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HomeMy WebLinkAboutSHX2018-00003 Campsites, Road, Grade Repairs - SHX Permit / Conditions - 6/26/2018 MASON COUNTY (a 0- � • COMMUNITY SERVICES Building,Planning,Environmental Health,Community Health June 26,2018 Chelsea Hamer Via Email:Chelsea.sendzik@parks.wa.gov Washington State Parks and Recreation Commission PO Box 42650 Olympia,WA 98504 RE:Shoreline Exemption for Washington State Parks and Recreation Commission for maintenance of the campground loop at Schafer State Park. Dear Ms. Hamer, On January 18,2018 Mason County issued a Shoreline Exemption for the maintenance work along the campground loop within Schafer State Park after damage occurred by flooding.On January 30,2018 you requested by letter a five-year programmatic shoreline exemption for similar work,anticipating future flooding events. This letter shall serve as the approval of the five-year programmatic exemption.The exemption is only from the requirement to obtain a substantial development permit prior to undertaking the project.The project still must be compliant with the Shoreline Master Program for Mason County and the Shoreline Management Act. The project and its location are described in your attached letter from January 30,2018.This exemption expires on January 17,2023. If you have any questions or concerns regarding this matter, please do not hesitate to contact me at 360.427.9670 ext.286. Sincerely, Xe& R"wt Kell Rowen Planning Manager cc: Marissa Watson,Planner Rick Mraz, Department of Ecology,Shorelands&Environmental Assistance s. :Don Hoch: MR a Director. STATE,OF WASHINGTON WASHINGTON STATE PARKS AND RECREATION COMMISSION 1111.Israel Rd S.W. • P.O.Box 42650 i Olympia,.WA 98504-2650e(360)902,8500 D TD (Telecommunications Device for the Deaf): (360)664-3133 www.parks;wa.gov Ja nuary 30,2018 Kell Rowen Mason:County Community:Development 615 Alder St I Mason County Building 8 Shelton, WA-98584 . Ms.:Rowen: The staff of Washington State Parks and Recreation CommissionW fv -yar.' . . ai . programmatic shoreline exemption.for the maintenance of the campground loop within Schafer State Park. Schafer State Park is located at.1365 W Schafer Park Rd, Elma; WA-98541, within Mason County. The specific location of the proposed maintenance activity:is situated within Section 29, Township 19I�T,.and Range6W. :.. Schafer State Park periodically experiences flooding:during the winter and spring:months, often resultin in relatively minor damages to the road and cam sites (displacement of on-site ravel - g Y g P. ( P g and logs, exposure of base rock, etc.) along the East Fork Satsop River. The maintenance_ activities required to restore the function of the campground.include the grading of the gravel campground road and various.campsites::and:relocating displaced logs above the ordinary high watermark of the.riverine,system. In.addition to the grading of existing gravel (estimated to be approximately 85 cubic yards),.. WSPRC requests the ability to apply up_to approximately 100 cubic ards CY of clean ravel " pA Y. Y ( ) .g annually, as needed,to restore the function of:the campground at Schafer State Park. It is.. understood that the grading of 200:CY or more will require a'grading permit from Mason County prior to conducting any.grading activities; it:is also:understood;that the:grading of:5:00 CY or more will require_a SEPA checklist and determination in addition to a grading.permit.: These infrastructure.repairs are.needed due to a combination.of normal wear on the:gravel infrastructure of the campground and the floodin of the East Fork Satso 'River. Grading.: Pg g p g ... . . activities and the:application of any:new gravel to the Schafer State Park campground will be confined to the imits o. t e existing ootprm ; grave wi not ,e.p ace. below or inary ig water mark(OHWM)of the Satsop River,nor will any material.be placed.with the intent of ... traveling'water ward of the OHWM. The aforementioned-repair activities qualify for a shoreline exemption,per WAC.173-27- 040(2)(b),whi&exempts: "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 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, configuration, location and external:appearance;within a reasonable period after decay or partial destruction, except.where repair causes.substantial adverse-effects to.