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HomeMy WebLinkAboutSEP2020-00045 BLD2020-00932 JARPA - SEP Determinations - 6/10/2021 MASON COUNTY Planning Division of Community Development Planning DEPARTMENT 615 W.Alder St. Bldg. 8, Shelton,WA 98584 360-427-9670 ext 352 DETERMINATION OF NONSIGNIFICANCE (WAC 197-11-340) SEP2020-00045 Description of Proposal: SEPA SUBMITTED FOR BLD2020-00932 Proponent: HAGEN DAVID F &CLAUDIA R Location of Proposal: 101 N LAKEFRONT LOOP Parcel Number: 423325000009 Legal Description: 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 43.21C.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 upon request. Please contact Julie Lewis at 360-427-9670 x352 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 the Dept. of Community Development, 615 W Alder St, Shelton WA 98584 by 06/24/2021. Appeal of this determination must be filed with a 14-day period following this final determination date, per Mason County Code Chapter 15.11 Appeals. Authorized Local Government Official Date Printed by:Julie Lewis on:06/10/2021 04:56 PM Page 1 of 1 fM r f N7Lr UE US Army Corps i Date received: ED WASHINGTON STATE of EnIneers Q Swte Disffict Joint Aquatic Resources Permit SEP 6 2020 pj Agencr-,,,r-Ffgreiiice#; Application (JARPA) Form1,2 Lel i A v. `,P U t�l V A! " 11tt't USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. Parcel#(s) q -------------------------------------- Part 1—Project Identification 1. Project Name (A name for your project that you create. Examples: Smith's Dock or Seabrook Lane Development) hell Part 2—Applicant The person and/or organization responsible for the project. [tLeM 2a. Name (Last, First, Middle) E. tC1aAAd, '(:X_, 2b. 6rganlYationof'applicable) mA 2c. Mailing Address (Street or PO Box) 2d. City, State, Zip Q 2e. Phone(1) 2f. Phone(2) 2g. Fax 2h. E-mail U%o -14 lv�q e n crrA 'Additional forms may be required for the following permits: • If your project may qualify for Department of the Army authorization through a Regional General Permit(RGP),contact the U.S.Army Corps of Engineers for application information(206)764-3495. - If your project might affect species listed under the Endangered Species Act,you will need to fill out a Specific Project Information Form(SPIF)or prepare a Biological Evaluation. Forms can be found at millMissions/CivilWorks/Reciulbtory/PermitGuidebook/EndangeredSpecies.aspx. • Not all cities and counties accept the JARPA for their local Shoreline permits.If you need a Shoreline permit,contact the appropriate city or county government to make sure they accept the JARPA. 2To access an online JARPA form with[help]screens,go to http://www,epermifting.wa.ciov/site/alias resourcecenter/oarpa Farpa form/9984/iarpa form.aspx. For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or help(a),oria.wa.gov. ORiA-16-011 Page 1 of 14 Part 3—Authorized Agent or Contact Person authorized to represent the applicant about the project. (Note: Authorized agent(s) must sign 11 b of this application.) n[ eM 3a. Name (Last, First, Middle) 3b. Organization (if applicable) 3c. Mailing Address(Street or Po Box) 3d. City, State, Zip 3e. Phone(i) 3f. Phone(2) 3g. Fax 3h. E-mail Part 4—Property Owner(s) Contact information for people or organizations owning the property(ies)where the project will occur. Consider both upland and aquatic ownership because the upland owners may not own the adjacent aquatic land. neI I ❑ Same as applicant. (Skip to Part 5.) ❑ Repair or maintenance activities on existing rights-of-way or easements. (Skip to Part 5.) ❑ There are multiple upland property owners. Complete the section below and fill out JARPA Attachment A for each additional property owner. ❑ Your project is on Department of Natural Resources (DNR)-managed aquatic lands. If you don't know, contact the DNR at (360) 902-1100 to determine aquatic land ownership. If yes, complete JARPA Attachment E to apply for the Aquatic Use Authorization. 4a. Name (Last, First, Middle) �R � t t�. 4b. Orga`i5ization (If applicable) rx ° 4c. Mailing Address (street or Po Box) 4d. City, State, Zip C' 4e. Phone(1) 4f. Phone(2) 4g. Fax 4h. E-mail ORIA-16-011 Page 2 of 14 Part 5—Project Location(s) Identifying information about the property or properties where the project will occur. h(� ❑ There are multiple project locations (e.g. linear projects). Complete the section below and use JARPA Attachment B for each additional project location. 5a. Indicate the type of ownership of the property. (Check all that apply.) hem ❑ Private ❑ Federal jiL Publicly owned (state,county, city,special districts like schools, ports,etc.) Cs l cX T IC ❑ Tribal ❑ Department of Natural Resources (DNR)— managed aquatic lands (Complete JARPA Attachment E) 5b. Street Address (Cannot be a PO Box. If there is no address,provide other location information in 5p.) hf elal y C- r 5c. City, State, Zip(If the project is not in a city or town, provide the name of the nearest city or town.) LtpjpJ 5d. County hel 5e. Provide the section, township, and range for the project location. [t@iPJ 1/4 Section Section Township Range 5f. Provide the latitude and longitude of the project location. hel • Example:47.03922 N lat./-122.89142 W long. (Use decimal degrees-NAD 83) 5g. List the tax parcel number(s)for the project location. hel • The local county assessor's office can provide this information. 51h. Contact information for all adjoining property owners. (If you need more space, use JARPA Attachment C.) lhelo Name Mailing Address Tax Parcel #(if known) i' ----.............