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HomeMy WebLinkAboutSPI2006-00288 SEP2008-00158 SEP2008-00020 SHX2008-00093 SHX2008-00008 BLD2008-00089 Replace Float - SHX Permit / Conditions - 11/19/2008 n ( MASON COUNTY PLEASE PLANNING DEPT. PRE-INSPECTION APPLICATION Id�3 _ MI MO 1. Owner:-� - Applicant: .- Na ur Site Address: %0 ;f- d Cot— Applicant Address: Owner Address: MtdQle riArIC Q0" City: L St W14 Zip' City: St WJq Zip q o Phone(153 ) 3-- � a Phone:( day / Phone:( ) evening Plann r: V Email Address: SNIP Plan T of Use INS Water Body 2. Parcel No. 920ag - 500 _ 6001 _ Parcel No. - p Legal Description: X 3. Purpose o Pre-Inspection 4. Use of building: SI YIa tt Fd M'11 M I 5. Do any of the following exist on or adjacent to property?: slope saltwater lake pond( � wetland( seasonal runoff( other( stream seasonal creek Directions to Site: a YlAd O VIVp N _3 Ct If the information is incomplete, then Mason County must disclaim any errors resulting from deficiencies in the original application. Pre-inspection reports remain valid only until development changes occur in the vicinity which affect the lot evaluated in this inspection,or the laws regulating development of the site change after the time of inspection. Applicant Signature. Date: 16) If you would like to be on site during inspection,please check e: RECEIVED Return application to: Department of Community Develop anning Division P.O. Box 186 OCT- Shelton, 2006 Shelton,WA 98584 (360)427-9670 426 W; CEDAR STi Please include a$205.00 check or money order payable to Mason County Treasurer When completed,this form becomes part of the parcel file. FOR OFFICRUSE ONLY'Accepted by: Date: MORE ON BACK SIDE Revised: 01/18M q Please illustrate below the proposed building site in relation to critical areas(slopes,streams,lakes,wetlands,etc.) existing improvements,as well as*petty l l es::4 " TE r: Departmental Review (For Office Use Only) Planning Department Findings: I oo W uj N = � X � guj L F' c"n p g � Q 1 Go r-/ r-1 P4{� yO yf in o v` p 10 cra o1 + 107 41* •a 4v d' Aj Ito-, y� LyO a W U � h N MASON COUNTY t DEPARTMENT OF COMMUNITY DEVELOPMENT Planning Division P O Box 279,Shelton,WA 98584 c' (360)427-9670 i MITIGATED DETERMINATION OF NONSIGNIFICAa BE KEPT IN THE (WAC 197-11-350) PARCEL FILE SEP2008-00158 Description of Proposal: Replace decaying 156'floating dock constructed in 20 ft sections with new 20 ft sections of dike -size, style and appearance. New dock will have encapsulated floats and 8 existing creasote pilings will be replaced with 7 steel pilings in same approx location. Proponent: VIRG FOX Site Address(N Assigned): 80 SE ARKADA CT SHELTON Directions to Site: Parcel Number: 220285000001 Legal Description: ARKADA, TOWN OF LOT: A OF SP#697 & TAX 639-U-1 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. MITIGATED MEASURES ARE ATTACHED. I� Please contact Grace Miller at ext. 360 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 12/3/2008. 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. /.2-/3I08 Authorized Local Government Official Date Ce: ���• � m"aiww�l MITIGATED DETERMINATION OF'NONSIGNIFICANCE (WAC 197-11-350) SEP2008-00158 CONDITIONS OF THIS DETERMINATION 1) All other necessary permits from Mason County, Washington State and/or Federal Agencies that are required for this proposed development and construction must be obtained prior to same development and construction. 2) Water quality is not to be degraded to the detriment of the aquatic environment as a result of this project. 3) Any discharge of sediment laden runoff or other pollutants to waters of the state is in violation of Chapter 90.48, Water Pollution Control and WAC 173-201A, Water Quality Standards for Surface Waters of the State of Washington and is subject to enforcement action. 4) During construction, all releases of oils, hydraulic fluids, fuels,other petroleum products, paints, solvents and other deleterious materials must be contained and removed in a manner that will prevent their discharge to waters and soils of the state. The cleanup of spills should take precedenece over other work on the site. 5) Debris or deleterious material resulting from construction shall be removed from the beach area and project site and shall not be allowed to enter waters of the State. 6) Noise produced by the pile driving shall be attenuated with wood block. PgoN.StA MASON COUNTY C DEPARTMENT OF COMMUNITY DEVELOPMENT sN Planning Division r o T P O Box 279,Shelton,WA 98584 o y oy (360)427-9670 v 1864 Exemption from Shoreline Management Act Case No.: SHX2008-00093 Substantial Development Prmit Recluinument The Proposal By: VIRG Fox 80 SE ARKADA CT SHELTON,WA 98584 To undertake the following development: Replace decaying 156"floating dock constructed in 20 ft sections with new 20 ft sections of like - size, shape and appearance. New dock will have encapsulated floats and 8 existing creosote pilings will be replaced with 7 new steel pilings in same approx location. Within Hammemley 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 B-normal maintenance Please contact Grace Miller at ext 360 if you have any questions. Issued: 12/3/2008 d=� •� �' Expires: 12/3/2010 Authorized Local Govemment Official �N2 cc: APPLICANT WDFW USACOE WDOE TRIBAL COUNCIL- ,,T�� Apa �&0 DESCRIPTION OF PROJECT r , a a r �• Remove 8 existing creosote pilings Install 7 new steel pilings " r Repair dock as defined below: Existing 12 ft.x 54 ft.float:#BLD200800089 No change except replacing creosote pilings with �ax x steel pilings(3 places) f �.a � Dtplr Replace decaying 156 ft.floating dock constructed } in 20 ft.sections with new 20 ft.sections of like- J S size style and appearance. New dock will have enc apsulated psulated floats and creosote pilings will be replaced with new steel pilings in the same approximate location. SEE DETA IL PLANS y4 F ak sF �, k d IS P WO :fY{;�V' y'k �i+N•�l' � y t `4 .., e. r r�' h- r '. y+• +S'.' a�. y4. •,: ( .�t : `•r g>�,.P` Y tea�,'Y c s 4 1y: } f i j r � o a p 43 -► N .c N W � r r ;Its Job 's �C ` ON r S r , -� IK s tv ti N RAMP g a. •2 S ` /. a... vil t r l�t Caw P. I 'Fox RM 1 so S.B.A KADA.COURT, LTo N, wA"M4 ' uFlPT 1 pp i5S MASON CO. ENViROMENTAL CHECKLIST A. BACKGROUND 1. Name of proposed project, if applicable: 4 t * 2. Name of applicant: 3. Address and phone number of applicant and contact person: ok6 4. Date checklist prepared: 5. Agency requesting checklist: /✓jute.. �� 6. Proposed timing or schedule (ingl qi%,O�asirt� f applic 30 Vol s 7. Do you have any plans for future expansion, or further activity related to or connected with this proposal If yes, explain. 8. List any environmenftinfbhvW orkyoa new tabo it=th-at�h'ae�# rr prbo*6d, or wilt 66" ` prepared, directly related to this proposal. 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. to . . 10. List any government approvals or permits that will be needed for your proposal, if kc©wn. /%Soh CO Jr�ds /�lrhl� T i/s� ' (/✓i/�� /���1►�✓Q� 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 speck information on project description.) 0�0�4 /C1 aid, Q,#"+4 x, 12. What is the location of the propo§al? GI ufficient information for a person to. derstand the precise location of your proposed.�rojeci ludiP�co'°a street address, if any, add aeotiori, township, and range, if known. If a prop'64ii66(6 ocbui 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. Sl0 ��OY�adct C�• y B. ENVIRONMENTAL ELEMENTS: 1. EARTH: a. General description of the site (circle one): Flat, rolling, hilly, steep slopes, mountainous, other cs.VII rQ ld o�y' b. What is the steepest slope on the site (approximate percent slope)? N19 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. Nib d. Are there surface indications or history of unstable soils in the immediate vicinity: If so, describe. �A Mason County Environmental Checklist page 2 e. Describe the purpose, type, and approximate quantities of any filling or grading.�proposed. Indicate source of fill. f. Could erosion occur as a result of clearing, construction, or use: If so, generally describe. ?� g. About what percent of the site will be covered with impervious surfaces after project i constructions (for example, asphalt or buildings)? 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. /V4ll He, b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. s4/o 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)? 1f ye,%describe type and provide names. If appropriate, state what stream or river it flow$Iinto. "Vrca d,q A-6. //CF rrgyd f J Af oO.*lj at) e-- 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. deJ J� , h 1CePairJJ3/'jl / c erne.�f W/Medge .e�C/S6' r'/� .irf,�itf� ure�i/ /(/Qu/4e Sites S�tw,(l� ti'Grt+d� �. ,lei 14 /ve J JPI-m 41, J -• Ar., 3) Estimate the amountof fill material that would%'&in or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicates the source of fill material. Nonce- 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. r IR Mason County Environmental Checklist Page 4 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. 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. /Y d 2) Describe waste material that will be discharged Into the ground from septic tanks or ofhqr sources, if pny(for example; dRmestic sevyage, industrial, containing the following f c�ie icals., ,aqricultural;`dtc. . d4scn1 a the general,si a of fiae"syst�rY ,.the'n ti +er of &rcl'ti ystdr►ts, tft'rieMber,of houses to be`senred appiioable), or the rwMber,oV-: a mals•or humans the;sys�tem(a),arel�xpacted t�s&ve.. 4 . , . e Ald e' 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. //H �' 2) Could waste materials enter ground or surface waters: Jf so, generally describe. i Mason County Environmental Checklist Page 5 d. Proposed measures to reduce or control surface,ground, and runoff water impacts, if any: 4. PL ANTS: 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: ,waterlily, eelgrass, milfoil, other other types of vegetation a'041,e✓ w4 ✓ ✓�J. •.91i,• !t/e�l�Hdf$- y6 j,�,,. d. p.�ae /..�gf w/a4 IV /S"i -Ic.,14a;J v/4/ /tl b. What kind and"amount of vegetation will be removed or altered? /ilo C. List threatened or endangered species known to be on or near the site. 'Alan` d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: /Ir/q 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: I . Birds: hawk, heron, eagle, songbirds, other Mammals: deer, bear, elk, beaver, other Fish: bass, salmon, trout, herring,shellfish,other j�R rl f b!//�/S� Q�✓� �W�/1`,1-e C�"/r/1� /� f s i�� � . �%t�' �� b. List any threatened or endangered species known to be on ornear the site. C. Is the site part of a migration route? If so, explain. d. Proposed measures to preserve or enhance wildlife, if any: psi"1 -AA 44 q C40sA-V4-/yd 4/6#V•►! 0:�a� ur%V/ee- Q 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. x.. 44Atel e4/o,d„1 /O.v aQ _ tail/ extJlnS b. Would your project affect the potential use of solar energy by adjacent properties: If so, generally describe. 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: i1/'of 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. 1) Describe special emergency services that might be required. 2) Proposed measures to reduce or control environmental health hazards,if any: /ZW0Va.l � Maio >4 . b. Noise. 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? 2) What type's anc�`leve s ofnoise would be created by or ass Wed with the'project on a short=term.,or,a long-tem'�basis.(for,example:`°.traf€e con"triuction, o ratloih;otheer)? Indicate-w0at-hour's n*e.,wopld coruie frgm the�site. ,41d`t{ , 3) Proposed measures to reduce or control noise impacts, if any: 8. LAND AND SHORELINE USE: a. What is the current use of the site and adjacent properties? i /* Mason County Environmental Checklist Page 8 b. Has the site been used for agriculture? If so, describe. C. Describe any structures on the site. - h/e►vdt .80 •/4,6 u lX C a�Jyc✓y�� �o&X- X/O . d. Will any structures be demolished? If so, what? /j/O ti r 4-�C r� 4XI f,�Y.af �fl/ d.4 _ r e. What is the current zoning classification of the site? f. 'What is the current comprehensive plan designation of the site? !� I g. If applicable, what is the current Shoreline Master Program designation of the site? C/A 0.4Al /V^s C14 o.t f �-ltv 4 C f.L.bcwl 1�sz.Ee.+�tl h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. AtX IN A4 6,14 o ;J.,L, L Approximately how many people would reside or work in the completed project? Approximately how many people would the completed project displace? /1/i10 �e„ 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 procted land uses and plans, if any: , ,1. 9. HOUSING: '4/a -'A0 yam,,. n�c u,� /Qa arawcl&e— Sm,-- Sze SA CyAd6cxd en rGiYLCi�` a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income housing. b. Approximately how many units, if any,would be eliminated? Indicate whether high, middle, or low-income housing. I c. Proposed measures to reduce or control housing impacts, if any: A1,4 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? b. What views in the immediate vicinity would be altered or obstructed? i C. Proposed measures to reduce or control aesthetic impacts, if any:e4ge -Pei- op 9 f C,4anl � 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? b. Could light or glare from the finished project be a safety hazard or interfere with views? Ad c. What existing off-site sources of light or glare may affect your proposal: d. Proposed measures to reduce or control light and glare impacts, if any: � rVdn� -/✓a c�ar+j-� 12. RECREATION: a. What designated and informal recreational opportunities are in the imamate vicinity?-, _.. J b. Would the proposed project displace any existing recreational uses? If so, describe. �v C. Proposed.measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: A14 Mason County Environmental Checklist Page 11 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. w 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: AIX 14. TRANSPORTATION: t a. Identify public streets and highways serving the site and describe proposed access to the existing street system. Show on site plans, if any. 