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SHX2016-00045 SEPA2016-00061 Bulkhead, Ramp, Pilings, buoy - SHX Application - 8/23/2016
I MASON COUNTY �PyoN ATE° DEPARTMENT OF COMMUNITY DEVELOPMENT M o A o �N Planning Division U = �- s N 615 W Alder St, Shelton,WA 98584 T N I' (360)427-9670 i o z 7 00 �O 1864 Exemption from Shoreline Management Act Case No.: SHX201 - 00 Substantial Development Permit Requirement The Proposal B : JO EPH BOYD 312 CANYON VALLEY DR RIC ARDSON, TX 75080-1934 Parcel Number: 423 81 00 40 Site Address: 150 N DIISCC VERY DR HOODSPORT To undertake the foll (wing c evelopment: (a) (built in 1987 but no County permits in file) An existing forty foot (40') concrete bulkhead with two wing walls of 12' & a prox 1 ' 8" on the north and south end; (b) An existing (no co i unty permits in file) approx 3'5" BY 18' aluminum ramp and an approx 8'3" BY 20'3" float with four 10" PV encapsulated and steel reinforced concrete float pilings. And two 8 by 1 by 5 foot concrete float rests; (c) The existing (no -kL my permits on file) bouy will be retrofitted: The existing permanent anchor on the lakebed will have an t ached permanent anchor chain of sufficient length to moor a vessel at the maximum Lake Cus n p of elevation of 738-feet elevation. A detachable section of sinking line, with appropriate tackle, w II e used to connect the anchor chain to the dock when a vessel is not being moored. An optional all line recovery float may be added to the removable line section. The removable line, with optional small line recovery float, shall be stored on the vessel or on the dock when a vessel is moored to the chain. No m oring buoy is allowed, per the property owner, Tacoma Power. Within LAKE CUSHMA nd/oi its associated wetlands is exempt from the requirement of substantial development because the developme i categorized under WAC 173-27-040(2) as being category A-does not exceed d ol lar t reshold Please contact Rebe o He sha at ext 287 rebeccah@co.mason.wa.us if you have any questions. Issued:8/23/2016 Authorized Local Government Official i --------------------------------------- t AGENCY USE ONLY 1 1 1 Date received: 1 F US ArmY Corps i of Engineers.• F t GTON STATE t W $HI ��a Joint Aq tic Resources Permit : Agency reference A Iic on DARPA Form' ,2 ' Tag Parcel#(s}:'�,- t USE BLACK OR BLUE TOE ER ANSWERS IN THE WHITE SPACES BELOW. t , l Part 1—Project Id ntifi ation 1. Project Name(A na r y4r project that you create.Examples;Smith"s Clack or Seabrook Lane Development) MA Boyd After-the Fact Pe itting Project Part 2—Applicant The person and/or orga ii2atior responsible for the project. hel 2a. Name(Last,First,M tl ) Boyd, Joseph & Barrill 2b. Organization(if a ble) 2c. Mailing Address( t on 10 Box) 312 Canyon Valley Dr v 2d. City, Mate,Zip Richardson, TX 7508 -1934 2e. Phone 0) tone(2) 2 . Fax 2h. E-mail (972)755-1505 Additional forms may be requ fort following permits: . If your project may qual' f De ent of the Army authorization through a Regional General Permit(RGP),contact the U.S.Army Corps of Engineers for applicatio inform n(206)764-3495. . If your project might a sppeeccies fisted under the Endangered Species Act,you will need to fill out a Specific Project Information Form(SPIF)or prepare a Biological Eva anion. F rms can be found at h ://www.nws.usa .a iUM. ions/CivilWorks/R ulato /PermitGui ebook/Endan eredS cies.as x. . Not all cities and counti ao ept JARPA for their local Shoreline permits.If you need a Shoreline permit,contact the appropriate city or county government to make su they at the JARPA. 2To access an online JARPA f Lwithp]screens,go to h ://www.e ermittin .wa. ov/ it aliasoureecenteMa a 'a rya fomi19984/'a a form-asx. For other help,contact the Go mlor's 01 Ice of Regulatory Assistance at 1-800-917-0043 or help(CD-ora.wa.gov. JARPA Revision 2012.1 Page 1 of 14 I r Part 3—Authorize, Agent or Contact Person authorized to rel resent he applicant about the project. (Note: Authorized agent(s) must sign 11 b of this application.) h[ gio 3a. Name(Last,First,Mi d } Schaumburg, Kimber ee 3b. Organization (if a u►e) BioResources, LLC. U. Mailing Address(s4t or Box) 10112 Bayview Rd K 3d. City, State, Zip Vaughn, WA 09394 3e. Phone i) 113f. P0 one 2); 3' . Fax 3h. E-mail (253) 884-5776 1063) 25-2973 Kimberly035@centurytel.not Part 4—Property ne s) Contact information for I eople r organizations owning the property(ies)where the project will occur. Consider both upland and aquatic o% iershiri because the upland owners may not own the adjacent aquatic land. nei ❑ Same as applicant. (30kip to Part 5.) ❑ Repair or maintenan acti ties on existing rights-of-way or easements. (Skip to Part 5.) ❑ There are multiple u lalnd operty owners. Complete the section below and fill out JARPA Attachment A for each additional pro rty o er. ❑ Your project is on part nt of Natural Resources (DNR)-managed aquatic lands. If you don't know, contact the DNR at(3 ) 902 100 to determine aquatic land ownership. If yes, complete JARPA Attachment E to apply for the Aquatid Ose A ithorization. 