HomeMy WebLinkAboutSEPA EPIC-210-83 - FARWEST PAINT MANUFACTURING - 133RD STREET VACATIONFARWEST PAINT STREET
VACATION -
SO. 133 "° & 134`" PL.
EPIG210 -83
Affidavit of Publication
STATE OF WASHINGTON
COUNTY OF KING
}
ss.
Cindy Strupp being first duly sworn on
oath, deposes and says that she is the chief clerk of
THE DAILY RECORD CHRONICLE, a newspaper published six (6) times a
week. That said newspaper is a legal newspaper and it is now and has been
for more than six months prior to the date of publication referred to,
printed and published in the English language continually as a newspaper
published four (4) times a week in Kent, King County, Washington, and it is
now and during all of said time was printed in an office maintained at the
aforesaid place of publication of said newspaper. That the Daily Record
Chronicle has been approved as a legal newspaper by order of the Superior
Court of the County in which it is published, to -wit, King County,
Washington. That the annexed is a ....NQ.tiC.e...Of...Action
as it was published in regular issues (and
not in supplement form of said newspaper) once each issue for a period
of two consecutive issues, commencing on the
8tldayof December , 19 83 ,and ending the
15thyof December 1983 , both dates
inclusive, and that such newspaper was regularly distributed to its sub-
scribers during all of said period. That the full amount of the fee
charged for the foregoing publication is the sum of $ 42 • 4 5 which
has been paid in full at the rate of per folio of one hundred words for the
first insertion and per folio of one hundred words for each subsequent
insertion.
i
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1 /DEC 2 0 19R1
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1 .CITY OF, TUKWILA
Pursuant to the provisions
of chapter 43.21C RCW,
notice is hereby given that:
I The City of Tukwila did on
NOTICE }OF -;;
Subscribed and.3worn to before me this
3
Chief Clerk
15th
/
for the State of Washington,
residing at KWIC, King County.
Federal Wa
Notary Public in a
day of
— Passed by the Legislature, 1955, known as Senate Bill 281, effective June
9th, 1955.
— Western Union Telegraph Co. rules for counting words and figures,
adopted by the newspapers of the State.
VN #87 Revised 5/82
41 let tit
November 21, 1983, take
the action described below.
Any action to set aside,,
enjoin, review, or otherwise
challenge such action on the
grounds of noncompliance
with the provisions of Chap-
ter 32.21 C. (State Enviro_ n-
mental Policy Act) 'shat( be
commenced within 30 days
or be barred.
The action taken by City of
Tukwila notice of which is
hereby given, was as
follows: .
Issue a determination of
Nonsignificance for vacation
of South 133rd easterly of
So. 134th Place to West,
Marginal Way South 99T.
Pertinent documents may
Ibe examined during regular
i business hours at. the Plan-
ning Department located at:
City Hall, 6200 Southcenter
Boulevard.
It This notice is given by
P Robert J. Sheehan and Paul
'E. Sheehan,' dba California
-^{` Avenue Co., a partnership
and filed by Robert J.
Sheehan, partner.
Published in the Daily Re-
cord Chronicle on Decemb-
er 8 and 1:5, 1'983. R8833
•
ntimmEsnr
• •
F A R W E S T P A I N T M A N U F A C T U R I N -C L ��,; `- ,;,il ,t �
. 4522 South 133rd ........- -
P.O. Box 68726
Tukwila, Washington 98168 { ,
(206) 244 -8844 (._..i - . ;;:.. ,; • , {a
December 16, 1983
L. Rick Beeler, Associate Planner
City of Tukwila
6200 Southcenter Boulevard
Tukwila, Washington 98188
Dear Mr. Beeler:
Enclosed is affidavit from The Daily Record Chronicle for the publication
of notice you requested in your letter of November 29, 1983.
Sincerely,
Robert J. Sheehan, Partner
dba California Avenue Co.
RJS:ag
Encl: Affidavit of Publication
cc:. Paul Sheehan
MATSON PAINT PRODUCTS WONDERGLO® High Quality Paints
1908
Citytf Tukwila
6200 Southcenter Boulevard
Tukwila Washington 98188
Gary L. VanDusen, Mayor
November 29, 1983
Robin Huber
Farwest Paint Co.