------------------..... ------------- ORIA-16-011 Page 3 of 14 5i. List all wetlands on or adjacent to the project location. hel C%n 5j. List all waterbodies (other than wetlands) on or adjacent to the project location. [hel 5k. Is any part of the project area within a 100-year floodplain? Ijtel ❑ Yes 5 No ❑ Don't know 51. Briefly describe the vegetation and habitat conditions on the property. nel .1 V3 5m. Describe how the property is currently used. hel �l�j i�.-��rr►.,�. f�`:a;C1��(.3L�' �,1u�`�.t��e-X'`�" �"� �..�2, � �.�15�1 t'�^���1 &A ip g �►;`a It w��f a Y��Y'�C1<I' Ctcx u u 1�ram-- WkA �y <' rn Ma 5n. Describe how the adjacent properties are currently used. nel 5o. Describe the structures (above and below ground) on the property, including their purpose(s) and current condition. [help) 5p. Provide driving directions from the closest highway to the project location, and attach a map. heel i N1 . O)f, +(Lt ._ i art` cVP ORIA-16-011 Page 4 of 14 Part 6—Project Description 6a. Briefly summarize the overall project. You can provide more detail in 6b. [hem l lJl ° r 6b. Describe the purpose of the project and why you want or need to perform it. h[ ejo 6c. Indicate the project category. (check all that apply) hf e1a] ❑ Commercial ❑ Residential ❑ Institutional ❑ Transportation ,,Recreational ❑ Maintenance ❑ Environmental Enhancement 6d. Indicate the major elements of your project. (check an that apply) [help] ❑ Aquaculture ❑ Culvert ❑ Float Retain-' all ❑ Bank Stabilization ❑ Dam/Weir ❑ Floating Home [' ,A ArUc� ❑ Boat House ❑ Dike/ Levee/Jetty ❑ Geotechnical Survey ❑ Road ElBoat Launch ElDitch El Land Scientific Land Clearing Measurement Device ❑ Boat Lift c /Pier El Marina/Moorage -lSt i ❑ Bridge ❑ Dredging ❑ Mining ti`Stormwater facility Bulkhead ❑ Fence ❑ Outfall Structure ❑ Swimming Pool Buoy, ❑ Ferry Terminal ❑ Piling/Dolphin ❑ Utility Line ❑ Channel Modification ❑ Fishway ❑ Raft ❑ Other: ORIA-16-011 Page 5 of 14 6e. Describe how you plan to construct each project element checked in 6d. Include specific construction methods and equipment to be used. Leipj • Identify where each element will occur in relation to the nearest waterbody. • Indicate which activities are within the 100-year floodplain. 6f. What are the anticipated start and end dates for project construction? (MonthNear) h[ eld • If the project will be constructed in phases or stages, use JARPA Attachment D to list the start and end dates of each phase or stage. Start Date: End Date: ❑ See JARPA Attachment D 6g. Fair market value of the project, including materials, labor, machine rentals, etc. LLel 6h. Will any portion of the project receive federal funding? Leipj • If yes, list each agency providing funds. ❑ Yes 18.No ❑ Don't know Part 7—Wetlands: Impacts and Mitigation ❑ Check here if there are wetlands or wetland buffers on or adjacent to the project area. (If there are none, skip to Part 8.) hel 7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. hf e_M Not applicable 7b. Will the project impact wetlands? hel ❑ Yes k No ❑ Don't know 7c.Will the project impact wetland buffers? [helps ❑ Yes &NO ❑ Don't know ORIA-16-011 Page 6 of 14 7d. Has a wetland delineation report been prepared? hel • If Yes,submit the report, including data sheets,with the JARPA package. ❑ Yes 5�,No 7e. Have the wetlands been rated using the Western Washington or Eastern Washington Wetland Rating System? h[ elpl • If Yes,submit the wetland rating forms and figures with the JARPA package. ❑ Yes I$ZNo ❑ Don't know 7f. Have you prepared a mitigation plan to compensate for any adverse impacts to wetlands? [help] • If Yes, submit the plan with the JARPA package and answer 7g. • If No,or Not applicable,explain below why a mitigation plan should not be required. ❑ Yes XNo ❑ Don't know 7g. Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was used to design the plan. hei 7h. Use the table below to list the type and rating of each wetland impacted, the extent and duration of the impact, and the type and amount of mitigation proposed. Or if you are submitting a mitigation plan with a similar table, you can state (below)where we can find this information in the plan. hl elpl Activity (fill, Wetland Wetland Impact Duration Proposed Wetland drain, excavate, Name' type and area (sq. of impact3 mitigation mitigation area flood, etc.) rating ft. or type" (sq. ft. or categoryZ Acres) acres If no official name for the wetland exists,create a unique name(such as"Wetland 1"). The name should be consistent with other project documents, such as a wetland delineation report. s Ecology wetiand category based on current Western Washington or Eastern Washington Wetland Rating System.Provide the wetland rating forms with the JARPA package. 3 Indicate the days,months or years the wetland will be measurably impacted by the activity.Enter"permanent"if applicable. 4 Creation C ,Re-establishment/Rehabilitation(R),Enhancement E,Preservation P,Mitigation Bank/In-lieu fee B Page number(s)for similar information in the mitigation plan, if available: ORIA-16-011 Page 7 of 14 7i. For all filling activities identified in 7h, describe the source and nature of the fill material, the amount in cubic yards that will be used, and how and where it will be placed into the wetland. hei 7j. For all excavating activities identified in 7h, describe the excavation method, type and amount of material in cubic yards you will remove, and where the material will be disposed. hf eM h I /[V I'� Part 8-Waterbodies (other than wetlands): Impacts and Mitigation In Part 8, "waterbodies" refers to non-wetland waterbodies. (See Part 7 for information related to wetlands.) LLe1PJ g Check here if there are waterbodies on or adjacent to the project area. (If there are none, skip to Part 9.) 