4a. Name(Last,First,M ) 4b. Organization(if ap 114WO4 Tacoma Power 4c. Mailing Address( t oe Box) P.O. Box 11007 4d. City, State,Zip Tacoma,WA 98411-01 01 4e. Phone(1) f. one(2) . Fax 4h. E-mail JARPA Revision 2012.1 Page 2 of 14 Part 5—Project Lc catio (s) Identifying information al out ttv i property or properties where the project will occur. [Leipj ❑ There are multiple pr j ct lo,,ations (e.g. linear projects). Complete the section below and use JARPA Attachment B for each ladd' onal project location. 5a. indicate the type q f wn ; hip of the property. (check all that apply.) lhelW X ❑ Private ❑ Federal ❑ Publicly owned (star ,c4ounty city,special districts like schools, ports,etc.) ❑Tribal ❑ Department of Natu al Re urces (DNR)—managed aquatic lands (Complete JARPA Attachment E) 5b. Street Address (C I PO Bost.If there is no address,provide other',location information in 5p.) hel 150 N Discovery Dirty 5c. City, State, Zip(if to is not in a city or town,provide the name of the nearest city or town.); hei Hoodsport, WA 98541 5d. County [helpi Mason So. Provide the sec tioj i, tow4hip, and range for the project location. ftiA "K Section Section Township Range 18 23N 4W 5f. Provide the latitudi nd It.,hNitude of the project location. • Example:47.039ZI N lat.t 122.89142 W long.(Use decimal degrees-NAD 8 ) ' 47.48701 N -123.243 5 So. Ust the tax parcel ni Imts)for the project location. hel The local county aqm ssor'4office can provide this information. 42318-50-00040 5h. Contact informati or al I adjoining property owners. (if you need more space,use JARPA Attachment C.) h[h%lw Name Mauling Address Tax Parcel#(if known) Perry et ux, Edward C O 1426 SE Rural St, Portland OR, 97202 42318-50-00039 Deborah Peterson JARPA Revision 2012.1 Page 3 of 14 511. List all wetlands o adj; nt to the project location, hel No wetlands on or d ce t to the project location. 5j. List all waterbodi-e { the- han wetlands) on or adjacent to the project location. Letpj Lake Cushman. Sk. is any part of the jk4ect,4jea within a 100 year tloodplain? h t X❑ Yes ❑ No ❑ on't know 51. Briefly de tion and habitat conditions on the property. LeAi i Site is heavily vege ted t h native vegetation. 5m. Describe how the p Pe.. °Y is currently used. hLPI Recreational. 5n. Describe how the ace properties are currently used. ftigW Recreational . So. Describe the stru es ' Dove and below ground)on the property, including their purpose(s)and current condition. het There is a cabin, a cc erete bulkhead, a fire pit, a ramp and float, and a buoy on the site. 5p. Provide driving clihIleition from the closest highway to the project location, and attach a map. &eAi From Shelton, take S R 101 orth to Hoodsport, turn left on Lake Cushman Rd and follow up the hill to Division 2 and turn left., Mo nt Church Drive bears left and becomes Mount Tebo Way. Turn left at the stop sign at the bottc m of a hill onto Potlatch Drive North, then turn right onto Sundown Drive, right onto Potlatch Drive III, And ght onto Discovery Drive. Site is at the bottom of the hill with a gated driveway. JARPA Revision 2012.1 Page 4 of 14 Part 6-Project D �criplion 6a. Briefly summarize I o all project. You can provide more detail in 6b. et ATF development i I d ., the following: a forty-foot(40') concrete bulkhead with two wing walls of twelve feet 13') a d approx. nineteen feet (18' 8") on the south and north ends, respectively, an ap IX. tl ree-foot(XV) by eighteen-foot(18') aluminum ramp, an approx. eight by twenty-foot(8'3" 0'3')float with four(4), ten inch (10") PVC encapsulated and steel reinforced concrete bat ositioning pilings, a concrete paver fire pit(less than 36" diameter), four (4) concrete an ' concre*(2'x 2'), ani, 0 bDyee,7 cl,c,- . tA1,111j { 3,711-11 61b. Describe the pu of , project and why you want or need to perform it. ftim The existing shoreli a ap urtenances are common to shoreline properties on Lake Cushman; however, they were 'metal d without the proper permits from Mason County. The applicants were unaware that i were mandatory and want to bring their property into compliance by obtaining all the required egulatory permits. 