Land Use Application SMC Chapter 21A.50.100
Critical Area Affidavit
Updated on: 2/01/11
Critical Areas
Web: www.ci.sammamish.wa.us
If you have questions, need more information or would like to schedule a pre-application conference regarding a land use application please
contact the City of Sammamish, Community Development Department.
The purpose of this affidavit is for the applicant to disclose to the city
the presence of any critical areas as defined in the Sammamish
Municipal Code 21A.50 and 21A.15.254. Disclosure is required: when
a proposed development site contains a critical area and/or required
buffer either on or within 215 feet of the property that is the subject of
the application; when there have been illegal alterations to critical areas
or buffers; and when violations have occurred (including whether
corrections satisfactory to the city have been completed).
Failure to accurately disclose this information may require additional
review, project revisions and/or fees. If you are unsure, 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, consistent with SMC
21A.50, must be submitted as part of the development application. No
notary is required for this affidavit.
Critical areas means those areas
in the City that are:
frequently flooded areas
landslide hazard areas
seismic hazard areas
erosion hazard areas
erosion hazards near
sensitive water bodies overlay
critical aquifer recharge areas
wetlands
streams
fish and wildlife habitat
conservation areas
Wetland management area overlay
Lakes
(Ord. 02005-193 § 2)
Affidavit
STATE OF WASHINGTION )
)ss
COUNTY OF KING )
Applicant(s), Representative and/or Owner(s):
The undersigned, being first duly sworn on oath deposes and says:
A. The affiant is competent to be a witness herein;
B. The affiant is the applicant for the above project;
C. To the best of the affiant’s knowledge:
□ The critical area on the development proposal site has not been illegally altered; or
□ The affiant has previously been found to be in violation of SMC 21A.50, for any property in the City; and
such violations have been corrected; or
□ The affiant has no known critical area on the development proposal site.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct.
Applicant Name:
Date:
Place (City):
Community Development Department
801 228th Avenue SE
Sammamish, WA 98075-9509
Phone: 425-295-0500
Fax: 425-295-0600
City Hall Hours: 8:30am-5:00pm
Permit Center: 8:30am-4:00pm
Gina Auld, King County Dept. of Natural Resources and Parks
