HomeMy WebLinkAboutVAR2008-00012 SEP2008-00139 FPA forestry moratorium waiver - FPA Permit / Conditions - 2/14/2006 1931660 NASON CC WA
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Return Address
MASON CO. COMMUNITY DEVELOPMENT
PLANNING
K 0- Box 279
Shelton, WA 98584
DOCUMENT TITLE (S)
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REFERENCE NUMBER (S) of related docum nts
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Additional Reference Ws on page
GRANTOR (S) Last, First and Middle Initial
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dditional Grantors on page
GRANTEE (S) Last, First and Middle Initial
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A Iditional Grantees on page
LEGAL DESCRIPTION (Abbe Form:quarter/quarter,sectio ,township&range,plat,lot,&block)
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Additional Legal Descriptions on page
PARCEL NUMBER
NOTICE OF FINAL ADMINISTRATIVE DECISION
Name of Waiver Applicant: Alan Lundgren
Mason County Department of Community Development hereby informs all interested
parties that a 2-acre waiver has been granted from the six-year development moratorium
for forest practices as established by RCW 7.6.0 .060 on tax parcel 52001-75-00120.
This waiver is subject to the conditions of a SEPA DNS issued on 11/13/08 (no
conditions).
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County staff on signed findings of Fact that this waiver is in compliance with
Mason County Ordinance 11.04.
Upon receipt of this notice, the property owner may request the county assessor to
reassess the valuation of his or her property as provided in RCW 84.41.030.
Construction of a single family residence and any out buildings pursuant to this waiver
are subject to all state and county regulations including building code requirements and
critical area restrictions.
This waiver will becomes effective 14 days from he date of this notice unless subject to
appeal.
Any party seeking an appeal has 14 days from the date of this notice to submit a written
appeal. Any appeal should be directed to the Clerk of the Board of Mason County as
provided in 15.11.020 Mason County Developme t Code.
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FINDING OF FACT
WAIVER OF FOREST MORATORIUM #VAR 2008-00012
APPLICANT: Al Lundgren
APPLICATION DATE: 8/15/08
Mason County has reviewed the above reference application for a 2-acre waiver of the
six-year moratorium resulting from a permitted lass III forest practice activity(241287)
and finds it in confonnance with all applicable County land use regulations in effect at
the time of application.
FINDINGS
The proposed waiver of six year moratorium is compliant with the following conditions:
The applicant has paid the prescribed fees.
The applicant has filed a complete application.
This six year moratorium waiver is in conformar ce with the following Mason County
ordinances:
Forest Practice Moratorium Ordinance 11.04
1. The development area is no larger than two (2) acres in size.
See attached site map.
2. The harvest and reforestation of the property shall be completed as specified in
the approved forest practices application/ otice.
No conditions were assigned to this perffA it.
3. There shall be no damage to a critical area or its associated vegetation area nor to
the shoreline area(if any) or any damage to those areas is repairable with
restoration.
No such damage has occurred.
4. The proposed development is consistent with the Mason County Comprehensive
Plan and Development Regulations.
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The proposed development is limited to residential per the criteria of the waiver
process. The location is zoned Rural-5 which is consistent with residential
development.
5. If necessary, mitigation shall be required for impacts to critical areas, stormwater,
and shorelines. Other mitigation may be required to prevent adverse
environmental impacts, pursuant to Mason County Ordinance#55-97, the
Environmental Policy Ordinance.
No mitigation required.
Title 15 Mason Development Code
This application for a waiver from the six year moratorium has been processed as
a Type II permit with appropriate notices
Comprehensive Plan and Development Regulations
The activity proposed for the site affected by this waiver from a six year
moratorium is compatible with the Mason County Comprehensive Plan and
Development Regulations. The site is zoned Rural Residential-5.
Shoreline Master Program
This property does not contain land that falls within the jurisdiction of the Mason
County Shoreline Master Program. Desi ation: X. Any activity in those portions
of this site shall be consistent with the requirements of the Shoreline Master
Program.
N/A
State Environmental Policy Act
This application for waiver from the six year moratorium#VAR 2008-00012 has
been reviewed for SEPA compliance un er case# SEP 2008-00139, and a
determination of non-significance has been made.
CONCLUSIONS
In conclusion, this application for a waiver from the six-year moratorium associated with
(no permit) is consistent with the above criteria. he following types of permits may be
issued prior to 5/8/14 under this waiver.
1. Building permits for a single family residence and/or for a residential outbuilding.
2
2. Single-family on-site septic permit.
3. Road access permit.
4. Earth modification permits.
5. Shoreline Master Program approvals.
6. Well and potable water permits.
7. Other approvals necessary to the develop ent of a single family residence and out
buildings.
Any permit issued under this waiver shall be conditioned, as necessary, to limit the
approval to only that development consistent with the intent of section 11.04.340 of the
Mason County Forest Practice Ordinance# 11.04.