6c. indicate the prof t ry. (Check all that apply) hel ❑ Commercial C❑ Residential ❑ Institutional ❑Transportation ❑ Recreational ❑ Maintenance Ei ivironmental Enhancement 6d. Indicate the majo m of your project. (Check aff tot apply) [help] ❑Aquaculture El Culvert X❑ Float ❑ Retaining Wall X❑ Bank Stabilizatio Dam /Weir ❑ Floating Home (upland) ElBoat House Dike/Levee/Jetty ❑ Geotechnical Survey El Road ❑ 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 X oy Ferry Terminal ❑ Piling/Dolphin ❑ Utility Line ❑ Channel Modificat�or Fishway ❑ Raft ❑ Other: JARPA Revision 2012.1 Page 5 of 14 6e. Describe how you h n to nstruct each project element checked in 6d. include specific construction methods and equi nt ' be used. et Identify where each nt 'fl occur in relation to the nearest waterbody. indicate whic anti are;. , in the'lotl-year floodplain. No new developmer t to o cur. Proposed ATF project mitigation will remove four existing concrete anchors (t 0 th appear to be derelict pier footings). The concrete will be removed when the lake's water is I w. An existing buoy wil 11 be rr ioved to the applicant's adjacent parcel to comply with Tacoma Power's shoreline r Ios. The buoy will be moved when the lake's water is low. Existing cable anch ring LWD to the shoreline will also be removed to comply with Tacoma Power's shoreline rides. I 6f. What are the antici ed art and end dates for projectt construction?(monthNear) gi • If the project will s ed in phases or stages,use JARPA Attachment D to list the start and end dates of each phase or stage. Start date: _UnI inown End date: ❑ See JARPA Attachment D 69. Fair market value Of e roject,'including materials,labor, machine rentals, etc. het Unknown. 6h. Will any portion of pTEnt receive federal funding? helIf yes,list each prg funds.ElYes x❑ No ] D 't know Mitigation Part 7-Wetlands: Ir�pa is and Miti g ❑ Check here if there ei re wett inds or wetland buffers on or adjacent to the project area. (If there are none, sicip to P irt 8.) nei 7a. Describe how th4i�Je4r has been designed to avoid and minimize adverse impacts to wetlands. h( IA X❑ Not applicabl 7b. {I the project i p4ct wi tlands? theim JARPA Revision 2012.1 Page 6 of 14 ❑Yes [] No n't know 7c. Will the project im land buffers? he[__pjl ❑ Yes ❑ No n't know 7d. Has a wetland del,ni ti report been prepared? MIA , If Yes,submit the rt,t uding data sheets,with the DARPA package. ❑ Yes ❑ No 7e. Have the wetland en!4ated using the Western Washington or Eastern Washington Wetland Rating System? hem • N Yes,submit the i nd Lng forms and figures with the JARPA package. ❑ Yes ❑ No ❑ n't know n Have you prepa ation plan to compensate for any adverse impacts to wetlands? het • If Yes,suftbm t the wiftt a JARPA package and answer 7g. • If No,or Not appli e. ,` ain below why a mitigation plan should not be required. ❑ Yes ❑ No Nit applicable 79. Summarize what 1 miti lation plan is meant to accomplish,and describe how a watershed approach was used to design t lane': het 7h. Use the table bel to li,, the type and rating of each wetland impacted,the extent and duration of the impact, and the ty an mount of mitigation proposed. Ord you are submitting a mitigation plan with a similar table, you I st (below)where we can find this information in the plan. het Activity(fill, Nethy ind Wetland Impact Duration Proposed Wetland drain, excavate, Na e' type and area (sq. of impace mitigation mitigation area flood, etc.) rating ft. or type4 (sq. ft. or category' Acres) acres) If no official name for the wetl nd axis 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 ba ion ciietland nt Western Washington or Eastern Washington Wetland Rating System.Provide the wetland rating forms with the JARPA p ge. 3Indicate the days,months or a the will be measurably impacted by the activity.Enter"permanent"if applicable. 4 Creation(C),Re-establishme Rehabil ation(R),Enhancement(E),Preservation(P),Mitigation Bank/in-lieu fee(B) Page number(s)f r simil r information in the mitigation plan, if available: JARPA Revision 2012.1 Page 7 of 14 71. For all failing activitie 1 i ent ed in 7h, describe the source and nature of the fill material, the amount in cubic yards that will be arcs31 nd and where it will be placed..into the wetland. Ihel 7j. For all excavating a, identified in 7h, describe the excavation method,type and amount of material in cubic yards you wilt ov` and where the material will be disposed, et Part 8—Waterbod (other than wetlands): Impacts and Mitigation In Part 8, "waterbodies" eiiers t non-wetland waterbodies. (See Part 7 for information related to wetlands.) ei ❑ Check here if there a e I*atbodies on or adjacent to the project area. (If there are none, skip to Part 9.) $a. Describe how the r ject designed to avoid and minimize adverse impacts to the aquatic environment. hel ❑ Not applicable The project is existin and 1 cated on the shoreline of Lake Cushman. It has hadtwill have minimal negative impacts on quad habitat or any other uses of the lake. BMPs will be followed during mitigation implemen tjon and buoy relocation. 