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HomeMy WebLinkAboutSHX2018-00795 DocK - SHX Application - 9/4/2018 i i------------------------- ---------� t AGENCY USE ONLY ' t Date received: US Army Corps WA H I TON STATE erg° ' Joint Aqu tIC eSOUrCeS Permit Agency reference#:� X2018 C�7SS Applicati n (J RPA) Form' h[ e1P] T xParcel#(s}: 4a�1S -5o • �� � USE BLACK OR BLUE INN TO ENTEI I ANSWERS IN THE WHITE SPACES BELOW. ----------------------------- ' i Part 1—Project Ide', tific tion , 1. Project Name (A name orCyour, roject that you create. Examples:Smith's Dock or Seabrook Lane Development) jpj Koch Dock Part 2—Applicant The person and/or organization r sponsible for the project. h[ eip] 2a. Name (Last, First, Midd ) Koch, David 2b. Organization (if applicable) 2c. Mailing Address (Stre at or Pot Box) 11611 NW 43Rd Ct. 2d. City, State, Zip Vancouver, WA 98685 2e. Phone(1) f.'Ph 01 ie(2) 2g. Fax 2h. E-mail 3602416927 1160241li780 ( ) Additional forms may be require J fdr the fl flowing permits: • If your project may qualify f r Departr ient of the Army authorization through a Regional General Permit(RGP),contact the U.S.Army Corps of Engineers for application in ormation 206)764-3495. • If your project might affect pecies lis ed under the Endangered Species Act,you will need to fill out a Specific Project Information Form(SPIF)or prepare a Biological Evaluation. Forr is can be found at http://www.nws.usace,arm mi/Miss' ns/CivilWorks,'Re ulator /PermitGuidebook/Endan ered5 ecies.as x. • 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 tI iey acre the DARPA. 2To access an online DARPA forrx i with[he ]screens,go to hftp://www.epermittinQ.wa.gov/sitl!/alias r sourcecenter/ar a iarpa form/9984/ar a form.as x. For other help,contact the Gover or's Offi for Regulatory Innovation and Assistance at(800)917-0043 or help(@oria.wa.Qov. JARPA Revision 2015.1 Page 1 of 14 r c 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.) [teip] 3a. Name (Last, First, Midd' ) Smith, Brad 3b. Organization (if applic' ble) Watersmith Construction 3c. Mailing Address (Stroft or PO'Box) 5018 Lambskin St. SW 3d. City, State, Zip Tumwater, WA 98512 3e. Phone(1) . ho a(2) 3g. Fax 3h. E-mail 360-412-0202 3 0-480 9820 360-412-0203 singingwaters@sbcglobaI.net Part 4—Property Ov rner( , ) Contact information for p ple or organizations owning the property(ies)where the project will occur. Consider both upland and aquatic own r hip ecause the upland owners may not own the adjacent aquatic land. Lbtam ® Same as applicant. (S ip to P rt 5.) ❑ Repair or maintenanc a�ctiviti Bs on existing rights-of-way or easements. (Skip to Part 5.) ❑ There are multiple upl nd pro erty owners. Complete the section below and fill out DARPA Attachment A for each additional propeity'own r. ❑ Your project is on Departmei it of Natural Resources (DNR)-managed aquatic lands. If you don't know, contact the DNR at(360) 902-1 00 to determine aquatic land ownership. If yes, complete DARPA Attachment E to apply for the Aquatic Use Aut iorization. 4a. Name (Last, First, Midd ) 4b. Organization (if appli b ) 4c. Mailing Address (str ' t or PoiBox) 4d. City, State, Zip 4e. Phone(i) 14f Phc ne(2) 4g. Fax 4h. E-mail JARPA Revision 2015.1 Page 2 of 14 Part 5—Project Lo ation'(s) Identifying information ab ut the roperty or properties where the project will occur. [bei ❑ There are multiple projj qct loc,itions (e.g. linear projects). Complete the section below and use JARPA Attachment B for each additic nal project location. 5a. Indicate the type of owners ip of the property. (check all that apply.) [hel ® Private ❑ Federal ❑ Publicly owned (state,county,, Ity, special districts like schools, ports,etc.) ❑ Tribal ❑ Department of Natur I Reso rces (DNR)— managed aquatic lands (Complete JARPA Attachment E) 5b. Street Address (can otibe a O Box. If there is no address,provide other location information in 5p.) [help 160 North Discovery Dri'e 5C. City, State, Zip(if the r ject' not in a city or town, provide the name of the nearest city or town.) he! Hoodsport, WA 98548 5d. County het Mason 5e. Provide the section,township,, and range for the project location. i,ei 'IA Section Section Township Range A 18 23 4W 5f. Provide the latitude 0,nd lon itude of the project location. hf eipl • Example:47.03922 1 let./ 22.89142 W long.