4522 So. 133rd.
P.O. Box 68726
Tukwila:WA 98168
Re:. Street Vacation
Dear Robin:
Enclosed is the public notice featured in the State Environmental Policy
Act to be published pursuant to the Determination of Nonsignificance
issued for your street vacation. Please publish in "Record Chronicle" on
the same day for two consecutive weeks, and mail me a copy of the affidavit
of publication you will receive from the newspaper.
The purpose of this notification is to establish and terminate any rights
to appeal the Determination of Nonsignificance. Once the mentioned 30
day period expires, rights to appeal also expire. Otherwise, appeal
rights could continue on into the future. Therefore, we advise applicants
to opt for publishing the notice, although additional effort and expense.
is involved. It is insurance against possible future problems.
If you have any questions, give me a call at 433 -1847.
Respectf »1
L. Rick Beeler
Associate Planner
RB /mlk
NOTICE OF ACTION BY
• ('L -���
f Goner rrn
1t"\ f c tU \ lLP\
Pursuant to the provisions of chapter 43.2]C RCW, notice is hereby given that:
ct itct
The
did on ODVti*lber^ Z.1( (9'x,3 (d.ete) take the action described -below_
Any action to set aside, enjoin, review, or otherwise challenge such action on the grounds of
noncompliance with the provisions of chapter 43.2]C RCW (State En v*ironmental Policy Act)
shall be commenced within 3 • days or be barred.
The action taken by
'tikw414
notice of which is hereby given, was as follows:
lajj ISSo t_ a Ofri7e..kmi rt.4 i ort of r nsi yn i ■tu c-Orl o +t
Sd . f33 r4 5-r, [ek (y of .S1.
(3) Saida • - . ..
Pertinent documents may be examined during regular business hours at the officc of-
C 1 fy � ( ZOO 5,0+11 e r Sou (e ∎t u vc . .
located at:
1f (Location, including room number)
-`t I S 4104. Lt LS g v!n b y Far we Mawyccia t»i t3r Lc .� GlRcJ
"qiled by 4411Vii b d J. �tre-eh
Cliza Or t -t aoctec.
WAC 197 -11 -1350
DETERMINATION OF NONSIGNIFICANCE
Description of proposal Street Vacation
Proponent Farwest Paint Manufacturing Co.
Location of proposal So. 133rd St. easterly of So. 134th Place
Lead agency` City of Tukwila
File No. EPIC - 201 -83
This proposal has been determined not to have a probably significant
adverse impact on the environment. An environmental impact statement
(EIS). is not required under RCW 43- 21C.020(c). Thisdecision was made
after review by the lead agency of acompleted environmental checklist
and other information on file with the lead agency. This information
is available to the public on request.
Responsible official Brad Collins
Position /title
Planning Director
Address and phone 6200 Southcenter Blvd., Tukwila, WA 98188 433 -1845
Date November 21, 1983
Signature
tee, 4 -tom ,¢/,,,rurN,�s -� r
At.* __
-Mo_ -
C1IY Oh TU011LA
PERMIT NUMBER - . •TR0L NUMBER 43 -3I3
CENTRAL PERMIT SYSTEM - PLAN CHECK ROUTING FORM
TO: BLDG, PLNG, P,W, FIRE
PROJECT Fi3y ai5- aZ. 4 if-`ec a(
ADDRESS
DATE. TRANSMITTED 11A5i 3
C,P,S, STAFF COORDINATOR PicA
POLICE I P,& R.
RESPONSE REQUESTED BY 8—Mr/g3
RESPONSE RECEIVED
PLEASE REVIEW THE ATTACHED PROJECT PLANS AND RESPOND WITH APPROPRIATE •
COMMENTS IN THE.SPACE BELOW, INDICATE CRUCIAL CONCERNS BY CHECKING•THE
BOX NEXT TOTHE LINE(S) ON WHICH. THAT CONCERN IS NOTED:
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D, R, C, REVIEW REQUESTED
PLAN RESUBMITTAL REQUESTED
PLAN CHECK DATE II/ 10/83
COMMENTS PREPARED BY
C.P.S. FORM 2
?OSTE D o rJ SiTF
CITY OF TUKWILA
NOTICE OF PUBLIC HEARING BY THE
TUKWILA CITY COUNCIL
NOTICE IS HEREBY GIVEN that the Tukwila City Council will conduct a Public
Hearing on the 28th day of November, 1983, at 7:00 p.m. in the Council
Chambers of Tukwila City Hall, 6200 Southcenter Boulevard, to' consider
the following:
VACATION OF THE UNOPENED PORTION OF SOUTH 133RD STREET
LYING EASTERLY OF SOUTH 134TH PLACE
Any and all interested persons are invited to be present to voice approval
disapproval, or opinions'on same.,
CITY OF TUKWILA
Maxine Anderson
City Clerk
Published Record Chronicle - November 8, 1983 .