8b. Will your pro ec t i ct waterbody or the area around a wate iy? nel x❑ Yes ❑ No 8c. Have you prepar m; ation'plan to compensate for the projects adverso impacts to non-wetland waterbodies i JARPA Revision 2012.1 Page S of 14 �I � • if Yes,submit the F tar i wfth JARPA package and answer 8d. • ff No or Not Spot to, ,. lain below why a mitigation plan should not be required. x❑ Yes ❑ No No applicable Proposed mitigatio �or 0 ie ATF development has been previously described. 8d. Summarize what mit at ion plan is meant to accomplish. Describe'how a watershed approach was used to design th lan. If you already eom 7'you do not need to restate your answer here. hel It will remove man ape d bris from the lakebed. I 80, Summarize imps ( )to 4ach waterbody in the table below, her Activity(clear, Water ody Impact Duration Amount of material Area (sq. % or dredge,fill, pile nan ie' location of impace (cubic yards)to be linear ft.) of drive, etc.) placed in or waterbody removed from directly affected waterbody sake shoreline 1 day Approx. six cubic sh an yards to be removed If no official name for the wate rb6dy exhits,create a unique name(such as"Stream 1")The name should be consistent with other documents provided. 2Indicate whether the impact II occur in or adjacent to the waterbody. If adjacent,provide the distance between the impact and the waterbody and indicate whether the impact w 11 occur wlihin the 100-year flood plain. 3 Indicate the days,months or ats the*aterbodv will be measurably impacted by the work. Enter"permanent'if applicable. 8f" For all activities id n iffe n 8e, describe the source and mature of the fill material, amount(in cubic yards) you will use, and h anc here it will be placed Into the waterbody, Cam] NIA. 89. For all excavating a d ing activities identified in8e, describe the method for excavating or dredging, type and amount I if at ``al you will remove, and where the material will be disposed. them JARPA Revision 2012.1 Page 9 of 14 NIA. Part 9-Additional 10om iation Any additional informatior you ci in 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 rk with any government agencies on this project, list them below. het Agency Name Contact Name Phone Most Recent Date of Contact 9b. Are any of the wetl s Of waterbodies identified in Part 7 or Part 6 of this DARPA on the Washington Department of EC o ' 's 3(d) List? bAw • If Yes,list the Para r(s)t Plow. • If you don't know, as ton Department of Ecology's Water quality Assessment tools at: W./hvww,e- .wa. r1 i)3d/. ❑ Yes X❑ No 9c. What U.S. Geolog Su ey Hydrological Unit Code (HUC) is the project in? el « Go to h _// ub.e '. ovt rf teftnd x.cfm to help identify the HUC. 17110018 9d. What Water Reso ;lrAent:ory Area dumber(WRIA#)is the project in? i�l Got ://www.e es/ is/ma s/wri 'a.htm to And the WRIA#. WRIA 16 9e. Will the in-water c tru, ion work comply with the State of Washington water quality standards for turbidity? Lh_ej Go to h :Jlwww.e a. / r rams/w sw s/cd eria.htmi for the standards. ❑ Yes ❑ N X❑ Not applicable 9f. If the project is wit Or then urisdictlon of the Shoreline Management Act,what is the local shoreline environment desk,W4 ifiiorti ei 1 • If you don't know cc ntac he local planning department. JARPA Revision 2012.1 Page 10 of 14 h For more info ma go u http'ffwww ecy.wa.gov/procirams/segs_ma/taws rules/173- WI J designations.htmi.. ❑ Rural X❑ roan ❑ Natural ❑ Aquatic ❑ Conservancy ❑ Other 9g. What is the Tashi t.G0J6usInessPerrnitsfToP:tcs/ n partment of Natural Resources Water Type? het +► Go to htt ://www.dFo ees#Practi s licabonsPa watert in .as x far the Forest Practices Water Ty 4 X❑ Shoreline ❑ Fish ❑ Non-Fish Perennial ❑ Non-Fish Seasonal 9h. Will this project be'di sig to meet the Washington Department of Ecology's most current stormwater manual? net • if No, provide the of 4 manual your project is designed to meet. X❑ Yes [] No Name of manual: torm ater Management Manual for Western Washington. 