8a. Describe how the project is designed to avoid and minimize adverse impacts to the aquatic environment. [Lelpi applicable--' t.y 81b. Will your project impact a waterbody or the area around a waterbody? hr eiO N Yes Nq ORIA-16-011 Page 8 of 14 8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland waterbodies? h[ eM • If Yes,submit the plan with the JARPA package and answer 8d. • If No,or Not applicable,explain below why a mitigation plan should not be required. [K Yes ❑ Don't know -eu rl r?I -G't'!j 8d. Summarize what the mitigation plan is meant to accomplish. Describe how a watershed approach was used to design the plan. • If you already completed 7g you do not need torestate your answer here. hel CC) )o, r' 8e. Summarize impact(s) to each waterbody in the table below. hel Activity (clear, Waterbody Impact Duration Amount of material Area (sq. ft. or dredge, fill, pile name' location' of impace (cubic yards)to be linear ft.) of drive, etc.) placed in or removed waterbody from waterbody directly affected If no official name for the waterbody exists,create a unique name(such as"Stream 1")The name should be consistent with other documents provided. 2 Indicate whether the impact will occur in or adjacent to the waterbody. If adjacent,provide the distance between the impact and the waterbody and indicate whether the impact will occur within the 1 oo-year flood plain. 3 Indicate the days,months or years the waterbody will be measurably impacted by the work. Enter"permanent"if applicable. 8f. For all activities identified in 8e, describe the source and nature of the fill material, amount(in cubic yards) you will use, and how and where it will be placed into the waterbody. hel N ORIA-16-011 Page 9 of 14 8g. For all excavating or dredging activities identified in 8e, describe the method for excavating or dredging, type and amount of material you will remove, and where the material will be disposed. LgjpJ N 1A Part 9-Additional Information Any additional information you can provide helps the reviewer(s) understand your project. Complete as much of this section as you can. It is ok if you cannot answer a question. 9a. If you have already worked with any government agencies on this project, list them below. [L@jPJ Agency Name Contact Name Phone Most Recent Date of Contact 9b. Are any oft a wetlands or waterbodies identified in Part 7 or Part 8 of this JARPA on the Washington Department of Ecology's 303(d) List? nel • If Yes,list the parameter(s)below. • If you don't know, use Washington Department of Ecology's Water Quality Assessment tools at: http://www ecv wa oov/progmms/wa/303d/. ❑ Yes >(No 9c.What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? nei • Go to hftip://cfpub.epa.gov/surf/locatelia.dex.cfm to help identify the HUC. 9d. What Water Resource Inventory Area Number (WRIA#) is the project in? nei • Go to htto�//www.ecy.wa.gov/water/wria/index.htmI to find the WRIA#. ORIA-16-011 Page 10 of 14 9e. Will the in-water construction work comply with the State of Washington water quality standards for turbidity? [Lel • Go to http://www.ecy.wa.gov/programs/Wq/swqs/criteria.html for the standards. ❑ Yes ❑ No N Not applicable 9f. If the project is within the jurisdiction of the Shoreline Management Act, what is the local shoreline environment designation? M!pj • If you don't know, contact the local planning department. • For more information, go to: htto://www ecv wa gov/programs/sea/sma/laws rules/173-26/211 designations.html. �baN ❑ Natural ❑ Aquatic ❑ Conservancy I9 Other: 9g. What is the Washington Department of Natural Resources Water Type? hel • Go to http://www.dnr.wa.gov/forest-practices-water-typing for the Forest Practices Water Typing System. t�Z Shoreline ❑ Fish ❑ Non-Fish Perennial ❑ Non-Fish Seasonal 9h. Will this project be designed to meet the Washington Department of Ecology's most current stormwater manual? hel • If No, provide the name of the manual your project is designed to meet. [&Yes ❑ No Name of manual: 91i. Does the project site have known contaminated sediment? nel • If Yes, please describe below. ❑ Yes KNo 9j. If you know what the property was used for in the past, describe below. hel 9k. Has a cultural resource (archaeological) survey been performed on the project area? hel • If Yes, attach it to your JARPA package. ❑ Yes ;K No ORIA-16-011 Page 11 of 14 91. Name each species listed under the federal Endangered Species Act that occurs in the vicinity of the project area or might be affected by the proposed work. LtLeM ii JJ l 9m. Name each species or habitat on the Washington Department of Fish and Wildlife's Priority Habitats and Species List that might be affected by the proposed work. h[� 1- IL ORIA-16-011 Page 12 of 14 Part 10—SEPA Compliance and Permits Use the resources and checklist below to identify the permits you are applying for. • Online Project Questionnaire at http://apps.oria.wa.gov/opas/. • Governor's Office for Regulatory Innovation and Assistance at (800) 917-0043 or helper-oria.wa.gov. • For a list of addresses to send your JARPA to, click on agency addresses for completed JARPA. 