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. z C. How many parking spaces would the completed project have? How many would the project eliminate? 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. f. How man vehicular trips per da `'w6u-d be enerated b the com letett ro'ebf`\If known, Y p P Y 9 Y P P J indicate when peak volumes would occur. IV-4 Pr osed'�measures to reduce�or control trans orfatiorr im aas, if An 9• oP P P y' s 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: b. Proposed measures to reduce or control direct impacts on public services, if any: ,A16 Mason County Environmental Checklist Page 13 16. UTILITIES: a. Circle utilities currently available at tie site: elect ci , natural gas atelS r fuse se ice ele r , sanitary sewer, pt- t , of er: f . b. Describe the utilities that are proposed for the project, the utility providing the sbrv►ice, and the general construction activities on the site or in the immediate vicinity which might be needed. /r'o4/ d,L•lr v✓ .G ww�c�-> fit/. o�.v s�u/c,� �.r �'`.�•.l�ir�J 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: Mason County Environmental Checklist Page 14 ESA LISTED'SALMONIDS CHECKLIST Anulicant Information Project Information Name w`S Name Phoned�_s�9 Location v sj isgi.4.4 Description � V f ,r,,,,L 1 tz s �oca7�rerJ �C�`' trGb� Plinl This worksheet was designed to help project proponents, and government agencies, i en t y when a project needs further analysis regarding adverse effects on ESA(Endangered Species'Act) liste fa nids. Salmonids are salmon,trout and chars, e.g. bull trout. For our purposes, "ESA Listed Salinonids'''is dek'ned 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 approprlate Department of Fish and wildlife(DFW) regional office can provide information for the following two questions. I. Are'ESA listed salmonids currently present in the watershed in which your project will be located? YES NO Please describe. 2. Has there ever been an ESA listed salmonid stock present in this watershed? YES NO Uncertain Please describe. (In Kn c3W't M /✓d losw<<1L Wo v l t✓ ek-4 74 If you answered "yes". to either of the above questions, you should complete the reminder of this checklist. G•t `a /�hd !�� l /s i(a I�ld<LI►� 0�6 i= t�.�r�js� o/6 1�{ 7 X IM/J he/// Alle�., jWi dl�vti 7-e�� ,�1�� y � �••,t At �.�►s y�,�f,�4-Ts �r 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: r7 2. Name of nearest'waterbodyc, a 3. What is the distance T frpin-// this project to the nearest body of water: P!h GV* , > :.f�N Often a buffer between the project and a stream can reduce the chance of a negative impact to f6sh. 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 X * natural temporary barrier(beaver pond) YES NO �1 * man-made barrier(culvert,dam) YES NO * other(explain): 6. If yes, are there any resident salmonid populations above the blockage? YES NO Don't know` ; 4/)q 7. What percent of the project will be impervious surface(including pavement&roof area)? ,f Mason County Environmental Checklist Page 16 j FISH MIGRATION: The following questions will help determine if.this project could interfere with migration of adult and juvenile flh. 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 If yes,will this be a i 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. Ii N� 4. Will this project require the building of new roads? YES NO Increased road mileage may affect the timing of water reaching a stream and may impact fish habitat. 5. Are culverts proposed as part of this project? YES NO X 6. Will topography chan es 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 filling or other partial blockage of flows? YES NO 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 sp± cies. 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? 4/d CA cm �G i Removal of shading vegetation 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 X-2 If yes,please describe. i 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 the removal of any vegetation from the stream banks: YES , NO ,>f 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 . . 3 i�otiiioM ONLY Agency Reference# Date Received: vt!r a JOINT AQUATIC RESOURCES PERMIT APPLICATION FORM (JARPA) (for use in Washington State) PLEASE TYPE OR PRINT IN BLACK INK OR FILL IN ELECTRONICALLY ❑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 JARPA Addition)to your local Government Planning Department and Washington Department of Fish&Wildlife Area Habitat Biologist ort the Agn)e day. NOTE: LOCAL GOVERNMENTS—You must submit any comments on these projects to WDFW within 15 working days. Based on the instructions provided, I am sending copies of this application to the following: (check all that apply) Local Government for shoreline: ❑Substantial Development ❑Conditional Use ❑Variance QExemption ❑Revision ❑Floodplain 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-Federal Permit Unit) Washington Department of Natural Resources for Aquatic Resources Use Authorization Notification ;Corp 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 will be designed to meet conditions of the most current Ecology/Department of Transportation Water Quality Implementing Agreement SECTION A-Use for all permits covered by this application. Be sure to ALSO complete Section C(Signature Block)for all permit applications. 1.APPL ANT ,✓ X MAILIN ADDRESS 2-0 se a1A WORK PHONE E-MAIL ADDRESS HOME PHONE FAX# a 3,3. a�L2zS K A .? - 11!V 11S3 W an agent is acting for the a pllcant during the permit process,complete#2. Be sure agent signs Section C(Signature Block) for all permit applications 2.AUTHORIZED AGENT 0 e- MAILING ADDRESS WORK PHONE I E-MAIL ADDRESS HOME PHONE fAX# 3. Relationship of applicant to property: ,®OWNER [:]PURCHASER [—]LESSEE ❑OTHER: 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) Local government with jurisdiction(city or county) WRIA# Waterbody you are working ine..." s��c Tributary of Is this waterbody on the 303(dj List YES NO v OIL If YES,what parameter(s)? Shoreline designation M4q•h For 303d List, http://www.ecy.wa.gov/programstwq/303d/index.htmi Zoning designation '/.Section Section Township Range Government Lot a/ ADO Al d A/ DNR stream type if known Latitude and Longitude: Tax Parcel Number Z Z OZ BSd DOOQ j ECY 070-15(Revised 11104)JARPA, Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 j 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? YES X=J For any portion of the p posed activity already completed on this property, indicate month and year of completion. Is the property agricultural land? DYES RNO Are you a USDA program participant? YES ,I NO 7a. Describe the proposed work that needs aquatic permits: Complete plans and specifications should be provided for g work waterward of the ordinary high water mark or line,Including types of equipment to be used. If applying fora shoreline permit,describe#I 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. PREPARATION OF DRAWINGS: See sample drawings and.guidance for completing the drawings. ONE SET OFORIGINAL OR GOOD QUALITY REPAODUCIME DRAWWGS NF BE ATTACHED. NOTE: Applicants are encouraged to submit photographs of the project sit,but these DO NOT substitute for dram"P. TIIE CORPS OF ENWANU AND COAST REQUIRE,DRAW/NGS ON 8-112 X 11 INCH SHEETS, LARGER DRAWINGS MAY SE REQU/RED'BYO1H!! AGa11 - 7b. Describe the purpose of the proposed work and why you want or need to perform it at the site. Please explain any specific needs that have influenced the design. oL c. Describe the potential impacts to characteristic uses of the water body. These uses may include fish and aquatic life,water quality, water supply,recreation and aesthetics. Identify proposed actions to avoid,minimize,and mitigate ittgate deitimentef impacts and provide proper protection of fish and aquatic life. Identify which guida►ic a,documents yoq have'used.)-Attach a separate sheet if additional space is needed. .44 14 a 7d. For in water construction ,will y project be in compliance with the Statp pf Washington water quality standards for turbidity WAC 173.201A-110? YES O (See USEFUL DEFINITIONS AND INSTRUCTIONS) 8. Will the project be constructed in stages? YES Q NO Proposed starting date: Ae- u?aI Estimated duration of activity: 9. Check if any temporary or permanent structures will be placed: i 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. fill material(rock,fill,bulkhead,or other material)be placed: aterward of the ordinary high water mark or line for fresh waters? if YES,VOLUME(cubic yards) /AREA (acres) 449 Waterward of the mean higher high water for tidal waters? If YES,VOLUME(cubic yards) /AREA (acres) ECY 070-15(Revised 11/04)JARPA, Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 2 11. Will material be placed in wetlands? AYES gNO If YES: A. Impacted area in acres: B. Has.a delineation been completed? If YES,please submit with application. HYES YES �NO C. Has:a wetland report been prepared? If YES,please submit with ap lication NO D. Type and composition of fill material(e.g.,sand,etc.) n a ,[ 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 JZ]NO IF YES,IMPACTED AREA IS ACRES OF DRAINED WETLANDS. NOTE: N your project will impact greater than'%of an acre of wetland,submit a mitigation plan to the Corps and Ecology for approval along with the JARPA form. NOTE:a 401 water quality certification will be required from Ecology in addition to an approved mitigation plan d your project impacts wetlands that are: a)greater than'%acre in size, or b)tidal wetlands or wetlands adjacent to tidal water. Please submit the JARPA form and mitigation plan to Ecology for an individual 401 certification N a)or b)applies. 12. Stormwater Compliance for Nationwide Permits Only: This project is(or will be)designed to meet ecology's most current stormwater manual,YES NO or an Ecology approved local stormwater manual. /�d If YES-Which manual will your project be designed to meet? /t✓j/ If NO-For dean water act Section 401 and 404 permits only—Please submit to Ecology for approval, along vwith this JARPA application,documentation that demonstrates the stormwater runoff from your project or activity will comply wittithe water quality standards,WAC 173.201(A) 13.Will excavation or dredging be required in water or wetlands? YES ®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 AP-olicy Act(SEPA)been completed 0 YES 0 NO SEPA Lead Agency: ,/vs¢A* lam . 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 APPLICATION 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 discharging wastewater and/or stormwater. TYPE OF APPROVAL ISSUING AGENCY IDENTIFICATION DATE OF APPLICATION DATE APPROVED COMPLETED? NO. 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(Revised 11104)JARPA. Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 3 SECTION B- Use for Shoreline and Corps of Engineers permits on/y: 17a.Total cost of project. This means the fair market value of the project,including materials,labor,machine rentals,etc. 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 YES JR NO If YES,please list the federal agency. 18. Local government with jurisdiction: 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.-TMssectionARISTbe completed ftranypermh covered by this application 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 furtlim," ify that I possess the authority to undertake the proposed activities. l hereby grant to-the agencies to which this application is made,'the right to enter the above-described location to inspect the proposed,in-progress or completed work. I agree to start work ONLY after all necessary permits have been received. DATE SIGNATU F AP U NT /I`/?-'0?W? DATE SIGNATURE OF AUTHORIZED AGENT 1 HEREBY DESIGNATE TO ACT AS MY AGENT IN MATTERS RELATED TO THIS APPLICATION FOR PERMIT(S). I UNDERSTAND THAT IF A FEDE RAL PERMIT IS ISSUED,1 MUST SIGN THE PERMIT. SIGNATURE OF APPLICANT DATE SIGNATURE OF LANDOWNER(EXCEPT PUBLIC ENTITY LANDOWNERS,E.G. DNR) THIS APPLICATION MUST BE SIGNED BY THE APPLICANT AND THE AGENT.IFAt 1Y AUTHORRED AGENT ISOESIGNATED. 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. ,1 A t� yy (J:�•�.g rI} ^�or y �. -IF~�ie appli,�tiert;ill -a~a �eF r#�ritr . � ,.a��, ,t�ipli�sftCaef r rrt erj p�rt��itiiiteit the propesed use may be a final his or,in the s eaaf1 ',tit 3h thi3 variartoe Is b�t�M rgttt: These Agencies are Equal Opportunity and Affirmative Action employers. For special accommodation needs,please contact the appropriate agency in the instructions. ECY-070-15 JARPA(Revised 11/04) Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 8001917-0043 4 MAWS COUNTY DEPA iEN'i' C�1�iITY DEVELOPMENT N Paint Division j' T P O Boot Sian,WA 98584 O Y „ (30OW7-9670 0 `1 'qRc N r E� F NOTIFICATION OF INCOMPLETE APPLICATION 4e February 05, 2008 VIRG FOX 80 SE ARKADA CT SHELTON WA 98584 Parcel No.: 220285000001 Project Description: REPLACING DAMAGED FLOAT Dear Applicant: r You have submitted a permit application (case no. BLD2008-00089)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. 360 if you have questions. Sincerely, 4u/awC- Grace Milller Land Use Planner Mason County Planning Department 2/5/2008 1 of 2 BLD2008-00089 NOTIFICATION OF INCOMPLETE APPLICATION 2/5/2008 Case No.: BLD2008-00089 Comrwnts: The Building Permit and Shoreline Exemption for the repair/replacement of a float to the end of a non-conforming float facility will require environmental review by the Mason County Planning Department. Enclosed please find a State Environmental Policy Act (SEPA)Checklist. This checklist must be completed and returned to the Permit Assiatnce Center with the applicable fee for further review of your proposal. Thank you. CC: Lakeshore Construction 2/5/2008 2 of 2 BLD2008-00089 i STATE RECEIVED o � FEB 2 8 208 't 1889�DY MCCD - PLANNING STATE OF WASHINGTON DEPARTMENT OF ECOLOGY PO Box 47775•Olympia,Washington 98504-7775• (360)40700B E KEPT IN THE HE Feb 27,2008 EL, FILE Ms.Grace Miller Your address Mason County _ ' is in the Department of Community Development Kennedy- Planning Division Goldsborough PO Box 279 watershed Shelton,WA 98584 Dear Ms.Miller: Thank you for the opportunity to comment on the mitigated determination of nonsignificance for the Fox Dock Replacement project(SEP2008-00020)located at 80 Southeast Arkada Court in Shelton as proposed by Virgil Fox. The Department of Ecology(Ecology)reviewed the environmental checklist and has the following comment(s): SOLID WASTE&FINANCIAL ASSISTANCE: Al Salvi(360)407-6287 Property owners,developers,and contractors are encouraged to recycle all possible leftover construction,demolition,and land clearing(CDL)materials and reduce waste generated. Recycling construction debris is often less expensive than landfill disposal. Please call Ecology's 1-800- RECYCLE hotline for facilities in the area that will accept your,CDL materials for reuse or recycling. The applicant proposes to remove a structure(s)that may contain treated wood. Please refer to Ecology's,publication"Focus on Treated Wood Exclusion,"available at http://w�vw.ecy.wa.gov/pubs/0304038.pdf,for suggested best management practices and disposal requirements for treated.wood. 