91. Does the project s`e aw known contaminated sediment? nei + N Yes ease desc 0 be ❑Yes X ❑ No, 9j. If you know what o rty was used for in the pest,describe below. gAl Prior to the early 190 's it w is a forest. 91k. Hasa cultural res a ce 'rchaeologicsl)survey been performed on the project area? hel' • if Yes,attach it to JAR 31A package. El Yes X❑ N Pae11of14 JARPA Revision 2012.1 ICI 9 91. Name each speci I steel rider the federal Endangered Species Act that occurs in the vicinity of the project area or might We ed y the proposed work. et The Chinook 1 on the bull trout, the Puget Sound steelhead, the marbled murrelet, streaked horned la' k, y llow-billed cuckoo, and the spotted owl are the ESA listed threatened or endan d sbecies in the area. 9m. Name each'spec a or bitat on the Washington Department of Fish and ildlife's Priority Habitats and 'Species List that ht affected by the proposed work. fheivi See above, plus cuftl ilroat tr Dut, Kokanee, and fisher. 0—SE mp Part 1 PAC li nce and Permits Use the resources and checki st below to identify the permits you are applying for. • Online Project Questic inaire at http://apps.ecy.wa.gov/opas/. • Governor's Off of R ulatory Assistance at (800) 917-0043 or help _ora.wa.gov. • For a list of adc re4ses to send your JARPA to, click on agency addresses for completed JARPA. 10a. Compliancewitht Sti to Environmental Policy Act (SEPA). (check ali that appiy.) el • For more informa"in EPA,go to ww w.ecv.wa,gov/programs/seW" a/e-review.htm ❑A copy of the S PA d ermination or letter of exemption is included with this application. X❑A SEPA deter nipation is pending with_Mason County (lead agency). The expected decision date i ❑ I am applying f a Fist Habitat Enhancement Exemption. (Check the box below in 10b.) nl eip ❑ This project is a(empt I choose type of exemption below). ❑ Categorical *em ion. Under what section of the SEPA administrative code (WAC) is it exempt? ❑ Other: 1 Ob. Indicate the peff yo are applying for_ (Cheat all that ap*.) MW LocAL GovERNmEw Local Government Sl iorelinipermits: X❑ Substantial Devolopn ient ❑ Conditional Use ❑ Variance ❑ Shoreline Exerr ption pe (explain): Other city/county!!permi : ❑ Floodplain Dev lopme it Permit X❑ Critical Areas Ordinance STATE GOVERNMENT JARPA Revision 2012.1 Page 12 of 14 Washington Department o Fish and Wildlife: 9 X❑ Hydraulic Proje App val (HPA) ❑ Fish Habitat Enhancement Exemption—Attach Exemption Form Effective July 10, 2012, o�'t must submit a check for$150 to Washington Department of Fish and Wildlife, unless your project quali ens for An exemption or alternative payment method below. Do not send cash. Check the a ro riate b x s. X❑ $150 check enclosed. (Check# Attach check made arable I o Washington Department of Fish and Wildlife. ❑Charge to billing 3CCOU under agreement with WDFW. (Agreement# 1 ❑My project is ex pt fro the application fee. (Check appropriate exemption) ❑ HPA proces ing is nducted by applicant-funded WDFW staff. (Agreement # ❑ Mineral pro ctin and mining. ❑ Project occ 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 odifi tion of an existing HPA originally applied for, prior to July 10, 2012. (HPA# Washington Depa nt 4 of Natural Resources: ❑Aquatic Use Autt iorization Complete JARPA A hm t E and submit a check for$25 payable to the Washington Department of Natural Resources. Do not send cash. Washington Depar xnent of Ecology: ❑ Section 401 Wat arlQua ty Certification FEDERAL GOVERNMENT United States Dep rime of the Army permits (U.S. Army Corps of Engineers): ❑ Section 404 (disc iarges ii ito waters of the U.S.) ❑ Section 10 (work in navigable waters) United States Coai it Guard permits: ❑ General Bridge ct Per it ❑ Private Aids to Navigation (for non-bridge projects) ❑ SEPA is pre-em ted by federal law. II Page 13 of 14 JARPA Revision 2012.1 ti tl 11 i n ur s Part -Author Ong gat e Signatures are requi-eo bef re submitting the JARPA package. The JARPA package includes the JARPA form, project plans, photo c. t 11a. Applicant Sign EArtioree(r uired) htgl I certify that to the tx ist,of knowledge and belief,the information provided in this application is true, complete, and accurate. I also :eltify at I have the authority to carry out the proposed activities,and I agree to start work only after 1 have recA iiv0d al necessary permits. I hereby authorize the age named in Part 3 of this application to act on my behalf in matters related to this application. t) (initi 1) By initialing here, I s ate tha I have the authority to grant access to the property. I also