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 developmentis 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;" Thank you for,your time.and consideration ofthe issuance of a programmatic shoreline exemption for the maintenance activities:outlined in this letter. Please feel free to contact Chelsea Hamer with any questions you may have. Respectfully, Chelsea Hamer Environmental Planner, SW Region Capital.Program . Washington:State Parks:and Recreation Commission- PO Box 42650:1 Olympia,_WA 985:04-2650 - Phone: (360)725-9764. . Chelsea.sendzik@parks:wa.gov PyoN:STATED MASON COUNTY C 4-1 Department of Community Services o A U Planning Division o N i 615 W Alder St, Shelton,WA 98684 7 N Y ti (360)427-9670 OJ �O 1864 Exemption from Shoreline Management Act Case No.: SHX2018-00003 Substantial Development Permit Requirement The Proposal By: SCHAFER STATE PARK PO BOX 42650 OLYMPIA, WA 98504-2650 Parcel Number: 619293060020 Site Address: 1365 W SCHAFER PARK RD ELMA To undertake the following development: REPAIR CAMPSITES AND GRAVEL ROAD DAMAGED BY FLOOD. INCLUDES REGRADING FLOOD DISTRIBUTED GRAVEL. NO EXPORTED FILL, POSSIBLE IMPORTED GRAVEL (LESS THAN 200 CY). Within Satsop River 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 Kell Rowen at ext 365 if you have any questions. Issued:1/18/2018 Authorized Local Government Official SHX2018-00003 January 18, 201 f r- --- ---- ---------------- ----i AG ENCY USE ONLY "bate receiived- WASHINGTON STATE uSA""yc°`� +� of Englneera Seattle District' #. SHXZ(�IPl t5®�D Joint Aquatic Resources Permit Agency reference Application..(JARPA) Form 2 hel Tax Parcel#(s)i USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. ' i JAN. 11 2018 Part 1. Project Identification. W Alder Street. �15 1. Project Name(A.name for your project that you create Examples"Srhith's bock or Seabrook Lane`Development) Schafer-State Park Campground Flood Damage Repairs Part 2—Applicant The person and/or organization responsible for the project. [hell 24. Name(Last, Flrst, Middle) Hamer,'Chelsea L. 2b:`Organization=(Ifapplicable) - - Washington,State::Parks and. Recreation:Commission 2c Mailing Address,(Street or•'P.O Box). , - PO Box 42650 2d City.State,:Zip Olympia,.WA 98504-2650 2e. Phone(1) 2f: Phone(2), 2g. Fax `2h.'E-ma'iL (360)725-9764 (360)664-03.12 Chelsea.hamer@parks.wa.gov 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. Ifyour 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 it http://www.nws.usace.army.mil/Missions/Ci4ilWorks/Redulatory/P.ermitGuidebook/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 govemmentto make sure they accept the JARPA. ZTo access an online JARPA form with.[help]screens,go to http://www.epermittipci.wa.gov/site/alias resourcecenter/iarga iarpa form/9984/iarga form.asex." For:other help,co.ntact.the Governor's Office for Regulatory Ihhgvation and Assistance tit(800)917-0043 or helpnoria.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) [held 39_Name(Last„Ftrst Middle) Same as above 3b Oeganization.(ifappli6able) :3c Mailing Address(Streefor Po Box) 3d City; State,,Zip 3e. Phone(1) 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: hf eM ®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. El Your.project is:on Department of Natural Resources (MR)-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. Na me(Last,_First, Middle) 4b Organization (if.applicable) 4c. Mailing Address_(Street or.PO Box) , 4d City, State, Zip 4e Pfione,(1,), 4f:�Phone(2j 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[ eM ❑ There are multiple project locations(e.g. linear projects). Complete the section below and use JARPA Attachment 13.for each.additional project location. 5a. Indicate;the type:of ownership:of the property.