(Use decimal degrees-NAD 83) 47.486787 N Lat/-123. 43335 W long 5g. List the tax parcel n' mber( )for the project location. [teipj • The local county ass' ssor's c1fice can provide this information. 42318-50-00041 5h. Contact information, or'all djoining property owners. (If you need more space, use JARPA Attachment C.) to Name Mailing Address Tax Parcel#(if known) Lake Cushman Maint. C 3740 N. Lake Cushman Rd. 423185100148 11- Hoodsport, WA 98548 Roger Bertram &Jennife 6545 SW Seymour St. 423185000040 Majewsk Portland, OR 97225 JARPA Revision 2015.1 Page 3 of 14 5i. List all wetlands on or adjace nt to the project location. [helpi N/A 5j. List all waterbodies ( ,t*r ft in wetlands)on or adjacent to the project location. [netp] Lake Cushman 5k. Is any part of the pro lect aroa within a 100-year floodplain? [net s ❑ No 51. Briefly describe the vilgetation and habitat conditions on the property. net No vegetation where con structic n is to occur. 5m. Describe how the pl o[pertylis currently used. [n� Undeveloped lot 5n. Describe how the a .jacent xoperties are currently used. net Residential 5o. Describe the structures (a ve and below ground)on the property, including their purpose(s)and current condition. net No structures 5p. Provide driving dire m the closest highway to the project location, and attach a map. [heipj Please see attached map and irections JARPA Revision 2015.1 Page 4 of 14 7/2/2018• Olympia,WA to 160 N Discovery Dr Directions-MapQuest YOUR TRIP TO 160 N Discovery Dr 1 HR 3 MIN 1 48.2 011 >� Est. fuel cos $4.55 (�;1 Trip time based on t affic con itions as of 11:21 AM on July 2, Print a full health report of your car with �\'V`✓y 2018.Current Traffi : Light HUM vehicle diagnostics(Soo)906-2503. 1. Start out going a st on 14th Ave. Then 0.23 riffles 0.23 total miles 2. Enter next round bout and take the 2nd exit onto 14th Ave. Then 0.23 ilas 0.46 total miles 3. Merge `1it c� 1-5 S',toward Portland. Ti 3. Then 0.89 hlii4s 1.35 total miles 4. Merged tc� US-11 1 N via EXIT 104 toward Port Angeles/Aberdeen. Then 5.98 miles 7.33 total miles 5. Merge onto Paci is Coast Scenic Byway/US-101 N toward Shelton/Port Angeles. Then 29.00,miles 36.33 total miles 6. Turn left onto N ake Cushman Rd. If you reach kinch CrO ek Rd you've gone a little too far. Then 2.64 0iiies 38.97 total miles T 7. Stay straight to go onto N Lake Cushman Rd/WA-119. Then 1.32 Miles 40.29 total miles S. Turn right to staV on N Lake Cushman Rd/WA-119. N Lake Cush an Rd s 0.3 miles past Duckabush Way. If you are on N .South'Standstill Dr and reach N Duckabush Dr N you've gone about 0.1 miles too fair. Then 5.27 iles 45.56 total miles 9. Turn left to stay!on N Lake Cushman Rd/WA-119. N Lake Cushman Rd s 0.3 miles past N Cushman Cut Off Rd. If you reach the end f Lake Cushman Rd you've gone about 0.6 miles too far. Then 1.59 miles 47.16 total miles 10. Turn I ft onto 14 Mount Church Dr. ` ) Then 0.16'miles 47.32 total miles https://www.mapquest.comi/directi nOist/l/ s/wa/oympia-282041225/to/us/Washington/hoodsport/98548-9591/160-n-discovery-dr-47.486787,-123.24... 1/3 7/2/2018 Olympia,WA to 160 N Discovery Dr Directions-MapQuest 11. Stay straight to o onto Mount Tebo Way. Then 0.15 miles 47.46 total miles 12. Turn left onto N'Potlatch Dr. Then 0.34 miles i 47.81 total miles 13. Take th' 1st left to stay on N Potlatch Dr. If you are on kirnta Dr nd reach N Prospect Dr you've gone about 0.3 miles too far. Then 0.12 wiles 47.92 total miles r+ 14. Turn ri,ht to st y on N Potlatch Dr. Then 0.13 rr iies 48.05 total miles 15. Turn ri h>t onto Iq Discovery Dr. 14 Then 0.15 iles 48.21 total miles 14) 16. 