CITY OF "VILA
41iEFMIT NUMBEP, CiiTROL NUhBER $3-,314a-
CENTRAL PERMIT SYSTEM - PLAN CHECK ROUTING FORM
TO: BLDG, IVJPLNGI 1 P,W, FIRE POLICE' 1 J P,& R.
PROJECT F,lyrv./5- au',?,& oefiJ' 2C i 9-yu
ADDRESS60, Ja.3-V L. c P ;,)3L1 °L i21,
DATE. TRANSMITTED 1/k5) .3 . RESPONSE REQUESTED BY ///q/13
C,P,S. STAFF COORDINATOR Pi(JP -RESPONSE RECEIVED
PLEASE REVIEW THE ATTACHED PROJECT PLANS AND RESPOND WITH APPROPRIATE
COMMENTS IN THE.SPACE BELOW, •INDICATE CRUCIAL CONCERNS BY CHECKING.THE
BOX NEXT TOiTHE LINE(S) ON WHICH.THAT CONCERN IS NOTED:
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PLAN RESUBIIITTAL REQUESTED
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PLAN CHECK DATE ►' -8- 3
COMMENTS PREPARED BY eec--
CIP,S, FORM 2
01-3-3/3
CITY OF TUKWILA
Ilb . RECEIVED
CITY OF TUKWttA
ENVIRONMENTAL CHECKLIST FORM
PJY 2 1983
WW1/6 DEPT.
This questionnaire must be completed and submitted with the application for.
permit. 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 the permit is exempt or unless the applicant and Responsible
Official previously agree an Environmental Impact Statement needs to becpmpleted.
A fee of $50.00 must accompany the filling of the Environmental Questionnaire
to cover costs of the threshold determination.
I. BACKGROUND
1. Name of Proponent: FMwE5T PA-zit) T 8F-6- (! 0. /ber* . S heehA
2. Address and Phone Number of Proponent: 4/0-72,2- Sough J3,3 rd
3. Date Checklist Submitted: ///-2/8'.7
4. Agency Requiring Checklist: (1,42/ Of ----/Doe,.
5. Name of.Proposal, if applicable:vp,(p 'Ipl p - cymbeev.sa0 rocriol`1 pF S, (53an
ja2LY of 5, 1341TN PL,
6. Nature and Brief Description of the Proposal (including but not limited
to its size, general design elements, and other factors that will give
an accurate understanding of its scope and nature):
1 7 i ".Q -11 «V ✓� c/a/7f, - QV 49te1-r/es4 7.t 4 f iOLi t /33
t;4 I, 14,o, y L 4(1I
7. Location of Proposal (describe (des robe the physical setting of the proposal, as .
well as the extent of the land area affected by any environmental im-
pacts, including any other information needed to give an accurate under-
standing of the environmental setting of the proposal):
�J #�
8. Estimated Date for Completion of the Proposal:
9. List of all Permits, Licenses or Government Approvals
Proposal (federal, state and .local):
(a) Rezone, conditional use, shoreline permit, etc.
