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Home My WebLink AboutSHX2007-00088 JARPA - SHX Permit / Conditions MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT .` PiannI09 Division P O Box 279,Shelton,WA 98584 r (360)427-9670 NOTIF�CATIONN OF INCOMPLETE APPLICATION March 18, 2008 Parcel No.: 222305100008 Project Description: EMERGENCY BULKHEAD REPAIR. Replaced washed out concrete bulkhead. New bulkhead will b e 4.5 to 5 ft tall, same as previous. Dear Applicant: You have submitted a permit application (case no. SHX2007-00088)for proposed construction or development in the county. Upon review of your application, I have determined that the contents of the application are incomplete or do not provide enough detail for review. Therefore, review of your application will not proceed until the necessary information is provided (see the comment section of this letter for details.) Once the information is submitted and the application is complete, I will continue to process your application accordingly. If the additional information is not provided to the County within 180 days of this request, the application shall expire and no further action on the proposed development shall take place. Please contact me at (360)427-9670, ext. 593 if you have questions. Sincerely e ecca Hersh, Land Use Planner Mason County Planning Department u14 3/18108 Page 1 of 2 SHX2007-00088 1■ NOTIFICATION OF INCOMPLETE APPLICATION Case No.: SHX2007-00088 3/18/08 Comments: Mason County had issued an emergency exemption to start and n repairing your bulkhead before all permits had been submitted approved. However, it has been months since that emergency repay as occurred. Please submit a building permit application application soon as possible. If Mason County does not recieve this with associated fees by April 2nd, 2008,the,repair will be considered "illegal and will become an enforcement case. If you have any questions, please call me at (360)427-9670 extension 593. Thank you. 3/18108 Page 2 of 2 SKX2007-00088 o,tk SU MASON COUNTY o P A o ° DEPARTMENT OF COMMUNITY DEVELOPMENT s S u Planning Division y' NOY P O'Box 279, Shelton,WA 98584 of moo~ (360)427-9670 1864 Exemption from Shoreline Management Act Case No.: SHX2007-00088 Substantial Development Permit Requirement The Proposal By: .iE. L NSTRUCTtoNyi�'� rou d P:O. 1590 ALL 98524 To undertake the following development: EMERGENCY BULKHEAD REPAIR. Replaced washed out concrete bulkhead. New bulkhead will b e 4.5 to 5 ft tall, same as previous. 11711 Within HOOD CANAL and/or its associated wetlands is exempt from the requirement of substantial development because the development is categorized under WAC 173-27-040(2)as being category D-emergency construction Please contact Rebecca Hersha at ext 593 if you have any questions. Issued: 12/21/07 Expires: 12/21/09 Authorized Local Government Official cc: APPLICANT WD USACOE WDOE TRIBAL COUNCIL Ma`s" • Ageucy Refemwe!f AGEt7tax U3�i OtJ1:'Y _ .. nzm SA-x ago p 13 &MT AQUATIC RESOURCES PERMIT APPLICATION FORM (DARPA) (for use in Washington state) PAS, TY PLEASE TYPL QR PRINT IN BLACK INK. TO FILL IN ELECTRONICALLY SE F11 TO MO THROUGH THE FORM ❑ Application for a Fish Habitat Enhancement Project per requirements of RCW 77..55.290. You must submit a copy of this completed JARPA application form and the(Fish Habitat Enhancement DARPA Addition)to your tocai Govemment Planning Department and Washington Department of Fish&Wildlife Area Habitat Biologist on 6 same day. NOTE: LOCAL GOVERNMENTS—You must submit any comments on these projects to WDFW within 15 working days. Based on the instructions provided,t am sending copies of this application to the following: (check all that apply) Local Government for shoreline:[]Substantial Development []Conditional Use []Variance fipemption []Revision ❑Floodpiain Management ❑Critical Areas Ordinance Washington Department of Fish and Wildlife for HPA(Submit 3 copies to WDFW Region) Washington Department of Ecology for 401 Water Quality Certification(to Regional Office-Fedemi Permit Unit) ❑ Washington Department of Natural Resources for Aquatic Resources Use Authorization Notification ❑ Corps of Engineers for: ❑ Section 404 ❑ Section 10 permit ❑ Coast Guard for: ❑ General Bridge Act Permit ❑ Private Aids to Navigation(for non-bridge projects) ❑ For Department of Transportation projects only: This project wfp be designed to meet conditions of the most current Ecology/Department of Transportation Water Quality impteizmting Agreement SECTION A-Use for all permits covered by this appiicai Be sure to ALSO complete Section C(Signature Block)for aft 1.APPLICANT permit applications. � J 2m q..".JD MAILING ADDRESS 4-014' ?2--5?evr h v E H o$U Il�wl, vW A 41$Ss� WORK PHONE � -MWIL ADDRESS _ HOME PHONE FAX# 360- IPH1 7467U !fan agent is acting lbr dw ap Dikant during the permit process;complete#2. Be sure agent signs Section C(Signature Block) 2.AUTHORIZED AGENT for ail permit applications �'t=3wl Co, TA/C. MAILING ADDRESS k,) tBo ,sq� X A L uYrn/ wq �4sS WORK PHONE E-MAIL ADDRESS HOME PHONE FAX# $60 1 Z%7- 66CX •ha*�c�srLc. 1`icrt.�0 3b�• t7�- 3 7S 1 3.Relationship of applicant to property: OWNER ❑ PURCHASER ❑ LESSEE ❑ 4.Name,address and phone number of property owner(s)if other than applicant: 5.Location(street address,Including city,county and zip code,where proposed activity exists or will occur) !I?II F SMTE' Ro�;s 106 v'r100'J wA q�,syz Local government with jurisdiction ' or coup IMA l�mJ COJ j T`( Waterbody you are working in 00 D C A L Tributary of WRIA# Is this waterbody on the 303(d)List** YES U NO �� T- C J j p L� If YES,what parameter(s)? "For 303d List, Shoreline designation (JQ)3R 2Czai�trl✓��L htto:/fwww.ecv.wa govloroorams/wof303d/index htmi oning designation MSe'[I f Sgcti0 Town �p �a1.1 �nt Lot r(l 3s pJ 4/ DNR stream type if known Latitude and Longitude: 4-7.571N S N I ZZ .q iyy UJ Tax Parcel Number ZZZ 30S/O 00 0�S ECY 070-15(Rev. 11/04) DARPA Contact the State of Washington Office of Regulatory Assistance for latest version or cap 360/407-7037 or 800/91740043 1 6. 'Describe the current use of the property,and structures existing on the property. Have you completed any portion of the proposed activity on this property? [IYES 0 NO For any portion of the proposed activity already completed on this property,indicate month and year of completion. S/ rJts-L.E' 1'ikA4I L-*' 26,5.r C—Nt-i A-a Is the property agricultural land? 0 YES NO Are you a USDA program par t? YES NO 7a. Describe the proposed work that needs aquatic permits: Complete plans and specifications should be of the ordinary high water manic or line,including provided for� waterward ng types of equipment to be used. if applying for a shoreline permit,describe all work within and beyond 200 feet of the ordinary high water mark. If you have provided attached materials to describe your project,you still must summarize the proposed work here. Attach a separate sheet if additional space is needed 12a-91.A.Ge 60 C-4 d. Fcej- cF tc w/c ee--r &J k4dW WksMEv p.!-f' Pi 21 tv tr CL13 f 07 ST.D2w,.n. 6%A-KHM1> v I L.L.. 136 tF1�Z r S r T�4 t.r- HE'1&K A1Jfl f'p*7?A1A/T 6_% pfZFVis'j.S_ ' PREPARATION OF DRAWINGS: See same&awinss and 9dderm nor om vle[itic the arawkw- ONE sErOF ORIGINAL OR GOOD QUAL nyREPRODUCftE DRAMNGS II(W RE ArrACHED. NOTES Appkwft are wwouraged to swim Owbwaphe of Qte pmject NOe,tKAtme DO NOT uftf{htta for ME CORPS OF ENGWEERS AND COAST GUARD REQUIRE DRA*%VGS ON 8-112 X 11 WCH SHEEM. LARGER DRAWJIyIGS MIYBE MQLMWO RYOTH R AGENCFES. 7b. Describe the purpose of the proposed work and why you want or need to have influenced the design, ire it at the site. Please explain any specific needs that Rf L A G F w As Kcp 4 j t.K Ht Td t?/Z 6_,f T PA M ACrr to c. Describe the potential impacts to charaderistic uses of the water body. These uses may Include fish and aquatic pa water quality, water supply,recreation and aesthetics. Proper Protection of fish and i��l+proposedactions to avoid,minimize,and mitigate detrimental Impacts and provide aquatic life. Identify which guidance documents you have used. Attach a separate street if additional space is needed. h�11�l ►M�}L E tJ Jl¢o>J htit�✓tcA�.. Sri pR c T�+. SJv4.J0 At�+� F3r3,— wlA n/hC+e'.M Pt?Ar C-11 L d-s wl L.t_ 7d. For in water construction work,will your project be In compliance with the State of Washington water quality standards for turbidity WAC 173201A 110? 