160 N is{cove Dr, Hoodsport, WA 98548-9591, 160 N DISCOVERY DR is on the right. Your destinat n'is 0.1',miles past N Discovery P1. If you reach A4ount eattle Way you've gone about 0.1 miles too far. 14s sub' t to our Term of Use.We don't guarantee accuracy.route conditions or usability.You assume all risk of use. Use of directions and m� s, s P 1, https:l/www.mapquest.com/directil ns/list/l/ s/wa/olympia-282041225tto/uslwashington/hoodsport/98548-9591/160-n-discovery-dr-47.486787,-123.24... 2/3 7/2/2018 ' Olympia,WA to 160 N Discovery Dr Directions-MapQuest ',Bremerton Z3_`. i III f j j I � i 408" i •v 'i r 'S10 I I it j BoDk a hotel tonight and Car trouble mid-trip? salfe With some great deals! MapQuest Roadside Assistance is here: (1 77-577-5766) (1-888-461-3625) https://www.mapquest.com/directi n list/1/ s/wa/oympia-282041225/to/us/washington/hoodsport/98548-9591/160-n-discovery-dr-47.486787,-123.24... 3/3 Part 6—Project Description 6a. Briefly summarize th over 11 project. You can provide more detail in 6b. [heipi Build new pier, ramp, and float. 6b. Describe the purpos, of th project and why you want or need to perform it. nei Owners need safe boatir g accei 3s to the water. 6c. Indicate the project iategor (Check all that apply) h[ elM ❑ Commercial Residential ❑ Institutional ❑ Transportation ❑ Recreational ❑ Maintenance ❑ En 'ironmental Enhancement 6d. Indicate the major ele en of your project. (Check all that apply) [help] ❑ Aquaculture Culvert Float ❑ Retaining Wall ❑ Bank Stabilization Dam /Weir ❑ Floating Home (upland) Road ❑ Boat House Dike/ Levee/Jetty ElGeotechnical Survey ❑ ❑ Boat Launch Ditch El Land Clearing Scientific Measurement Device ❑ Boat Lift Dock/ Pier ❑ Marina / Moorage Stairs ❑ Bridge Dredging ❑ Mining ❑ Stormwater facility ❑ Bulkhead Fence ❑ Outfall Structure ❑ Swimming Pool ❑ Buoy Ferry Terminal ilia/Dolphin ❑ Utility Line ❑ Channel Modification Fishway ❑ Raft ❑ Other: JARPA Revision 2015.1 Page 5 of 14 6e. Describe how you pl in to cc nstruct each project element checked in 6d. Include specific construction methods and equip ent to a used. hei • Identify where each 0 ementA ill occur in relation to the nearest waterbody. • Indicate which activiti s are rhinthe 100-year floodplain.Construction will include t x pier, a Yx 16' ramp, and a 10' x 16'float. ACQ treated hem-fir framing. Hot dipped galvanized st el ha7 connectors, 1' x 6' grey composite decking and fiberglass grating as Required, foam filled poi ethylfloatation, galvanized steel pipe piling pneumatically driven to refusal as Needed to support the fi ed piei and secure the floating dock. Ari'so 3.5'x(o"5Fk lR-5 aIld '9- 4'L4x-)o(6 CI O,I vah;�.cd s} ( P; v+tie��►a .mot u ro a v e-. L4 tv{-x I 6f. What are the anticipated stagyt and end dates for project construction? (MonthNear) [help] • If the project will be d nstruct d in phases or stages, use DARPA Attachment D to list the start and end dates of each phase or stage. Start date:Nov. 1 `2018 End date: Nov. 30`h 2018 ❑ See JARPA Attachment D 6g. Fair market value of l hle pr ject, including materials, labor, machine rentals, etc. hei $9,500.00 61h. Will any portion of the proj t receive federal funding? hei a • If yes, list each ageHry'provi ing funds. ❑ Yes ® No Dor t know Part 7--Wetlands: 1IMpaots and Mitigation ❑ Check here if there art, wetlai ids or wetland buffers on or adjacent to the project area. (If there are none, skip to Pa 8.)[hell 7a. Describe how the prDject h s been designed to avoid and minimize adverse impacts to wetlands. [help] ❑ Not applicable i 7b. Will the project imp ict wed,ands? [hei ❑ Yes ❑ No Q Do 't know 7C. Will the project imp ciwetl nd buffers? hei JARPA Revision 2015.1 Page 6 of 14 ❑ Yes ❑ No Don't know 7d. Has a wetland delin anion r port been prepared? !L ld u� • If Yes,submit the report incl ` ing data sheets,with the JARPA package. ❑ Yes ❑ No 7e. Have the wetlands b can rat d using the Western Washington or Eastern Washington Wetland Rating System? h[ ei • If Yes, submit the w land rat g forms and figures with the JARPA package. ❑ Yes ❑ No Do ''t know 7f. Have you preparedp