-';(check au:tnat apply) hf elpl. ❑ Private ❑ Federal ®. Publiclyowned state,county, cit ,special districts like schools, ports,etc. ( Y Y P P ) . ❑ 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 elpl. 1365 Schafer Park Road 5.c. City, State, Zip(if,the.project'is not m a dity'ortown-,-provide,the name of the-nearest city'o[.town.),,h[ elf] w , Elora;WA 98541 5d. County. hf elpl Mason. 5e. Provide the,section,stownship,,and range forthe-project location.. hf elpl.;, 114 Section ° Section" Township Range SW 29. : 19N :.. : 6W 5f Provide the latitude andlongitude of the project location. hf elpj J. Example;"47 03922 N Iat:/-122.89142 W long. (Use decimal degrees-'NAD 83) 47.097458 N lat. /A23.468329 W long. . . 5 List the�taX arcel-nurriber s for.the r`o'ectlocation hei 5 9. p ( �. p qj I�l • The localcounty.=assessor's office can provide_this`information: r 61929-30.60020 . . 5h. Contact information for.all adjoining property owners. (if you•need morespace.use JARPA Attachment.C.) hf elpl Name Mailing Address TaxRarcel:#(if known) . ............_................................--....----------------=-----------..........------------........................................... 61930-44-00020. ORIA-16-011 Page 3 of 14 5i. List.all wetlands on,or adjacent to the project location. h[ eM : 5j..List all�waterbodies(other than wetlands) 'on or adjacent to.the project.location. 6m Satsop River 51k is-any part_ofahe project area within a 100=yearflood0lain? hf "i - ® Yes ❑ No ❑'Don't know 51. Briefly'descrlbe,the vegetation,and habitat conditions onthe property:,. of elpl This area of the park primarily consists of bigleaf maple(Acermacrophyllum);vine maple (Acercircinatum), western red cedar:(Thuja plicata), Douglas fir(Pseudotsuga menziesh), snowberry(Symphoricarpos),sword.fern Pol stichum munituin ,with occurrences of Himalayan blackberry Rubus armeniacus 5m Describe hFow,the property is.currently used.; of elpl.:, This property is a:state-owned public recreation:park which offers day-use and camping opportunities. 5n Describe how the adjacent properties are currently used. f h elpl The adjacent properties include residences; agricultural and forest lands.: 50. Describe,the'structures(above and below ground).`on the property,.including their purpose($) and current This park contains comfort stations, arranger residence, picnic shelters, a group camp shelter, a shop, and a park office. 5p."Provide driving directions from the closest highway to_th'e project;ocation,:and attach a map. tiI ei0 From 1-5, take exit 104 for US-101; follow U.S-101 /WA-8/WA-12 to 4th St in Satsop; take E Satsop Rd tow , Schafer Park.Rd. ORIA-16-011 Page 4'of 14 Part 6—Project Description 6a. Briefly summarize the overall protect You can provide more detail In 6b h[ eloj Flooding from the Satsop River displaced gravel and logs used.to define designated camping:areas and the road within the campground at Schafer State Park. The proposed work will gather the existing; dispersed gravel on site and use that material to fill exposed areas and holes scoured by flood waters. In addition to the grading of the existing gravel, additional'rock may need.to be applied to even out the grade of the existing:campground loop road. 6b: Describe the purpose-.of:the.jproject and why you want or:need'to;perform it, hel ; Please'see 6a. 6C Indicate the project,category„(Check allthat apply) hf elpl ❑ Commercial :;. - _ ❑ Residential: ..0 Institutional. El Transportation El Recreational ❑x Maintenance O'Environmental Enhancement 6d ihdiicate the major elem�j o en of°your protect :(check all that apply) [help] ❑ Aquaculture ❑ Culvert ❑ Float ❑ Retaining Wall. ❑ Bank Stabilization ❑ Dam/Weir ❑ Floating Home (upland) .. o El Boat House. ❑'Dike/ Levee/Jetty ❑ Geotechnical Survey ©:R ad 0 Boat Launch ElDitch ElLand Clearing- cienti is Measurement Device. ❑ Boat:Lift El Dock]Pier D:Marina/,Moorage: ❑Stairs ❑ Bridge ❑ Dredging ❑ Mining ❑ Stormwater facility ❑ Bulkhead ❑ Fence El Outfall Structure .. El Swimming Pool ❑ Buoy ❑ Ferry Terminal ❑ Piling/Dolphin Ut❑ i lity Line El Channel Modification' ❑ Fishway ❑ Raft © Other- campsites ORIA-16-011 Page 5 of 14 6e.