10a. Compliance with the State Environmental Policy Act (SEPA). (Check all that apply.) hel • For more information about SEPA,go to www.ecy.wa.gov/programs/sea/sepa/e-review.html. ❑ A copy of the SEPA determination or letter of exemption is included with this application. A SEPA determination is pending with (lead agency). The expected decision date is Ltil4M?t ❑ I am applying for a Fish Habitat Enhancement Exemption. (Check the box below in tob.) h[ elp] ❑ This project is exempt(choose type of exemption below). ❑ Categorical Exemption. Under what section of the SEPA administrative code (WAC) is it exempt? ❑ Other: ❑ SEPA is pre-empted by federal law. 10b. Indicate the permits you are applying for. (Check all that apply.) [be] LOCAL GOVERNMENT Local Government Shoreline permits: ❑ Substantial Development ❑ Conditional Use ❑ Variance Shoreline Exemption Type (explain): 'f"� ��,, /w,"d (17 ���`����� ��� 'C� Other City/County permits: ❑ Floodplain Development Permit ❑ Critical Areas Ordinance STATE GOVERNMENT Washington Department of Fish and Wildlife: ❑ Hydraulic Project Approval (HPA) ❑ Fish Habitat Enhancement Exemption—Attach Exemption Form Washington Department of Natural Resources: ❑ Aquatic Use Authorization Complete JARPA Attachment E and submit a check for$25 payable to the Washington Department of Natural Resources. Do not send cash. Washington Department of Ecology: ❑ Section 401 Water Quality Certification FEDERAL GOVERNMENT United States Department of the Army permits (U.S. Army Corps of Engineers): 9 Section 404 (discharges into waters of the U.S.) ❑ Section 10 (work in navigable waters) United States Coast Guard permits: ❑ General Bridge Act Permit ❑ Private Aids to Navigation (for non-bridge projects) ORIA-16-011 Page 13 of 14 Y Part 11—Authorizing Signatures Signatures are required before submitting the JARPA package. The JARPA package includes the JARPA form, project plans, photos, etc. LheM 11 a.Applicant Signature (required) LheM I certify that to the best of my knowledge and belief, the information provided in this application is true, complete, and accurate. I also certify that I have the authority to carry out the proposed activities, and I agree to start work only after I have received all necessary permits. I hereby authorize the agent named in Part 3 of this application to act on my behalf in matters related to this application. (initial) By initialing here, I state that I have the authority to grant access to the property. I also give my consent to the permitting agencies entering the property where the project is located to inspect the project site or any work related t the project. (initial) Applicant Printed Named Applicant Signature Date 11 b. Authorized Agent Signature hel I certify that to the best of my knowledge and belief, the information provided in this application is true, complete, and accurate. I also certify that I have the authority to carry out the proposed activities and I agree to start work only after all necessary permits have been issued. Authorized Agent Printed Name Authorized Agent Signature Date 11 c. Property Owner Signature (if not applicant) Lft[pJ Not required if project is on existing rights-of-way or easements (provide copy of easement with JARPA). I consent to the permitting agencies entering the property where the project is located to inspect the project site or any work. These inspections shall occur at reasonable times and, if practical, with prior notice to the landowner. Property Owner Printed Name Property Owner Signature Date 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. If you require this document in another format, contact the Governor's Office for Regulatory Innovation and Assistance(ORIA)at(800) 917-0043. People with hearing loss can call 711 for Washington Relay Service. People with a speech disability can call(877)833- 6341. ORIA publication number: ORIA-16-011 rev. 07/2017 ORIA-16-011 Page 14 of 14 SEPA Environmental Checklist Mason County Permit Center Use: SEP Single Family DNS: $600.00 ''rr ❑ Other DNS: 0 to 9.99 acres: $730 Parcel#: '70��j�jo�'C 10 to 20 acres: $880 Over 20 acres: $1100 Date E I V E D ❑ DS/EIS: $5000+ $90 per hour SEP 16 2020 615 W. Alder Street Purpose of checklist: Governmental agencies use this checklist to help determine whether the environmental impacts of your proposal are significant. This information is also helpful to determine if available avoidance, minimization or compensatory mitigation measures will address the probable significant impacts or if an environmental impact statement will be prepared to further analyze the proposal. Instructions for applicants: rhei f This environmental checklist asks you to describe some basic information about your proposal. Please answer each question accurately and carefully, to the best of your knowledge. You may need to consult with an agency specialist or private consultant for some questions. You may use "not applicable" or "does not apply" only when you can explain why it does not apply and not when the answer is unknown. You may also attach or incorporate by reference additional studies reports. Complete and accurate answers to these questions often avoid delays with the SEPA process as well as later in the decision- making process. 