(b) .King County Hydraulics Permit
(c) Building permit
/9s,3
Required for the
YES
YES
YES
NO ✓
NO ,
NO
• •
(d) Puget Sound Air Pollution Control Permit YES NO ✓
(e) Sewer hook up permit YES NO ✓
(f) Sign permit YES NO ✓
(g) Water hook up permit YES NO ✓
(h) Storm water system permit YES NO ✓
(i) Curb cut permit YES NO ✓
(j) Electrical permit (State of Washington) YES NO L/7
(k) Plumbing permit (King County) YES NO ✓
(1) Other:
10. Do you have any plans for future additions, expansion, or futher activity
related to or connected with this proposal? If yes, explain:
11. Do you know of any plans by d'thers.which may affect the property covered by
your proposal? If yes, explain:
12. Attach any other application form that has been completed regarding the pro-
posal; if none has been completed, but is expected to be filed at some future
date, describe the nature of such application form:
II. ENVIRONMENTAL IMPACTS
(Explanations of all "yes" and "maybe" answers are required)
1. Earth. Will the proposal result in:
(a) Unstable earth conditions or in changes in geologic
substructures?
(b) Disruptions, displacements, compaction or overcover-
ing of the soil?
(c) Change in topography or ground surface relief fea-
tures?
(d) The destruction, covering or modification of any
unique geologic or physical features?
YES MAYBE NO
YES MAYBE NO
(e) Any increase in wind or water erosion of soils,
either on or off the site? t✓
(f) Changes in deposition or erosion of beach sands, or
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:
2. 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 any change in climate, either
locally or regionally?
Explanation:
3. Water. Will the proposal result in:
(a) Changes in currents, or the course or direction
of water movements, in either marine or fresh
waters?
(b) Changes in absorption rates, drainage patterns,
or the rate and amount of surface water runoff?
(c) Alterations to the course or flow of flood waters?
(d) Change in the amount of surface water in any water
body?
(e) Discharge into surface waters, or in any,alteration
of surface water quality, including but not limited
to temperature, dissolved oxygen 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 aquifer by cuts or excavations?
-3-
• •
(h) Deterioration in ground water quality, either
through direct injection, or through the seepage
of leachate, phosphates, detergents, waterborne
virus or bacteria, or other substances into the
ground waters?
(i) Reduction in the amount of water otherwise avail-
able for public water supplies?
Explanation:
4. Flora. Will the proposal result in:
(a) Change in the diversity of species, or numbers
of any species of flora (including trees, shrubs,
grass, crops, microflora 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 barrier to the normal replenishment of
existing species?
(d) Reduction in acreage of any agricultural crop?
Explanation:
5. Fauna. Will the proposal result in:
(a) Changes in the diversity of species, or numbers
of any species of fauna (birds, land animals
including reptiles, fish and shellfish, benthic
organisms, insects or microfauna)?
(b) 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 migration
or movement of fauna?
(d) Deterioration . to existing fish or wildlife
habitat?
Explanation:
YES MAYBE NO
6. Noise. Will the proposal increase existing noise
levels?
Explanation:
7. Light and Glare. Will the proposal produce new
light or glare ?.
Explanation:
8. Land Use. Will the proposal result in, the altera-
tion of the present or planned land use
of an area?
YES MAYBE. NO
J
ation• A
2..e.A.4.4.4.,t, (1,436
9. Natural Res urces. Will the proposal result in:
(a) Increase in the rate of use of any natural
resources?
(b) Depletion of any nonrenewable natural
resource?
Explanation:
10. Risk of•Upset. Does the proposal involve a risk of an
explosion or the release of hazardous
substances (including, but not limited
to, oil, pesticide's, chemicals or radi-
ation) in the event of an accident or
upset conditions?
Explanation:
• •
11. Population. Will the proposal alter the location,
distribution, density, or growth rate
of the human population of an area?
Explanation:
12. Housing. Will the proposal affect existing housing,
or create a demand for additional housing?
Explanation:
13. Transportation /Circulation. Will the proposal 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, rail or air traffic?
(f) Increase in traffic hazards to motor vehicles,
bicyclists or pedestrians? •
Explanation:
14. Public Services. Will the proposal have an effect upon,
or result in a need for new or altered
governmental services in any of the
following areas:'
YES MAYBE. NO
(a) Fire protection?
(b) Police protection?
(c) Schools?
(d) Parks or other recreational facilities?
(e) Maintenance of public facilities, including
roads?
v
,v
(f) Other governmental services?
Explanation:
15. 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:
16. Utilities. Will the proposal result in a need for
new systems, or alterations to the
following 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:
17. Human Health. Will the proposal result in the crea-
tion of any health hazard or potential
health hazard (excluding mental health)?
