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ABOUT THE CRITICAL AREAS AFFIDAVIT Submittal Instructions Complete (City of Sammamish)

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801 228
th
Ave NE
Sammamish, WA 98019
425-295-0500 | www.sammamish.us
2020-01-CAA Page 1 of 2
CRITICAL AREAS AFFIDAVIT
ABOUT THE CRITICAL AREAS AFFIDAVIT
Submittal Instructions
Complete & save this form
before uploading it to
MyBuildingPermit.com in the
“File Upload” section along
with the rest of the submittal
documents.
Code Reference
Environmentally Critical Areas
Chapter 21A.50 SMC
Resources
King County iMap
Sammamish Property Tool
Questions?
Submit Project Guidance
Visit the Permit Center
City of Sammamish
801 228th Ave SE
Sammamish, WA 98075
www.sammamish.us
The Critical Area Affidavit is designed for applicants to disclose to the City
if there are any critical areas located on the proposed project site(s).
If you are unsure if critical areas are located on your project site(s), please
contract with a qualified professional to review on-site and surrounding
conditions and determine the presence of critical areas and/or buffers.
If such areas are present, a Critical Areas Study must be submitted as part
of the development application. Failure to accurately disclose critical areas
information may require additional review, project revisions and/or fees.
ABOUT CRITICAL AREAS
CRITICAL AREAS
CRITICAL AREAS INCLUDE:
Frequently flooded areas
Landslide, seismic, and erosion hazard areas
Areas within the erosion hazards near sensitive water bodies overlay
Streams and adjacent buffers
Critical aquifer recharge areas
Wetlands and areas within the wetland management area overlay
Fish and wildlife habitat conservation areas
PER SMC 21A.15.254 AND CHAPTER 21A.50 SMC
2020-01-CAA Page 2 of 2
CRITICAL AREAS AFFIDAVIT
AFFIDAVIT
NO notary is required for this affidavit.
The undersigned, being first duly sworn on oath deposes and says:
A. I am over the age of eighteen (18) years and competent to be a witness herein.
B. I am the applicant, representative, and/or owner for the ____________________________
project located at ____________________________________ in Sammamish, Washington.
C. To the best of my knowledge (select one below):
☐
There is no known critical area and/or required buffer on or within 215 feet of the
proposed development property.
☐
The critical area on the development proposal site has not been illegally altered
☐
I have previously been found to be in violation of SMC 21A.50, for any property in
the City; and such violations have been corrected
☐
I will restore code violations through the development proposal
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Print Name(s):
Signature(s):
Date:
(City and State)
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ABOUT THE CRITICAL AREAS AFFIDAVIT Submittal Instructions Complete (City of Sammamish)

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Completed 24 January 2021

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