mitigE ton plan to compensate for any adverse impacts to wetlands? h( elpl • If Yes, submit the plo i with t JARPA package and answer 7g. • If No, or Not applico We, ex in below why a mitigation plan should not be required. ❑ Yes ❑ No El Notkpplicable 7g. Summarize what the mitiga ion plan is meant to accomplish, and describe how a watershed approach was used to design the plan. Li eipj 7h. Use the table below'i to list t e type and rating of each wetland impacted, the extent and duration of the impact, and the typ and a ount of mitigation proposed. Or if you are submitting a mitigation plan with a similar table, you ca state below)where we can find this information in the plan. [help Activity (fill, etlari 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 category2 Acres) acres) If no official name for the wetlan exists,c eate 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 currei t Western Washington or Eastern Washington Wetland Rating System.Provide the wetland rating forms with the JARPA pack age. 3Indicate the days,months or yeo,s the we and will be measurably impacted by the activity. Enter"permanent'if applicable. °Creation(C),Re-establishment/ ehabilita on(R), Enhancement(E),Preservation(P),Mitigation Bank/In-lieu fee(B) Page number(s)for'similar Information in the mitigation plan, if available: 7i. For all filling activitie identi ed in 7h, describe the source and nature of the fill material, the amount in cubic yards that will be us d,l and iow and where it will be placed into the wetland. hei JARPA Revision 2015.1 Page 7 of 14 7j. For all excavating ac Ivities i ientified in 7h, describe the excavation method, type and amount of material in cubic yards you will r move and where the material will be disposed. [neAt Part 8—Waterbodi s (otlier than wetlands): Impacts and Mitigation In Part 8, "waterbodies" refers to non-wetland waterbodies. (See Part 7 for information related to wetlands.) nei ® Check here if there ar' Wate odies on or adjacent to the project area. (if there are none, skip to Part 9.) 8a. Describe how the pr ject is esigned to avoid and minimize adverse impacts to the aquatic environment. Le-1PJ ❑ Not applicable All laws and recommend----]ationsrom governing officials will be followed at all times. Construction will not begin until all the proper permil s have been procured and approved. 8b. Will your project impact a terbody or the area around a waterbody? n[ eU ® Yes ❑ No M JARPA Revision 2015.1 Page 8 of 14 8c. Have you prepared mitiga ion plan to compensate for the project's adverse impacts to non-wetland waterbodies? bei • If Yes, submit the pla i With th JARPA package and answer 8d. • If No,or Not applicaj I4,expl in below why a mitigation plan should not be required. ❑ Yes ® No Not ipplicable 8d. Summarize what the mitigaI ion plan is meant to accomplish. Describe how a watershed approach was used to design the plan.' • If you already compl�ted 7g u do not need to restate your answer here. [hel N/A 8e. Summarize impact( )W e h waterbody in the table below. h( eipl Activity(clear, WaterbOody Impact Duration Amount of material Area (sq.ft. or dredge, fill, pile name' location2 of impact' (cubic yards)to be linear ft.) of drive, etc.) placed in or waterbody removed from directly affected waterbody Pile driving Lake Near shore 1 day 0 6 C shma If no official name for the waterb Ay exists create a unique name(such as"Stream V)The name should be consistent with other documents provided. 2 Indicate whether the impact will )ccur in o' adjacent to the waterbody. If adjacent,provide the distance between the impact and the waterbody and indicate whether the impact will i iccur with n the 100-year flood plain. 3Indicate the days,months or ye rs the wa erbody will be measurably impacted by the work. Enter"permanent"if applicable. 