RECOMMENDATIONS
I,being a duly appointed designee of the Mason County Department of Community
Development Director, hereby attest to and certify that appropriate provisions have been
made for this six year moratorium waiver and hereby recommend approval.
Robert Fink, Planning Manager Date
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Michael MacSems, Forest Practices Planner Date
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' MASON COUNTY Shelton (360) 427-9670
DEPARTMENT OF COMMUNITY DEVELOPMENT Belfair (360) 275-4467
Permit Processing/Inspections/Addressing Elma (360) 482-5269
Mason County Bldg. III 426 W.Cedar
7854 P.O.Box 186 Shelton,WA 98584
FINAL ADMINISTRATIVE D CISION
Mason County Department of Community Deve opment hereby grants a waiver from the
six-year development moratorium for forest practices as established by RCW 7.6.09.060
on tax parcel 52001-75-00120. See attached site plan for location of waiver.
This release is not subject to any conditions of a SEPA DNS.
County staff onRJJC signed Findings of Fac that this release is in compliance with
Mason County Ordinance 108-98.
This waiver will becomes effective 14 days frorr the date of this decision unless subject
to appeal.
Any party seeking an appeal has 14 days from t e date of this notice to submit a written
appeal. Any appeal should be directed to the Clerk of the Board of Mason County as
provided in 15.11.020 Mason County Development Code.
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taff Date
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ON.STA MASON COUNTY
M C ° DEPARTMENT OF COMMUNITY DEVELOPMENT
o A° = Planning Division
o T z P Box 279, Shelton,WA 98584
Z�oJ N Y y (360)427-9670
1864
DETERMINATION OF N NSIGNIFICANCE
(WAC 197-11-340)
SEP2008-0 139
Description of Proposal: This SEPA is associated with a 2-acre waiver of a six year
development moratorium consistent with section 11.04.080 -
11.04.110 MCC. The purpose of the waiver is to allow the property
owner to build a garage. Slopes as steep as 18% are on site, but
licensed geologist David Strong as provided written evidence that
no landslide hazard areas exist within 300' of this site. There are
no other critical area issues.
Proponent: ALAN LUNGREN
Location of Proposal: 2465 W HANKS LAKE RD SHELTON
Parcel Number: 520017500120
Legal Description: TR 12 OF SURVEY 1/132 SURVEY 31/42
Directions to Site: Shelton-Matlock rd, o Hanks Lake Rd, to end (2465). -
Lead Agency: Mason County
The Lead Agency for this proposal has determined that it does not have a probable significant
adverse impact on the environment. An Environmental Impact Statement (EIS) is not required
under RCW 43.21 C.030(2)(c). This decision was made after review of a completed
Environmental Checklist and other information on file with the Lead Agency. This information is
available to the public upon request.
Please contact Michael MacSems at ext. 571 with any questions. This DNS is issued under WAC
197-11-340(2). The Lead Agency will not act on this proposal for 14 days from the date shown
below, when the determination is final. Comments must be submitted to Dept. of Community
Development, P.O. Box 279, Shelton WA 98584 by 11/28/2008. Appeal of this determination
must be filed within a 14-day period following this final determination date, per Mason County
Code Chapter 15.11 Appeals.
Authorized Local Government Official Date
(MASON CO. ENVIROM NTAL CHECKLIST
A. BACKGROUND '�C 19 zcc $
1. Name of proposed project, if applicable:
2. Name of applicant:
3. Address and phone number of applicant and contact person:
4. Date checklistprepared:
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5. Agency requesting checklist:
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6. Proposed timing or schedule (including phasin , if applicable):
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7. Do you have any plans for future expansion, or further activity related to or connected with this
proposal: If yes, explain.
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8. List any environmental information you know aL out that has been prepared, or will be
prepared, directly related to this proposal.
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9. Do you know whether applications are pending for governmental approvals of other proposals
directly affecting the property covered by yourproposal? If yes, explain.
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10. List any government approvals or permits that will be needed for your proposal, if known.
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11. Give a brief, complete description of your propc sal, including the proposed uses and the size
of the project and site. There are several quesi ions 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 nclude additional specific information on
project description.)
12. What is the location of the proposal? Give suffi lent information for a person to understand the
precise location of your proposed project includ ng a street address, if any, and section,
township, and range, if known. If a proposal wc uld 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.
B. ENVIRONMENTAL ELEMENTS:
1 . EARTH:
a. General description of the site (circle one): Flat olling, hilly, steep slopes, mountainous, other
b. What is the steepest slope on the site (approximate percent slope)? , yb
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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.
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d. Are there surface indications or history of unstable soils in the immediate vicinity: If so,
describe.
Mason County Environmental Checklist Page 2
e. Describe the purpose, type, and approximate c uantities of any filling or grading proposed.
Indicate source of fill.
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f. Could erosion occur as a result of clearing, cor struction, or use: If so, generally describe.
g. About what percent of the site will be covered with impervious surfaces after project
constructions (for example, asphalt or buildings)?