Explanation:
YES MAYBE NO
• •
18. Aesthetics. Will the proposal result in the obstruc-
tion of any scenic vista or view open to
the public, or will the proposal result
in the . creation of an aesthetically of-
fensive site open to public view?
Explanation:
19. Recreation. Will the proposal result in an impact
upon the quality or quantity of exist-
ing recreational opportunities?
Explanation:
20. Archeological /Histroical. Will the proposal result in
an alteration of a signifi-
cant archeological or his-
torical site, structure,
object or building?
Explanation:
CERTIFICATION BY APPLICANT:
YES MAYBE NO
I, 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.
nature and Title Date
-8-
I U KW 1 LA
•
*PERMIT NUMBER , INTROL NUMBER X33- I
CENTRAL PERMIT SYSTEM - PLAN CHECK ROUTING FORM
TO: BLDG, PLNG, 1 P,W, FIRE POLICE
PROJECT Faru.2,5 AM.& ,5h'et l/2e
ADDRESS6D, J33�,L -1 °L _)Q.L
DATE. TRANSMITTED . RESPONSE REQUESTED BY /rid}' /g3
C,P,S. STAFF COORDINATOR PAP. RESPONSE RECEIVED
PLEASE REVIEW THE ATTACHED PROJECT PLANS AND RESPOND WITH APPROPRIATE •
COMMENTS IN THE. SPACE BELOW, INDICATE CRUCIAL CONCERNS BY CHECKING. THE
BOX NEXT TO ,THE LINECS) ON WHICH.THAT CONCERN IS NOTED:
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D, R,- C,REVIEW REQUESTED
PLAN RESUBIIITTAL REQUESTED
=A1\ CHEt1KC DATE /VV�."3
COMMENTS PREPARED BY%�i
C;P,S, FORM 2
MY OF IUKWILA
iirERMIT NUMBERFpc. -)W -3 •TROL NUMBER: 3:3-3 Li-3-
CENTRAL PERMIT SYSTEM - PLAN CHECK ROUTING FORM
TO: BLDG, PLNG, 1 P,W, FIRE POLICE 1 1 P,& R,
PROJECT Fart i5 /- )Qa(l-&
ADDRESS60, la Y L old 6', ) 3 ' - 4 L ,
DATE. TRANSMITTED II/)3 . RESPONSE REQUESTED BY ii/P//3
C,P,S, STAFF COORDINATOR Pic RESPONSE RECEIVED
PLEASE REVIEW THE ATTACHED PROJECT PLANS AND RESPOND WITH APPROPRIATE
COMMENTS IN THE. SPACE BELOW, INDICATE CRUCIAL CONCERNS BY CHECKING-THE
BOX NEXT TO,THE LINE(S) ON WHICH. THAT CONCERN IS NOTED:
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PLAN RESUBMITTAL REQUESTED
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PLAN CHECK DP,TE
COMMENTS PREPARED BY 17
C;P,S, FORM 2
CITY OF TUKW ILA
.PERMIT NUMBER • •TROL NUMBER X3-3
CENTRAL PERMIT SYSTEM -. PLAN CHECK ROUTING FORM
TO: BLDG, PLNG, P,W, _I'L FIRE POLICE P,8 P,
• PROJECT F uwi5� )Q? ih' t VQ(°_0i
ADDRESS60. /53-vd. 01, 13L/ °L ILL,
DATE. TRANSMITTED . RESPONSE REQUESTED BY 8)4/1'3
C, P, S, STAFF COORDINATOR Pick?, RESPONSE RECEIVED
PLEASE REVIEW THE ATTACHED PROJECT PLANS AND RESPOND WITH APPROPRIATE •
COMMENTS IN THE. SPACE BELOW, INDICATE CRUCIAL CONCERNS BY CHECKING.THE
BOX NEXT TO THE LINE(S) ON WHICH.THAT CONCERN IS NOTED:
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PLAN RESUBiMITTAL REQUESTED COMMENTS PREPARED BY
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CITY OF TUKWILA
•RMIT NUMBER - COIOROL NUMBER $3- I3
CENTRAL PERMIT SYSTEM - PLAN CHECK ROUTING FORM
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TO: BLDG, 1- PLNG, P,W, FIRE V POLICE P,& R.