'YESQ NO See USEFUL DEFINITIONS AND INSTRUCTIONS B. Will the project be constructed in stages? YES ❑ NO Proposed starting date: j-SAF Estimated duration of activity: y. LJCSK - 9. Check 9 any temporary or permanent structures will be placed: Waterward of the ordinary high water mark or line for fresh or tidal waters AND/OR Waterward of the mean higher high water for tidal waters? 10.Wili fill material(rock,ON,bulkhead,or other material)be placed: ❑ Waterward of the ordinary high water mark or tine for fresh waters? If YES,VOLUME(cubic yards) /AREA (acres) ❑ Waterward of the mean higher high water for tidal waters? If YES,VOLUME(cubic yards) /AREA (acres) ECY 070-15(Rev. 11104) DARPA Contact the State of WashingtOn Offim of Reaulatory Assistance for latest version or call 3601407-7037 or BM17-0043 2 11. Will material be placed in wetlands? ❑ YES PS NO If YES: A. impacted area in acres: B. Has a delineation been completed? If YES,please submit with application. ❑ YES ❑ NO C. Has a wetland report been prepared? N YES,please submit with application ❑ YES ❑ NO D. Type and composition of fill material(e.g.,sand,etc.) E. Material source: F. List all soil series(type of soil)located at the project site,and indicate if they are on the county's list of hydric soils. Soils information can be obtained from the natural Resources Conservation Service(NRCS). G. WILL PROPOSED ACTIVITY CAUSE FLOODING OR DRAINING OF WETLANDS? ❑ YES ❑ NO If YES,IMPACTED AREA IS ACRES OF DRAINED WETLANDS. NOTE:If your project wil impact greater than%of an we of wetland,submit a mitigation plan b the Corps and Ecology for approval ai nQ with the JARPA form. NOTE:A 401 water quality cutilkaton wti be required tram Ecology in addition ban approved iragaUcn plan 9 your project kipacis wetlands that are: aj greater it m%acre in size, orb)tidal wetlands or weUw*adjacent to tidat water. Please submit the JARPA form and mitigaion plan to Ecology for an kx tvidual 401 certification ia)orb))apples. 12. Stormwater Compliance for Nationwide Permits Only: This project is(or will be)designed to meet ecology's stormwater manual,or an Ecology approved focal stommwater manual ❑ YES ❑ NO If YES—Which manual will your project be designed to meet? If NO—For dean water act Section 401 and 404 permits only—Please submit to Ecology for approval, along with this JARPA application,documentation that demonstrates the stormwater runoff from your project or activity will comply with the water quality standards,WAC 173.201(A) 13.Will excavation or dredging be required in water or wetlands? ❑ YES 10 NO If YES: A. Volume: (cubic yards)/area (acre) B. Composition of material to be removed: C. Disposal site for excavated material: D. Method of dredging: _ 14. Has the State Environmental Policy Act(SEPA)been completed ❑ YES NO AMYL TMI— cT SEPA Lead Agency: MPtSo>,,! Cps jTy SEPA Decision: DNS,MDNS,EIS,Adoption,Exemption Decision Date(end of comment period) SUBMIT A COPY OF YOUR SEPA DECISION LETTER TO WDFW AS REQUIRED FOR A COMPLETE APKJCATION 15. List other Applications,approvals or certifications from other federal,state or local agencies for any structures,Construction discharges or other activities described in the application(i.e.preliminary plat approval,health district approval,building permit,SEPA review. federal energy regulatory commission license(FERC),Forest practices application,etc.). Also.indicate whether work has been completed and indicate all existing work on drawings. NOTE:For use with Corps Nationwide Permits,identify whether your project has or will need an NPDES permit for dischan ling wastewater and/or stomtwater. TYPE OFAPPRovAI ISSUING AGENCY IDENTIFICATION DATE OF APPLICATION GATE APPROVED COM KETED4 NO. d4 M�RSoJroiAnly lt.Dr N 4 t?rL mMtT MV>4.J COJJ7Y rb 16. Has any agency denied approval for the activity you're applying for or for any activity directly related to the activity described herein? ❑ YES NO If YES,explain: ECY 070-15(Rev. 11/04) JARPA Contact the State of Washington Office of Reaulatory Assistance for latest version or call 3=407-7037 or 800/917-0043 3 Y SECTION B- Use for Shoreline and Corps of Engineers permits on1 : 17a.Total cost of project. This means the air market value of the project,including materials,labor,machine rentals,etc. ZS'' Dom 17b. if a project or any portion of a project receives funding from a federal agency,that agency is responsible for ESA consultation. Please indicate If you will receive federal funds and what federal agency is providing those funds. See instructions for information on ESA.