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h. Proposed measures to reduce or control erosio , or other impacts to the earth, if any:
2. AIR:
a. What types of emissions to the air would result rom the proposal (i.e. dust, automobile, odors,
industrial wood smoke) during construction and when the project is completed? If any,
generally describe and give approximate quantities, if known.
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b. Are there any off-site sources of emissions or odor that may affect your proposal? If so,
generally describe. �� 0
Mason County Environmental Checklist Page 3
C. Proposed measures to reduce or control emissions or other impacts to air, if any:
3 WATER:
a. Surface:
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.
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.
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.
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4) Will the proposal require surface water withdrawals or diversions? Give general
description, purpose, and approximate q antities if known.
Mason County Environmental Checklist Page 4
5) Does the proposal lie within a 100-year loodplain? If so, note location on the site plan.
)� 9
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.
b. Ground:
1) Will ground water be withdrawn, or will water be discharged to ground water? Give
general description, purpose, and approximate quantities, if known.
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.
#3&7
C. Water runoff (including storm water):
1) Describe the source of runoff (including torm water) and method of collection and
disposal, if any (include quantities, if known). Where will this water flow? Will this flow
into other waters? If so, describe.
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2) Could waste materials enter ground ors rface waters: If so, generally describe.
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Mason County Environmental Checklist Page 5
d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any:
4. PLANTS:
a. Check or circle types of vegetation found on the site:
deciduous tree: alder, maple, aspen, other
X evergreen tree:(fair cedar, pine, other
shrubs
grass
pasture
crop or grain
wet soil plants: cattail, buttercup, bullrus i, skunk cabbage, other
water plants: water lily, eelgrass, milfoil, other
other types of vegetation
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b. What kind and amount of vegetation will be removed or altered?
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C. List threatened or endangered species known t be on or near the site.
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d. Proposed landscaping, use of native plants, or other measures to preserve or enhance
vegetation on the site, if any:
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Mason County Environmental Checklist Page 6
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, onn d of er t%ic: 5._ 5.
Mammals: deer bear, elk, beaver, other
Fish: ass salmo tro , herring, shellf sh, other
b. List any threatened or endangered species known to be on or near the site.
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C. Is the site part of a migration route? If so, expla n.
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d. Proposed measures to preserve or enhance wildlife, if any:
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. _
b. Would your project affect the potential use of solar energy by adjacent properties: If so,
generally describe.
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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:
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Mason County Environmental Checklist Page 7
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.
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1) Describe special emergency services the t might be required.
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2) Proposed measures to reduce or control environmental health hazards, if any:
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b. Noise.
1) What types of noise exist in the area whi h may affect your project (for example: traffic,
equipment, oper,ation, other)?
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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 exarr pie: traffic, construction, operation, other)?
Indicate what hour's noise would come from the site.
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3) Proposed measuures to reduce or control noise impacts, if any:
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8. LAND AND SHORELINE USE:
a. What is the current use of the site and adjacent properties?
Mason County Environmental Checklist Page 8
b. Has the site been used for agriculture? If so, d scribe.
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C. Describe any structures on the site.
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d. Will any structures be demolished? If so, what
e. What is the current zoning classification of the E ite?
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f. What is the current comprehensive plan design 3tion of the site?
g. If applicable, what is the current Shoreline Master Program designation of the site?
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h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify.
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i. Approximately how many people would reside c r work in the completed project?
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j. Approximately how many people would the corr pleted project displace?
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k. Proposed measures to avoid or reduce displacement impacts, if any:
Mason County Environmental Checklist Page 9
I. Proposed measures to ensure the proposal is compatible with existing and projected land uses
and plans, if any: �—
9. HOUSING:
a. Approximately how many units would be provided, if any? Indicate whether high, middle, or
low-income housing.
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b. Approximately how many units, if any, would bE eliminated? Indicate whether high, middle, or
low-income housing. N 0 IV
C. Proposed measures to reduce or control housi g impacts, if any:
10. AESTHETICS:
a. What is the tallest height of any proposed struc ure(s), not including antennas; what is the
principal exterior building materials) proposed?
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b. What views in the immediate vicinity would be e Itered or obstructed?
C. Proposed measures to reduce or control aesth tic impacts, if any:
Mason County Environmental Checklist Page 10
11. LIGHT AND GLARE
a. What type of light or glare will the proposal produce? What time of day would it mainly occur?
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b. Could light or glare from the finished project be a safety hazard or interfere with views?
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C. What existing off-site sources of light or glare rr ay affect your proposal:
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d. Proposed measures to reduce or control light a id glare impacts, if any:
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12. RECREATION:
a. What designated and informal recreational opportunities are in the immediate vicinity?
b. Would the proposed project displace any existir g recreational uses? If so, describe.