give my consent to the permitting agencies brit the project site or any work e ' the property where the project is located to inspect related to the prof (initial) Wes"/G Applicant Printed Name 47 Kpplicant Signature Date 11b. Authorized A n�Sigi ature h[ eA I certify that to the b of knowledge and belief,the information provided in this application is true, complete, and accurate. I alsotify at I have the authority to cant'out the proposed activities and i agree to start work only after all necess ryl peff ifts have been issued. Authorized Agent Printe4 Nime Authorized Agent Signature Date 11c. Property Owni r ign ture(if not aP ) plicant . n[t1 Not required' p oje is of existing rights-of-way or easements. I consent to the pe �n_Ctg�� encies entering the property where the project is located to inspect the project site or any work. These i s� ' s shall occur at reasonable times and, if practical,with prior notice to the landowner. I Property Owner Printed i me Property Owner Signature Date 18 U.S.0§1001 provides th t: ever,in any manner within the jurisdiction of any department or agency of the United States knowingly falsifies,conceals,or co rs�up by any trick,scheme,or device a material fact or makes any false,fictitious,or fraudulent statements or representations or makes of uses i Iny false writing or document knowing same to contain any false,fictitious,or fraudulent statement or entry,shall be fined not than$10,000 or imprisoned not more than 5 years or both. If you require this docum n i'n an her format,contact the Govemoes Office of Regulatory Assistance(ORA)at(800)917.0043. People with hearing loss n call 7 11 for Washington Relay Service.People with a speech disability can call(877)833-6341. ORA publication number. E -01 9 rev.06-12 JARPA Revision 2012.1 Page 14 of 14 �JN.STgTFO MASON COUNTY �P C DEPARTMENT OF COMMUNITY DEVELOPMENT o a°u 9= Planning Division o T = 615 W Alder St, Shelton,WA 98584 Zoo N Y o~ (360)427-9670 J � 1864 DETERMINATION OF NONSIGNIFICANCE (WAC 197-11-340) SEP2016-00061 Description ol Proposal: (a) (built in 1987 but no County permits in file) An existing forty foot (40') concrete bulkhead with two wing walls of 12' & approx 18' 8" on the north and south end; 9 ( Y (b) An existing no count permits in file) approx 3'5" BY 18' � aluminum ramp and an approx 8'3" BY 20'3" float with four 10" PVC encapsulated and steel reinforced concrete float pilings. And two 8 by 1 by 5 foot concrete float rests; (c) The existing (no county permits on file) bouy will be retrofitted: The existing pe rmanent anchor on the la kebed will have an attached permanent anchor chain of sufficient length to moor a maximum Lake Cushman pool elevation of 738-feet vessel at them with ap propriate riate section of sinking line, p elevation. A detachable s g pp tackle, will be used to connect the anchor chain to the dock when a vessel is not being moored. An optional small line recovery float may be added to the removable line section. The removable line, with optional small line recovery float, shall be stored on the vessel or on the dock when a vess el is moored to the chain. No r the roe owner, Tacoma Power. mooringbuoy is allowed, e property rty , Y p A Habitat Management Plan has been submitted that recommends the following mitigation: 4 CONCRETE ANCHORS (2 WHICH ARE ECOLOGY BLOCKS AND 2 POURED CONCRETE) WILL BE REMOVED. No heavy equipment may be used on the lake bed. Removal shall occur within the first low lake level season after SUP is issued. Propo ent: JOSEPH BOYD Location f pro sal: 150 N DISCOVERY DR HOODSPORT Par el Nurr ber: 423185000040 Legal Description: LAKE CUSHMAN #3 TR 40 Direc ions toSite: LAKE CUSHMAN RD FOLLOW TO DISCOVERY DR L ad Ag ncy: Mason County MASON COUNtf ENVIR NMENTAL CHECKLIST MA O N CO. ENVIRONME NTAL CHECKLIST A. BAC ZRO JND 1. Na eof p oposed project, if applicable: Boyd After-the Fact Permitting Pro130t. 2. Nan ie of applicant: Joseph and Barbara Boyd. 3. Add e' s a d phone number of applicant and contact person: 312 Ca on V kiley Drive, Richardson, TX 75080-1934, (972) 765-1506. 4. DO.- chec ilist prepared: 5-21-16. 