* FEDERAL FUNDING 0 YES NO if YES,please list the federal agency. 18.Local government with jurisdiction: M"0�J C b j t 19.For Corps,Coast Guard and DNR permits,provide names,addresses and telephone numbers of adjoining property owners,lessees, etc. - Please note: Shoreline Management Compliance may require additional notice—consult your local government. NAME ADDRESS PHONE NUMBER SECTION C-IWS section MUST be c le for any permit covered by this applicaftri 0. Application is hereby made for a permit or permits to authorize the activities described herein. i certify that I am familiar with the information contained in this application,and that to the best of my knowledge and belief,such information is true,complete,and accurate. I further certify that I possess the authority to undertake the proposed activities. I hereby grant to the agencies to which this application is made,the right to enter the above-described bcation to Inspect the proposed,in-progress or completed work. I agree to start work.O Y after all necepsary permits have been received. DATE RE OF APPLICANT Z l oG v-7 • J C3�j/!LD C�� rt-. Cps DATE SIGNAYURE OF AUTHORIZED AGENT I-Z/l a1o7 I HEREBY DESIGNATE IL5AUL p Co✓51. CO. TO ACT AS MY AGENT IN MATTERS RELATED TO THIS APPLICATION FOR P R IT(S . i UNDERS AND THAT IF EDERAL P RMIT IS ISSUED,I MUST SIGN THE PERMIT. ld U7 1 RE OF APPLICANT DATE R OF LANDOWNER(EXCEPT MPUB�LICE �TYNDOWNERS,�GDN�R) �� . . THIS PGCATION MUST BE SIGNED BY THE APPLICANT AND THE AGENT,IFAN AUTHORIZED AGENT IS DESIGNATED. 18 U.S.0§1001 provides that: Whoever,in any manner within the jurisdiction of any department or agency of the United States knowingly falsifies,conceals,or covers up by any trick,scheme,or device a material fact or makes any false,fictitious,or fraudulent statements or representations or makes or uses any false writing or document knowing same to contain any false,fictitious,or fraudulent statement or entry,shall be fined not more than$10,000 or imprisoned not more than 5 years or both. ii . wo 'tea r � Ile t#ts,evbrtf #�pY of x " _ ��,fir stnrcture�3tif11 indae thepptdsitttate#octbti ofeaicrieKttisti � o ,, tti!gey�e> I, 0ttt 1�#hat wa h C ff tit,attOn invplvas ait€jitttai aisle or variattoe,set lx�f the master aAolot icii I vldes that,the R Fo d rs,� r le a Ind do ll Vie,bT,j�the case of a van rlf , v�fe 4 ht= These Agencies are Equal Opportunity and Aiflma live Action employers. For special accommodation needs,please contact the appropriate agency in the instructions ECY 070-15(Rev. 11/04) JARPA Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 4 f - I Arthaud seawall damage— 11711 E Hwy 106, • 1Ua fie ; ' ,,AC (�s __" b �v « s i ce ►mot- 6,e (t 4D �-� (-,s/c- Ck- 61"-4 &t-t PI-t -fa Pla.C4e- � � �vr�tir v1 THESE PLANS MW4iA da ON THE JOB SITE . , MUST ME_T -,_,'_L _3_ ENT FOR INSPECTION. WA.SFi Ni , ON 5'.A'(E CODES CHANGES SUBMITICH"'NG SC1 M,!GPWORKL ! 'II PRIOR TO F v i -- l `F- A� �- `.`..�- qPPt-11711 =- YD7Ca� X 2. FttG F tares�'OPOGRAPHY � I � 1 i Dunumv ee ina numoer i( /�.(,[lU i Direction: Scale: Approval:for offve use Building: vw��G�iry��u�:a�u•11_ d'il U / �� 1 Uate OT Planning: (�C) appitcanon: Env. Health: r yc��vlr c, profectApp -eVa o � /�lr� -7 —�0a )Ell eo-n7frD( �� ° MASON . ENVIROMENTAL CHECKLIST el�n� A. BACKGROUND 1. Name of proposed project, if applicable: Crn�.rc� env►t �La Ic 1, e a.cQ -Re P a,; ►- 2. Name of applicant: 11 -711 I✓ Stc-t-e---Z! o u.t'f- QVO -D y) , \/V 4 4S 5(T 2 3. Address and phone number of applicant and contact person: S+e,p�e� F. -►�+ a;t�c.( S8/-Z87� 15�s'5Fs West Cisa ►R v L-a-&q& o - Sk,rprjse , A-2- 4353-7 �L 3� 580 -8 $1 `F 4. Date checklist prepared: To-nL&ar 13, znv$ 5. Agency requestinichecklist: 6. Proposed timing or schedule (including phasing, if applicable): 7. Do you have any plans for future expansion, or further activity related to or connected with this proposal: If yes, explain. �o 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. b a Lvois f" — ✓5i Sc.