'For additional information-or clarification,please contact Dee Williams with Ecology's Hazardous Waste and Toxics Reduction program,at(360)407-6348. Ecology's comments are based upon information provided by the lead agency. As such,they do not constitute an exhaustive list of the various authorizations that must be obtained or legal requirements that must be fulfilled in order to carry out the proposed action. If you have any questions or would like to respond to these comments please contact the appropriate reviewing staff listed above. Department of Ecology Southwest Regional Office (SM: 08-1057) cc: Al Salvi, SW&FAP Virgil Fox(Applicant) _ MASON! COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Punning vision T P o Box 27%Shelton,WA 98584 o� Y. ~ (360)427-0670 I�` t�g4 O Abl- MITIGATED R� r // DETERMINATION OF NONSIGNIFICANCE (WAC 197-11-350) ) /4 H SEP2009-00020 Description of Proposal: Replace existing floating dock with new floating dock of same size - 12'wide by 54' long located approximately 160'to 215'beyond the OHWM. Proponent: VIRG FOX Site Address(if Assigned): 80 SE ARKADA CT SHELTON Directions to site: End of Lynch RD to left to 80 SE Arkada CT. Parcel Number: 220285000001 Legal Description: ARKADA, TOWN OF TR 1-A& TAX 639-U-1 SP#697 TRACT A 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. MITIGATED MEASURES ARE ATTACHED. Please contact Grace Miller at ext. 360 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 2/27/2008. 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. �1�3In Au orized Local Govemment Official I IDate LG: � E MITIGATED DETERMINATION OF NONSIGNIFICANCE (WAG 197-11-350) SEP2008-00020 CONDITIONS OF THIS DETERMNNATION �) Residential developers and individuals shall be required to control erosion during construction. Removal of vegetation should be minimized and any areas disturbed should be restored to prevent erosion and other environmental impacts.X l 2) The new floating dock shall be located to avoid shading of eelgrass and other aquatic vegetation.X 3) Floatation for the structure shalt be entirely enclosed and contained to permanently prevent the breakup or loss of the floatation material into the water. X 4) Water quality is not to be degraded to the detriment of the aquatic environment as a result of this project. X 5) Debris or deleterious material resulting from construction shall be removed from the beach area and project site and shall not be allowed to enter waters of the State. X N.STA MASON COUNTY ,FRS c DEPARTMENT OF COMMUNITY DEVELOPMENT o A o I Planning Division >- - S N P O Box 279,Shelton,WA 98584 _ N y (360)4279670 1864 Exemption from Shoreline Managwnent Act Case No.: SHX2008-00008 Substantial Developnent Pe"nit Rmpftment The Proposal By: LAKESHORE CONSTRUCTION TO BE KEp-r P.O.BOX 1058 BELFAIR,WA 98528 PA �N THE To undertake the following development: SCE FILE Replace existing floating dock with new floating dock of same size and in same location. The float is 12'wide by W long, located approximately 160'to 215' beyond the OHWM. Within Hammemley Not 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 B-normal maintenance Please contact Grace Miller at ext 360 if you have any questions. Issued: 2/13/2008 A'. &A' . Expires: 2/13/2010 Authorized Local Government Official co APPLICANT WDFW- USACOE WDOE TRIBAL COUNCIL - MASON COS.Et4V1ROM1WfkL CHECKLIST A. i0ACKGROUND 1. Name of proposed project, if applicable: �,°�,4W i 2. Name of applicant: 1:--4 7L and hone number. f applicant and contact person: 3 Address p e o app a sz a• ,fjp/ A Al,0I 4. Date checklist prepared: o' 5. Agency requesting checklist: Nl a �co h Co Gonw� fl- v 6. Proposed timing or schedule (including phasing,if applicable): 30 DaS 7. Do you have any plans for future expansion, or further activity'related to or'cohnected with this proposal: 1f yes, explain. ' 8. List any environmental information you know about that has been prepared, or will be prepared, directly related'to this proposal. 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. � d 10. List anyr"rpt approvals or permits that.will be needed for your proposal, if known, �,s �, fco . , Y;F s�, w�l�!►F 5zo OOP MASON,COUNTYuersn . on-Single Family 0-9.99 Acres 5660 ENVIRONMENTAL CHECKLIST 10 to 20 Acres$670 over E�00 Acres$840 EIS(DS)S"2,245+62/hr Purpose of Checklist: The State Environmental Policy Act (SEPA), chapter 43.21 C RCW, requires all governmental agencies to consider the environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of this checklist is to provide information to help you and the agency identify impacts from your proposal (and to reduce or avoid impacts from the proposal, if it can be done) and to help the agency decide whether an EIS is required. Instructions for Applicants: This environmental checklist asks., ryto,cteseRbe some basic information about your proposal. Governmental agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of an EIS. Answer the questions briefly, with the most precise information known, or give the best description you can.. You must answer each question accurately and carefully, to the best of'your knowledge. In most cases, you should be able to answer the-questions from your own observations or project plans without the need to hire experts. If you really do not know the answer, or if a question does not apply to your proposal, write "do not know"or"does not apply". Complete answers to the questions now may avoid unnecessary delays later. Some questions ask about governmental.regulations, such as zonirg, shoreline., and landmark designations. Answer these questions if you�can. If you have problems, the governmental agencies can assist you. The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time or on different parcels of land. Attach any additional information that will help describe your proposal orlts„environmental effects. The agency to which you submit this,checklist may ask,you to explain your answers or provide additional information,reasonably related to determining if there may be significant adverse impact. Use of Checklist for Non-project Proposals: Complete this checklist for non-project proposals, even though questions may be answered "does not apply". IN ADDITION, complete the'SUPPLEMENTAL ACTIONS'(part,b). There is a fee required, for the processing of the checklist, see above for the appropriate fee. Please make your check payable to "Mason County Treasurer'. For non-project actions, the references in the checklist to the works "project", "applicant", and "property or site" should be read as "proposal"; "proposer', and *i#6 fed'g 1 � respectively. FEB 1 1 ?008 MASON COUNTY 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 nay modify this form to include additional speck information on project description.) �<`v� q,ct�(1,.fp u�v� ���a+ - 5q►'y1� S►Z� 1 Z� ��'¢ `Sq b►1 �, ,<�,� � w 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 tothis checklist. �0 5E: A cle, e- - Cd4l )—y MAP gµJ- 5t14 As 13vV1+ SVV&ey vtded B. ENVIRONMENTAL ELEMENTS: 1. EARTH: a. General description of the site (circle one): Flat, rolling, hilly, steep slopes, mountainous, other Wa lfy — Hc%mw�:Qr3kr 1K1-e +A.k— ,,,� Qa6,5CLI -- b. What is the steepest slope on the site (approximate percent slope)? NA C. What general es of soils are found on the site for example', clay, sand ravel t 9 types f P Y� , gravel, , muck). If you know the classification of agricultural soils, specify them and note any prime farmland. 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,rand approximate quantities of anyfilling or,grading proposed. Indicate source of fill 140 ��— f. Could erosion occur as a result of clearing, construction, 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)? i NA 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. owl b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. ,I D Mason County Environmental Checklist Page 3 I 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'-pr©vide nantes. If appropriate,,state ghat stream or river it flows into. j 5c 43 1 0. 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. / ( 6 a-t- I V e w R(v w4 Sc c.� -GA l vt. a•. .0 of 4 xr- 0(.i T- �or3 is 4a & o4 -5t'4-P 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. 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. IJA i Mason County Environmental Checklist Page 4, 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. 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. No b. Ground: 1) Will ground water be withdrawn:, or.wifl water be discharged to ground water? Give general description, purpose, and approximate quantities, if known. i 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. ohm, 2) Could waste materials enter ground or surface waters: If so, generally describe. Nj Mason County Environmental Checklist Page 5 d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: �t q 4. PLANTS: a. Check or circle type&of,vegetation found on the sites 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,,miffoil,other other types of vegetation / v ti d cv W ft' ,V 1le�e,�-u'��h W e v� � �/� f ice•-- 'Ta v .1n 4r-%,ov �-aKc_r_ Wy e-wv eh.T Soup- V4 - b 4/)OM) by'kI -p� Pass 10�'oJ,-A 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. d. Proposed landscaping, use of native plants, or other measures to preserve or enhance j vegetation on the site,,if any: 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 w iV b. List any threatened or endangered species known to be on or near the site. Wa n� C. Is the site part of a migration route? If so, explain. N A d. Proposed measures to preserve or enhance wildlife, if any: WTI) OtXqL 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. f� p z�—t 44 Wa OLYL.1 b. Would your project affect the potential use of solar energy by adjacent properties If so, generally describe. v 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: NA Mason County Environmental Checklist Page 7 7. ENVIRONMENTAL HEALTH: a. Are there any environmental health hazards, including exposuree to toxic chemicals, risk of fire and explosion, spill, or hazardous waste, that could occur as a'resu t'of this proposal? If so, describe. 1) Describe special emergency services that might be requited. A/#n L-- 2) Proposed measures to reduce or control environmental health hazards, if any: � A b. Noise. 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? 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. 3) Proposed measures to reduce or control noise Impacts, if any; 8. LAND AND SHORELINE USE: a. What is the current use of the site and adjacent properties? t R,e s ti ll-� H �-ti v� 4 aL f a. c-e w�— ov 1 b-v fZ k s i d-e k �71 CV J Mason County Environmental Checklist Page 8 b. Has the site been used for agriculture? If so, describe. C. Degcnbe an' y structures on the site. d. Will any structures be demolished? If so, what? e. What is the current zoning classification of'the site? f. What is the current comprehensive plan designation of the site? g. If applicable, what is the current Shoreline Master Program designation of the site? QA r /V4 /1/o c,4aInSA- XX-1�-et,lc h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. ? A18 !✓o c 4 a�y-- 47 'Y e f 4 c i. Approximately how many people would reside or jwork in the completed project? -I6 / u � 6¢Cca f1O�wl �vySTl SA �t GAS N� cA) ` S j. Approximately how many people would the completed project displace? k. Proposed measures to avoid or reduce displacement impacts, if any: Mason County Environmental Checklist Page 9 l I. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: ��r►e o S,c la�,r�- IS -rkq SQMe_ VZ-e a � L.pc a 4m0*b Q µ z- 1111t o "S 4-w T'-c V v r',W_ 4ev t iv+ i wd Vl 9. HOUSI NG: ti� J 4-10 r►•?a4-h-b `4-Y 'D o e J qJa g.-,-v-- 4t v3"_ A n I s5 U � a. Approximately how Many units would be provided, if any? Indicate whether high, middle, or low-income housing. d�1 A b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or low-income housing. 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? N.A b. What views in the immediate vicinity would be altered or obstructed? v e-- C. Proposed measures to reduce or control aesthetic impacts, if any: New V7Iow4— Lv4vIcL Qf-- M,VVt- Ad4-, kc. ci I 11� 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? b. Could light or glare from the finished project be a safety hazard or interfere with views? �o C. What existing off-site sources of light or glare may affect your proposal: N d YX t, d. Proposed measures to reduce or control light and glare impacts, if any: 12. RECREATION: a. What designated and informal recreational opportunities are in the immediate vicinity? �i � I�►�� a �IKS b. Would the proposed project displace any existing recreational uses? If so, describe. No C. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: N Oq Mason County Environmental Checklist Page 11 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. NA b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. N C. Proposed measures to reduce or control impacts, if any: 14. TRANSPORTATION: a. Identify public streets and highways serving the site and describe proposed access to the existing street.system. Show on site plats, if any. 