PROJECT Faru)15/ at-M.b er VC c i-U
ADDRESS,133-rd- 6, )30 °L at ,
DATE. TRANSMITTED I i/.0l S3 . . RESPONSE REQUESTED BY ilia /S 3.
C,P,S. STAFF COORDINATOR P/c 1 RESPONSE RECEIVED
PLEASE REVIEW THE ATTACHED PROJECT PLANS AND RESPOND WITH APPROPRIATE •
COMMENTS IN THE SPACE BELOW, INDICATE CRUCIAL CONCERNS BY CHECKING THE
BOX NEXT TO ,THE LINE(S) ON WHICH.THAT CONCERN IS NOTED:
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PLAN CHECK DATE
COMMENTS PREPARED BY
C;P1S, FORM 2
PERMIT NUMBER IiiNTROL NUMBER $3-34:
CENTRAL PERMIT SYSTEM PLAN CHECK ROUTING FORM
TO: BLDG, PLNG, P.W. : FIRE
PROJECT Ftw'i5- atirT&
ADDRESS
DATE. TRANSMITTED / /.3
C. P, S, STAFF COORDINATOR P 'Ck-0
POLICE
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RESPONSE REQUESTED BY 21/21.? 3
• RESPONSE RECEIVED
PLEASE REVIEW THE ATTACHED PROJECT PLANS AND RESPOND WITH APPROPRIATE
COMMENTS IN THE. SPACE. BELOW, INDICATE CRUCIAL CONCERNS BY CHECKING-THE
BOX NEXT TO :THE LINE(S) ON WHICH. THAT CONCERN IS NOTED:
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PLAN CHECK DATE // /57/3
COMMENTS PREPARED BY
C;P,S, FORM 2
Go1 3-3J3 •
CITY OF TUKWILA
ENVIRONMENTAL CHECKLIST FORM
RECEIVED
CITY OF TUIONII.A
NOV 2 1983
WILDING OEM
This questionnaire must be completed and submitted with the application for.
permit. 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 the permit is exempt or unless the applicant and Responsible
Official previously agree an Environmental Impact Statement needs to be 9mpleted.
A fee of $50.00 must accompany the filling of the Environmental Questionnaire
to cover costs of the threshold determination.
I. BACKGROUND
1. Name of Proponent: ) 4 4wE..T p/} =a r ,4t' . e!/). //Robert . Sheehan
2. Address and Phone Number of Proponent: 12/52- Souk/, )3 rd ,S4reef; :.
3. Date Checklist Submitted: /y/.2/8 3
4. Agency Requiring Checklist: C,'i. y pf --7;104/ is In
5. Name of, Proposal , if applicable:VOti(A11O1.1 CF(yti3pet,w0 porzlic*Nop S. Mao
11212• OF S. 134TO R..
6. Nature and Brief Description of the Proposal (including but not limited
to its size, general design elements, and other factors that will give
an accurate understanding of its scope and nature):
J L 41)
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7. Location of Proposal (describe the physical setting of the proposal, as
well as the extent of the land area affected by any environmental im-
pacts, including any other information needed to give an accurate under-
standing of the environmental setting of the proposal):
8. Estimated Date for Completion of the Proposal:
.9) /933
9. List of all Permits, Licenses or Government Approvals Required for the
Proposal (federal, state and local):
(a) Rezone, conditional use, shoreline permit, etc.
(b) King County Hydraulics Permit
(c) Building permit
YES NO
YES NO v//
YES NO
• •
(d) Puget Sound Air Pollution Control Permit YES NO /
(e) Sewer hook up permit YES NO ✓
(f) Sign permit YES NO ✓
(g) Water hook up permit YES NO ✓
(h) Storm water system permit YES NO ✓
(i) Curb cut permit YES NO ✓
(j) Electrical permit (State of Washington) YES NO i/
(k) Plumbing permit (King County) YES NO ✓
(1) Other:
10. Do you have any plans for future additions, expansion, or futher activity
related to or connected with this proposal? If yes, explain:
,d -Pita.o aZ`"v
11. Do you know of any plans by d"thers which may affect the property covered by
your proposal? If yes, explain:
12. Attach any other application form that has been completed regarding the pro-
posal; if none has been completed, but is expected to be filed at some future
date, describe the nature of such application form:
II. ENVIRONMENTAL IMPACTS
(Explanations of all "yes" and "maybe" answers are required)
1. Earth. Will the proposal result in:
(a) Unstable earth conditions or in changes in geologic
substructures?