� , ra�o Fa D F W 9. Do you know whether applications are pending for governmental approvals of other proposals directly affecting the property covered by your proposal? If yes, explain. -7;0 10. List any government approvals or permits that will be needed for your proposal, if known. — S epic -qe pt W A-C-- vzvaA 11. Give a brief, complete description of your proposal, including the proposed uses and the size of the project and site. There are several questions 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 include additional specific information on project description.) Replace. 1,D l►h . --eeT of concxefe- 6"Ikke-aJ� vnla.sW -�o . wr�C v�J- R 5 r rvl - e 51�1- cw�c� �v 'Q�iw� as rp euidus . 12. What is the location of the proposal? Give sufficient information for a person to understand the precise location of your proposed project including a street address, if any,.and section, township, and range, if known. If a proposal would 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. WR/4 15 .91Z t��. � •. o3w LVat-ea-b wry q 15 M a.,ri vie- L a tu.d.e,•. N 4-7 -rY'' `a►1I;�-Y.�C�Q '. W Z3 0 0 59 y ILL f sex— '. N w 1/4 sue-;aVI •. 2 If E• �.�. `7"a w►� S-k p : Z2-N � 171 I B. ENVIRONMENTAL ELEMENTS: U.til on t Wa ' q$Sq Z 1. EARTH: a. General description of the site (circle one).(!at, rolling, hilly, steep slopes, mountainous, other b. What is the steepest slope on the site (approximate percent slope)? r,�.Vi ve.u> �.Dw� E• �-. �� lb � �o p �op�-.'-�.i (2-S- 0apPro)0 C. What general types of soils are found on the site (for example, clay, sand, ravel peat, muck) If you know the classification of agricultural soils, specify them and note an a farmland. d. Are there surface indications or history of unstable soils in the immediate vicinity: If so, describe. h o Mason County Environmental Checklist Page 2 C. Proposed measures to reduce or control emissions or other impacts to air, if any: novi-2 He Qc)44 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. Wq, -e ,bod r a.L , vJ ; 6 5 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. p �2S - --k`d cJ Ware i.-5 GLccess Pa;r fi I [ i wL j+--e-e! zS -F®off' work coy- ri'do �, 1Na-I�e v ,vc� Of- +k-L- -464 V1:'4. Cows f v�bWA h'�#,dis 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. W I( 'f— -it>" J1 is-{ VL5 4V-'� P'&�e'r i cus +kt be4LCL.' - I�v�- Hew �,�� --��s c��;d.a►�. 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. -7'1.D Mason County Environmental Checklist Page 4 e. Describe the purpose, type, and approximate quantities of any filling or grading proposed. Indicate source of fill. AA Y1 f. Could erosion occur as a result of clearing, construction, or use: If so, generally describe. na g. About what percent of the site will be covered with impervious surfaces after project constructions (for example, asphalt or buildings)? 4o-f-p vi of- h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: 2. AIR: a. What types of emissions to the air would result from 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. Non b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. No Mason County Environmental Checklist Page 3 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. ho 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. C. Water runoff (including storm water): 1} Describe the source of runoff(including storm 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. 54-orwi w4+t- rah o-F-� l�i t l i v�� c�-�-� 1!e✓-fi u cQ2 S'-r+- �`e��v�t a,v�d -i-hrDw� d✓a�i v� a _ P;P i n.1 c Ca►1a� — 2) Could waste materials enter ground or surface waters: If so, generally describe. �D Mason County Environmental Checklist Page 5 d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: ®✓nM-71°4pp ,( ck- cr A b as I vx a" Cc ec u,M Ve r�t'S a s b �T 4. PLANTS: a. Check or circle types of vegetation found on the site: ✓ deciduous tree: alder, maple, aspen, other evergreen tree: fir, cedar, pine, other shrubs ✓ grass pasture crop or grain wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other water plants: water lily, eelgrass, milfoil, other other types of vegetation b. What kind and amount of vegetation will be removed or altered? C. List threatened or endangered species known to be on or near the site. —hDOf- d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: '?1 Mle— 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, songbirds, other ✓ Mammals: deer, bear, elk, beaver, other Fish: bass, salmon, trout, herring, shellfish, other b. List any threatened or endangered species known to be on or near the site. hon e- C. Is the site part of a migration route? If so, explain. d. Proposed measures to preserve or enhance wildlife, if any: I°vo j e c�" �c c��-,'2 S 5 kc�.t-1 mot" �✓ad.