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. Instructions for Lead Agencies: Please adjust the format of this template as needed. Additional information may be necessary to evaluate the existing environment, all interrelated aspects of the proposal and an analysis of adverse impacts. The checklist is considered the first but not necessarily the only source of information needed to make an adequate threshold determination. Once a threshold determination is made, the lead agency is responsible for the completeness and accuracy of the checklist and other supporting documents. A. BACKGROUND rh.elp) 1. Name of proposed project, if applicable: (tielppj � � „erg �,t C'1� l �IQ � lJ f1t-1 2. Name of applicant: a 3. Address and phone number of applicant and contact person: It eid SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 1 of 11 A ],cantpJ&J ei epic,;IJ 4. Date checklist prepared: lthlei 5. Agency requesting checklist: wlo / 6. Proposed timing or schedule (including phasing, if applicable): fnelpj [NA] 1 � —A TI �, �,/,��:y , :,3, �l�f e: 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. r,e); CNaJ 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. L,e�. I'd T F PerM,OI VVI 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. Lhf�lni C/Vone-J �1 I �h� 10. List any government pprovals or permits that w IIl be needed for your proposal, if known. 11. Give 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.) e!b LATF pexm;�, � 4, St►mmv- J Jge4 vve, i4rl d davely `,, .17 1 i — C, y,,' ; ,^ J f -c°�,,f` c) ' /,, �!1 �} C cl,j C r r � I fLv!-e e } �. ) 0 �f l �{a(✓v'� i�r,c c, , l F� .jl 12. 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. Ik!pl Parcel#(s): IS 0 rn el H�a j�5v_U��%; Address: (6;) Legal Description: IIL-e;k, C".5 /11 #11 j K I Twp/Range/Section and/or GPS location: 3,� SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 2 of 11 B. ENVIRONMENTAL ELEMENTS `ntsv 1. Earth a. General description of the siteP-ieipj (circle one): Flat, rolling, hilly, Csteep slops'' mountainous, other: b. What is the steepest slope on the site (approximate percent slope)? tie 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 agricultural land of long-term commercial significance and whether the proposal results in removing any of these soils. q ,t�q�l d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. EfLui. e. Describe the purpose, type, total area, and approximate quantities and total affected area of any filling, excavation, and grading proposed. Indicate source of fill. �1e1 �Y , f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. rtje N !,r I.I g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? [he,Ir,, h r':I 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 during construction, operation, and maintenance when the project is completed? If any, generally describe and give approximate quantities if known. Li�f-)l b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. L�j [VI) c. Proposed measures to reduce or control emissions or other impacts to air, if any: t, SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 3 of 11 3. Water a. Surface Water: rlei - 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. rt)ei 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. ,eu ( 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. neR WORD 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. iel M0 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. Inet] N(D 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 Water: 1) Will groundwater be withdrawn from a well for drinking water or other purposes? If so, give a general description of the well, proposed uses and approximate quantities withdrawn from the well. Will water be discharged to groundwater? Give general description, purpose, and approximate quantities if known. tj (D 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. #,elvj 0®'fig Q-- c. Water runoff(including stormwater): 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 water flow into other waters? If so, describe. ( else SEPA Environmental checklist(WAC 197.11-960)(MC version-non project portion omitted): 2016 Page 4 of 11 2) Could waste materials enter ground or surface waters? If so, generally describe. [,elpj No 3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If so, describe. �O d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage pattern impacts, if any: 4. Plants lhei,1- a. Check the types of vegetation found on the site: fItipj _deciduous tree: alder, maple, aspen, other — evergreen tree: fir, cedar, pine, other shrubs grass pasture crop or grain orchards, vineyards or other permanent crops wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other water plants: water lily, eelgrass, milfoil, other other types of vegetation moved or altered? h-al b. What kind and amount of vegetation will be re L��., 9 1 WkkL c. List threatened and endangered species known to be on or near the site. Lei d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: t�'crr�L �� w 1`'t n;a�;��z ✓c �' r r-, .eft >��` e. List all noxious weeds and invasive species known to be on or near the site. 5. Animals a. List any birds and other animals which have been observed on or near the site or are known to be on or near the site. Examples include: Ihelp1 birds: hawk, heron, eagle, songbirds, other: mammals: deer, bear, elk, beaver, other: fish: bass,Osamo trout, herring, shellfish, other: SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 5 of 11 b. rList any threatened and endangered species known to be on or near the site. lLeip k1 eLJ1 Cluj c. Is the site part of a migration route? If so, explain. Le�j � l d. Proposed measures to preserve or enhance wildlife, if any: jhelpi (.;j`�l� ��✓,��1�/r12_ p�)I G,'!Jr.,.;1c-,f e. List any invasive animal species known to be on or near the site. 