HomeMy WebLinkAboutSHX2007-00096; JARPA - SHX Permit / Conditions ON.STA MASON COUNTY
�P5 ° DEPARTMENT OF COMMUNITY DEVELOPMENT
o a o >'y Planning Division
y s N = P O Box 279,Shelton,WA 98584
Z� N y y (360)427-9670
OJ �O
1864
Exemption from Shoreline Management Act
Case No.: SHX2007-00096 Substantial Development Permit Requirement
The Proposal By: C.PAUL GREGORY �� C7 0Q 30
19333-4TH AVE.SW
NORMANDY PARK,WA 98166
TO BE KEPT IN THE
To undertake the following development: PARCEL FILE
Restore tidal barrier to renew protection of existing residence and property from tidal and storm
damage.
STORM REPAIR/DAMAGE - EROSION OF BERM
Within HOOD CANAL and/or its associated wetlands is exempt from the requirement of substantial development because the
development is categorized under WAC 173-27-040(2)as being category
D-emeraencv construction
Please contact James Scholz at ext 294 if you have any ions.
Issued: 1/2/2008
Expires: 1/2/2010 Authorize LocjGoernment Official
cc: APPLICANT WDFW USACOE WDOE TRIBAL COUNCIL
AGENCY USE ONLY d_-1RPA-FORM LAST UPDATED:Alwrch 19,2007
Agency Reference Date Recen ed
Circulated by floc d go%-t or agentw-)
Project Trac'Ung Number
�,fi.:
Washington State JOINT AQUATIC RESOURCES PERMIT APPLICATION (JARPA) Form
Step 1:Get Ready Step 2:Complete Form Step 3:Check Work Step 4:Copy and Send In
C'ro to v\v\vv.civrnuttui«.ur,_ Use black ink Use internet"Help" Use final retiieu See JARPA Contacts at
for correct form and Check correct buttons to answer checklist at \\\N\\_epenu ittiuu-ur_for
instructions. permit boxes. questions completely. epennittin_ ,r,. correct mailing addresses.
Fish Habitat Enhancement Projects per RCW 77.55.181. You must submit copy of completed JARPA form and Fish Habitat
Enhancement JARPA Addition to your Local Government Planning Dept and WA Dept of Fish and Wildlife(WDFW)Area Habitat
Biologist on same day. Note for Local Governments: You must submit comments to WDFW within 15 working days.
Based on instructions at mww.epermittinq.org, I am sending copies of this application to the following: (check all that apply)
ElLocal Government for Shoreline: FISubstantial Development Wondition,alUse 01tvariance Wemption []Revision
r1loodplain Management []Critical Areas Ordinance
XxlWashington Department of Fish and Wildlife for Hydraulic Project Approval(Submit 2 copies to WDFW Region)
17washington 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: Mection 404 permit r1section 10 permit
III []Coast Guard for. nGeneral Bridqe Act Permi thrivate Aids to tAavigation(for non-bridge projects)
[]For Department of Transportation projects only: This project vAN be designed to meet conditions of the most current
Ecology/Department of Transportation Water Quality Implementing Agreement
I
PROJECT TITLE: Emergency repair and restoration of tidal barrier breached by severe storm water
PROJECT DESCRIPTION: Restore tidal barrier to renew protection of existing residence and property from tidal and storm
damage.
SECTION A-Use for all permits covered by this application. Be sure to ALSO complete Section C(Signature Block)for all
permit applications.
1.APPLICANT C.Paul Gregory
MAILING ADDRESS
19333 4"t Ave SW Normandy Park,WA 98166
WORK PHONE E-MAIL ADDRESS HOME PHONE FAX#
206 824-8122 c em ast.net 206 870-1459
If an agent is acting for the applicant during the permit process,complete 02. Be sure agent signs Section C(Signature Block)for
all Per►►rnapplications
II�
2.AUTHORIZED AGENT
MAILING ADDRESS
WORK PHONE E-MAIL ADDRESS HOME PHONE FAX#
3. Relationship of applicant to property: 0 OWNER [] PURCHASER [] LESSEE []
4. Name,address and phone number of property owner(s)if other than applicant:
5. Location(street address, including city, county and zip code, where proposed activity exists or will occur)
20213 North Shore Road Tahuya,WA 98588
Local government with jurisdiction(city or county) Mason County
Waterbody you are working in Hood Canal EM Tributary of WRIA#
Is this waterbody on the 303(d)List YES ❑ NO
If YES,what parameter(s)? m eA
Shoreline designationL.