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. N 4 C. How many parking spaces would the completed project have? How many would the project eliminate? D c.l 1a In I U 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). O Mason County Environmental Checklist Page 12 e. Will the project use (or occur in the immediate vicinity of)water,raill�,or air transportation? If so, generally describe. N f. How many vehicular trips per day would be generated by the,completed project: If known, indicate when peak volumes would occur. g. Proposed measures to reduce or control transportation impacts, if any: 15. PUBLIC SERVICES: a. Would the project result in an increased reed for public service(for example: fire protection, police protection,health care, schools, other)? If so, generally describe: a b. Proposed measures to reduce or control direct impacts on public services, if any: Mason County Environmental Checklist Page 13 16. UTILITIES: a. Circle utilities currently available at the site: et , natural gasorr, se ' e, sanitary sewer, eptic s , 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. 1ya *V*Al CJ��1,��4L) o✓ �-j H d' /-100wW 124r1 74 !J/e vi /s/o a , I Signature: The akbove answers are true and complete,to the best of my knowledge. I understand that the lead agency is relying on them to snake its decision. Signature: z0Z ln-.2a Date submitted: Mason County Environmental Checklist Page 14 ESA LISTED SALMONIDS CHECKLIST Anulicant Information Project Information Name Vl o, t/ /moo`>` Name - Phone 7 .F� Location .54 mt aJ an i A 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 j 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 listing. I€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 Please describe. 2. Has there ever been an ESA listed salmonid stock present in this watershed? YES NO dd Uncertain Please describe. UM Kh©w k7 /'I-t J Cc 7L Wd v 6 cL PYP S.P/t 7 If you answered "yes" to either of the above questions, you should complete the remainder of this checklist. / 744 Prat` /J ��y?L% ►It c/: I cZ Y April 2003 Mason County Environmental Checklist Page 15 L PROJECT SPTCIFICES: The questions.in°this section are specific to the project and vicinity. 1. Name of watershed: 2. Name of nearest waterbody: 14 M&I B Y s 3. What is the distance from this project to the nearest body of water: ®,1 AA ,+V . 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 tots, farmland,etc.)? ve o 3e �eti �4 5. Is the project above a: * natural permanent barrier(waterfall) YES NO X * natural temporary barrier(beaver pond) YES NO X * man-made barrier(culvert,,dam) YES NO * other(explain): 6. If yes, are there any resident salmonid populations above the blockage? YES NO Don't know IVl*;7 7. What percent of the project will be impervious surface (including pavement &roof area)? Mason,County Environmental Checklist Page 16 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. Ground water? YES NO Amount From where Depth of well 2. Will any water be rerouted: YES NO ,'W— 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? /A If to a surface water discharge,please give the name of the waterbody. 4. Will this.project require the building of new roads? YES NO X- Increased road mileage may affect the timing of water reaching a stream and may impact fish habitat. 5. Are culverts proposed as part of this project? YES NO ->4-- 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 filling or other partial blockage of flows? YES NO 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 impaatwater 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. l. 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 wat body? / YES _ NO Co•sj flue L,' 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 load'contaminants(fertilizers,other waste discharges, or runoff)to the waterbody? YES NO 7--or 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. 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 th 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? Mason County Environmental Checklist Page 19 l S "" Y as f6 O0 aN o O b 41 m O. Y V QI 4i 00 ,� t. 0 y(40 PC q a � a i° 0Z� Z eo u ° do d N C a w do WZ t3 x c to ra L1Q �p Q� d CO "� -A Ya Y N m fY� �$ o $ter o K�W cd 10 va O W 1rI �� r r m X C3 N `O Li Li C CL o Cz yo YYa N is a e LL 34 N -� i U �g 1itL.0 Co a Ab LL.1 W L QZWZ 4•W W ` N{►ao Nw �OOH aO x xg-cn <41 ~N4 N nevewwowwmoN Toox as�ow Tan SHEET ID CODE Lake Shore Construction OntOurs & h+ar:en�....eer�ur.bsAnoe '"D�DiO°""`"10"'"' PIER 71MOT.Fapaw.GnrpMb9 sts maw Typical Float Design OriCej3t5 — SHEET No. ' E ommo Isometric ngineenng D �- 1 of 1 Phone:360-264-5161 on�rTa V ?MW uraao �no. � Tani Ws vwrTat 0ATE6 T -- 2 g Back T� X a te- 0000TIVFU JOINT AQUATIC RESOURCES PERMIT APPLIC0N$&5'tJARPA) (for use In Washington State) PLEASE TYPE OR PRINT IN BLACK INK, TO FILL IN ELECTRONICALLY USE F11 TO MOVE THROUGH THE FORM Application for aFish 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 JARPA Addition)to your local Government Planning Department and Washington Department of Fish&Wildlife Area Habitat Biologist on the same day. NOTE: LOCAL GOVERNMENTS-You must submit any comments on these projects to WDFW within 15 working days. Based on the instructions provided,I am sending copies of this application to the following:.(check all.that apply) ❑ Local Government for shoreline:[]Substantial Development ❑Conditional Use [3variance 'V�xemption []Revision E]Floodplain 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-Federal 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 will be designed to meet conditions of the most current Ecology/Department of Transportation Water Quality Implementing Agreement SECTION A-Use for all permits covered by this applkation. Be sure to ALSO complete Section C(Signature Block)for all permit applications. 1.APPLICANT \J MAILING ADDRESS 80 WORK PHONE E-MAIL ADDRESS HOME PHONE FAX# Kan agent Is acting for the applicant during Me permit process,complete#2 Be sure agent signs Section C(Signature-Block) for all permit applications 2.AUTHORIZED AGENT �rJh.. �i►� _�MAILING ADDRESS og to, ,� a a8s7a� WORK HONE E-MAIL ADDRESS HOME PHONE FAX# l0 2�s 00—LR 3.1'' elationship of applicant to property: OWNER ❑ PURCHASER LESSEE ❑ 4.Name, address and phone number of property owner(s)If other than applicant: 5.Location(street add ,including ,co and zip code,where proposed activity exists or,*All r) 190 S Ir AryKoAck C+- Ok . (\A t4sov\- 0 ou Local government with jurisdiction or county) vv` &)y% Waterbody you are working in M JTcibutary of WRIA# Is this waterbody on the 303(d)List" YES NO - 'sou 11�{ If YES,what parameter(s)? "*For 30.3d List, Shorelin designation U 00A hfto*/Avww wa.. v l oning designationJ CAM 1,_ '/.Section Section T Rangel lGovernment Lot DNR stream type if known Latitude and Longitude: Tax Parcel Number /� /� )L S SO ECY 070-15(Rev. 11/04) JARPA Contact the State of Washington 9fflae of i3ggulatory Assistance for latest version or call 380/407-7037 or 800/917-0043 1 & Describe the current use of the property,and structures existing on the property. Have you completed any portion of the proposed aptivtty on this property? ❑ YES & NO For any pbrtion of the proposed activity already completed on this property,indicate month and year of completion. "DOCKCa 0,&r is the property agricultural land? YES NO Are you a USDA program participant? 0 YES 06 NO 7a. Describe the proposed work that needs aquatic permits: Complete plans and specifications should be provided for all work waterward of the ordinary high water mark or line,including 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 hgrp Vch a separate sheet if additional space is needed. � placsZ. �E c Se C+t(M' vj�'- ploa+wl Dock (a� S . ll Irtc�v.�e. A �0�-4- vv'I S 4 �Q ton r- v PREPARAara+�Yv\ N OF DRAWIN See sample drawings and guidance for oompleft the drawings. ONE SET OF ORIGINAL OR GOOD QUALITY REPRODUGBLE ORAININUMUST REATTACHED. NOTE: Appkants are a oouraged to submit photographs of the pmjad site,but these DO NOTsubsdkda for drawings. THE CORPS OF t;NGINEERS AND COAST GUARD REQUIRE DRAN7NGS ON 8-112 X 11 INCH SHEETS: LARGER DRAWINGS MYSE REQUIRED OY OTHERAGENCIE& 7b. Describe the purpose of the proposed work and why you want or need to perform it at the site. Please explain any specific needs that have influenced the design. 7c. Describe the potential impacts to characteristic uses of the water body. These uses may include fish and aquatic pfe,water quality, water supply, recreation and aesthetics. Identify proposed actions to avoid,minimize,and mitigate detrimental impacts and provide proper protection of fish and aquatic life. Identify which guidance documents you have used. Attach a separate sheet If additional Space is needed. I10 i rvvp cLc" -s 7d. For in water construction work,will your project be in compliance with the State of Washington water quality standards for turbidity WAC 173.201A-110? JtYES NO See USEFUL DEFINITIONS AND INSTRUCTIONS B. Will the project be constructed in stages? YES ❑ NO Proposed starting date: M.PYck L!L� Estimated duration of a 9. Check If 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.Will fill material(rock,fiH,bulkhead,or other material)be placed: ' f ❑ Waterward of the ordinary high water mark or line 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. 11/04) JARPA Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or t1 M17-0043 2 11. Will material be placed in wetlands? ❑ YES ® 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? H YES,please submit with application ❑ YES ® NO D. Type and composition of fill material(e.g.,sand, etc.) (�o 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 will bW greater than%of an acre of wetland,subnt a mitigation plan io the Corps and Ecology for approval along with the OMA form. NOTE:A 401 water quIlly certlfication will be required from Ecology in additlon ban approved mitigation plan if your project impacts weilancis ow are: a)greater than%acre In size, or b)Wal wetlands or wetlands adjacent to tidal water. Please submit the JARPA form and mitigation plan to Ecology for an individual 401 cerfilicati n 9 a)or b)applies. 12. Stormwater Compliance for Nationwide Perrnits Only: This project is(or will be)designed to meet bco y's most current stormwater manual,or an Ecology approved local stormwater manual. ❑ YES ❑ NO If YES-Which manual will your project be designed to meet? If NO—For clean 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 NO ItYES: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( EPA)been completed YES ❑ NO SEPA Lead Agency: 11d ASOvt�C t " SEPA Dedslon: 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 APPLICATION 15. List otiiter Aplplpations,approvals or certifications from other federal,state or local agencies for any strurtltrmW conshiction discharges or other adk4t1las,described in the application 0.e.preliminary plat approval,health district approval,bukft permit,SEPA review, federal anerlgy regulatory commission license(FERC),Forest pracdoes application,etc.). Also,.indk to whetherwork has been oompltlbd and indicate all existing work on drawings. NOTE:For use with Corps Nationwide Permits,klentify whether your project has or will need an NPDES permit for discharl ling wastewater and/or stomiwater. TYPE OF APPROVAL ISSUNG AGENCY IDENTFICATION DATE OF APPLICATION DATE APPROVED COIiAPIETED7 NO. iA v"` OUrx 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 Q NO If YES;explain: ECY 070-15(Rev. 11104) JARPA Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 3 SECTION B.- Use for Shoreline and Corps of Engineers permits only: 17a.Tptal cost of project. This means the fair market value of the project,Including materials,labor,machine rentals,etc. dow. of(0 ts.3 0 17b.If a project or any portion of a.project receives funding from a federal agency,that agency is responsible for ESA consultation. Please ndicate if you will receive federal funds and what federal agency is providing those funds. See instructions for information on ESA.* EDERAL FUNDING ❑ YES NO If YES,please list the federal agency. 18.Local government with jurisdiction: 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 govemment. I NAME ADDRESS PHONE NUMBER SECTION C This seafto MUST be emphiled i'br any Permit covered by fh*oppocalffon 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 loos,corrnplete,and accurate. I further c w*that 1 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 location to inspect the proposed,in-progress or completed work. I agree to start work ONLY after all necessary permits have been received. DATE SIGNATURE OF APPLICANT DATE SIGNA OF 2nORIZED AGENT I.HE EBY DESIGNATE f7 TO ACT AS MY AGENT IN MATTERS RELATED TO THIS APPLICATION FOR PERMIT(S). i UNDERSTAND THAT IF A FEDERAL PERMIT IS ISSUED,I MUST SIGN THE PERMIT. SIGNATURE OF APPLICANT DATE SIGNATURE OF LANDOWNER(EXCEPT PUBLIC ENTITY LANDOWNERS,E.G.DNR) THIS APPLICATION MUS BE S ONE=D BY THE APPLICANT AND THE AGENT,IF AN AUTHOROW AGOU IS DMGM4TED. 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 fad 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$10,000 or Imprisoned not more than 5 years or both. These are Equal Opporlunit and Af rmni live Action employers. For special accommodation needs.please contact the appropriate agency in the Instructions ECY 070-15(Rev. 11/04) JARPA Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 4 r Department of Natural Resources BRiAN BOYLE OLYMPIA. WAS14INGTON %;aumonoetr of Public Lw, s as 98504 DET$ tATtON OF N0N8j(;=CANCE Description of proposal Repair of recreational dock that will be used to moor two off-season Alaska fish tenders (100 foot maximum lenoth) . Proponent Richard Z. LeMay Location of proposal. including street address. if any Mason County on Arcadia, Point tactinn 99_ Tnwnchi 90N- Ramp-W. w_M_ (see exhibit attached) . i i Lead agency Department of Natural Resources The lead agency for this proposal has determined that it does not have a probable significant adverse impact on the environment. AA environmental impact statement (EIS) is not required under RCW 43.21C.