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. !,.,e1p b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. iri 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: Lhei 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!1 0C) 1) Describe any known or possible contamination at the site from present or past uses. Ncvh�0—, 2) Describe existing hazardous chemicals/conditions that might affect project development and design. This includes underground hazardous liquid and gas transmission pipelines located within the project area and in the vicinity. 3) Describe any toxic or hazardous chemicals that might be stored, used, or produced during the project's development or construction, or at any time during the operating life of the project. 4) Describe special emergency services that might be required. SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 6 of 11 5) Proposed measures to reduce or control environmental health hazards, if any: b. Noise 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? 01 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)? Indi- cate what hours noise would come from the site. !,ei i 3) Proposed measures to reduce or control noise impacts, if any: ji,eJ.f ,j 4 8. Land and shoreline use a. What is the current use of the site and adjacent properties?Will the proposal affect current land uses on nearby or adjacent properties? If so, describe. jLeip b. Has the project site been used as working farmlands or working forest lands? If so, describe. 00 How much agricultural or forest land of long-term commercial significance will be converted to other uses as a result of the proposal, if any? M M2.1 If resource lands have not been designated, how many acres in farmland or forest land tax status will be converted to nonfarm or nonforest use? ft1t,,,A 1) Will the proposal affect or be affected by surrounding working farm or forest land normal business operations, such as oversize equipment access, the application of pesticides, tilling, and harvesting? If so, how: c. Describe any structures on the site. 1h d. Will any structures be demolished? If so, what?ILi ipl e. What is the current zoning classification of the site? t,c.E f. What is the current comprehensive plan designation of the site? [;, e r) , yy E SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 7 of 11 g. If applicable, what is the current shoreline master program designation of the site? th__�Pj h. Has any part of the site been jclassified as a critical area by the city or county? If so, specify. i. Approximately how many people would reside or work in the completed project? help] C j. Approximately how many people would the completed project displace? ItIpi Ihas`'---- k. Proposed measures to avoid or reduce displacement impacts, if any: Lt�i /✓ L. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if.any: _�rE m. Proposed measures to ensure the proposal is compatible with nearby agricultural and forest lands of long-term commercial significance, if any: 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low- income housing. Ihet)] N f A. b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or low-income housing. nee[.1 dd 0 1 ' c. Proposed lmeasures to reduce or control housing impacts, if any: Lei;) 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? Lhe� b. What views in the immediate vicinity would be altered or obstructed? 1 el 00110-- c. Proposed measures to reduce or control aesthetic impacts, if any: o elpi 11. Light and glare a. What type of light or glare will the proposal produce? What time of day would it mainly occur? rheinPli UO b. Could light or glare from the finished project be a safety hazard or interfere with views? hel QD SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 8 of 11 c. What existing off-site sources of light or glare may affect your proposal? pf"rD d. Proposed measures to reduce or control light and glare impacts, if any: [help] pa '- 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? heirv' b. Would the proposed project displace any existing recreational uses? If so, describe. JrLe �O c. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: 1heipi 13. Historic and cultural preservation a. Are there any buildings, structures, or sites, located on or near the site that are over 45 years old listed in or eligible for listing in national, state, or local preservation registers located on or near the site? If so, specifically describe. 1,t} ipl b. Are there any landmarks, features, or other evidence of Indian or historic use or occupation? This may include human burials or old cemeteries. Are there any material evidence, artifacts, or areas of cultural importance on or near the site? Please list any professional studies conducted at the site to identify such resources. joke-p 0 c. Describe the methods used to assess the potential impacts to cultural and historic resources on or near the project site. Examples include consultation with tribes and the department of archeology and historic preservation, archaeological surveys, historic maps, GIS data, etc. r� d. Proposed measures to avoid, minimize, or compensate for loss, changes to, and disturbance to resources. Please include plans for the above and any permits that may be required. 