C. Proposed measures to reduce or control impac s on recreation, including recreation
opportunities to be provided by the project or ar plicant, if any:
Mason County Environmental Checklist Page 1 I
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.
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b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural
importance known to be on or next to the site.
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C. Proposed measures to reduce or control impacts, if any:
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14. TRANSPORTATION:
a. Identifypublic streets and highways servin the site and describe proposed access to the
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existing street system. Show on site plans, if ar y.
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b. Is site currently served by public transit? If not, what is the approximate distance to the
existing street system? Show on site plans, if a iy.
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C. How many parking spaces would the completed project have? How many would the project
eliminate?
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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).
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Mason County Environmental Checklist Page 12
e. Will the project use (or occur in the immediate icinity of) water, rail, or air transportation? If
so, generally describe. M d
f. How many vehicular trips per day would be generated by the completed project: If known,
indicate when peak volumes would occur.
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g. Proposed measures to reduce or control transp rtation impacts, if any:
15. PUBLIC SERVICES:
a. Would the project result in an increased need fc r public service (for example: fire protection,
police protection, health care, schools, other)?
If so, generally describe:
b. Proposed measures to reduce or control direct i pacts on public services, if any:
Mason County Environmental Checklist Page 13
16. UTILITIES:
a. Circle utilities currently available at the site:CeleEtriq:ity) natural gas, ate=, refuse service,
telephon sanitary sewer, kgEHiDother
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.
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Signature:
The above answers are true and complete to the best of my knowledge. I understand that the
lead agency is relying on them to make its decision.
Signature:.
Date submitted: (J.'
Mason County Environmental Checklist Page 14
ESA LISTED SALMOMIDS CHECKLIST
Applicant Information Protect Information
Name Ak1l UA h `n Name
Phone 3 (;C) - °I 0 - C3 8[J 6 Location
Description
This worksheet was designed to help project proponents, and government agencies, identify when a project
needs further analysis regarding adverse effects on ESA (E dangered Species Act) listed salmonids. Salmonids
are salmon, trout and chars, e.g. bull trout. For our purposes, "ESA Listed Salmonids" is defined as fish species
listed as endangered, threatened or being considered for list ng.
If ESA listed species are present or ever were present in the water shed where your project will be located, your
project has the potential for affecting them, and you need to comply with the ESA. The questions in this section
will help determine if the ESA 111stings will impact your pro ect.
The Fish Program Manager at the appropriate Department of Fish and Wildlife (DFW) regional office can provide information for the
following two questions.
1. Are ESA listed salmonids currently present in the watershed in which your project will be located?
YES -3<'- NO Please describe. _
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2. Has there ever been an ESA listed salmonid stock p esent in this watershed?
YES NO Uncertain Please escribe.
If you answered "yes" to either of the above questi ns, you should complete the remainder of this
checklist.
April 2003
Mason County Environmental Checklist Page 15
PROJECT SPECIFICES: The questions in this section are specific to the project and vicinity.
1. Name of watershed: Q "
2. Name of nearest waterbody: jj ��JA
3. What is the dirt nce from this pr ject to the nearest body of water:
1400 1 . Often a buffer between the project and a stream can reduce
the chance of a negative i pact to fish.
4. What is the current land use between the project and the potentially affected water body (parking lots,
farmland,etc.)?
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5. Is the project above a:
* natural permanent barrier(waterfall) YES NO
* natural temporary barrier(beaver pond) YES NO
* man-made barrier(culvert, dam) YES NO
* other(explain):
6. If yes, are there any resident salmonid populations a ove the blockage?
YES NO Don't know
7. What percent of the project will be impervious surfa e (including pavement & roof area)?
P <�
Mason County Environmental Checklist Page 16
FISH MIGRATION: The following questions will h 1p determine if this project could interfere with
migration of adult and juvenile fish.
Both increases and decreases in water flows can affect fish migration.
1. Does the project require the withdrawal of: ,
a. Surface water? YES NO
Amount
Name of surface water body
b. Ground water? YES NO
Amount
From where
Depth of well
2. Will any water be rerouted: YES NO
If yes, will this require a channel change?
3. Will there be retention or detention ponds? YES NO x
If yes, will this be an infiltration pond or a surface discharge to either a municipal storm water system or
a surface water body?
If to a surfa
ce water discharge, lease give the nam of the g , p g waterbod .
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4. Will this project require the building of new roads? YES NO
Increased road mileage may affect the timing of water reaching a stre im and may impact fish habitat.
5. Are culverts proposed as part of this project? YES NO
6. Will topography chan affect the duration/directi of runoff flows?
YES NO If yes, describe the changes.
7. Will the project involve any reduct' of the flood ay or floodplain by filling or other partial blockage
of flows? YES NOi If yes, how will the loss of flood storage be mitigated by your
project?
Mason County Environmental Checklist Page 17
WATER QUALITY: The following questions will help determine if this project could
Adversely impact water quality. Such impacts can cause problems for listed species.
