HomeMy WebLinkAboutJARPA - SHX Application 2 AGENCY USE ONLY
Agency Reference#: Date Received:
Circulated By:: local govt. or agency)
JOINT AQUATIC RESOURCES PERMIT APPLICATION FORM (DARPA)
(for use in Washington State)
PLEASE TYPE OR PRINT IN BLACK IN
01 am applying for a Fish Habitat Enhancement Project per requirements of RCW 75.20.350. You must submit a copy of this
completed JARPA application from, 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 day
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 ®Exemption;❑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 Nationwide Permits(to Regional office-Federal Permit Unit)
❑ Washington Department of Natural Resources for: o Aquatic Resources Use Authorization Notification
❑Corps of Engineers for: ❑Section 404 ❑Section 10 permit
❑Coast Guard for: ❑Section 9 Bridge Permit
❑ US Fish&Wildlife Service or National Marine Fisheries Service for Endangered Species Act ESA Consultation
SECTION A-Use for all permits covered by this applicadon. Be sure to also c to Section C ature Block)for all permit applicaflons.
1.APPLICANT
Raymond & Ann Kimbel
MAILING ADDRESS
371 SE Kimbel Lane, Shelton WA 98584
WORK PHONE E-MAIL ADDRESS HOME PHONE FAX
ff an agent Is acdng for the apppcant during the permit process,complete#2.
2.AUTHORIZED AGENT
Bay Marine Contractors, Inc.
MAILING ADDRESS
3348 Fishtrap Loop Rd NE, Olympia WA 98506
WORK PHONE E-MAIL ADDRESS HOME PHONE FAX i
360.956.3451 360. 786.6644
3.RELATIONSHIP OF APPLICANT TO PROPERTY: 10 OWNER ❑PURCHASER o LESSEE O 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)
371 SE Kimbel Lane, Shelton WA 98584
LOCAL GOVERNMENT WITH JURISDICTION(CITYORCOUNTY Mason County
WATERBODY TRIBUTARY OF WRW
Hammersley Inlet The Narrows, Puget Sound
114 SECTION SECTION TOWNSHIP RANGE GOVERNMENT LOT SHORELINE DESIGNATION
22 20N 03W Urban Residential.
LATITUDE AND LONGITUDE IF KNOWN ZONING DESIGNATION
TAX PARCEL NO: DNR STREAM TYPE,IF KNOWN
320224690370
DARPA,Revised 12/98,contact Ecology's Permit Assistance Center for Latest Version,3601407-7037 1 of 4
e:DESCRIBE THE CURRENT USE OF THE PROPERTY,AND STRUCTURES EXISTING ON THE PROPERTY. IF ANY PORTION OF THE PROPOSED ACTIVITY IS ALREADY COMPLETED ON
THIS PROPERTY,INDICATE MONTH AND YEAR OF COMPLETION.
A single-family residence, a garage, sheds, a concrete bulkhead, and a ramp and float are
located at the site.
IS THE PROPERTY AGRICULTURAL LAND? ❑YES ®NO ARE YOU A USDA PROGRAM PARTICIPANT? DYES ®NO
70.DESCRIBE THE PROPOSED CONSTRUCTION AND/OR FILL WORK FOR THE PROJECT YOU WONT TO BUILD THAT NEEDS AQUATIC PERMITS.: COMPLETE PLANS AND SPECIFICATIO IS
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. ATTACH A SEPARATE SHEET IF ADDITIONAL SPACE IS NEEDED.
Erosion is occurring along the toe of the bank on an unbulkheaded 50 foot section of
frontage at the proposed project site. Additional shoreline protection is necessary to
protect an existing residence. Shoreline protection shall be constructed using large
angular rock running landward of the existing concrete bulkhead, the adjoining concrete
rubble bulkhead, and the toe of the slope, along approx. 50 lineal feet of frontage.
Height of the bulkhead to be a maximum of 4.5 feet above the existing beach grade. Base
rock to be keyed into beach a minimum of 18-24" below the existing beach grade. Entire
length of the bulkhead repair to be backed with 4-8" quarry spalls and filter fabric.
Entire bulkhead to be constructed landward of MHHW. Minimal vegetation shall be
disturbed. Existing woody debris to remain on beach.