8f. For all activities ides ified in 8e, describe the source and nature of the fill material, amount (in cubic yards) you will use, and ho and ere it will be placed into the waterbody. h[�el No fill for this project i JARPA Revision 2015.1 Page 9 of 14 8g. For all excavating or d�edg'ig activities identified in 8e, describe the method for excavating or dredging, type and amount offn6terie I you will remove, and where the material will be disposed. [b-elpl No excavating or dredgi0ig for tl iis project Part 9—Additional linformation Any additional information you ain provide helps the reviewer(s) understand your project. Complete as much of this section as you can. 11 is ok ii you cannot answer a question. 9a. If you have already worked with any government agencies on this project, list them below. [hel Agency Name Contact Name Phone Most Recent Date of Contact 9b. Are any of the wetly nds or aterbodies identified in Part 7 or Part 8 of this JARPA on the Washington Department of Ecol' gy's 3 3(d) List? [helpt • If Yes,list the pararr,eter(s)b elow. • If you don't know, use Washi igton Department of Ecology's Water Quality Assessment tools at: httr)://www.ecy.wa.-O)v/progr mstw /303d/. ® Yes ❑ No 4, 4'-DDE, 4,4'-DDD, 4, '-DDT' Alpha-BHC, Beta-BHC, Endrin, Endrin Aldehyde, Hepatchlor, Heptachlor Epoxide, Endosulfan, Ai rin, 9c. What U.S. Geologioal Survay Hydrological Unit Code (HUC) is the project in? h[ !g • Go to htt ://cf ub.e 'a. ov/s /locate/index.cfm to help identify the HUC. 9d. What Water Resou ce Inv ntory Area Number(WRIA#) is the project in? hf elpl • Go to httr)://www.ec .wa. ov servicesf is/ma s/wriat'wria.htm to find the WRIA#. 16 JARPA Revision 2015.1 Page 10 of 14 9e. Will the in-water con tructiOi work comply with the State of Washington water quality standards for turbidity? [help] • Go to http://www.ec a' ov/ o rams/w /sw s/criteria.html for the standards. ® Yes ❑ No Not applicable 9f. If the project is within the juri diction of the Shoreline Management Act, what is the local shoreline environment design tign? el • If you don't know,co i itact the local planning department. • For more informatio',go to: tt ://www.ec .wa. ov/ ro rams/sea/sma/laws rules/173- 26/211 desi n ti' ns. tmi. ❑ Rural &Urb n Natural ❑ Aquatic ❑ Conservancy ❑ Other 9g. What is the Washing on De artment of Natural Resources Water Type? teo • Go to htt ://www.dnr.1 ov/f rest-practices-water-typing for the Forest Practices Water Typing System. ❑ Shoreline ❑Fish ❑ Non-Fish Perennial ❑ Non-Fish Seasonal 9h. Will this project bed s gne` to meet the Washington Department of Ecology's most current stormwater manual? [Leipl • If No, provide the na e;of th manual your project is designed to meet. ❑ Yes ❑ No Name of manual: 9L Does the project site ave kliown contaminated sediment? hel • If Yes, please descri a belo ❑ Yes ❑ No 9j. If you know what the]properly was used for in the past, describe below. h[ eid Undeveloped land 9k. Has a cultural resource (a haeological) survey been performed on the project area? het + If Yes,attach it to yo r JAR package. ❑ Yes ❑ No JARPA Revision 2015.1 Page 11 of 14 91. Name each species I stpd a der the federal Endangered Species Act that occurs in the vicinity of the project area or might be affe t¢d b the proposed work. h� / 9m. Name each specie o hat itat on the Washington Department of Fish and Wildlife's Priority Habitats and Species List that rr g6t be affected by the proposed work. het None Part 10—SEPA Coonplialice and Permits Use the resources and c hecklis L below to identify the permits you are applying for. • Online Project Q1 jestion iaire at http://apps.oria.wa.ciov/opas/. • Governor's Office for R gulatory Innovation and Assistance at(800)917-0043 or help@oria.wa.gov. • For a list of addresses to send your JARPA to, click on agency addresses for completed JARPA. 10a. Compliance with the 5tat Environmental Policy Act (SEPA). (check all that apply.) hei • For more informatio about PA, go to www,ecv,wa.gov/programs/seafseiDa/e-review,htmi. ❑ A copy of the SE 3A det rmination or letter of exemption is included with this application. ® A SEPA determination ii pending with Mason County (lead agency). The expected decision date is TBT ❑ I am applying forb Fish liabitat Enhancement Exemption. (check the box below in 10b.)