Water quality can be made worse by runoff from impervious surfaces,altering water temperature,discharging
contaminants,etc.
1. Do -Lou know of fly problems with water quality, in any of the streams, within this watershed? YES
NO If yes, describe.
2. Will your project either duce or increase shade along or over a waterbody?
YES NO
Removal of shading vegetation or the building of structures such as docks or floats often results in a change in shade.
3. Will the project increase nutrient loading or h ve the potential to increase nutrient loading or
contaminants (fertilizers, other waste discharges, or noff)to the waterbody? YES NO
4. Will turbidity be me e d because of constructionof the project or during operation of the project?
YES NO :r
In-water or near water work will often increase turbidity.
5. Will your project require long term maintenance, i.e. bridge cleaning, highway salting, and chemical
sprays for vegetation mp3apd1gement, clearing of parking lots?
YES NO If yes,please describe.
Mason County Environmental Checklist Page 18
VEGETATION: The following questions are designed to determine if the project will affect riparian
vegetation,thereby,adversely impacting salmon.
1. Will the project involve t oval of any vegetation from the stream banks:
YES NO �r
If yes, please describe the existing conditions, and the amount and type of vegetation to be removed.
2. If any vegetation is removed, do you plan to re-plant?
YES NO If yes, what types of plants will you use?
Mason County Environmental Checklist Page 19
l�P.0" COUP A
' MASON COUNTY Shelton (360) 427-9670
DEPARTMENT OF COMMUNITY DEVELOPMENT Belfair (360) 275-4467
Permit Processing/Inspections/Addressing Elma (360) 482-5269
Mason County Bldg. III 426 W.Cedar
>as4 P.O.Box 186 Shelton,WA 98584
NOTICE OF APPLICATION
FOREST PRACTICES SIX-YEAR MORATORIUM WAIVER
November 13,2008
This is a Notice of Application as required by the Mason C ounty Development Code 15.07.010.Notice to
be posted on site and mailed to all property owners of reco d within 300 feet of subject property.
Applicant Name: Alan Lundgren
Date of Application: August 15,2008(not complete s submitted)
Date of Determination
of Completeness: October 16,2008
Location of Project: Lot 12 of survey 1/132,NW '/4,Section 1,Township 20N.,Range 5W.,WM.
Parcel Number: 52001-75-00120
Permit Application No: VAR 2008-00012 and SEP 200 -00139
Description of Project: In May 2008 the owner of this roperty applied for and received a Class III FPA
to log portion of his property.As a condition of this application,a standard six-
year development prohibition was imposed on the area of the cut.Before the
owner can develop this portion of his property he must receive a waiver from the
moratorium.The waiver covers up to two acres and allows for residential
construction and associated deN elopment.This moratorium would otherwise
expire on 5/16/14.
Approvals,Actions
and Required Studies: This project is subject to SEPA review with final approval by the Director of the
Mason County Department of Community Development.
Public Comment
Period: Comments are welcome anytime between today's date and the close of a 14-day
SEPA comment period(11/28/ 8).Any comments should be directed to the
Staff member listed below.
Existing Environmental
Documents: SEPA Checklist,geo-technical letter by David Strong
County Staff Contact: Michael MacSems,360-427-9 70 ext 571 (mms@co.mason.wa.us)
Date,Time&Place of
Scheduled Public Meeting:No public meeting required.
Timeline for Final
Action: Final action shall follow with' (the standard) 120 days from date of Letter of
Completeness(plus stays for preparation and review of any required studies).
Signed By: Date:
oo
Forest Moratorium Waiver/Release Application
This application is to be used to waiver a portion of a parcel for development permits or to release
the entire tract from the six year moratorium for dev lopment permits. This process was created
under the guidance of RCW 76.09.060. This applic tion needs to be filled out completely, so
that we have all the information to process this in an xpedient manner.
Are you requesting a Waiver or a Release from the' oratorium?
Waiver ❑ Release
Applicant's Name: r- L- N V. ®(S , l.'
Applicant's Address: +(? -�7'r
14.F c
Operator's Address:
Parcel numbe6bf effected Parcel: : nc-) - 75 sac) 1. Z-? r7-0C/ 75--DVV� 33 C)
Parcel size in acres: S17,z
Identify what type of timber was removed, ie: Douglas Fir, Western Red Cedar, Alder, Maple,
etc: L2 o L A
Was the timber harvest done under an approved forest practice application:V'Yes ❑ No
Was there an enforcement action taken by the Depart ent of Natural Resources (DNR):
❑ Yes o
Forest Practice Application Number: 7
Forest Practice Application Date of Approval:
What is your int tion to do with the effected parcel:
G
Are there any critical areas on your site? ie: wetlands, streams, creeks, ste p sl pes, etc..:
Yes ❑ No Identify the type critical area/s:
Please list.-Conditions of approvals b DNR pr your forest practi a application:
f
Were any of the buffer areas effected by the timberharvest? ❑ Yes Ol No
Identify if you harvested any timber in the critical areas on your site: ❑ Yes A�`No
Did you replant per DNR standards: ❑ Yes ZNo
APPLICATION SIGNATURE
1) I certify that I am the forest land owner, as that term is defined in RCW,76.09.020 and
WAC 222-16-010, and that am familiar with the requirements of the Forest Practices Act, RCW
76.09 and the forest practices rules, WAC Title 222. I am specifically familiar with RCW
76.09.060(3) and its effects.