7b. DESCRIBE THE PURPOSE OF THE PROPOSED WORK AND WHY YOU WANT OR NEED IT AT THE SITE. PLEASE EXPLAIN ANY SPECIFIC NEEDS THAT HAVE INFLUENCED THE DESIGN.:
The proposed bulkhead, as per the owner's request, is for protection of the toe of the bank,
which is eroding due to wave action. Rock is the only material that is both environmentally
friendly and strong enough to be used in the construction of a marine bulkhead.
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. ATTACH A SEPARATE SHEET IF SPACE IS NEEDED.
The proposal is above MHHW and will not have any negative impacts on aquatic habitat or on any
other uses of the waterbody, plus the use of rock provides habitat for marine life.
PREPARATM OF MAWINW:SEE SAMPLE DRAW94GS AND GUIDANCE FOR COMPLETING THE DRAWINGS. ONE SET OF ORIGINAL OR 0000 QUAUTYREPRODUCIBLEDRAW NGS*W BE
ATTACHED.NOTE:APPLICANTS ARE ENCOURAGED TO SUBMIT PHOTOGRAPHS OF THE PROJECT SITE,BUT THESE DO NOT SUBSTITUTE FOR DRAWINGS. THE CORPS OF ENGINEAM AND
COAST GUARD REQUIRE ORA WWQS ON 8.112 X II INCH SHEEM.LARGERORANTNOS MAYBE REQUIRED BYOTHERAOENCIES.
8.WILL THE PROJECT BE CONSTRUCTED IN STAGES? DYES IN NO
PROPOSED STARTING DATE: As soon as possible after receipt of all permits and approvals.
ESTIMATEDDURATMOFACTivm;_ Within 14 days after the start of work.
9.CHECK IF ANY STRUCTURES WILL BE PLACED:
® WATERWARD OF THE ORDINARY HIGH WATERMARK OR LINE FOR FRESH OR TIDAL WATERS;AND/OR
O WATERWARD OF MEAN HIGH WATER LINE IN TIDAL WATERS
10.WILL FILL MATERIAL(ROCK,FILL,BULKHEAD,PILINGS OR OTHER MATERIAL)BE PLACED:
D WATERWARD OF THE ORDINARY HIGH WATER MARK OR LINE FOR FRESH WATERS? IF YES,VOLUME(CUBIC YARDS) /AREA (ACRES)
D WATERWARD OF THE MEAN HIGHER HIGH WATER FOR TIDAL WATERS? Nolte IF YES.VOLUME(CUBIC YARDS) /AREA (ACRES)
JARPA,Revised 12198,contact Ecologys Permit Assistance Center for Latest Version,360/407-7037 2 of 4
i
11.WILL MATERIAL BE PLACED IN WETLANDS? D YES IM NO
IF YES:
A. IMPACTED AREA IN ACRES:
B. HAS A DELINEATION BEEN COMPLETED? IF YES,PLEASE SUBMIT WITH APPLICATION. D YES D NO
C. HAS A WETLAND REPORT BEEN PREPARED?IF YES,PLEASE SUBMIT WITH APPLICATION. D YES D NO
D. TYPE AND COMPOSITION OF FILL MATERIAL(E.G.,SAND,ETC.):
E. MATERIAL SOURCE:
F. LIST ALL SOIL SERIES(TYPE OF SOIL)LOCATED AT THE PROJECT SITE,6 INDICATE IF THEY ARE ON THE COUNTY'S LIST OF HYDRIC SOILS.SOILS INFORMATION CAN BE OBTAINED FROM
THE NATURAL RESOURCES CONSERVATION SERVICE
12.WILL PROPOSED ACTIVITY CAUSE FLOODING OR DRAINING OF WETLANDS? D YES IM NO
IF YES,IMPACTED AREA IS ACRES,
13.WILL EXCAVATION OR DREDGING BE REQUIRED IN WATER OR WETLANDS? 0 YES ®NO
IF YES:
A.VOLUME: (CUBIC YARDS)/AREA (ACRES)
B.COMPOSITION OF MATERIAL TO BE REMOVED:
C. DISPOSAL SITE FOR EXCAVATED MATERIAL:
D. METHOD OF DREDGING:
14.HAS THE STATE ENVIRONMENTAL POLICY ACT(SEPA)BEEN COMPLETED? ®YES O NO
SEPALEADAGENCY; Mason County. SEPADECISION: DNS, MONS, EIS,ADOPTION, EXEMPTION DECISION DATE(END OF PERIOD)
SUBMIT A COPY OF YOUR SEPA DECISION LETTER TO WDFW AS REQ TE 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,BUIWING PERMIT,SEPA REVIEW,FERC LICENSE,FOREST PRACTICES
APPLICATION,ETC.)ALSO INDICATE WHETHER WORK HAS BEEN COMPLETED AND INDICATE ALL EXISTING WORK ON DRAWINGS.