5. Agency reluesting checklist: Mason County 6. Pro ed iming or schedule (including phasing, if applicable): No new deV 1 DpM ant. Mitigation and compliance with Tacoma Power's rules will orcur when the lake is low. 7. Do Vou ha ve any plans for future expansion, or further activity related to or coonoctec with this proposal: if yes, explain. No. tin you know about that has been information vironmental I 8. Li any e pre ared, or will be prepared, directly related to this proposal. HMP & M applications are pending for gover nmental P. u k ow whether a p 9 9 9. Dolyo pp ap irovals of other proposals directly affecting the property covered by yo r pro sal? If yes, explain. No. 10. Lis �ny vernment approvals or permits that will be needed eded for you r prc posal, if known. A Mason County shoreline substantial permit, an HF A front the WDFW, and permits from Tacoma Power, the USACE, an the Lake Cushman Management Company. 11. Give a b f, complete description of your proposal, including the proposed us s and the size of the project and site. There are several questions lat r in th s checklist that ask you to describe certain aspects of your pr posal. You do not need to repeat those answers on this page. (Lead MASON COUNTI i(ENVIRC MENTAL CHECKLIST 2 age cies rr ay modify this form to include additional specific information on projo ct des ription). ATF develc ipment includes the following: a forty-foot (40') concrete bulk ead ith two wing walls of twelve feet (12') and approx. nine e n f t (18' 8") on the south and north ends, respectively, an app x. th a-foot (3'5") by eighteen-foot (18') aluminum ramp, an app ei t by twenty-foot (8'3" x 20'3") float with four (4), ten inch (10" VC ncapsulated and steel reinforced concrete float positioning / pilin s�, a ncrete paver fire pit (less than 36" diameter), �►,X� ) , and a y., ctn�l c ,c �,� c�-��1,�t 4/e 4, 'r � T. 12. Wh t s the location of the proposal? Give sufficient information for a per oil to inderstand the precise location of your proposed project inch d ng E street address, if any, and section, township, and range, if kno . If a proposal would occur over a range of area, provide the range or Onda 'es of the site(s). Provide a legal description, site plan, vicinity ma , and pographic map, if reasonably available. While you should sub n an plans required by the agency, you are not required to duplicate Mal s or d tailed plans submitted with any permit applications related to this c eck st The site is located on Lake Cushman at 150 N Dis qve Drive, Hoodsport. Section 18, Township 23N, Range 04W. Pa $1 nu rnber 42318-50-00040. The legal description is: Lake Cui hman #3 TR 40. B. E RONME NTAL ELEMENTS: 1. EA TH: a. Ge eral description of the site (circle one): Flat, rolling, hilly, steep slopes, moll intainc us, other. Gentle slope to the shoreline. b. W at is th 3 steepest slope on the site (approx. percent slope)? Approx. 30 6. C. What gen a.ral types of soils are found on the site (for example, clay, sand, gravel, peat, muck)? If you know classification of agricultural soils, specify them and note any prime farmland. Sand, gravel, and clay. d. Ar there surface indications of history of unstable soils in the immediate vic ity: I so, describe. No. MASON COUNTf ENVI NMENTAL CHECKLIST 3 quantities of an fill ing or e. Des nbe t e purpose, type, and approximateq Y 9 grad'ng proposed. Indicate source of fill. No filling or grading proposed. f. Cou d ero on occur as a result of clearing, construction, or use: If so, gen ally escribe. No. g. Abo Awha t percentage of the site will be covered with impervious surf s ter project constructions (for example, asphalt or buildings)? Th F roject created an extremely small amount of impervious su a0e a a (approx. 30 sf). h. Proi i Iosed neasures to reduce or control erosion, or other impacts to the eart i, if a : N/A. 2. AIRI a. Wh t pe of emissions to the air would result from the proposal (i.e. du , Lit obile, odors, industrial wood smoke) during construction and wh n he roject is completed? If any, generally describe and give ap im a quantities, if known N/A b. Are there any off-site sources of emissions or odors that may affect your pro odsal? If so, generally describe. N/A C. Pr posed measures to reduce or control emissions or other impacts to air, if a y': N! 3. WATER: a. Surface: 1} Is ere any surface water body on or in the immediate vicinity of th site (including year-round and seasonal streams, saltwater, lak s, ponds, wetlands)? If yes, describe type and provide names. If propriate, state what stream or river it flows into. La ce Cushman. 2 Wi I the roject require work over, in, or adjacent to (within 200 project �I any fee t) the described waters? If yes, please describe and attach MASON COUNtf EJNVIR( NMENTAL CHECKLIST 4 available plans. Yes, see HMP entitled Boyd ATF Permitting Project 5-23-16. 3) Esti ate the amount of fill and dredge material that would be pla din or removed from surface water or wetlands and indicate the rea of the site that would be affected. Indicate the source of fill mat vial. Ap rox. 24 sf of concrete will be removed as mitigation. 