�e wu� 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. n-0 b. Would your project affect the potential use of solar energy by adjacent properties: If so, generally describe. --h o 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: 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. —ki O 1) Describe special emergency services that might be required. QI ( 2) Proposed measures to reduce or control environmental health hazards, if any: b. Noise. 1} What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? - /+'minima,/ J aA- R+. lato dtvt ��✓ese�t-f 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 example: traffic, construction, operation, other)? Indicate what hour's noise would come from the site. DDT 5:�a PM � �-�wte �1oct,✓S 3) Proposed measures to reduce or control noise impacts, if any: ho nR-- he eAtA 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, describe. no C. Describe any structures on the site. 2 Bed,v'oom d. Will any structures be demolished? If so, what? t✓o e. What is the current zoning classification of the site? S► k � iFaml17 Re 5 i'd.P,"-a-I f. What is the current comprehensive plan designation of the site? i5 n5 Lt.. - +mot , v,e s i g. If applicable, what is the current Shoreline Master Program designation of the site? N/A, h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. No i. Approximately how many people would reside or work in the completed project? Z j. Approximately how many people would the completed project displace? k. Proposed measures to avoid or reduce displacement impacts, if any: none. ►n a c-dec� 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: -- wo rk- a CC o pQ e- 9. HOUSING: a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income housing. hones b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or low-income housing. hone C. Proposed measures to reduce or control housing impacts, if any: 10. AESTHETICS: a. What is the tallest height of any proposed structure(s), not including antennas; what is the principal exterior building material(s) proposed? fK t p v-t a+ h�k� b. What views in the immediate vicinity would be altered or obstructed? hoh� C. Proposed measures to reduce or control aesthetic 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? hon � b. Could light or glare from the finished project be a safety hazard or interfere with views? no C. What existing off-site sources of light or glare may affect your proposal: hoh e- d. Proposed measures to reduce or control light and glare impacts, if any: hake_ 12. RECREATION: a. What designated and informal recreational opportunities are in the immediate vicinity? b. Would the proposed project displace any existing recreational uses? if so, describe. VV0 kle— c. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: hone,., vie e-CU-4 Mason County Environmental Checklist Page I I 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. nb b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. C. Proposed measures to reduce or control impacts, if any: Ko Kf— Me etu d 14. TRANSPORTATION: a. Identify public streets and highways serving the site and describe proposed access to the existing street system. Show on site plans, if any. F. 574-6--e_ -.aLa-;e.- to � Wti'r a-v\ ,+ VJ a M.a'Save. Co 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 any. Ye,S C. How many parking spaces would the completed project have? How many would the project eliminate? Say s e pa„ki vtJ - Z c a. V-S 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). Mason County Environmental Checklist Page 12 e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. 