14. Transportation a. Identify public streets and highways serving the site or affected geographic area and describe proposed access to the existing street system. Show on site plans, if any. helC�l SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 9 of 11 b. Is the site or affected geographic area currently served by public transit? If so, generally describe. If not, what is the approximate distance to the nearest transit stop? �,j eip3 c. How many additional parking spaces would the completed project or non-project proposal have? How many would the project or proposal eliminate?LI,jp d. Will the proposal require any new or improvements to existing roads, streets, pedestrian, bicycle or state transportation facilities, not including driveways? If so, generally describe (indicate whether public or private). Lhelm] Q0 e. Will the project or proposal use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. (neap ti !A f. How many vehicular trips per day would be generated by the completed project or proposal? If known, indicate when peak volumes would occur and what percentage of the volume would be trucks (such as commercial and nonpassenger vehicles). What data or transportation models were used to make these estimates?LtIeip1 g. Will the proposal interfere with, affect or be affected by the movement of agricultural and forest products on roads or streets in the area? If so, generally describe. ko h. Proposed measures to reduce or control transportation impacts, if any. golf 15. Public services a. Would the project result in an increased need for public services (for example: fire protection, police protection, public transit, health care, schools, other)? If so, generally describe. L 1'-0 b. Proposed measures to reduce or control direct impacts on public services, if any. [nA 16. Utilities a. Circle utilities currently available at the site: [LApj electricity, natural gas, water, refuse service, telephone, sanitary sewer, septic system, other SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 10 of 11 h t 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. LnoEf. C. 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: i OU; Date Signed: `a Print Name of Signee: If applicable, Position and Agency/Organization: Date Submitted: SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 11 of 11 KLULIVED 3628 South 351h Street i Tacoma,Washington 98409-3192 SEP 16 2020 TACOMA POWER TACOMA PUBLIC UTILITIES 615 W. Alder Street TACOMA PUBLIC UTILITIES January 2, 2020 VIA EMAIL and USPS David and Claudia Hagen 211 S. 212th St. Des Moines, WS 98198 SUBJECT: Tacoma Power Shoreline Use Permit Application Review: Lot 9, Plat of Lake Cushman No. 11 (Tax Parcel No. 42332-50-00009) REFERENCE: Project No. 2019-259/SUP442 Dear Mr. and Mrs. Hagen, Thank you for applying for a Shoreline Use Permit(SUP)for your existing shoreline structures, located on Tacoma Power property adjacent to and associated with your development lot No. 9, Division 11, Lake Cushman. As you know, Tacoma Power's Cushman Hydroelectric Project area (Project) includes all lands located waterward of the 742-foot elevation Project boundary on Lake Cushman. Tacoma Power also retains a 10-foot lateral strip on your leased development lot adjacent to the Project boundary(see enclosure). All structures and uses located waterward of 742 feet elevation, and all structures and fill placed within the 10-foot lateral strip require authorization from Tacoma Power. Tacoma Power has reviewed your SUP application package for conformance with Tacoma Power's Shoreline Use Specifications and Permitting Guidelines (SUSPG)and has the following comments: Items Reviewed: • SUP.application package dated December 11, 2019, received December 16, 2019, • Drawings, by James Farley, P.E., dated December 10, 2019 (enclosed)with redlines by Tacoma Power, and • Tacoma Power records. 1. Astro-turf lawn. To be removed. Redlined into the above referenced drawings is an existing astroturf lawn located between the development lot and the shoreline. Astro-turf is a prohibited use per Section 5 of the SUSPG. The astroturf must be removed from Tacoma Power property. Native plants may be planted, but no lawn may be planted. 2. Cottage stone and rock bulkhead—three sections,with drainage pipes. Allowed, with conditions. Redlined into the above referenced drawings are two existing cottage stone bulkhead sections and one existing rock bulkhead section with drainage pipes which you propose to retain. Conditions: The bulkhead sections will be permitted as Prior Existing Uses, per Section 4.4 of the SUSPG, and subject to the conditions therein. 3 ' � r Hagen January 2, 2020 Page 2 of 5 3. Concrete and cottage stone steps —two sections. Allowed,with conditions. Redlined into the above referenced drawings are two existing sets of steps. The northernmost set is concrete and cottage stone and provides access from the development lot to the stone patio. The second set is concrete and provides access from the development lot to the fixed pier and lakebed. Conditions: The two sets of steps will be permitted as a "Prior Existing Use" per Section 4.4 of the SUSPG, and subject to the conditions therein. 4. Cottage stone retaining walls—two sections. Allowed,with conditions. Redlined into the above referenced drawings are two existing cottage stone retaining walls located behind the bulkheads. Conditions: The two retaining walls will be permitted as a "Prior Existing Uses" per Section 4.4 of the SUSPG, and subject to the conditions therein. 5. Stone Patio. Allowed, with conditions. Redlined into the above referenced drawings is an existing stone patio located between the northernmost section of retaining wall and bulkhead. Conditions: The two retaining walls will be permitted as a "Prior Existing Uses" per Section 4.4 of the SUSPG, and subject to the conditions therein. 