[help] ❑ This project is ex mpt (c oose type of exemption below). ❑ Categorical E,! empti n. Under what section of the SEPA administrative code (WAC) is it exempt? ❑ Other: ❑ SEPA is pre-em ed by ederal law. JARPA Revision 2015.1 Page 12 of 14 10b. Indicate the permit you a applying for. (Check all that apply.) hel LOCAL GOVERNMENT Local Government horeli a permits: ❑ Substantial Development ❑ Conditional Use ❑ Variance ,Shoreline Exempt on Ty (explain): t)1-(f tz `fYlre -b l r� Other City/County permits, ❑ Floodplain Development Permit ❑ Critical Areas Ordinance STATE GOVERNMENT Washington Depart) ent 4f Fish and Wildlife: -6;_k rdraulic Project Approy 31 (HPA) ❑ Fish Habitat Enhancement Exemption—Attach Exemption Form You must submit a check for$150 to Washington Department of Fish and Wildlife, unless your project qualifies for an exemption or alteeriative iPayment method below. Do not send cash. Check the a ro riate s: ❑$150 check encl sed.C ieck# Attach check made' ayable o Washington Department of Fish and Wildlife. ❑My project is exb pt fro the application fee. (Check appropriate exemption ❑ HPA proces ing is donducted by applicant-funded WDFW staff. Agreement ❑ Mineral pro ecting and mining. ❑ Project occ s on f rm and agricultural land. (Attach a copy', f�urre land use classification recorded with the county auditor, or other proof of current land use.) ❑ Project is a Odific tion of an existing HPA originally applied for, prior to July 10, 2012. HPA# Washington Depa mlent f Natural Resources: ❑ Aquatic Use AuttIorization Complete DARPA A achme it E and submit a check for$25 payable to the Washington Department of Natural Resources. Do not send cash. Washington Depa ment 44 Ecology: ❑ Section 401 Water Qual ty Certification FEDERAL GOVERNMENT United States DepOirtment of the Army permits (U.S. Army Corps of Engineers): ❑ Section 404 (disd iarges it to waters of the U.S.) ❑ Section 10 (work in navigable waters) United States Coast Gua d permits: ❑ Private Aids to NavigatiOn (for non-bridge projects) JARPA Revision 2015.1 Page 13 of 14 Part 11—Authorizi g Si natures Signatures are required 0Wre 0 ubmitting the DARPA package.The DARPA package includes the DARPA form, project plans, photos, et el 11a. Applicant Signature (requited) hei I certify that to the best my k wledge and belief, the information provided in this application is true, complete, and accurate. I also certOy that have the authority to carry out the proposed activities, and I agree to start work only after I have receive all ne essary permits. I hereby authorize the agent na ed in Part 3 of this application to act on my behalf in matters related to this application. I�(nitial) By initialing here, I state hat I hlive the authority to grant access to the property. I also give my consent to the permitting agencies ent Jrg thO property where the project is located to inspect the project site or any work related to the project. (initial) Applicant Printed Name Applicant Signature Date 11 b.Authorized Agent iginatu a hel I certify that to the best of my kr owledge and belief, the inform on provi d in this application is true, complete, and accurate. I also certifythat have the authority to car outth prop ed activities and I agree to start work only after all necessary permits ed. 7 -+ ' q ' 1 2 Authorized Agent Printed Nanie Authon Date 11 c. Property Owner Si natur (i€not applicant) Lem Not required if project is 6n existing rights-of-way or easements. I consent to the permitting agencies entering the property where the project is located to inspect the project site or any work.These insp, ctions shall occur at reasonable times and, if practical, with prior notice to the landowner. Property Owner Printed Nam Property Owner Signature Date 18 U.S.0§1001 provides tha:Whoe r, in any manner within the jurisdiction of any department or agency of the United States knowingly falsifies,conceals,or covers ip by an trick, scheme,or