`Describe how you plan to construct each.project element checked_ in 6d.;anclude specific construction methods,and equipment to_beused.; heel . , f• Identify where_each eleni6nt.wi�ll occur_in relation-to the nearestmaterbody:- . • " Indicate.Which activities are withi,n,the 106=yeaw flo`odplain.;- a .- A grader, a front end.loader,and a roller, along with hand tools, will be used to gather displaced gravel and logs. and redistribute to exposed:areas within campsites; common areas,.and:the campground.loop road. . Vn What are.the anticipated'stait.and end dates for projecf construction?:(Month/Year) hf elpl • 'If the,project will be consttucted'in phases of stades, use'JARPA Attachment D to list the'stait and end dates of.each phase.o stage. Start Date: As soon as End Date: ❑ See JARPA Attachment D permitting allows 6g Fair market value of the:project, Including materials, labor. machine rentals; etc. li[ eloj Approximately$4,000 6h Will,any portlon;of the "roiect:receive federal,funding� hf elol . . • `df yes lisf each agency providing funds.' ❑Yes ® 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.) hLelp 7a.:Describe how-the project has been,designed to,avoid and minimize:adverse impacts to wetlands. hf elal' ❑ Not applicable 7b .Willthe project impact Wetlands?' hel ❑ Yes - ❑ No , ❑ Don't know 7c:Will`the'project-impact.wetland,buffers?. Lter D Yes 0 No D Don't know ORIA-16-011 Page 6 of 14 7d. Has a wetland delineation report been pre pared2 7f Yes,'submit the report, including data'sheets,with the JARPA package. ❑ Yes i ❑ No- ss 7e..Have the wetlands been rated using the Western Washingtonfor Eastern Washington Wetland Rating, System? if°elpl •,. -1f.Yes„submit the wetland-rating forms-and figures with the JARPA'package. El Yes El No ❑.Don't know: 7f Haye ota re aced a mitigation plan to com ensate for an adverse impacts,to wetlands? hf elpl y, : p p, p y • If Yes,submit4lie plan with the.JARPA package.and.answer 7g, •. ;If No,or Not applicable,explain below why,a`mitigation:plan should not be required: ❑ Yes ❑ No ❑ Don't know 7 Summar-ize.what the miti'�ation lan.is meant td accom fish; and.describe.how.a;watersh g. g p p ed approach was used,to design the.plan.:(ham]. 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 (belovi)where we can findahis:information in the.plan. . hf elp� Activity(fill; Wetland . Wetland impact. Duration Proposed Wetland drain; excavate,- -Name'- type and area (so. of impact3 mitigation mitigation area. flood, etc.) rating 2 ft.or type` (sq.ft. or catego 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: .. 2 Ecology-wetland category based on currentwestern 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.: . "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 . 7L 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. [heelp] 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.,[heip] 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.) ligt] M.Check here if there are waterbodies on or adjacent to the project.area.: If there are:none, skip to Part:9:) : 8a: Describe h-m the.project is designed to avoid and minimize adverse impacts to the aquatic environment ,. 0 Not applicable. This proposed work will take lace upland: within shoreline 200' buffer and will re rade:existin p p p p ( ) 9 9 gravel: throughout the:campground (campground loop road,:campsites,-and common areas).: 8b.Will your project impact a waterbody,or the areaaround a waterbody? h[ etp) ❑.Yes . N.No ORIM6-011 Page 8'of 14 8c Have you preparetl a rii"itigatiorr;plim to compensate for the project's'adverse impacts`to non-wetland waterbodies? h[ . ; • If Yes,submit the plan with the'JARPA package`and answer 8d.". • If No;`o"r Not applicable,explain tielow;why"a mmgp ion'plan should not be required: 0 Yes © No 0 Don't know . 