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 on requdst. There is no comment period for this DNS. :X This DNS is issued under 197-11-340(2)• the lead agency will not act on this proposal for 15 days from the date below. Comments must be submitted by 10/27/88 — - Responsible official John DeMever Position/title Manager, Division of Aquatic Lands Phone753-5324 Address John Cherberg Date Signature Tix _ ZZdZB_ S4 - Ale. There is no agmy SEPA *' ,. ,-... "'. R�.� - �� - +v _ _. ��w �� �� ' 1 1. Y i .. ���� . 7 � i � ` _ .{ � ` ' I 1 { ` � 1 f � I �y rV y 1�y i I i �f. f }� _ r1 d i }a�� �' 1 � ' I � �� i� !�ft {RIQ �' I � � � � i I }i � �f ,� _ � � til + '� I?� I � � I ?� ■ '� � ,�� � ■ �-.` r _ - � ,' +- -- - � �: � � �,� __ � � � - r_? r ��:; q _ - _ -.�� F i'� t _ /��_ �.,' , _ � '��" tip`'� ��+�F.w C�,R`' r f� -. �4���r�r�"s a {� G��1��� F g �..- �� - ._.Q= �� '� _ __ A _ `- Imo. �'-w _f_ rRT ��p � '��� _ - �� - 'I � � �. _ �' i� , - ,�, ram" ,�_ '4-_ ` �-� A , _ �r � - �--- - 1 Y __ -- �u � �:� "➢ _ - - �� �� � - �� . _ � �, - :.. '.�,� .�, _} - - .�,:, WASHINGTON STATE DEPARTMENT OF aturcl Resources BRIAN BOYLE Commissioner of Public Lands OLYMPIA, WA 98504 M E M O R A N D U M F R i October 21, 1988 TO: Marsha Hixson, SEPA Coordinator Analysis and Planning FROM: Larry Ledgerwood Division of Aquatic Lands SUBJECT: Revised Determination of Nonsignificance (DNS) Recently, we submitted a SEPA routing request - DNS: Proponent - Richard Z. Lemay Dated - October 10, 1988 Please advise reviewers of a change under the Description of Proposal ; to read (120 foot ± length) . Thank yo b v c: App. No. 20-012822 BV5 5 Equal Opportunity/Affirmative Action Employer AGENCY USE ONLY Agency Reference#: Date Received: Circulated by: (local govt. or agency) JOINT AQUATIC RESOURCES PERMIT APPLICATION FORM (JARPA) (for use in Washington State) c r PLEASE TYPE OR PRINT IN BLACK INK OR FILL IN ELECTRONICALLY ❑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 JARPA Addition) to your local Government Planning Department and Washington Department of Fish &Wildlife Area Habitat Biologist on the same day. NOTE: LOCAL GOVERNMENTS—You must submit any comments on these projects to WDFW within 15 working days. Based on the instructions provided, I am sending copies of this application to the following: (check all that apply) Local Government for shoreline: ❑Substantial Development ❑Conditional Use ❑Variance ErExemption ❑ Revision ❑Floodplain Management ❑Critical Areas Ordinance [✓7 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-Federal 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 will be designed to meet conditions of the most current Ecology/Department of Transportation Water Quality Implementing Agreement SECTION A-Use for all permits covered by this application. Be sure to ALSO complete Section C(Signature Block)for all permit applications. 1.APPL ANT _ MAILIN ADDRESS WORK PHONE E-MAIL ADDRESS HOME PHONE FAX# If an agent is acting for the aldplicant during the permit process,complete#2. Be sure agent signs Section C(Signature Block) for all permit applications 2. AUTHORIZED AGENT , N A.� MAILING ADDRESS WORK PHONE E-MAIL ADDRESS HOME PHONE FAX# 3. Relationship of applicant to property: ,®OWNER []PURCHASER []LESSEE ❑OTHER: 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) Local government with jurisdiction(city or county) cn Waterbody you are working in 64„, Tributary of WRIA# Is this waterbody on the 303(cl List YES NO❑ J. , c rz If YES,what parameter(s)? Shoreline designation For 303d List, ✓��h http:/Iwww.ecy.wa.gov/programs/wq/303d/index.html Zoning designation Y.Section I Section Township I Range Government Lot a/ d('1 Al 14 Ir1/ DNR stream type if known Latitude and Longitude: Tax Parcel Number Z ('yZ ✓�t�f'ifry p©l ECY 070-15(Revised 11/04)JARPA, Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 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? YES �NO For any portion of the proposed activity already completed on this property, indicate month and year of completion. Is the property agricultural land? DYES NO Are you a USDA program participant? 0YES NO 7a. Describe the proposed work that needs aquatic permits: Complete plans and specifications should be provided for all work waterward of the ordinary high water mark or line, including 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. ;i reor,4 -- PREPARATION OF DRAWINGS: See sample drawings and guidance for completing the drawings. ONE SET OF ORIGINAL OR GOOD QUALITY REPRODUCIBLE DRAWINGS MUST BE ATTACHED. NOTE: Applicants are encouraged to submit photographs of the project site,but these DO NOT substitute for drawings. THE CORPS OF ENGINEERS AND COAST GUARD REQUIRE DRAWINGS ON 8-112 X 11 INCH SHEETS. LARGER DRAWINGS MAYBE REQUIRED BY OTHER AGENCIES. 7b. Describe the purpose of the proposed work and why you want or need to perform it at the site. Please explain any specific needs that have influenced the design. 7c. Describe the potential impacts to characteristic uses of the water body. These uses may include fish and aquatic life,water quality, water supply, recreation and aesthetics. Identify proposed actions to avoid, minimize, and mitigate detrimental impacts and provide proper protection of fish and aquatic life. Identify which guidance documents you have used. Attach a separate sheet if additional space is needed. 7d. For in water construction work, will your project be in compliance with the State of Washington water quality standards for turbidity WAC 173.201A-110? 0 YES NO (See USEFUL DEFINITIONS AND INSTRUCTIONS) 8. Will the project be constructed in stages? YES❑ NO ❑ Proposed starting date: Ae— /'S---2�04 k Estimated duration of activity: �t 9. Check if 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.Will fill material(rock, fill, bulkhead, or other material)be placed: ❑Waterward of the ordinary high water mark or line 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(Revised 11/04)JARPA, Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 2 11. Will material be placed in wetlands? AYES �N0 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? If YES, please submit with application ❑YES KJNO D. Type and composition of fill material(e.g., sand, etc.) /40 E. Material source. a / 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? DYES NO IF YES, IMPACTED AREA IS ACRES OF DRAINED WETLANDS. NOTE: If your project will impact greater than of an acre of wetland,submit a mitigation plan to the Corps and Ecology for approval along with the JARPA form. NOTE:a 401 water quality certification will be required from Ecology in addition to an approved mitigation plan if your project impacts wetlands that are: a)greater than''/:acre in size, or b)tidal wetlands or wetlands adjacent to tidal water. Please submit the JARPA form and mitigation plan to Ecology for an individual 401 certification if a)or b)applies. 12. Stormwater Compliance for Nationwide Permits Only: This project is(or will be)designed to meet ecology's most current stormwater manual, or an Ecology approved local stormwater manual. YES NO /�✓/ If YES—Which manual will your project be designed to meet? ,/ff If NO—For clean 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? DYES RINO 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 21 YES ONO SEPA Lead Agency: 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 APPLICATION 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 discharging wastewater and/or stormwater. TYPE OF APPROVAL ISSUING AGENCY IDENTIFICATION DATE OF APPLICATION DATE APPROVED COMPLETED? J"i Al'i A < NO. 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(Revised 11/04)JARPA. Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 3 SECTION B - Use for Shoreline and Corps of Engineers permits only: 17a. Total cost of project. This means the fair market value of the project, including materials, labor, machine rentals, etc. 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: 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-This section MUST be completed for any permit covered by this application 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 location to inspect the proposed, in-progress or completed work. I agree to start work ONLY after all necessary permits have been received. DATE SIGNATU F AP LI NT !/ X1/_0 U DATES `• O SIGNATURE OF AUTHORIZED AGENT I HEREBY DESIGNATE TO ACT AS MY AGENT IN MATTERS RELATED TO THIS APPLICATION FOR PERMIT(S). I UNDERSTAND THAT IF A FEDE RAL PERMIT IS ISSUED, I MUST SIGN THE PERMIT. SIGNATURE OF APPLICANT DATE SIGNATURE OF LANDOWNER(EXCEPT PUBLIC ENTITY LANDOWNERS, E.G. DNR) THIS APPLICATION MUST BE SIGNED BY THE APPLICANT AND THE AGENT,IF AN 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. COMPLETED BY LOCAL OFFICIAL A. Nature of the existing shoreline. (Describe type of shoreline, such as marine. stream, lake, lagoon,marsh, bog, swamp,flood plain, floodway,delta;type of beach, such as accretion,erosion, high bank, low bank, or dike; material such as sand,gravel, mud, clay, rock, riprap; and extent and type of bulkheading,if any) B. In the event that any of the proposed buildings or structures will exceed a height of thirty-five feet above the average grade level, indicate the approximate location of and number of residential units,existing and potential, that will have an obstructed view: C. If the application involves a conditional use or variance, set forth in full that portion of the master program which provides that the proposed use may be a conditional use, or, in the case of a variance, from which the variance is being sought: These Agencies are Equal Opportunity and Affirmative Action employers. For special accommodation needs, please contact the appropriate agency in the instructions. ECY 070-15 JARPA(Revised 11/04) Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 4 © WASHINGTON JOINT AQUATIC RESOURCE PERMITS APPLICATION (JARPA) INSTRUCTIONS, SAMPLE DRAWINGS & AGENCY CONTACTS NOTE,• DO NOT SUBM/T this section with your application. This Joint Application may be used to apply for Hydraulic Project Approvals, Shoreline Management Permits, Approvals for Exceedance of Water Quality Standards,Water Quality Certifications, Coast Guard Bridge Permits, Department of Natural Resources Use Authorization, and Army Corps of Engineers Permits. You must submit readable copies of the completed application form together with detailed drawings, prepared in accordance with the drawing guidance to the appropriate agencies. When appiyina. you do NOT need to send copies of the instructions Remember, depending on the type of project you are proposing, cther permits may be required that are not covered by this application. Use the following list to determine which permits to apply for. Your project may require some or all of these permits. If you have trouble deciding which permits you need,please contact the appropriate agency for questions. Agency telephone numbers are attached. IF ANY OF THE BOXED ITEMS LISTED UNDER A PERMIT TITLE BELOW APPLY TO YOUR PROJECT, THEN YOU MUST CHECK THE BOX FOR THAT PERMIT ON THE TOP OF PAGE ONE OF THE JARPA FORM AND SEND A COMPLETED COPY OF THE APPLICATION FORM TO THE AGENCY RESPONSIBLE FOR ISSUING THAT PERMIT. Complete Sections A &C for any of the permits listed below. Also complete Section B for Shoreline and Army Corps of Engineers permits. Detailed drawings are required for any of these permits(see attached drawing guidelines for drawing requirements). ❑ Hydraulic Project Approval from the Department of Fish and Wildlife under 77.55 RCW is required if your project includes construction or other work,that: • will use, divert, obstruct, or change the natural flow or bed of any fresh or salt water of the state. This includes bed reconfiguration, all construction or other work waterward under and over the ordinary high water line, including dry channels, and may include projects landward of the ordinary high water line(e.g., activities outside the ordinary high water line that will directly impact fish life and habitat, falling trees into streams or lakes,dike construction etc.). ❑ Shoreline Substantial Development Conditional Use Variance Permit or Exemption from Local Government(under the Shoreline Management Act, 90.58 RCW;)required for work or activity in the 100-year floodplain, or within 200 feet of the ordinary high water mark of Shorelines of the State(check with your local government); and which includes any one of the following: • dumping; • drilling; • dredging; • filling; • placement or alteration of structures(whether temporary or permanent); or • any activity which substantially interferes with normal public use of the waters regardless of cost. ❑ Floodplain Management Permits and/or Critical Areas Ordinances review by Local Government for: • work in frequently flooded areas, geologically unstable areas, wildlife habitats, aquifer recharge areas, and wetlands. ❑ Section 401 Water Quality Certification from the Department of Ecology Regional office under 33 USC§ 1341 of the Clean Water Act is needed when a federal approval is required for a project, including the following: • Corps of Engineers 404 Permit--Send to Ecology's Federal Permits Unit in the Regional Office; • FERC hydropower license--Attach FERC exhibit E or an Applicant Prepared Environmental Assessment and send to the State of Washington's Office of Permit Assistance ❑ Aquatic Resources Use Authorization Notification from the Department of Natural Resources is required if your project: • is on, crosses, or impacts the bedlands,tidelands or shorelands of a navigable water. ❑ Section 404 Permit from the Corps of Engineer under 33 USC§ 1344 of the Clean Water Act is required if your project includes: • placement of dredged or fill material waterward of the ordinary high water mark, or the mean higher high tide line in tidal areas, in waters of the United States, including wetlands*, • mechanized land clearing and sidecasting in waters of the United States, including wetlands*. • Endangered Species Act(ESA) Consultation** ECY 070-15 JARPA(Revised 11/04) Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 1 ❑ Section 10 Permit from the Corps of Engineer is required for: • any work in or affecting navigable waters of the United