(b) Disruptions, displacements, compaction or overcover-
ing of the soil?
(c) Change in topography or ground surface relief fea-
tures?
(d) The destruction, covering or modification of any
unique geologic or physical features?
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YES MAYBE NO
•
(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
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:
2. 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 any change in climate, either
locally or regionally?
Explanation:
3. Water. Will the proposal result in:
(a) Changes in currents, or the course or direction
of water movements, in either marine or fresh
waters?
(b) Changes in absorption rates, drainage patterns,
or the rate and amount of surface water runoff?
(c) Alterations to the course or flow of flood waters?
(d) Change in the amount of surface water in any water
body?
(e) Discharge into surface waters, or in any alteration
of surface water quality, including but not limited
to temperature, dissolved oxygen 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 aquifer by cuts or excavations?
-3-
YES MAYBE NO
(h) Deterioration in ground water quality, either
through direct injection, or through the seepage
of leachate, phosphates, detergents, waterborne
virus or bacteria, or other substances into the
ground waters?
(i) Reduction in the amount of water otherwise avail-
able for public water supplies?
Explanation:
4. Flora. Will the proposal result in:
(a) Change in the diversity of species, or numbers
of any species of flora (including trees, shrubs,
grass, crops, microflora 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 barrier to the normal replenishment of
existing species?
(d) Reduction in acreage of any agricultural crop?
Explanation:
5. Fauna. Will the proposal result in:
(a) Changes in the diversity of species, or numbers
of any species of fauna (birds, land animals
including reptiles, fish and shellfish, benthic
organisms, insects or microfauna)?
(b) 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 migration
or movement of fauna?
(d) Deterioration to existing fish or wildlife
habitat?
Explanation:
YES MAYBE NO
YES MAYBE NO
6. Noise. Will the proposal increase existing noise
levels?
Explanation:
7. Light and Glare. Will the proposal produce new
light or glare?
Explanation:
8. Land Use. Will the proposal result in the altera-
tion of the present or planned land use
of an area?
Explanation:
U 7-•ci •
9. Natural Res urces. Will the proposal result in:
(a) Increase in the rate of use of any natural
resources?
(b) Depletion of any nonrenewable natural
resource?
Explanation:
10. 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 radi-
ation) in the event of an accident or
upset conditions?
Explanation:
11. Population.
Explanation:
• •
Will the proposal alter the location,
distribution, density, or growth rate
of the human population of an area?
12. Housing. Will the proposal affect existing housing,
or create a demand for additional housing?
Explanation:
13. Transportation /Circulation. Will the proposal 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, rail or air traffic?
(f) Increase in traffic hazards to motor vehicles,
bicyclists or pedestrians?
Explanation:
..(A47
14. Public Services. Will the proposal have an effect upon,
or result in a need for new or altered
governmental services in any of the
following areas:
(a) Fire protection?
(b) Police protection?
(c) Schools?
(d) Parks or other recreational facilities?
(e) Maintenance of public facilities, including
roads?
YES MAYBE NO
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tv
• •
(f) Other governmental, services?
Explanation:
15. 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:
16. Utilities. Will the proposal result in a need for
new systems, or alterations to the
following 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:
17. Human Health. Will the proposal result in the crea-
tion of any health hazard or potential
health hazard (excluding mental health)?
Explanation:
YES MAYBE NO
• •
YES MAYBE NO
18. Aesthetics. Will the proposal result in the obstruc-
tion of any scenic vista or view open to
the public, or will the proposal result
in the creation of an aesthetically of-
fensive site open to public view?
Explanation:
19. Recreation. Will the proposal result in an impact
upon the quality or quantity of exist-
ing recreational opportunities?
Explanation:
20. Archeological /Histroical. Will the proposal result in
an alteration of a signifi-
cant archeological or his-
torical site, structure,
object or building?
Explanation:
CERTIFICATION BY APPLICANT:
I, 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.
nature and Title ' Date
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