2—010 0&3 10 Zoning desi nation
'/.Section Section owrtship Range Government Lot IMI DNR stream type if known .
Office of Regulatory Assistance.JARPA JARPA FORM LAST UPDATED:March 19,2007 For help call 800-917-W43 or visit vnvva.epermitting.org 1
k
Latitude and Longitude: ax Parcel Number 3221812 9W30
6. Describe(a)the current use of the property,(b)structures existing on the property, and(c)existing environmental conditions.
Have you completed any portion of the proposed activity on this property? ❑ YES x[] NO
For any portion of the proposed activity already completed on this property, indicate month and year of completion.
Residential-Vacation Home
M Is the property agricultural land? ❑ YES El NO CM Are you a USDA program participant? ❑ YES El 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.
Storm water from the inland breached the existing berme that protects the house and property
from Hood canal tide and storms. This breach is about 15'across. The proposed work will fill the
breach with material from the inland side and restore the berme to its original condition. (See attached
sketch and photo)
PREPARATION OF DRAWINGS: See sample drawings and guidance for completing the drawings. OFE SET OF ORFGWAL OR GOOD QUALITY REPRODUCFBLE
DRAWROS j STT BE ATTACFFED. NOTE: App9cants are encouraged to submit photographs of the project site,but urese DO NOT substitute for drawings. THE CORPS
OF ENGMMEERS AND COASTGUARD REMAREDRAWMMGS OAF 8-112 X 11 MMCH SHEETS LARGER DRAWMMGS MAYBEREC MM BYOTHER AGES
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.
Repair tidal barrier(berme)to original condition protect home and property from further storm and tidal
damage.
03 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. Identity 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.
No impact
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-410)? ❑ YES ❑ NO
8. Will the project be constructed in stages? ❑ YES Qx NO
i
Proposed starting date: 1&W
Estimated duration of activity: 2 days
9. Check if any temporary or permanent structures will be placed:
❑ Watemard 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?
I
10. Will fill material(rock,fill, bulkhead,or other material)be placed: NO
❑ 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)
Office of Regulatory Assistance,JAR PA JARPA FORM LAST UPDATED:March 19,2007 For help call 800-917-0043 or visit vA^✓v.e ermitting.org 2
11. Will material be placed in wetlands? ❑ YES NO
If YES:
A. Impacted area in acres:
B. Has a delineation been completed? N YES, please submit with application. ❑ YES ❑ NO
C. Has a wetland report been prepared? If YES, please submit with application ❑ YES ® NO
C D.Type and composition of fill material(e.g.,sand, etc.)
CM E. Material source:
03 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 M NO
If YES, IMPACTED AREA IS ACRES OF DRAINED WETLANDS.
NOTE:If your project will impact greater than 1/10 of an acre of wetland,submit a mitigation plan to the Corps and Ecology for approval along with the DARPA form.
NOTE:A 401 water quality certification may be required from Ecology in addllim to an approved mitigation plan if your project wetland impacts are greater than 1/10 acre in size.
Please submit the JARPA form and mitigation plan to Ecology for 401 certification review.
12. Stormwater Compliance: This project is(or will be)designed to meet ecology's most current Restoration
stormwater manual,or an Ecology approved local stormwater manual. ❑ YES ❑ NO
If YES—Which manual will your project be designed to meet?
m 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
m 13. Will excavation or dredging be required in wafer or wetlands? ❑ YES Ox 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:
m 14. Has the State Environmental Policy Act(SEPA)been completed YES 0 NO
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
i
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.
i
i
i
I
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: j
I
f
Office of Reclulatory Assistance,JAR PA DARPA FORM LAST UPDATED:March 19 2007 For help call 800-917-0043 or Visit wvna.epermitting.m 3
SECTION B- Use for Shoreline and Corps of Engineers permits onto:
03 17a. Total cost of project. This means the fair market value of the project, including materials,labor,machine rentals, etc.
$5,000
' 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.