device a material fact or makes any false,fictitious,or fraudulent statements or representations or makes or ises any alse writing or document knowing same to contain any false,fictitious,or fraudulent statement or entry, shall be fined not more than$1 ,000 or imprisoned not more than 5 years or both. If you require this document(1 anothe format,contact the Governor's Office for Regulatory Innovation and Assistance(ORIA)at(800) 917-0043. People with hear g toss c in call 711 for Washington Relay Service. People with a speech disability can call(877)833-6341. ORIA publication number: E V-019 9 rev.09/2015 DARPA Revision 20151 Page 14 of 14 f Street 36 South 35"' Ta ma,Washington 98409-3192 0MA POWER T TACOMA PUBLIC UTILITIES TA COMA PUBLIC UTILITIES August 1, 2018 VIA EMAIL and USPS David and Marla dchKoch Living Trust 11611 NW 43rd Vancouver, WA 685 i SUBJECT: Lake Ciqsh n Division 3 Lot 41 Shoreline Proposal on Tacorns Po er Property Dear Mr. and Mrs Koch: The City of Laco a` De rtment of Public Utilities, Light Division (Tacoma Power)was recently concte t re ew the enclosed undated construction plans submitted by Brad Smith, Watersm h Construction, for construction of a new landing, stairs, fixed pier, ramp and float structur . n a ended site plan was submitted, on 8/1/18, for placement of a pre- formed concrete n hor,or a buoy alternative. All proposed structures will be located on Tacoma Power p erty fronting your development lot No.41, Plat of Lake Cushman No.3. The proposed stri iclIures and uses on Tacoma Power property waterward of 742 feet elevation will require issuar ce of a short-term license for construction from Tacoma Power once your regulatory permitc,, are r ived. Tacoma Power has no obiection to you moving forward with regulatory ermit no for I he DroDosed structures as shown in the enclosed drawings, on Tacoma Power Owe Please provide a opy o this letter to the regulatory agencies when you submit your plans to . them. Feel free to conta me at 253-441-4180 or wwright(a)ci.tacoma.wa.us if you have any questions. l Sincerely, Wyn Wright Shoreline and La d$ Co rdinator Tacoma Power Enclosure cc: Dori Bishop, . Real Estate Specialist, City of Tacoma Watersmith C nistru ion, Authorized Agent i t t 0 0 . fl 0 M N � 1 it t + {Sup f2�L. \ �y I u� d w h v � 4 `r 4. v q j • O M N � v 1 40 ZT it .�S � r 1 PO t ,yr • o I a sc � ® M oa It4 J n 4 M a • . 1Q. . da �o i qi * IQ �n u o M Q' � • lz L WWI— ......... 4 'L�nA 9(ti - i f a to �1 b m M I M 0 ' d ti p a o �' k j! 2� Y )�X P } • O , mom V t _c cu (� cu e , cn c O m aJ ai •4A c� :N i C6 �, L a d t/) C O O NeeW +�+ O E V) ai �y r CL s u r i R t � t ca _ ctr': uy cu I O �t t.a�.p►ws+�wtst�iattta•ttt+•ttttf �°,��;'. i � L 0 0 An An s. 00 S— � Q 3 }� L ai L CL 4-- Lt3 4-J � :� � 'ice Wf cr �v� III -0; CA O .tA CL v I 4-J o cu W ,< O E04r 0 4 3 "'6 8 South 35 Street T ma Washington 98409-3192 F A `OtIA POWER TA OMA PUBLIC UTILITIES TACOMA PUBLIC UTILITIES August 1, 2018 i VIA EMAIL and USPS David and Marla ochI g Koch Living Trust 11611 NW 43`d Ct Vancouver, WA85 Subject: Tacc mfr Poler Shoreline Use Permit Application Review Lot 1, Plat f Lake Cushman No. 3 (Tax fOrcel o. 42318-50-00041) Reference: Projo t'No. 018-137/SUP385 Dear Mr. and Mrs Koch,l Thank you for apl ilying f r a Shoreline Use Permit(SUP)for your proposed shoreline structures and uses associa ed Witt Lot 41, Plat of Lake Cushman No. 3. As you know, Tacoma Power's Cushman Hydroe ectric F Iroject area (Project) includes all lands located waterward of the 742- foot elevation Pro edt bot indary. Tacoma Power also retains a 10-foot lateral easement on your leased developm n1l lot jacent to the Project boundary. All structures and uses located waterward of 742 obt el vation, and all structures and fill placed within the 10-foot lateral easement require)aOtho ation from Tacoma Power. Your SUP applic ion a drawings were received on July 12, 2018 and August 1, 2018. A pre- application site vic,it was completed on March 2, 2018. Tacoma Power h s Irevi ed your SUP application package for conformance with Tacoma Power's Shorelin Use S ecifications and Permitting Guidelines (SUSPG) and has the following comments: Items Revie c : • SUP appli alion dated June 28, 2018; • Drawings pages), not signed or dated, but received from Brad Smith, Watersmith Constructi n on my 12, 2018, • Amended ite plai showing the addition of a pre-formed concrete anchor for a buoy alternative Md • Tacoma P Wer R cords. 