1(/v f. How many vehicular trips per day would be generated by the completed project: If known, indicate when peak volumes would occur. 2 Pe ✓ g. Proposed measures to reduce or control transportation impacts, if any: 15. PUBLIC SERVICES: a. Would the project result in an increased need for public service (for example: fire protection, police protection, health care, schools, other)? If so, generally describe: n b. Proposed measures to reduce or control direct impacts on public services, if any: no kLQ. ku,&A ( Mason County Environmental Checklist Page 13 16. UTILITIES: a. Circle utilities currently available at the site: electricit natural gas wa a refuse service, telephone .sanitary sewer eptic system other: 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. 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 1 :3 ZOO O II Mason County Environmental Checklist Page 14 ESA LISTED SALMONIDS CHECKLIST Applicant Information Proiect Information Name _P e4� f�t'Vl Name-� � y1-(� Cl,U C, Phone ( � �-7 Location 1 I I I E S� 7Zou 1..` I n(P Description This worksheet was designed to help project proponents, and government agencies, identify when a project needs further analysis regarding adverse effects on ESA (Endangered Species Act) listed salmonids. Salmonids are sahnon, 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 listing. 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 listings will impact your project. 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 NO 1,!f Please describe. 2. Has there ever been an ESA listed salmonid stock present in this watershed? YES NO ✓ Uncertain_W_ Please describe. If you answered "yes" to either of the above questions, you should complete the remainder of this checklist. April 2003 - 1 - i PROJECT SPECIFICES: The questions in this section are specific to the project and vicinity. 1. Name of watershed: 2. Name of nearest waterbody: 3. What is the distance from this project to the nearest body of water: Often a buffer between the project and a stream can reduce the chance of a negative impact to fish. 4. What is the current land use between the project and the potentially affected water body (parking lots,farmland,etc.)? 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): j 6. If yes, are there any resident salmonid populations above the blockage? YES NO Don't know 7. What percent of the project will be impervious surface(including pavement&roof area)? i -2 - FISH MIGRATION: The following questions will help 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• Groundwater? 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 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 surface water discharge,please give the name of the waterbody. 4. Will this project require the building of new roads?. YES Increased road mileage may affect the timing of water reaching a stream and may impact fish hOabitat. 5• Are culverts proposed as part of this project? YES NO 6. Will topography changes affect the duration/direction of runoff flows? YES NO If yes, describe the changes. 7• Will the project involve any reduction of the floodway or floodplain by fillip or othe Partial blockage of flows? YES NO If yes, how will the loss of flood storage be mitigated by your project? a 4 -3- r 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 you know of any problems with water quality, in any of the streams, within this watershed? YES NO If yes,-describe. 2. Will your project either reduce 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 have the potential to increase nutrient loading or contaminants (fertilizers, other waste discharges, or runoff) to the waterbody? YES NO 4. Will turbidity be increased because of construction of the project or during operation of the project? YES NO 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 management, clearing of parking lots? YES NO If yes,please describe. I -4- VEGETATION: The following questions are designed to determine if the project will affect riparian vegetation, thereby,adversely impacting salmon. 1. Will the project involve the removal of any vegetation from the stream banks: YES NO 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? -5-