8d Summarize`.what#lie-mitigatioh plan is'rrteant to accomplish Des cribe'how'ia watersh`ed,'app�oach was used to.design the plan. ..If you already completed 7g you do not need to restate-your answer here."[help]; , ; 8ei Summarize-impact(s)to each waterbody in:the table-below. rilol f e . - v y( Duration Amount material Activitclear,. Waterbody impact Area (sq.ft. or dredge,fill, pile name' locationZ of impact . . (cubic yards) to be linear ft.) of .drive, etc.) .. placed:iin or removed waterbody, from waterbody directly affected. ' 1f no official name for the waterbody exists,create a unique name:(such as"Stream 1")The name should be consistent with other documents provided. Indicate whether the impact will occurin 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 100-yearflood plain. 'Indicate the da s,'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:: hLe] 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., h[ elpj 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;If is ok if you cannot answer a question. 9a. If you have:alr"early worked.with any government'agencies on this project, Ilst them below. of elol A enc Name Contact' h g ` y Name Plone, Most Recent - .,Date of Contact Mason'County Kell Rowers December.2017 WDFW Margie Bigelow December 2017 ' 9b: Are.any of the wetlands or Waterbodies idehtified.in Part 7,or Part 8 of=this JARPA on the Department of Ecology's,303(d) List? h[ el • if Yes;-list the parameters)below. • Ifyouu don't know,.use Washington.Departme'n't,of Ecology's Water Quality Assessment tools at h ttp a/www.a cy.wa.g ov/p rog ram s/wd/303d/. © Yes ❑ No Bacteria Temperature Dissolved Oxygen §t. -What U S..Geolo gical Survey Hydrological'Unit Code (HUC) is the project in?° hel" Go to h f //cf ub.6pa.aov/surf%locateAnde• p p ��� � xicfmto-help identify the=HUC: 17100104 Y (YR 9d What Water Resource Inventor, Area,Nurriber , IA#) is the-project!in?. hel f�] • G_o.folhftp://www.ocy.wa.ciov/water/wria/i'ndex.htm[to'find the WRIA# WRIA-22—Lower Chehalis ORIA-167011 Page 10'of 14 9e Will the in-water construction:work comply with the State of Washington water`quality�standards for turbidity?,``� hl pip1 •: Go fd:http.//wwww.ecy.wa.dov/programs/Wa/swas/boteria.html for th&standatds. ❑Yes ❑ No ©-Not applicable 9f If,the roject is,within they °p � :jurisdiction'of the Shoreline Management Act;what is the local shoreline environment designation? hf elpl" If you don't know, contact:the local planning department.° For more'information,'go t6..litt6:%/www.e6V.wa".gov/programs/sea/srna/laws rules/173-2L/211 designations:htmi' ..' ❑ Urban El Natural El Aquatic ❑ Conservancy -® Other:Rural 9g..What is the Washington.Department of'Natural Resources Wbter Type?: bpjpI',; • Go to,hftp://www.dnr.wa.gov/forest-PrEictices-water-typing for the Forest Practices Water Typing System. 0-Shoreline_ ❑ Fish ❑ Non-Fish Perennial ❑ Non-Fish Seasonal :9,h.Will.this"project be designedto meet the Washington Department of Ecology's,most'current stormwater manual7h[ elp] " If No;provide'the name of the manual your project,is designed-to meet. ' ® Yes ❑ No Name of manual: 9i. Does the proiect"s to have known contaminated sediment?- h[ eta • If Yes please;descnbe below. ❑ Yes :® No 9j If you know what the property was used for in-the past,.describe below. of elol The property was previously owned by the:Schafer family, who owned a large lumber:and logging operation-, the Schafer Bros. Logging Company donated the property to the State of Washington in 1924. . 