6. Fire pit. Allowed. Redlined into the above referenced drawings is an existing movable fire pit. You propose to retain the fire pit on the patio year-around. Fire pits no larger than 3 feet in internal diameter are an allowed use per Section 4.2 of the SUSPG. 7. Fixed pier. Allowed, with conditions. As shown in the above referenced drawings, you propose to retain your existing fixed pier supported by nine wood pilings and four concrete- filled aluminum pilings with wood post extenders. The pilings are set on pre-formed concrete footings. Based on the measurements provided, the total overwater coverage is approximately 370 square feet. Conditions: a. The existing fixed pier will be permitted as a Prior Existing Use, per Section 4.4 of the SUSPG, and subject to the conditions therein. b. When the 50% repair/replacement threshold outlined in the conditions of Section 4.4 above are met, then the structure will be required to be reduced to begin to come into compliance with Tacoma Power's 300-square foot overwater coverage maximum allowance. Work with Tacoma Power to determine a reduction strategy when that time comes. 8. Moorinq buoy. To be removed or converted. Not shown in the above referenced drawings, nor marked on the application, is an existing mooring buoy. Per Appendix B Section 6 of the SUSPG, applicants are allowed a dock or a buoy, not both. However, Tacoma Power will�aJlo_w you!onvert the " buoy anchor,into a "mooring buo altern .g". Please indicate to Tacoma Power whether you will remove or convert Your existing mooring buoy. See enclosed diagrams. 9. Debris. To be removed. All debris, concrete, abandoned anchors and building materials, etc. located on Tacoma Power's property waterward of 742 feet elevation and on the lakebed fronting your development lot must be removed. s Hagen January 2, 2020 Page 3 of 5 \ Other Information: y 10. Tacoma's 10-foot lateral strip area. Tacoma retains a 10-foot lateral strip on the development lots adjacent to the 742-foot elevation boundary. Any permanent structures or fill in this area must be approved by Tacoma. You currently have retaining walls, a hot tub, stairs, fill, and astro-turf located in the 10-foot lateral strip area. 11. Cultural Resources Survey. Not required at this time. A Cultural Resources Survey (CRS) is not required at this time because the ground disturbance that occurred when your project was constructed was prior to Tacoma Power's Hydroelectric License survey requirement. Please be aware that a CRS will be required, in the future, before any ground disturbing activities will be permitted. Next Steps: 12. Update drawings. (Applicant) Updated drawings which show all structures and uses located on Tacoma Power Project lands and which contain all the required elements detailed in Section 7.1.6 of the SUSPG, including relevant property boundaries, are required before your application can be approved. Please see the attached redlined drawings for Tacoma Power's notes as well as the enclosed example plans to help you understand the information we need. Additionally, please have your engineer correct the notations associated with waterward-most beam and four aluminum pilings associated with your fixed pier. The beam appears to be a log, not 2x10 beams, and the pilings are topped with wood post extenders (Figure 1). These items must be shown and the attachment methods fully described. Once updated, please provide a copy to Tacoma Power for review and approval. 13. Required regulatory permits or waivers. (Applicant) Once Tacoma Power approves your updated plans, we will provide you with a letter allowing you to move forward with the regulatory permit applications for the structures and uses on Tacoma Power Project lands. Regulatory permits or written waivers will be required from Mason County, the WA Department of Fish and Wildlife, and the US Army Corps of Engineers for the retention of your shoreline structures and conversion or removal of your mooring buoy. Per Section 1 of the SUSPG, copies of the necessary regulatory permits are required before Tacoma Power can issue you authorization to occupy and use our Project lands. 14. Short-term License. (Tacoma Power) After you have provided copies of the required regulatory permits, Tacoma Power will issue you a short-term license to perform the required removal work described above. 15. Shoreline Use Permit. (Tacoma Power) Upon verification that you completed the requirements of the short-term license, Tacoma Power will issue a 5-year Shoreline Use Permit for the allowed uses and structures. Please do not commence any work on Tacoma Power Project lands, waterward of 742 feet el evation or within the 10-foot lateral strip area, without written permission to do so from Tacoma Power. Hagen January 2, 2020 Page 4 of 5 If you have questions regarding this review of your application, please contact me at (253) 441-4180 or via email at wwright(aDcityoftacoma.org. S*ncerely, -- n WynnAMright Shoreline and Lands Coordinator Enclosures c: Dori Bishop, Sr. Real Estate Specialist, City of Tacoma Bret Forrester, Wildlife and Lands Manager, Tacoma Power Darrin Masters, WA Department of Fish and Wildlife Jason Sweeney, US Army Corps of Engineers Marissa Watson, Mason County Kyrra Wilson, Wildlife and Recreation Lands Officer, Tacoma Power Hagen January 2, 2020 Page 5 of 5 t - . -- } i ♦♦ 3 i Figure 1. Waterward-most beam appears to be a log and pilings have wood post extenders. These design aspects must be shown correctly on the drawings.