States(e.g., floats, piers, docks, dredging,excavation, piling, buoys, overhead power lines,etc.). ❑ General Bridge Act Permit from the Coast Guard is required for: • construction of a new bridge or modification to an existing bridge over a navigable waterway. ❑ Private Aids to Navigation from the Coast Guard is required for: • installing a fixed structure or floating object within the waters of the United States. *Wetlands that are determined to be isolated by the Army Corp of Engineers are no longer regulated under Section 404 of the Clean Water Act. These wetlands are regulated by the Department of Ecology under the state Clean Water Act RCW 90.48. For further information please contact the Office of Regulatory Assistance at 1-800-917-0043 or at assistance ora.wa. ov **Endangered Species Act(ESA)Consultation with the National Marine Fisheries Service and/or U.S. Fish and Wildlife Service: If your project is authorized, funded or carried out by a Federal agency and the Federal agency determines that the proposed project may affect ESA listed species or critical habitat, consultation under Section 7 of the ESA is required. ESA Consultation is the responsibility of the Federal agency, not the applicant JARPA forms should be submitted directly to the responsible Federal agency, not to the National Marine Fisheries Service or the U.S. Fish and Wildlife Service. The responsible Federal agency may require additional information from the applicant to assess potential project impacts to listed species and their habitat. Information on ESA - http://endangered fws qov/hcp/index html or http://endangered fws qov/whatwedo html or http://offices.fws qov/directory/ListOffices cfm USEFUL DEFINITIONS & INSTRUCTIONS The following definitions are presented to help applicants in completing the JARPA. They may not negessarily represent specific language from the laws implemented through JARPA. Ordinary High Water Mark or Line means the visible line on the banks where the presence and action of waters are so common as to leave a mark upon the soil or vegetation. In any area where the ordinary high water line cannot be found,the ordinary high water line adjoining saltwater shall be the line of mean higher high water,and the ordinary high water line adjoining freshwater shall be the elevation of the mean annual flood. Mean Lower Low Water is the 0.0 tidal elevation,determined by averaging each day's lowest tide at a particular location over a period of 19 years. It is the tidal datum for vertical tidal references in the salt water area. Mean High Water and Mean Higher High Water Tidal Elevations at any specific location can be found in tidal benchmark data compiled by the United States Department of Commerce, Environmental Science Services Administration, Coast and Geodetic Survey, dated January 24, 1979. This information can be obtained from the Corps of Engineers at(206)764-3495. The determination of tidal elevation is obtained by averaging each day's highest tide at a particular location over a period of 19 years, measured from mean lower low water, which equals 0.0 tidal elevation. Shorelands or shoreland areas means those lands extending landward for 200 feet in all directions as measured on a horizontal plane from the ordinary high water mark,floodways and contiguous floodplain areas landward 200 feet from such floodways; and all wetlands and river deltas associated with the streams, lakes,and tidal waters which are subject to the provisions of 90.58 RCW. Shorelines means all water areas of the state, including reservoirs, and their associated wetlands, together with the lands underlying them, except stream segments upstream of the point where mean annual flow is less than 20 cubic feet per second, and lakes less than 20 acres in size. Wetlands mean areas that are inundated or saturated by surface water or ground water at a frequency and duration sufficient to support, and that under normal circumstances do support, a prevalence of vegetation typically adapted for life in saturated soil conditions. Wetlands generally include swamps, marshes, bogs, and similar areas. Bridge means any structure including pipelines and conveyor belts, which transports traffic or materials across a navigable water. Aquatic Tidelands means the area between the ordinary high tide line and extreme low tide line, unless otherwise established. Aquatic Shorelands means the shore areas of non-tidal navigable lakes or rivers between the ordinary high water line and the line of navigability unless otherwise established. Aquatic Bedlands means the area waterward of and below the line of navigability on non-tidal rivers and lakes, or below the extreme low tide mark in navigable tidal waters, or below the outer harbor line where a harbor has been created ECY 070-15(11104)JARPA. Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 2 Nationwide Permit issued by the Corps of Engineers for projects with minimal impacts. For a complete packet of nationwide permits and application information, contact the Corps Regulatory branch at(206)764-3495 or visit their website http://www.nws,usace,army.mil Section 303(d)listed waters These are water quality limited estuaries, lakes, and streams that fall short of state surface water quality standards, and are not expected to improve within the next two years. Mixing zone means that portion of a water body adjacent to an effluent outfall where mixing results in the dilution of the effluent with the receiving water. Water quality criteria may be exceeded in a mixing zone as conditioned and provided for in WAC 173-201A-40Q Turbidity means the clarity of water expressed as nephelometric turbidity units(NTU)and measured with a calibrated turbidimeter. Background conditions means the biological, chemical, and physical conditions of a water body, outside the area of influence of the discharge under consideration. Instructions for question 7d. Water Quality Standards—Compliance for turbidity mixing zone requirements. The water downstream of the allotted mixing zone(100 ft, 200 ft, 300 ft,dependent on how fast the water is flowing and measured in cubic feet per second)must have the same visual clarity as the water upstream of the project impact site(the water cannot be greater than 5 NTUs above the background water). The following section from WAC 173-201A-110 authorizes the turbidity mixing zone. All work in or near the water, and water discharged from the site shall meet the State's Water Quality Standards,WAC 173-201A. A mixing zone for turbidity is authorized within WAC 173.201A-030 during and immediately after necessary in-water or shoreline construction activities that result in the disturbance of in-place sediments. Use of a turbidity mixing zone is intended for brief periods of time(such as a few hours or days)and is not an authorization to exceed the turbidity standard for the entire duration of the construction. Use of the mixing zone is subject to the constraints of WAC 173-201A-100(4)and(6), requiring an applicant have supporting information that indicates the use of the mixing zone shall not result in the loss of sensitive or important habitat, substantially interfere with the existing or characteristic uses of the water body, result in damage to the ecosystem,or adversely affect public health. The mixing zone is authorized only after the activity has received all other necessary local and state permits and approvals, and after the implementation of appropriate best management practices to avoid or minimize disturbance of in-place sediments and exceedances of the turbidity criteria. Within the mixing zone,the turbidity standard is waived, and all other applicable water quality standards shall remain in effect. The mixing zone is defined as follows: 1) For waters up to 10 cfs flow at time of construction, the point of compliance shall be 100-feet downstream of project activities. 2) For waters above 10 cfs up to 100 cfs flow at time of construction, the point of compliance shall be 200-feet downstream of project activities. 3) For waters above 100 cfs flow at the time of construction, the point of compliance shall be 300 feet downstream of project activities. 4) For projects working within or along lakes, ponds, wetlands, estuaries, marine waters or other non-flowing waters, the point of compliance shall be at a radius of 150-feet from the activity causing the turbidity exceedance. ECY 070-15(11104)JARPA. Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 3 GUIDANCE FOR COMPLETION OF DRAWINGS General Informatioi. Three types of illustrations are needed to properly depict the proposed activity: Vicinity Map, Plan View, and Cross-Sectional Vew. Drawings to scale should be prepared using clear printing, black ink, and the fewest number of sheets possible. Include the scale. The importance of clear accurate drawings cannot be overstated. At a minimum, drawings must contain the following irformation; other information may be required depending on project type. If you have questions regarding completing the drawincs,call the appropriate agency. "NOTE: Army Corps cf Engineers drawing requirements are found at: http://www.nws.usace.army.mil/PublicMenu/Menu.cfm?sitename=REGBpagename=mainpage_Permit_Applicant_info . 1. Vicinity Mao A copy of a county or city road map,or a U.S. Geological Survey topographic map may be used. Include: a. North arrow. b. Name of waterbody(and river mile if appropriate). C. Location of the proposed activity(indicate with a circle, arrow, X, or similar symbol). d. Provide latitucl°and longitude of the site to the nearest second. e. Provide directbns to the site. 2. Plan View. This drawing illustrates the proposed project area as if you were looking down at the site from overhead. a. North arrow. b. Name of waterbody and direction of water flow. C. Location of exsting shoreline. Tidal Waters: Show the Ordinary High, Mean High, Mean Low, Mean Higher High, and Mean Lower Low Water Marks or Lines and/or wetland boundaries. Indicate elevation above datum. Non-tidal wate s: Show the Ordinary High Water Mark or Line, Meander Line,and/or wetland boundary. d. Dimensions of the activity or structure and impervious surfaces, distance from property lines, and the distance it extends into the waterbody beyond the Ordinary High, Mean High Mean Higher High, and Mean Low Water Mark or Line, and/o-wetland boundaries,as appropriate. e. For Corps perraits, indicate the distance to Federal projects and/or navigation channels(if applicable). To ascertain, call the Carps Regulatory Branch Office at(206)764-3495. f. Show existing-tructures on subject and adjoining properties. g. Indicate adjoining property ownership. h. If fill material is to be placed, identify the type of material, amount of material(cubic yards), and area to be filled(acres). i. If project involv--s dredging, identify the type of material, amount of material(cubic yards), area to be dredged, method of dredgng, and location of disposal site. Dredging in areas shallower than-10 feet needs to be clearly identified on drawirgs. j. Identify any part of the activity that has been completed. k. Indicate types and location of aquatic,wetland, riparian and upland vegetation. I. Erosion control measures,stabilization of disturbed areas, etc. M. Utilities, including water, sanitary sewer, power and stormwater conveyance systems(e.g., bioswales). n. Indicate stormwater discharge points. o. Proposed landscaping where applicable(for complex landscape plans, please attach a separate drawing). p. Where applicab,e, plans for development of areas on or off site as mitigation for impacts associated with the proposal. q. On all variance applications the plans shall clearly indicate where development could occur without approval of a variance, the physical features and circumstances on the property that provide a basis for the request,and the location of adjaceit structures and uses. 3. Cross-Sectional View. This drawing illustrates the proposed activity as if it were cut from the side and/or front. Include: a. Location of water lines. Tidal Waters: S-iow the Ordinary High, Mean High, Mean Higher High, and Mean Lower Low Water Marks or Lines, and/or wetland boundary. Non-tidal waters_ Show the Ordinary High Water Mark or Line, and/or wetland boundary. b. Water depth or tdal elevation at waterward face of project. C. Dimensions of We activity or structure, and the distance it extends into the waterbody beyond the Ordinary High, the Mean High, tf a Mean Higher High and Mean Low Water Mark or Line, and/or wetland boundaries. d. Indicate dredge and/or fill grades as appropriate. e. Indicate existing and proposed contours and elevations. f. Indicate types and location of aquatic,wetland, and riparian vegetation present on site. g. Indicate type and location of material used in construction and method of construction. h. Indicate height or structure. 4. Clearance and Elevatic-is. Applies to Coast Guard Bridge Permits only. a. Vertical clearance,measured from Mean Higher(tidal waters)or Ordinary High(non-tidal water). b. Horizontal clearance between piers or pilings. C. Bottom elevation of the waterway at the bridge. 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 800/917-043 4 AGENCY CONTACTS Below is a list of agencies to which a copy of the Joint Application may be sent, and which permit each agency issues. Technical assistance and information is also availablE from these offices. State of Washington Office of Regu atory Assistance State of Washington Office of Regulatory Assistance Telephone 1-800-917-0043 or(360)407-7037 Mailing Address Fax(360)407-6904 PO Box 47600 Olympia, WA 98504-7600 Physical Address 300 Desmond Drive Lacey, WA 98504 Department of the Army Permit (Section 404 or Section 10) U.S.Army Corps of Engineers, Telephone(206)764-3495 Seattle District FAX(206)764-6602 Regulatory Branch Post Office Box 3755 Seattle,WA 98124-3755 U.S.Army Corps of.Engineers Telephone(509)238-4570 Eastern Washington Information FAX(509)238-4570 P.O. Box 273 Chattaroy,WA 99003-0273 U.S.Army Corps of Engineers Telephone(509)682-7010 Central Washington Information FAX(509)682-7710 P.O. Box 2829 Chelan,WA 98816-2829 Department of Ecology Permits —401 Water Quality Certification Washington State Department of Ecology—Headquarters Mailing Address Post Office Box 47600 Telephone(360)407-6000 Olympia, WA 98504-7600 Physical Address 300 Desmond Drive Lacey, WA 98504 Central Region Telephone(509)575-2490 15 West Yakima Avenue, Ste 200 FAX(509)575-2809 Yakima,WA 98902-3401 Eastern Region Telephone(509)329-3400 4601 North Monroe, Suite 202 FAX(509)329-3529 Spokane, WA 99205-1295 Northwest Region Telephone(425)649-7000 3190- 160th Avenue S.E. FAX(425)649-7098 Be*vue,WA 98008-5452 Southwest Region Telephone(360)407-6300 Mailing Address: FAX(360)407-6305 P.O. Box 47775 Olympia,WA 98504-7775 Physical Address 300 Desmond Drive Lacey,WA 98504 ECY 070-15 JARPA(Revised 11I04). Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 8001917-0043 5 Department of Fish and Wildlife (Hydraulic Project Approval)-Submit 3 copies of the JARPA application to Regional offices. Contact regional offices for questions or assistance. Headquarters Washington State Department of Fish and Wildlife Telephone(360)902-2534 600 Capitol Way North TDD(360)902-2207 Olympia, Washington 98501-1091 FAX(360)902-2946 Region 1 (Pend Oreille, Ferry, Stevens, Spokane, Lincoln, Whitman, Columbia, Garfield,Asotin, and Walla Walla Counties) Washington State Department of Fish and Wildlife Telephone(509)892-1001 2315 North Discovery Place FAX(509)921-2440 Spokane, WA 99216 Region 2(Okanogan, Douglas, Grant,Adams, and Chelan Counties) Washington State Department of Fish and Wildlife Telephone(509)754-4624 1550 Alder Street NW FAX(509)754-5257 Ephrata,WA 98823-9699 Region 3(Franklin, Kittitas, Yakima, and Benton Counties) Washington State Department of Fish and Wildlife Telephone(509)575-2740 1701 South 24th Avenue FAX(509)575-2474 Yakima,WA 98902-5720 Region 4(Whatcom, Skagit, Snohomish, King, Island, and San Juan Counties) Washington State Department of Fish and Wildlife Telephone(425)775-1311 16018 Mill Creek Boulevard FAX(425)338-1066 Mill Creek,WA 98012-1296 Region 5(Lewis, Wahkiakum, Cowlitz, Skamania, Clark, and Klickitat Counties) Washington State Department of Fish and Wildlife Telephone(360)696-6211 2108 Grand Blvd. FAX(360)906-6776 Vancouver, WA 98661-4624 Region 6(Pacific, Pierce,Thurston, Grays Harbor, Mason, Jefferson, Clallam, and Kitsap Counties) Washington State Department of Fish and Wildlife Telephone(360)249-4628 48 Devonshire Road FAX(360)664-0689 Montesano,WA 98563-9618 Local Government (Shoreline Management Act Approval) Appropriate City or County Planning, Building, or Community Development Department Refer to:http://www.ora.wa.gov/counties/index.htm -for city and county contact information. Natural Resources Conservation Service (NRCS) ,formerly Soil Conservation Service(SCS)for information regarding activities on agricultural land NRCS West 316 Boone Avenue, Suite 450 Telephone(509)323-2900 Spokane, WA 99201-2348 FAX(509)323-2909 Coast Guard Section 9 Bridge Permit Commander 13th Coast Guard District(OAN)Telephone(206)220-7282 915 Second Avenue. Room 3510 FAX(206)220-7265 Seattle,WA 98174-1067 Attn: Bridge Administrator Private Aids to Navigation Commander 131h Coast Guard District(OAN) 915 Second Avenue, Room 3510 Telephone(20-7 220-7285 Seattle, WA 98174-1067 FAX(206)220265 Attn: PATON Manager Department of Natural Resources,Aquatic Resources Authorization to use bedlands, tidelands,or shorelands of navigable waters. Headquarters Telephone(360)902-1000 Northwest Region Telephone(360)856-3500 Pacific Cascade Region Telephone(360)577-2025 South Puget Sound Region Telephone(360)825-1631 Northeast Region Telephone(509)684-7474 Southeast Region Telephone(509)925-8510 Olympic Region Telephone(360)374-6131 ECY 070-15 JARPA(Revised 11/04).Contact the State of Washington Office of Regulatory Assistance for latest version or call 360/407-7037 or 800/917-0043 6 DESCRIPTION OF PROJECT Remove 8 existing creosote pilings - Install 7 new steel pilings , � * Existing 12'x 54'float; c ; No change except replacing creosote pilings with steel pilings(3 places) r * Replace decaying 149'6" floating dock section / With open foam floats that now rests on beach at low tide with pier,gangway,and rampthat will let in total light and will not rest on beach. Footprint reduced from approx.1300 sf to ` ' Via approx 600 sf Pier structure will extend 100'out from MHW line. 56 gangway will , bridge between pier and existing float. See sheet 3 ems•. *Repair bulkhead to receive f ��\ new gangway. See sheet 4 W % \\ SEE DETAIL PLANS AND PHOTOS See sheet 5 \ \ \ UA e� fER \ - J" I Fj f � • � -1 i r �° F ayGg 'afiro ARd/ry •... 4 crzass � ^ it C7 NtJR 4"NE E A . 9FJOpiT."L : p 6R7.f8EKlS�4f - rrRe.'4�eaL(66ffQyf'as .� x r YSHEET i40 ZIIHS 7G�r/r0v jars-fc-% f,f� d—"w I M S-Powq 7 vid T� - EXISTING FLOATS EXISTING FLOATS 4 EXISTING FLOATS FACSIMILE OF PROPOSAL FACSIMILE OF PROPOSAL FACSIMILE OF PROPOSAL i y r - m: SHEET 5 z �tt bo% B x' ,� � s � $vlKhepd LXls4ln Con c slab i ✓st Pier Co N,- Vj OL W a/ tvN ve of A c,✓ B I {C kit a o49HG4OYJ d-.p v SHEET 4 �a P�cod b 4t .6i � -DatK fro a►c v VACINITY MAP TAX Y'ARCEL: DOC #220285000001 e� ZONING: V, Ca v, o I Fox R5 1 ADDRESS: 80 S.E.ARKADA COURT, SHELTON, WA 98584 SHEET 1 DESCRIPTION OF PROJECT Remove S existing creosote pilings Install 7 new steel pilings Repair dock as defined below: / C Existing 12 ft.x 54 ft,float:#BLD200800089 1 No change except replacing creosote pilings with steel pilings(3 places ! Replace decaying 156 ft. floating dock constructed ✓ y . in 20 ft.sections with new 20 ft.sections of like- / size style and appearance. New dock will have encapsulated floats and creosote pilings will be replaced with new steel pilings in the same approximate location. SEE DETAIL PLANS Lk � � � y�. •fit; � � .. w x � `._ <Y .y I � t,; C, Qi•Kf i!i,�4,T , (}/�'� i •�M' KNd �IJORl{i':6pvE Lbf E 9!{(1RT` .r4�#t#EVISEDJ:S 5i{py� ,4t qtzq . T!y a I cC" �IO�yuy� Yit1g '0. MITASONlt . . i „4 ,1a SHEET //11 " •� ._. it •IS1tIf v�] . SITE P' "SITE y - Da fz. jL VDAI -17 dud s�aUrg777� t i , 2 J L kF NL SON CO MASON COUNTY Shelton (360) 427-9670 DEPARTMENT OF COMMUNITY DEVELOPMENT Belfair (360) 275-4467 Planning _ Mason County Bldg.1 411 N.5th Elma (360) 482-5269 P.O.Box 279 Shelton,WA 98584 1854 June 9,2008 Virgil Fox 80 SE Arkada CT Shelton,WA 98584 RE:Replacement of existing non-conforming floating dock system Parcel No.22028-50-00001 or Dear Mr.Fox: This letter is in response to your question that we had discussed in our meeting in the office on May 16, 2008.You had asked if the portions of your floating dock between the residence and the newly re- constructed float located approximately 156'beyond the OHWM could be replaced in a pier and ramp design?You had also provided drawings of your proposal.After discussing this question with several staff in the Planning Department and the State Department of Ecology,we have determined that it cannot be approved as proposed.The proposal does not meet the definition of normal maintenance and repair and is therefore not exempt from a shoreline substantial development permit. The proposal cannot be exempted through the normal maintenance and repair process with a building permit.This proposal is not normal repair(see below).Nor is replacement in this manner considered repair. The exemption criteria reads(b)Normal maintenance or repair of existing structures or developments, including damage by accident,fire or elements. `Normal maintenance"includes those usual acts to prevent a decline, lapse,or cessation from a lawfully established condition. `Normal repair"means to restore a development to a state comparable to its original condition, including but not limited to its size, shape and configuration, location and external appearance, within a reasonable period after decay or partial destruction, except where repair causes substantial adverse effects to the shoreline resource or environment.Replacement of a structure or development may be authorized as repair where such replacement is the common method of repair for the type of structure or development and the replacement structure or development is comparable to the original structure or development including but not limited to its size,shape, configuration, location and external appearance and the replacement does not cause substantial adverse effects to shoreline resources or environment. It would be inconsistent with the Mason County Shoreline Master Program Policies and Use Regulations to allow complete replacement because it does not meet the size,shape,configuration,location and external appearance criteria for normal maintenance and repair.In order to construct a pier,ramp and float facility at your location,you would need to apply for a shoreline substantial development permit.The pier,ramp and float facility would need to meet the size for new construction which is 100'beyond the ordinary high water mark or 115'if proposed for community use. I realize this is not the answer you were hoping to receive but after thorough investigation,this is still the same answer that applied during our December 7, 2006 site inspection.Thank you. Sincerely, Grace Miller,Planner DEPT OF COMMUNITY DEVELOPMENT habitat, remove or reduce impediments to migration of fish, or enhance the fishery resource available for use by all of the citizens of the state, provided that any structure, other than a bridge or culvert or instream habitat enhancement structure associated with the project, is less than two hundred square feet in floor area and is located above the ordinary high water mark of the stream. (ii) "Watershed restoration plan" means a plan, developed or sponsored by the department of fish and wildlife, the department of ecology, the department of natural resources, the department of transportation, a federally recognized Indian tribe acting within and pursuant to its authority, a city, a county, or a conservation district that provides a general program and implementation measures or actions for the preservation, restoration,re-creation, or enhancement of the natural resources, character, and ecology of a stream, stream segment, drainage area, or watershed for which agency and public review has been conducted pursuant to chapter 43.21C RCW,the State Environmental Policy Act; 16. A public or private project, the primary purpose of which is to improve fish or wildlife habitat or fish passage, when all of the following apply: (i) The project has been approved in writing by the department of fish and wildlife as necessary for the improvement of the habitat or passage and appropriately designed and sited to accomplish the intended purpose; (ii) The project has received hydraulic project approval by the department of fish and wildlife pursuant to chapter 75.20 RCW; and (iii) The local government has determined that the project is consistent with the local shoreline master program. The local government shall make such determination in a timely manner and provide it by letter to the project proponent. Before determining that a proposal is exempt,the Review Authority may conduct a site inspection to ensure that the proposal meets the exemption criteria. The exemption granted may be conditioned to ensure that the activity is consistent with the Master Program and the Shoreline Management Act. B. Applicability to Nonconforming Development. "Nonconforming development" means a shoreline use or structure which was lawfully constructed or established prior to the effective date of the Act or the Master Program, or amendments thereto,but which does not conform to present regulations or standards of the Program or policies of the Act. Nonconforming developments may continue to be utilized for the same purpose established on the date of the statute. If a change in use is proposed for such development, any new use must obtain a permit by applicable regulations; PROVIDED that a proposed new use for such development that does not conform to Master Program policies may be considered as a Conditional Use. Normal maintenance and repair of nonconforming developments shall be allowed. MASON COUNTY CODE TITLE 15-DEVELOPMENT CODE — June 30 2004 version 16 "Normal maintenance" includes those usual acts to prevent a decline, lapse, or cessation from a lawfully established condition. "Normal repair" means to restore a development to a state comparable to its original condition within a reasonable time period after decay or partial destruction except where repair involves total replacement which is not common practice or causes substantial adverse effects to the shoreline resource or environment WAC 173-27-040(2)(b)). A reasonable period of time for repair shall be up to one year after decay or partial destruction, except for bulkhead replacement which shall be allowed up to five years. Total replacement which is common practice includes but is not limited to floats, bulkheads and structures damaged by accidents, fire and the elements. This program shall not restrict the reconstruction within two years of the date of damage of any existing single-family residence which is damaged or destroyed by fire, accident or the elements, PROVIDED that nonconformance with the standards and regulations of this program shall not be increased by such reconstruction. Reconstruction of any development other than single-family residences and their appurtenant structures shall be done in accordance with the requirements for new development. Expansion of a nonconforming development is prohibited. Nonconforming development may be continued provided that it is not enlarged, intensified or increased or altered in any way which increases its nonconformity: PROVIDED significant environmental damage does not result. Expansion of a development which is nonconforming by reason of substandard lot dimensions, setback requirements or lot area, but which is not a nonconforming use may be allowed as a Variance. Lots created prior to the December 2002 adoption of this ordinance which do not meet the minimum lot size may be used for a single family residence without a Variance Permit PROVIDED both of the following criteria can be met: a. A permit for on-site sewage disposal system which meets all current codes for