TYPE OF APPROVAL ISSUING AGENCY IDENTIFICATION NO. DATE OF APPLICATION DATE APPROVED COMPLETED?
None at this time
Shoreline exemption Mason County 5-07
Building Permit Mason Count 5-07
HPA WDFW
5-07
16.HAS ANY AGENCY DENIED APPROVAL FOR THE ACTIVITY DESCRIBED HEREIN OR FOR ANY ACTIVITY DIRECTLY RELATED TO THE ACTIVITY DESCRIBED
HEREIN? 0 YES ®NO IF YES,EXPLAIN:
SECTION 8-Use thr SHom#ns end Caps o/Enonaaa pwndb g&j
1 S.TOTAL COST OF PROJECT.THIS MEANS THE FAIR MARKET VALUE OF THE PROJECT,INCLUDING MATERIALS,LABOR,MACHINE RENTALS,ETC.
Approx. $25,000
17.L k GOVERNMENT WITH JURISDICTION: j
Mason County f
18.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.
NE ADDRESS PHONE NUMBER
I
r
�I
i
JARPA,Revised 12/98,contact Ecologys Permit Assistance Center for Latest Version,360/407-7037 3 of 4
1 '
SECTION B-Use for Shoreline and Corps of Engineers permits goXi
79.TOTAL COST OF PROJECT.THIS MEANS THE FAIR MARKET VALUE OF THE PROJECT,INCLUDING MATERIALS,LABOR,MACHINE RENTALS,ETC.
7b. 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 FUNDINIG ❑YES ONO IF YES,PLEASE LIST THE FEDERAL AGENCY
S.LOCAL GOVERNMENT WITH JURISDICTION:
Plane County
9.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 REQLWE ADDITIONAL NOTICE—CONSULT YOUR LOCAL GOVERNMENT.
NAME ADDRESS PHONE NUMBER
SECTION C-This section MUST be conwleted for any penWt covered by this applicadon
.APPLICATION IS HEREBY MADE FOR A PERMIT OR PERMITS TO AUTHORIZE THE ACTIVITIES DESCRIBED HEREIN. I CERTIFY THAT I AM FAMILIAR WITH THE
NFORMATION CONTAINED IN THIS APPLICATION,AND THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF,SUCH INFORMATION IS TRUE,COMPLETE,AND
CCURATE. I FURTHER CERTIFY THAT I POSSESS THE AUTHORITY TO UNDERTAKE THE PROPOSED ACTIVITIES. I HEREBY GRANT TO THE AGENCIES TO WHICH
IS APPLICATION IS MADE,THE RIGHT TO ENTER THE ABOVE-DESCRIBED LOCATION TO INSPECT THE PROPOSED,IN-PROGRESS OR COMPLETED WORK 1
AGREE TO START WORK ONLY AFTER ALL NECESSARY PERMITS HAVE BEEN RECEIVED.
SIGNATURE OF APPLICANT DATE
SIGNATUgE-9 rAUTHORIZEO AGENT DATE
s f�� o
DATE
I HEREBY DESIGNATE Bay Marine Contractors.Inc.
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 WPLICANT DATE - D
S13NAT'URE LANDOWNER,(EXCEPT PU13UC-ENTf Y LANDOVMERS,-E:G.DM)
THIS APPL ICI BE SIGNED BY THE APPLICANT AND THE AGENT,IF AN AUTHORIZED AGENT IS DESIGNATED.
18 US.0§1001 provides that:Whoever,in any manner within the Jurisdiction of any departrnent 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 conmin any false,fictitious,or fraudulent statement or
,entry,shag be tined not acre than$10,000or impriseaw-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.