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Home My WebLink AboutSEPA EPIC-ND-19 - HOMECO - REZONEHOMECO REZONE 14004 - 53 "° AV S EPIGND -19 CITY OF TUKWIL.A • CERTIFICATION. BY APPLICANT: • • I hereby certify that the information furnished in this environmental checklist sheet is -true and accurate to the best of my knowledge. Project Name: gnature and Title /A /aci7, Date Project Address: ,'i001: — .S 3 BELOW THIS LINE FOR CITY USE ONLY ACTION BY OTHER'DEPARTMENTS: =Check one 1. Date of Review: Building by: Planning 1— b Engineering by: Police by: Fire by:` -: 2. Agency review of environmental checklist determined that: ':.The project is exempt by definition. The project has no significant environmental impact and application should be processed without further consideration of environmental affects. The project has significant environmental impact and a complete environ mental impact statement must be prepared prior to further action for permit More specific information is needed to determine impact.- Sing ature and. Tit e .of Responsible Official 3. Applicant was notified of decision on: by Date Staff Person by Letter, phone. In accordance with Washington State Environmental Policy Act and City of %,i Tukila Ordinance No 759. (1•) Means recommend afull environmental impact statement be•done. ( -). Means recommend a full environmental impact statement'not "be' done: CITY OF TUKWILA ENVIRONMENTAL QUESTIONNAIRE This questionnaire must be completed by all persons applying for a permit from the city of Tukwila., unless it is determined by the Responsible Official that an environmental assessment or full impact statement is required. Other forms have been developed for single- family home applications and legislation proposals. BACKGROUND DATA: 1. Name of applicant: ( &.' O' F�t/2AUi-A( 2. Address and phone of Applicant: /2.-7A/-i2 6 iv 7 ,4 q ✓� 3.719 5 A4 wn, y ,f28- 3. 4. 5. Project name: i✓ /i4 Project location: 5 )„4. F' s's A✓E s o a N DS'f9d ?'U Nature and brief description of proposal: ie c zo •'/ O _fc "7a 0 6 6. Estimated completion date: 9oj9,4),s A<4 ;n 12E .cNC A/ .i.evn‘- 7. Do you have any plans for future expansion, if yes please explain: N a What other governmental permits are required prior project? Rezone, conditional use, substantial (a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (1) to completion of this YES)( NO "YES. _ NO X YES.Y.. NO YES NO y • YES )( . NO YES N0)( YES 5( NO YES NO YES NO,C YES Y NO YES4 NO development, etc. King County Hydriolics Permit Building permit Puget Sound Air Pollution Control. Permit Sewer hook up permit Sign permit Water hook up permit Storm water system permit Curb cut permit Electrical permit (State of Washington) Plumbing permit (King County) Other • 9. Do you know of any plans by others which may affect the property covered by your proposal? If yes, explain: A/c) 10. Agency requiring checklist: City of Tukwila, Department - 11. Accepted by agency on: rt4AA (fl (9 . by: (to be filled in by city upon receipt of checklist) ENVIRONMENTAL •IMPACTS (Explanations of all "yes" and "maybe" answers are required.) • Yes Maybe Earth. Will the proposal result in: (a) Unstable earth conditions or in any changes in geologic sub - structures: (b) Disruptions, displacements or overcovering of the soils: (c) Change in topography or ground surface relief features? (d) The destruction, covering, or modification of any unique geologic or physical features? (e) Any increase in wind or water erosion of soils, either on or off the site? (f) Changes in deposition or erosion of beach sands, or in changes in siltation, deposition, or erosion which may modify the channel of a river or stream or the bed. of the ocean . or any bay, inlet or lake? Explanation: Air. Will the proposal result in: (a) Air emissions or deterioration of ambient air quality? (b) The creation of objectionable odors? (c) Alteration of air movement, moisture or temperature, or in any change in climate, • either locally or regionally? Explanation:. Water. Will the proposal result in: (a) Changes in currents, or the course or direction ofwater movements, in either marine or fresh waters? (b) Changes in absorption rates, drainage patterns, or the amount of surface water run- off? (c) Alterations to the course or flow of flood waters? (d) Change in the amount of surface water in any watercourse? (e) Discharge into surface waters, . or in any alteration of sur- face.'water quality, including