1. Dock Structu e All ed. As shown in the above referenced drawings, you have proposed to construct a P-sq are-foot fixed pier, ramp and float structure with 10 driven steel pilings. The psec structure meets the conditions of Appendix B Section 2 of the SUSPG as will be allo e . Beause your dock is designed to the maximum overwater coverage allowed for ne truc ures on Lake Cushman, please be aware that the entire finished structure, inCIL ding ar iy trim or fascia, must be within the 300-square-foot specification; there are no excepti nos and overbuilds will be required to be reduced to meet the specification. Koch August 1, 2018 Page 2of2 2. Landing and Stairs. Allowed. As shown in the above referenced drawings, you have proposed to construct a 16-square-foot landing supported by 4 driven steel pilings and stairs which lead from the development lot to the dock structure. The proposed structures meet the conditions of Appendix B Section 10 of the SUSPG. 3. Mooring buoy alternative. Allowed. As shown in the above referenced amended site plan, you have proposed to install a pre-formed concrete anchor for installation of a mooring buoy alternative. One mooring buoy alternative is allowed per eligible shoreline development lot. Please refer to the enclosed buoy alternative.diagram. 4. Debris. To be removed. Any debris and/or abandoned building materials, chains, anchors, tires, etc. located on.Tacoma Power's property and lakebed fronting your development lot will be required to be removed as a condition of your permit. Other Information: 5. Phased Work. Allowed. You have proposed to perform the shoreline construction in two phases.\Phase 1 will be conducted during the reservoir draw-down period and include construction of the upland landing, stairs, fixed pier, ramp and float pilings. Phase 2 will be conducted during the full-pool season and include floating in a pre-fabricated float to be connected to the Phase 1 structures. Tacoma Power approves this construction plan. 6. Tree Removal. Application needed. Not shown in your application package, but previously discussed, is your proposal to remove several trees from Tacoma Power property. Tacoma Power requires the company performing the tree removal to obtain a short-term license and provide insurance to Tacoma. Please have the tree removal company submit a separate application for this action approximately 8 weeks prior to when they expect to perform the work. Next Steps for Applicant: 7. Regulatory Permits. Required. Regulatory permits are required from Mason County and the Washington Department of Fish and Wildlife for your proposed uses. Per Section 1 of the SUSPG, copies of your acquired permits are required before Tacoma Power can issue an SUP. As you receive your regulatory permits and/or waivers, please send copies to Tacoma Power to satisfy this requirement. Enclosed please find a letter from Tacoma Power, the land owner, allowing you to move forward with regulatory permitting for this project. Next Steps for Tacoma Power: 8. Cultural Resources Survey. Required. A cultural resources survey(CRS) is required for the ground disturbance that will occur during construction. The CRS's are scheduled as the lake level, weather and availability allows and must be completed prior to any work occurring on the property. Please see Section 6.2 of the SUSPG for more information. 9. Short-term license. Required. Once you have provided copies of the required regulatory permits (#6) and the CRS (#7) has been completed, Tacoma Power will issue you a short- term license for construction.