 03) Telephone: ZCY.. 33V 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 ii CITY OF TUKWILA Department of Community Development 6300 Southcenter Boulevard, Tukwila, WA 98188 Telephone: (206) 431 -3670 FAX (206) 431 -3665 E -mail: tukplan@ci.tukwila.wa.us AFFIDAVIT OF INSTALLATION AND POSTING OF PUBLIC INFORMATION SIGN(S) State of Washington County of King City of Tukwila I (PRINT NAME) understand that Section 18.104.110 of the Tukwila Municipal Code requires me to post the property no later than fourteen (14) days following the issuance of the Notice of Completeness. I certify that on the Public Notice Board(s) in accordance with Section 18.104.110 and the other applicable guidelines were posted on the property located at so as to be clearly seen from each right -of -way primary vehicular access to the property for application file number I herewith authorize the City of Tukwila or its representative to remove and immediately dispose of the sign at the property owner's expense, if not removed in a timely manner or within fourteen (14) days of a Notice letter. Applicant or Project Manager's Signature On this day personally appeared before me to me known to be the individual who executed the foregoing instrument and acknowledged that he /she signed the same as his /her voluntary act and deed for the uses and purposes mentioned therein. SUBSCRIBED AND SWORN to before me this day of NOTARY PUBLIC in and for the State of Washington residing at My commission expires SEPA_APP -VU 1/23/173 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 - Continue to Question 2 -0 - 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. NO - Continue to Question 3 -0 - 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. ICS:6)- 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. 6- Continue 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. O Continue to Question 6 -0 YES - Continue to Question 6 -0 Ltty of l ukw SA Screening C hecklzst Part A (continued) 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. Phase 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. 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. tiD 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 Catty of l ukwzta SA Screening C:heckltst appropriate response. NO - Continue to Question 2 -0 (Page 2) - Continue to Question 1 -4 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. 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. - 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. lE5 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. C" it 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. 0- 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. • Lity of 1 W ;SA Screening Checklist NO - Continue to Question 3 -0 (Page 2) YES - Continue to Question 3 -0 (Page 2) 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 Litt' of l ukTmla L SA Screening Checklist • 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 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) Purpose of checklist: D j UN /7y The State Environmental Policy Act (SEPA), chapter 43.21 C RCW, requires all governmentalpr agencies to consider the environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of this checklist is to provide information to help you and the agency identify impacts from your proposal (and to reduce or avoid impacts from the proposal, if it can be done) and to help the agency decide whether an EIS is required. Instructions for applicants: This environmental checklist asks you to describe some basic information about your proposal. Governmental agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of an EIS. Answer the questions briefly, with the most precise information known, or give the best description you can. You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you should be able to answer the questions from your own observations or project plans without the need to hire experts. If you really do not know the answer, or if a question does not apply to your proposal, write "do not know" or "does not apply." Complete answers to the questions now may avoid unnecessary delays later. Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions if you can. If you have problems, the governmental agencies can assist you. The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time or on different parcels of land. Attach any additional information that will help describe your proposal or its environmental effects. The agency to which you submit this checklist may ask. you to explain your answers or provide additional information reasonably related to determining if there may be significant adverse impact. Use of checklist for nonproject proposals: Complete this checklist for nonproject proposals, even though questions may be answered "does not apply." IN ADDITION, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D). For nonproject actions, the references in the checklist to the words "project," "applicant," and "property or site" should be read as "proposal," "proposer," and "affected geographic area," respectively. • RECE /V FD ENVIRONMENTAL CHECKLIST FEB 02 2006 A. BACKGROUND 1. Name of proposed project, if applicable: Clearwire WA- SEA119 -B 2. Name of applicant: Clearwire, LLC 3. Address and phone number of applicant and contact person: Todd Walton 5808 Lake Washington Blvd., Suite 300 Kirkland, WA 98033 (206)334 -4116 4. Date checklist prepared: 2/1/06 5. Agency requesting checklist: • • City of Tukwila 6. Proposed timing or schedule (including phasing, if applicable): Construction to begin as soon as practicable following permitting. 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. No 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. None known 9. Do you know whether applications are pending for govemmental approvals of other proposals directly affecting the property covered by your proposal? If yes, explain. None known. 10. List any government approvals or permits that will be needed for your proposal, if known. Conditional Use Permit, Building permit. 11. Give 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.) Clearwire proposes to construct an unmanned wireless facility for the purpose of providing broadband intemet service. Clearwire proposes to build a new 60' tower, and place small equipment cabinets near the base of the structure. 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. In City of Tukwila Right of Way adjacent to 15000 57th Ave. S. Page 2 of 11 2 • • B. ENVIRONMENTAL ELEMENTS 1. EARTH a. General description of the site (circle one); flat, rolling, hilly, steep slopes, mountainous, other b. What is the steepest slope on the site (approximate percent slope ?) Less than 5% in construction area, considerable steeper north and south in the ROW. 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. Unknown. d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. None known. e. Describe the purpose, type, and approximate quantities of any filling or grading proposed. Indicate source of fill. Minimal disturbance will occur during the short construction phase related to potential trenching of utilities and placement of an approximate 3'x 3' support cabinet. f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. g. No erosion is expected as a result of this project. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? Less than 1%. h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: None are necessary. Page 3 of 11 3 • • 2. AIR a. What types of emissions to the air would result from the proposal (Le., dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities if known. No emissions are anticipated as a result of this project. b. Are there any off -site sources of emission or odor that may affect your proposal? If so, generally describe. No off -site emission sources will affect the proposal. c. Proposed measures to reduce or control emissions or other impacts to air, if any: None are necessary. 3. WATER a. Surface Water: 1) Is there any surface water body on or in the immediate vicinity of the site (including year - round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type and provide names. If appropriate, state what stream or river it flows into. No surface water bodies known to be located in the vicinity of the project. 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 work anticipated to occur within 200' of water bodies. 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. N/A 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. No 5) Does the proposal lie within a 100 -year flood plain? 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 Page 4 of 11 4 b. Ground Water: 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 such systems, the number of houses to be served (if applicable), or the number of animals or humans the system(s) are expected to serve. N/A - no waste water associated with the project. 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. N/A 2) Could waste material enter ground or surface waters? If so, generally describe. N/A d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: No measures needed. 4. PLANTS a. Check or circle types of vegetation found on the site: _xxx_deciduous tree: alder, maple, aspen, other _xxx_evergreen tree: fir, cedar, pine, other xx shrubs xx grass pasture crop or grain wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other water plants: water lily, eel grass, 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. Page 5 of 11 5 • • d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: none proposed 5. ANIMALS a. Circle any birds and animals which have been observed on or near the site or are known to be on or near the site: Birds: hawk, heron, eagle, songbirds, other Mammals: deer, bear, elk, beaver, other Fish: bass, salmon, trout, herring, shellfish, 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: N/A — none needed. 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 project will require approximately 40A electrical service to the cabinets. b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. No. c. 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: N/A 7. ENVIRONMENTAL HEALTH 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. No. 1) Describe special emergency services that might be required. None. Page 6 of 11 6 • • 2) Proposed measures to reduce or control environmental health hazards, if any: None are necessary. b. Noise 1) What types of noise exist in the area which 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. Minor noise associated with short construction phase. 3) Proposed measures to reduce or control noise impacts, if any: None are necessary. 8. LAND AND SHORELINE USE a. What is the current use of the site and adjacent properties? City Right of Way with an adjacent water reservoir and single family residences: b. Has the site been used for agriculture? If so, describe. Unknown. c. Describe any structures on the site. Utility poles in Right of Way. d. Will any structures be demolished? If so, what? None. e. What is the current zoning classification of the site? ROW, adjacent to SFR. f. What is the current comprehensive plan designation of the site? ROW. g. 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. Page 7of11 7 Approximately how many people would reside or work in the completed project? None. j. Approximately how many people would the completed project displace? None. k. Proposed measures to avoid or reduce displacement impacts, if any: None are necessary. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: The proposal for the 'tower includes camouflaging and painting the facility to match the surrounding trees. 9. HOUSING a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low- income housing. N/A b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or low- income housing. N/A c. Proposed measures to reduce or control housing impacts, if any: None are necessary. 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. Antennas proposed to be mounted inside a 60' tower. b. What views in the immediate vicinity would be altered or obstructed? None. c. Proposed measures to reduce or control aesthetic impacts, if any: None are necessary. 11. LIGHT AND GLARE Page 8 of 11 8 • • a. What type of Tight 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? N /A. d. Proposed measures to reduce or control light and glare impacts, if any: N/A 12. RECREATION a. What designated and informal recreational opportunities are in the immediate vicinity? None known. 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: N/A 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. 0 b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. N/A c. Proposed measures to reduce or control impacts, if any: N/A 14. TRANSPORTATION a. Identify public streets and highways serving the site, and describe proposed access to the existing street system. Show on site plans, if any. The site is accessed from 57th Ave. S. Page 9 of 11 9 • • b. Is site currently served by public transit? If not, what is the approximate distance to the nearest transit stop? N/A — site will not require public access. c. How many parking spaces would the completed project have? How many would the project eliminate? The project will not eliminate any parking stalls and will not require a permanent parking stall. 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. The site will require approximately one visit per month by a technician, for site maintenance purposes. g. Proposed measures to reduce or control transportation impacts, if any: None are necessary. 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 b. Proposed measures to reduce or control direct impacts on public services, if any. None are necessary. 16. UTILITIES a. Circle utilities currently available at the site: electricity, natural gas, water, refuse service, telephone, sanitary sewer, septic system, other. Electricity and telephone are available at the site. b. 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 which might be needed. The site will require power and telephone service. Page 10 of 11 10 C. SIGNATURE 1, the undersigned, state that to the best of my knowledge the above information is true and complete. It is understood that the lead agency may withdraw any declaration of non - significance that it might issue in reliance upon this checklist should there be any willful misrepresentation or willful lack of full disclosure on my part. Proponent: Name Printed: Date: Page 11 of 11 lea kiAgt -r6A1 001. 11