EDERAL FUNDING ❑ YES xQ NO If YES, please list the federal agency.
18. Local government with jurisdiction: Mason County
19. Provide names,addresses and telephone numbers of adjoining property owners, lessees, etc. Please note: Shoreline
Management Compliance may require additional notice—consult your bcal government.
NAME ADDRESS PHONE NUMBER
NA
SECTION C-This section MUST be for any permft covered by this appikadw
" 20. Application is hereby made for a permit or permits to authorize the activities describes!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 art work ONLY after all necessary permits have been received.
DATE
SIGNATUR L ANT AN Ala—
D E
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 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 MUST BE SIGNED BY THE APPLICANT AND THE AGENT,IF AN AUTh1OBRED 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 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.
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,
Office of Regulatory Assistance,JARPA JARPA FORM LAST UPDATED:March 19,2007 For help call 800-917-0043 or visit vAA,,t.epermitting.org 4
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 we Equal Oppoduniity and Atrkmative Action employers.
For special accommodation needs,please contact the appropriate agency in the ions
Office of Regulatory Assistance,JARPA JARPA FORM LAST UPDATED:March 19.2007 For help call 800 917 0043 or visit vJm.epermMing.org 5
{�opP l�,�rhT�rl�
WrCfa- txl0� i-�RoM
WLANn SIP6
2o2t 3 NoZTN -*2" }o p R b
WAC 197-11-880: Emergencies. Page 1 of 1
197-11-875 « 197-11-880>> 197-11-890
WAC 197-11-880
Emergencies.
Actions that must be undertaken immediately or within a time too short to allow full compliance with this chapter,to
avoid an imminent threat to public health or safety,to prevent an imminent danger to public or private property,or to
prevent an imminent threat of serious environmental degradation,shall be exempt.Agencies may specify these
emergency actions in their procedures.
[Statutory Authority:RCW 43.21 CA 10.84-05-020(Order DE 83-39),§197-11-880,filed 2/10/84,effective 4/4/84.]
http://apps.leg.wa.gov/WAC/default.aspx?cite=197-11-880 12/19/2007
MASON COUNTY DCD 0q(p I on "
Sent SEPr45 2rJ0 ? to(check all that apply)
Skokomish Tribal Nation WA Department of Ecology
Natural Resources Dept. Environmental Review Section
ATTN: Marty Ereth PO BOX 47703
N 541 Tribal Center Rd. Olympia,,WA 98504-7703
Shelton,WA 98584
Quinault Indian Nation U.S.Army Corps of Engineers
ATTN: Mark Mobbs SEPA Reviewer
PO Box 189 PO Box C-3755
Tahola,WA 98587 Seattle,WA 98124
Squaxin Tribal Nation WA Dept.of Fish and Wildlife
Natural Resources Dept. ATTN: Margie Schirato(saltwater)
2952 SE Old Olympic Highway 2391 W Deegan Rd.
Shelton,WA 98584 Shelton,WA 98584
The Confederated Tribe of the Chehalis WA Dept.of Fish&Wildlife
ATTN:SEPA Reviewer ATTN:Gloria Rogers(freshwater)
420 Howanut Rd. PO Box 695
Oakville,WA 98568 Elma,WA 98541
Shannon Soto WA Dept.of Transportation
WA DNR,South Puget Sound Region Alan P.O.
Hess, Development Review Engineer
950 Farman Avenue North P.O.Box 47440
Enumclaw,WA 98022-9282 Olympia,V11A 98504-7440
Elizabeth Ellis City of Shelton
WA DNR,Aquatic Resources Sh West Cots St:
PO BOX 47027 Shelton,WA 98584
Olympia,WA 98504-7027
Office of Archeaology&Historic Preservation
Boyd Powers ATTN:Stephanie Kramer
WA DNR,SEPA Center P.O.Box 48343
PO BOX 47015 Olympia,WA 9850.4-8343
Olympia,WA 98504-7015 School District:
1
3
Olympic Region Clean Air Agency � Mason Cty Public Works ATTN:
2940-B Limited Ln.NW
Olympia,WA 98502
Mason Cty Env.Health ATTN:
Mason County Transit a Agent:
PO Box 1880
Shelton,WA 98584
Applicant: -PGL u I Y-e-
Ave-
� q-(U 1