9k Hasa cultural resource forcha2ological) survey Abe2n'performed.on the project area?,: h[ elp] •. If Yes,attach,it to your JARPA package. ❑ Yes ® No ORIM 6-011 Page 11 of 14 91. Name eachfspecies listed under the federal Endangered Species Act that occurs in the vicinity of the project ameffey dwork. he, 1pl .., According to the U.S. Fish and Wildlife Service Environmental lConservation Online System (accessed January 3, 2018), the following species may potentially be found near the project site: Marbled murrelet(Brachyrainphus marmoratus); Threatened - Streaked horned lark(Eremophila alpestris strigata), Threatened - Yellow-billed cuckoo (Coccyzus americanus),.Threatened Bull trout(Salvelinus confluentus), Threatened 9m .Name each species or-hatiitat on fhe Washin ton Department of'Fish and' Priorit g p y Habitats and Species List theft'might be affected by,the-proposed,work 'n[ elpl According to the Washington Department of Fish and Wildlife's Priority.Habitats and Species data (accessed- January:3,_2018),.the following_species are found within the East Fork Satsop:River, adjacent to the project area:. -: Resident coastal cutthroat(Oncorhynchus clarkJ) ::Winter steelhead (Oncorhynchus mykiss) - Summer/Fall chi nook,(Oncorhynchus tshawytscha) . .Fall chum.(Oncorhynchus keta) - Coho (Oncorhynchus kisutch) Riverine aquatic habitat 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:6ria.wa.goV/opas/: •. . Governor's Office-for Regulatory Innovation and.Assistance at(800).917-0043 or helper-oria.wa.aov.' For a;list of addresses to send your JARPA to, click on agency addresses for completed DARPA: 1Oa ,Compliance with the�State.Environmental Policy A'ct(SEPA): (check,all that apply.), h[ elpj • For more information about SEPA,go.io www.ecy.wa.gov/program"jsea%sepa/E-ieview.himi. ❑ 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 ❑ lam applying for a Fish Habitat.Enhancement Exemption. (Check the box below in 1 ob.) hl N This project is exempt(choose type of exemption below).: . N Categorical Exemption: Under what section of the SEPA administrative code (WAC) is it exempt? WAC 197-11-800(33) Repair, remodeling and maintenance activities ❑ Other: .. ... ❑ SEPA is pre-empted by federal:law. 10113 Indicate.the:permits-you are"applying for:(Check ail that apply)",h[ elp] LOCAL GOVERNMENT ORIA-167011 Page.12 of 14 . Local Government Shoreline permits: ❑ Substantial Development ❑ Conditional Use ❑ Variance ® Shoreline Exemption Type (explain): 17 50.400(B)(1)(b) "Normal maintenance or the repair of existing structures or developments,-including damage by accident, fire or elements." Other City/County permits: ❑ Floodplain Development Permit ❑ Critical Areas Ordinance STATE G.OV,ERNMENT. . . Washington Department of Fish and Wildlife: ❑ Hydraulic Project Approval (HPA) ❑ Fish Habitat Enhancement Exemption-Attach Exemption Form Washington Department of Natural Resources: El Aquatic Use Authorization- . Complete JARPA Attachment E and submit a check for$25 payable to the Washington Department of Natural Resources. Da 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): ❑ 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). Part 11=Authorizing Signatures Signatures are required before submitting the JARPA package.The JARPA package includes the JARPA form, project plans, photos, etc: hl eM 11a.Applicant Signature (required) ei 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.- CLH (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.agenciies entering the property where.the project is located to_inspect the project site or any work related to the project. CLH . (initial) Chelsea L. Hamer 1/10/2018 Applicant Printed Name . . AppliBTnt Signat re. Date 11 b.Authorized Agent Signature ht eloj ORIA-167011 Page 13 of 14 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 1 agree to start work only after all necessary permits have been issued. Chelsea L. Hamer 1/10/2018 Authorized Agent Printed Name Autrodzed.Agelit Signature . Date 11 C. Property Owner Signature (if not applicant) hel 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 anyfalse writing or document knowing same to contain any false,-fictitious, or fraudulent statement or entry, shall be fined not more than$1.0,000 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 71.1 for Washington Relay Service. People with a speech disability can call(877)833-6341. ORIA publication number: ORIA-16-011 rev.07/2017 ORIA-1.6-011 Page 14 of 14 14 r w 000 ir A. Aw #p, ,,.. . Baia" �. ♦���������� � ♦♦ T ♦' ,/�1,� y.Dy �� r c 1 - r t w ; +N. 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