setbacks and sizing, has been granted by the Mason County Health Services. b. All side yard and shore yard setbacks can be met. Residential development on lots which do not meet these bulk, dimensional or Performance Standards criteria maybe allowed as a Variance PROVIDED approval has been granted by the Mason County Health Services. C. Criteria for Granting Permits. Upon the December 2002 effective date of this Program, a Permit or a Statement of Exemption shall be granted only when the proposed development is consistent with: 1. Policies and regulations of the Mason County Shoreline Master Program and applicable policies enumerated in Chapter W58 RCW in regard to shorelines of the state and of statewide significance; and 2. Regulations adopted by the Department of Ecology pursuant to the Act , MASON COUNTY CODE TITLE 15-DEVELOPMENT CODE - June 30 2004 version 17 MASON COUNTY Single Family $360 ENVIRONMENTAL CHECKLIST Non-Single Family 0-9.99A 90 10 to 20 Acresres$7$705 Over 20 Acres$885 Purpose of Checklist: EIS(DS)$2,360+65/hr The State Environmental Policy Act (SEPA), chapter 43.21 C RCW, requires all governmental agencies to consider the environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of this checklist is to provide information to help you and the agency identify impacts from your proposal (and to reduce or avoid impacts from the proposal, if it can be done) and to help the agency decide whether an EIS is required. Instructions for Applicants: This environmental checklist asks you to describe some basic information about your proposal. Governmental agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of an EIS. Answer the questions briefly, with the most precise information known, or give the best description you can. You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you should be able to answer the questions from your own observations or project plans without the need to hire experts. If you really do not know the answer, or if a question does not apply to your proposal, write "do not know" or "does not apply". Complete answers to the questions now may avoid unnecessary delays later. Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions if you can. If you have problems, the governmental agencies can assist you. The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time or on different parcels of land. Attach any additional information that will help describe your proposal or its environmental effects. The agency to which you submit this checklist may ask you to explain your answers or provide additional information reasonably related to determining if there may be significant adverse impact. Use of Checklist for Non-project Proposals: Complete this checklist for non-project proposals, even though questions may be answered "does not apply". IN ADDITION, complete the SUPPLEMENTAL ACTIONS (part D). There is a fee required, for the processing of the checklist, see above for the appropriate fee. Please make your check payable to "Mason County Treasurer". For non-project actions, the references in the checklist to the works "project", "applicant", and "property or site" should be read as "proposal", "proposer', and "affected geographic area", respectively. MASON CO. ENVIROMENTAL CHECKLIST A. BACKGROUND 1. Name of proposed project, if applicable: 2. Name of applicant: tI�-- —ox 3. Address and phone number of applicant and contact person: go JE" AYk��4 el, -1 7•s 4M 4. Date checklist prepared: 5. Agency requesting checklist: /✓/V.r'6 . C+ 6. Proposed timing or schedule (including phasing, if applicable): 30 APA y s 7. Do you have any plans for future expansion, or further activity related to or connected with this proposal: If yes, explain. 10 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. 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. A10 10. List any government approvals or permits that will be needed for your proposal, if known. /11- aFso1V Ca /�5 4 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.) / ►�f./O`!f C� �/G�i/ls ��C1�9� �T"Ld�,'0 N ��j/�J �`d Q� QH 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. S-O '� 6- X0'/<4dc1 C/- i'G c ia.�j 41#10 aye✓ B. ENVIRONMENTAL ELEMENTS: 1. EARTH: a. General description of the site (circle one): Flat, rolling, hilly, steep slopes, mountainous, other b. What is the steepest slope on the site (approximate percent slope)? NA 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. /!' ,17 d. Are there surface indications or history of unstable soils in the immediate vicinity: If so, describe. /✓A Mason County Environmental Checklist Pate 2 e. Describe the purpose, type, and approximate quantities of any filling or grading proposed. Indicate source of fill. ,44 L. f. Could erosion occur as a result of clearing, construction, or use: If so, generally describe. /✓'O g. About what percent of the site will be covered with impervious surfaces after project constructions (for example, asphalt or buildings)? 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. hG b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. A/o Mason County Environmental Checklist C. Proposed measures to reduce or control emissions or other impacts to air, if any: Ale ti 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. eJ �h KePeji✓ 3y 9-e�/ c PmeK7`r¢��o.��C /SE'r/'�"/-�•af ROV-) e e /vPcv L�/K<_ i9 ,Re cy�j%<1�f. �G�pl,-, . We-d ,f/¢R / �//.7�J �l'1�j 3) Estimate the ramount of fill and dredge material that would We place in or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicates the source of fill material. Nvn-4- 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. r� Mason County Environmental Checklist Page 4 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. y's 6) Does the proposal involve any discharges of waste materials to surface waters? If so, describe the type o-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. wo 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 stor-n 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. A c 2) Could waste materials enter ground or surface waters: If so, generally describe. /✓`0 Mason County Environmental Checklist 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 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 Ur d,✓ W-M 41" ✓eJ. 7�d/�� N/6•!�Ale 'Rt r 041 c4-- X/1.7- i �J'Ve /44-e �YIL f4LIIC G � �Cc/�rdJ2�J G✓d0 v/ Ct ek-da, NI//e AAA ,0/a�p dz Af AIA A - b. What kind and1mount of vegetation will be removed or altered? OVo h`{— c. List threatened or endangered species known to be on or near the site. Iva,nV_ d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: IY'17 Mason County Environmental Checklist Pape 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 74- c? -t-d b. List any threatened or endangered species known to be on or near the site. C. Is the site part of a migration route? If so, explain. d. Proposed measures to preserve or enhance wildlife, if any: y f /f/'a 4414 C4,1 f /,id'o ,fit, Goyc. de�6L� E'ti ✓i ytsnma,� ,� /owe wold 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. /Y / � / e e �/O x�� 1"dWQ✓ Ale,�� /6 , ✓f al f41�I p Q ��C1J7`/n S b. Would your project affect the potential use of solar energy by adjacent properties: If so, generally describe. /v 6 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 7. ENVIRONMENTAL HEALTI-: 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. /1/0 1) Describe special emergency services that might be required. /!//-7 2) Proposed measures to reduce or control environmental health hazards, if any: /�w o � 14M So b. Noise. 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? 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. A/d0-e- 3) Proposed measures to reduce or control noise impacts, if any: lV�re.- 8. LAND AND SHORELINE USE: a. What is the current use of the site and adjacent properties? <3I Q6C.s Tte.l i�a�J 4 �n �`Q I a Mason County Environmental Checklist Page 8 b. Has the site been used for agriculture? If so, describe. C. Describe any structures on the site. iL/avdt 80 0,� o U la C a��cr✓�� AD C'1-L, d. Will any structures be demolished? If so, what? L e. What is the current zoning classification of the site? /? g 6-- f. What is the current comprehensive plan designation of the site? g. If applicable, what is the current Shoreline Master Program designation of the site? OXAl A/J, CLtvti ci� h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. i. Approximately how many people would reside or work in the completed project? A15 0 e— j. Approximately how many people would the completed project displace? /1/sh e„ k. Proposed measures to avoid or reduce displacement impacts, if any: ✓26V Mason County Environmental Checklist I. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: 9. HOUSING: �t/3 Acl1o��( e. /}h _rlr�cci /�� i �t�b���✓�_ .S4m� S% .�l/aesx�+ r%iGrX- d�� le,11 U / Ph'l ✓ �(1FJ1 / Q�Cir, ��{1L�/dY/I dJ ( �iN/{�D<<e a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income housing. /1/-x b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or low-income housing. Ale C. Proposed measures to reduce or control housing impacts, if any: N,4 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? '/VA b. What views in the immediate vicinity would be altered or obstructed? we* 'e- C. Proposed measures to reduce or control aesthetic impacts, if any: r f. Mason County Environmental Checklist Page 10 1 11. LIGHT AND GLARE a. What type of light or glare will the proposal produce? What time of day would it mainly occur? A/0nW-- b. Could light or glare from the finished project be a safety hazard or interfere with views? A/I C. What ex__istting off-site sources of light or glare may affect your proposal: /fro h `C- d. Proposed measures to reduce or control light and glare impacts, if any: lf cdZong-�- 12. RECREATION: a. What designated and informal recreational opportunities are in the immediate vicinity? ,—'1 7 , "lZa o P/-/"i b. Would the proposed project displace any existing recreational uses? If so, describe. /v C. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: A/A) Mason County Environmental Checklist 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. A/ b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. 11114 C. Proposed measures to reduce or control impacts, if any: N114 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. 1,,,. S!4 ,ol¢h 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. //d C. How many parking spaces would the completed project have? How many would the project eliminate? ,44 GLj vet 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). /✓d 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. A1v f. How many vehicular trips per day would be generated by the completed project: If known, indicate when peak volumes would occur. 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: A/O b. Proposed measures to reduce or control direct impacts on public services, if any: IA16 Mason County Environmental Checklist 16. UTILITIES: a. Circle utilities currently available at t e site: electricity, natural gas wate� r(fuse se ice ele n , sanitary sewer, pti t m, other: A) c b. Describe the utilities that are proposed for the project, the utility providing the service, and the general construction activ ties on the site or in the immediate vicinity which might be needed. , / �/� vL, �/ Tr'y 0'� .�vc/i c.-t-�, lt/a vl-+�/ s�ct/Gv �«✓ �..�iJ 1`i'"f 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: Mason County Environmental Checklist Page 14 ESA LISTED SALMONIDS CHECKLIST Applicant Information Project Information Name Vi✓'s, �DX Name Phone —c���7 Location Description ,,,/�� �0���Q� . � /�<R- /-C►-cam.� �-� /z' This worksheet was designed to help project proponents, and�government agencies, ident9 w needs further analysis regarding adverse effects on ESA (Endangered Species Act) listed salmonidse Salm n ds are salmon, trout and chGrs, e.g. bull trout. For our purposes, "ESA Listed Salmonids" is defined as fish species listed as endangered, threatened or be-ing 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 Please describe. Are�dk/- /I/: i P 4/oue / acc ✓e 2. Has there ever been an ESA listed salmonid stock present in this watershed? YES NO Uncertain Please describe. .4 flh C),A1-1 A,-cj ZoV u/o a/CJ 6'</d 7� If you answered "yes" to either of the above questions, you should complete the remainder of this checklist. i� s �/G 1K 7 / /A/ /1lee� Apri 12003 Mason County Environmental Checklist PROJECT SPECIFICES: The questions in this section are specific to the project and vicinity. 1. Name of watershed: (1-4 2. Name of nearest waterbody: 3. What is the distance from this project to the nearest body of water: M6 " 4/� /&—*4 4 . 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 X * natural temporary barrier(beaver pond) YES NO X * man-made barrier(culvert,dam) YES NO K * other(explain): 6. If yes, are there any resident salmonid populations above the blockage? YES NO Don't know A1,0q 7. What percent of the project will be impervious surface (including pavement & roof area)? i,//`;7 Mason County Environmental Checklist Nee 16 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 ►nigration. 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 S� 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. /Y/'/17 4. Will this project require the building of new roads? YES NO Increased road mileage may affect the timing of water reaching a stream and may impact fish habitat. 5. Are culverts proposed as part of this project? YES NO X 6. Will topography char es 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 filling or other partial blockage Of flows? YES NO _ If yes, how will the loss of flood storage be mitigated by your project? Mason County Environmental Checklist 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? !J+C V 1116 CGt ow j,G Removal of shading vegetation 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 Y _ 4. Will turbidity be increased because of constriction 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. Mason County Environmental Cliecklist Pale IS 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? N Mason County Environmental Checklist