2) I certify and declare under penalty of perjury under the laws of the state of Washington
that the foregoing is true and correct.
Signed this_L17_day off t
._ (month) a
itY) (State)
STATE OF WASHINGTON)
) SS
COUNTY OF MASON )
On this-/v-_day of ��before me, the undersigned, a
Notary Public in and for the State of Washi gton, dul commissioned and sworn, personally
appeared4
t me known to be the individ al described in
and who executed the within and fo egoing instrument, and acknowled ed that
signed the same as free
Ag
and voluntary act and deed, for the uses and purposes therein mentioned.
pG�IVEN under my hand and official seal thi _ 43 day of
�Q
Ire
r«.........
Jum H' � 8 NOTARY P IC i n for th to e
STATE AIM of Washington r siding at �0%z
*COMMON"E*"A*I&am
MASON COUNTY DEVELOPMENT REGULATIONS May 5,2002
LIST OF ADJACENT PROPERTY OWNERS
WITHIN 300 FEET OF YOUR PROPERTY BOUNDARIES
I
Addresses are to be obtained from the Mason County Assessor's Office, Bldg. 1 Second Floor.
MASON COUNTY DEVELOPMENT REGULATIONS May 5,2002
Publication cost is the responsibility of tlhe applicant. Final permit processing
will = occur until advertising fees have been paid to the newspaper by the
applicant. The Shelton-Mason County Journal will bill the applicant directly.
I/WE understand that I/WE must sign and date the attached acknowledgment
indicating and that I/WE understand that is MY/OUR responsibility. 1/WE
must submit the signed page as part of pplication in order for it to be
considered as complete.
DATE
OWNER
APPLICANT
P6ozJ co
MASON COUNTY
Shelton (360) 427-9670
DEPARTMENT OF COMMUNITY DEVELOPMENT Belfair (360) 275-4467
Planning
Mason County Bldg.1411 N.5th Elma (360) 482-5269
P.O.Box 279 Shelton,WA 98584
1854
Alan Lundgren
118 Grand Army
Westport, WA 98595
September 9, 2008
Re: 52001-75-00120
Dear Mr. Lundgren,
This letter is in follow up to our meeting yesterday on your property. You have applied
for a waiver from an existing six-year development moratorium, which includes the
above referenced parcel, in order to construct an out building.
When I walked your property I was looking for nvironmental issues that would not have
concerned the DNR when you applied for your Class III FPA, but would have concerned
the County had you applied for the more appropriate Class IV General FPA. My only
concern is the 18 to 20% slope just west of the area that you wish to have waived. As I
explained to you yesterday, an approved geologi al assessment is required for both the
waiver and your eventual building permit. For your convenience, I am enclosing a list of
firms that you may want to contact to discuss your needs. The list is not exhaustive and it
probably makes sense to shop around.
In addition to the geological assessment, I need Iwo other things from you. The first item
is a site plan of you property showing no more than two acres of ground to be waived. If tj
you limit your waiver to the ground within the above referenced tax parcetnumber, I
expect you will be well under two acres. The second thing that I need from you is a list of
all of the property owners within 300 feet of yot r property. I need this so that I can mail a
Notice of Application to these people. Yesterday I gave you a tax parcel map with the tax
number of the properties that need to receive no ice highlighted. Patti McLean(ext. 498)
in the Assessor's Office can assist you in obtain ng this information. Please provide me
with the map and the list of names and addresses as soon as you can, and have the
geological assessment delivered to my attention when it is ready.
If you have any other questions I can be reached at ext. 571 or by e-mail at
nuns@co.mason.wa.us. Thank you.
Si rely,
chael MacSems, FPA Reviewer
Apr 07 08 05: 44p Bob Skinner 360-893-4047 p. 2
For DNR Region Office Use Only NASHING70N STATE XPARTMENrOF
Natural .Resources FPAIN
Forest Practices Application/Notification Region
Received Date:
Western Washington
YOU MUST USE THE INSTRUCTIONS T� COMPLETE THIS APPLICATION.