temperature or turbidity? (f) Alteration of the direction or rate of flow of ground waters? (g) Change in the quantity of ground waters, either through direct additions or withdrawals, or through interception of an acquifer by cuts or excavations? (h) Deterioration in ground water quality, either through direct injection, or through the seep- age of leachate, phosphates, detergents, waterborne virus or bacteria, or other substances .into the ground waters? Reduction in the amount of water otherwise available for public water supplies? (i) Explanation: s Maybe No Flora. Will the proposal result in: (a) Change in the diversity of species, or numbers of any spec h s of flora (including trees, shrubs, grass, crops', micro -flora and aquatic plants)? (b) Reduction of the numbers of any unique, rare . or endangered species of flora? (c) Introduction of new species of flora into an area, or in a bar- rier to the normal replenishment of existing species? Explanation: Fauna.. Will the proposal result in: (a) (b) Changes in the diversity of species, or numbers of any species of fauna (birds, land animals including rep- tiles, fish and shellfish, benthic organisms, insects, or micro- fauna)? Reduction of the numbers of any unique, rare or endangered species of fauna? (c) Introduction of new species of fauna into an area, or result in a.barrier . to the_ mi grati on or movement of fauna?' (d) Deterioration to existing wildlife • habitat? Explanation: Noise. Will the proposal increase exist ing noise levels? Explanation: Yes Maybe No Light and Glare. Will the proposal produce new light or glare? Explanation: ° Land Use., Will the proposal result in the alteration of the present .or planned land. use of an area? Explanation: Natural Resources. Will the proposal re -. sult in: (a) Increase in the rate of use of any natural resource? (b) Depletion of any nonrenewable nat- ural resource? Explanation:. Risk of Upset. Does the proposal involve a risk of an explosion or the release of hazardous substances (including, but not limited to, oil, pesticides, chemicals or radiation) in the event of an accident or . upset conditions? Explanation: Population. Will the proposal alter the location, distribution, density, or growth rate of the human population of an area? Explanation: to 4it./ G. OeiC For/ fn,C./ 0►= ►°6-4S6N !c du44/7 j /o‘t6L.E FA / 12�x.davL/ Yes Maybe No • Housing. Will the proposal affect existing housing availability, or create a demand for additional housing? Explanation: Transportation /Circulation. Will the pro -. posal result in: (a) Generation of additional vehicular movement? (b) Effects on existing parking facilities, or demand for new parking? (c) Impact upon existing transportation systems? (d) Alterations to present patterns of circulation or movement of people and /or goods? (e) Alterations to waterborne or air traffic? Explanation: Local Services. Will the prOposal have an effect upon, or result in a need for new services in any of the following areas: (a). Fire protection? (b) Police protection? (c) Schools? (d) Parks? (e) Maintenance of public facilities, including roads? (f) Other 'governmental services? Explanation: Yes Maybe No Energy. Will the proposal result in: (a) Use of substantial amounts of fuel or energy? (b) Demand upon existing sources of energy, or require the development of new sources of energy? Explanation: Utilities. Will the proposal result in a need for new systems, or alterations to the follow- ing utilities: (a) Power or natural gas? (b) .Communications systems? (c) Water? (d) Sewer or septic tanks? (e) Storm water drainage? (f) Solid waste and disposal? Explanation: Yes Maybe Human Health. Will the proposal result in the creation of any health hazard or potential health hazard (excluding mental health)? Explanation: Aesthetics. Will the proposal result in the obstruction of any scenic vista or view open to the public, or will the proposal result in the creation of an aesthetically offensive site open to public view? Explanation: Recreation. Will the proposal result in an impact upon the quality or quantity ofex- isting recreational opportunities? Explanation:' Archeological /Historical. Will the proposal result in an alteration of a significant archeological or historical site? Explanation: Revenue. Will the proposal cause a signifi- cant.increase in city revenues? Explanation: Employment. Will the proposal create a significant amount of new jobs? Explanation: Yes Maybe' No .