TYPE OR PR, T IN AK.
t. Landowner,Timber Owner, and Operator
iu 2L i LU2Lh'an'ie of Ti viB;LR OWNER
�4
Mailing Address; Mailing Address
Mailing Address:
City, State,Zip City, State,Zip -- City, State,Zip
r/ V*-,
3F
i Phore 2 6 Y 51 Phone
Phone h yo y,
j
Email: Email
3*& At 2
2. Contact person
Contact-_rsof�e Phone
e-1 e r I E ail: 76-1 1 4;1 C I' A 47 A— 5 Av
-n
3. Are you a small forest landowner?
[ I No, 0( Yes. it Yes and harvesting1salvaging limber, include a checklist pMAp, Linless.exempt(see instructk)ns)
4. Are you substituting Prescriptions from an approved state or ederal conservatior, agreement or watershed
analysis?
[X Ne, yes. Vlrite 'bSij-jg prescriptions"in tables that apply. Attach or reference prescfipti0ns10foS,7wa1k0n Erie.
S. What is the legal description of your forest practice?
..........
(quarter quarter) Section Tommssnip Range EW I
Tax Parcel Number County
F
/V
1 �
JznA/
//V/
6. Have you reviewed tI1I$ forest practices activity area to determine whether it may involve historic sites and/or
Native American cultural resources?Read the instaicricns r')&,bre answering this question
( j No. Yes,
7Q-46W(7-22-07; '/QES7F-RN WASHINGTON
24128 '72
7.Is this forest practice application/notification:(Answer every uesdon)
a. No [ j Yes For timber harvest(including salvage)a dlor road construction,within the city limits or inside an
urban growth area?If Yes,include SEPA Environmental Checklist or SEPA Determination.
b. D4 No [ J Yes For timber harvest and/or road constru ' n within a public park?If Yes,include SEPA
Environmental Checklist or SEPA Deterin'nation-except for harvesting<salvaging less than 5,000
board feet within a developed public park
C. (No [ j Yes Within 500 feet of a public park? Park name:
d. No ( ] Yes On land that has been platted?If it was s liort or long platted after January f, 1960,include a
SEPA Environmental Checklist or SEPA L Wterminafton.
e. ] No ( ] Yes In a county-approved Conversion Option Harvest Plan(COHP)? If yes,include a copy.
f. TA No [ I Yes Within 2W of the Ordinary High Water Mark(OHWM)or floodway of Type S water? If yes,
include a copy of your Substantial Develolunent Permit or a letter from the county.
g. K No [ J Yes A request for a multi-year permit? If yes,length requested: [ 13 years [ ]4 years or [ ]5 years.
Not everyone qualifies for a mu"arpennit See instructions for details.
h. A4 No [ ] Yes An Alternate Plan? ff yes,include a copy-
No [ I Yes For road work that is included in an RMA ?if Yes, what is the RAMP#?
j. b<No [ j Yes Within 50 miles of saltwater,and do you own more than 500 acres of forest land in Washington
State? if Yes- include the"Marbled Mum det Form'or altachheference HCP prescriptions.
R. If constructing or abandoning forest roads,complete the table below. N you are installing or retmwing crossings in
typed water-then complete the table below or show the all th i information on an attached map. Include
abandonment plan for temporary roads and abandonment pm ects,Installation and removal of crossings in Type S
or F Waters also require a Hydraulic Project Approval(HPA)p Prmit from the Washington State Department of Fish
and Wildlife(WDFW).
Road Abandonment Installing or Removing Structures in Typed Water
Construction Plans
Road � Crossing Water Activity Structure Proposed Size
Identifier m �, n m m Identifier
(Name, �- a c — = c m YPe (Install, (Culvert, or Dimensions
Number L °7 v' w o m (Letter. F. Replace Bridge. of New
J `� a Number) ,Ns) Remove) Forts) Structure
J a
Q
9. if depositing spoils,and/or expanding or developing a rock pit lbr forestry use,complete the table below.Show
locations on your Activity Map.
FT!ds Rock Pit Identifier Acres f New Rods Pit Acres of Existing Rock Pii
(Name, Number, eveloped Expandedd Letter)
00-46W(7-22-07) 2 of 5 WESTERN WASHINGTON
I
-------------
241 2872
10. If operating in or within 200 feet of a wetland,complete the table below.Show the boundaries of each wetland and
WMZ on your Activity Map.
Wetland Weiland Type Planned Planned Acres of How Many How Many
Identifier
ntifier (A, B or Forested) 'Activities ctivi#ies in Wetland Acres are you Acres are you
(Number n Wetland WM Z
Draining. Ftlhng?
Letter
)
If not harvesting or salvaging timber, skip to question 21
11.If harvesting or salvaging timber,complete table below. how all harvest areas on your Activity Map,include green-
up information for even-aged harvests.
Unit Harvest Type Harvest Alethod Aries to Volume to Volume to Steepest Slope
Number (Even-aged. Uneven-aged, (Ground, Cable, be be be' in Harvest Unit
Salvage,Right-of-Way,Rock Helicopter,Animal) Harvested Harvested Harvested (°J6)
Pit Spoils Area) (mbo M
c r
,4.
12.Reforestation.You must check the appropriate box(es).
[ ]Planting. Tres Species:
KNaturai. Include a Natural Regenerafian Plan
[ j Not required because of the following:
[ j i am converting some or all of this land to non-forest land in the next 3 years or lands are exempted under WAC
222-34-050
[ j Individual dead,dying,down,or windthrown trees will salvaged
[ j Trees are removed under a thinning program reasonably expected to maximize the long-term productivity of
commercial timber
[ J I am leaving at least 100 vigorous.undamaged,and we 11-distributed saplings or merchantable trees per acre
[ j There is an established plantation(an average of Igo s Dedlings per acre)and my harvest wit not damage it
13. Mark and describe the following harvest activities that will be done in or over typed water.
Activity i Type S Water Type F Water Type Np Water Type Ns Water
Equipment Crossing
Ground Skidding
Suspending Cables
Cable Yarding
Failing and Bucking
If not using the exempt 20 acre parcel RMZ rule, skip to question 17
14-If using the exempt 20-acre parcel RMZ rule on type S,F,or
RMZs on your Activity Map, p waters answer the foflawing questions. Show all
a• [ J No [ ] Yes Was this parcel 20 acres or less before June 5,2006?
b. [ J No [ J Yes Have you owned less than 8o forested kaes since June 4,2006?
00-46W(7-22-07) 3 of 5
WESTERN WASHINGTON
241 2 8 Y Z
ia. it harvesting within the Maximum RMZ widths of a Type S or F water on a 20-acre exempt parcel,complete the table
below.
Strearn_Segment Identifier Water Type Stream Width What is the Maximum RMZ
(S• F) (Bankfill width) Width?
16.Are you harvesting within 29 feet of a Type Np water on a Z cre exempt parcel?
No Skip to question 19.
[ Yes See instructions and describe leave tree strategy in qu isfion 23. Then skip to question 19.
17. If harvesting within 200 feet of any of Type S or F waters,co mptete the table below. Include DFC for all inner zone
harvest-unless you have an HCP prescription. Show R and CMZs on your Activity Map.
Stream Segment Water Site Class Stream Width Is there a RMZ Harvest Total width of
Identifier Type (fee CMZ? Code(s) RMZ
i (Letter) S. F (feet)
18. If harvesting within 50 feet of Type Np water,complete the t kble below. Show RMZs on your Activity Map.
Total Stream Length of No-Harvest. Stream Total Stream Length of No-Harvest.
Segm Length in 5o foot Buffers in Segment Length in 50._foot Buffets in
Identifier Harvest Unit Harvest Unit Identirw Harvest Unit Harvest Unit
(Letter) (feet) (feet) (Letter) (feet)
(feet)
19. What is the Forest Tax Registration Account Number?
For tax reporting infarmation or to receive a tax number, call the,0epartme of Revenue at 1-a00-548-W29.
20. Is the taxpayer eligible for the EARR Tax Credit? Yes No
21.How are the following marked on the ground?(Flagging,pa' roam fens etc)
Harvest Boundaries: le Cti 4_
Clumped Wildlife Reserve Trees/Green Recruitment Trees: P gCPG
Right-of-way limitstroad c:entedines: fiv
Riparian Management Zone Boundaries and LeavetTake Trees:
Channel Migration Zone:
Welland Management Zone Boundaries and LeavelTake Trees:
22. Are you converting the land to non-forestry use within 3 years of harvest?
No_ [ j Yes Include a SEPA Environmental Checklist or SEPA Determination and copy of approved Clearing
and Grading Permit
QQ-46W(7--22-" 4 of 5 WESTERN WASHINGTON
2& Addihionah hdorrroon: 2412872
The tniRornation on this appticationMoacafion is true.
We understand this proposed forest practice is subject
o The Forest Practices Act and Rules
o Ail other federal,afaie or local regulations
dangppred Species
• Compliance with the Forest Act and not e�rnpi Err
Act,or oUw federal,sUde or local laws.
0 if we said that not the tothe or city rally denydeVe10h1rrtf!!tt
perrnits on#ft parcel for the next 6 years.
The f ilor+rirrg may result in an Illegal incidental take of a wtain endangered fish
o Conversion of land to non4bresby use
o Harveshn9 within the maximum RUZ on a 20-acto exempt parcel that was acquired afbsr.tune 6,
ne of TOR
p re of t�natore tha FER
(If efferent than )
Print Name: Print Name: Print Name:X Jeri W.S"Asi,4er
Date: — Data: — �' Date: —d
*NOTE: ff you am a 7knnber R%0ft ole mv," are submidbg#* tyre,f armkr*nreeS
SIjnatWp,provide wriam eve ktm Me WWWrla has been imditd
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M08251672 Natural Resources 09.61-08 04-10-20M 212
I output .Page 1 of i
FOREST PRACTICE ACTIVITY MAP 2 41 28 7 2
TOWNSHIP 20 NORTH HALF 0,RANGE 5 WEST(W.M.)HALF 0,SECTION 1
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