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if kno Nn. No. 5) Do(s the proposal lie within a 100-year floodplain? If so, note loci tion on the site plan. Yes, the ATF site is located on the shc reline of Lake Cushman. 6) Do s the proposal involve any discharges of waste materials to Sul ce waters? If so, describe the type of waste and anticipated vol me of discharge. No. b. round: 1) Mll gr and water be withdrawn, or will water be discharged to ground Nate? Give general description, purpose, and approximate quantities, f kno%A n. NIA. 2 groundthe from escri a waste material that will be discharged into eptic anks or other sources, if any (for example: domestic sewage, ndust 'al, containing the following chemicals...,agricultural, etc.). escri De the general size of the system, the number of such systems, he nu nber of houses to be served (if applicable), or the number of "ima s or humans the system(s) are expected to serve. NIA. C. We r ru ff(including storm water): 1) D cribe the source of runoff(including storm water) and method of co ection and disposal, if any (include quantities, if known). Where wil this water flow? Will this flow into other waters? If so, describe. NI k. MASON COON COUNtf E NVIR NMENTAL CHECKLIST 5 s: if so water n or surface , 2 I (Could waste materials enter grou nd generally describe. NIA. d. Proposed measures to reduce or control surface, ground, and runc ff water impacts, if any: NIA. 4. PLA 7S: a. Che or circle types of vegetation found on the site: X_dec d0ous tree: alder, maple, aspen, other x_ever r6en Iee: fir, cedar, pine, other x_shru s _x_ gras past ire crop or gra n wet ail pl ts: cattail, buttercup, bulrush, skunk cabbage, other _watEi r plan : water lily, eelgrass, milfoil, other other type of vegetation b. Wh t kind and amount of vegetation will be removed or altered? No e; C. List threat ned or endangered species known to be on or near the site. Un mown. d. Pr osed landscaping, use of native plants, or other measures to pre erve r enhance vegetation on the site, if any: None proposed. 5. AN MAL a. Cir I any birds and animals which have been observed on or near the site are known to be on or near the site: Birds: haivk, heron, eagle, songbirds, other Mammals) der, bear, elk, beaver, other Fish: bass, salmon, trout, herring, shellfish, other b. List 3ny th leatened or endangered species known to be on or near the site. HEC MASON COUN e NVIR I NMENTAL CHECKLIST 6 The Chino salmon, the bull trout, the Puget Sound steelhead, the norl hern spotted owl, the Hood Canal summer-run chum, the streitked horned lark, and the yellow-billed cuckoo. C. Is t ite part of a migration route? If so, explain. No, Lake Cushman is Ian -lock-locke id due to two dams. d. Pro osed Measures to preserve or enhance wildlife, if any: See above (4d� 6. EN RGY j kND NATURAL RESOURCES: a. Wh t kinds of energy (electric, natural gas, oil, wood stove, solar) will be usei 10 m et the completed project's energy needs? Describe whether it will o used for heating, manufacturing, etc. NI b. Wo I Y o r project affect the potential use of solar energy by adjacent pro ies If so, generally describe. N/A. C. W a# kin s of energy conservation features are included in the plans of thi proposal? List other proposed measures to reduce or control energy im acts, f any: NIA. 7. EN�/IROIS(MENTAL HEALTH: a. ArE there any environmental health hazards, including exposure to toxic chE mical , risk of fire and explosion, spill, or hazardous waste, which COL Id occur as a result of this proposal? If so, describe. N/A. 1} Describe special emergency services that might be required. An ambulance in the event of a construction accident. 2) P oposed measures to reduce or control environmental health hatards, if any: N/A. MASON COUN SNVIR NMENTAL CHECKLIST 7 b. Noisj 1) Wh t types of noise exist in the area which may affect your project (for xample: traffic, equipment, operation, other)? NIA. 2) Whi it 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: traff c, construction, operation, other)? Indicate what hours noise wou Id come from the site. NIA 3) Prol osed measures to reduce or control noise impacts, if any" N/ 8) Lo D AN SHORELINE USE: a. WK It s thecurrent use of the site and adjacent properties? Re r atio nal. b. HaE the s' a been used for agriculture? If so, describe. No.l C. De cribe any structures on the site. A c bin, lus ATF development includes the following: a forty-foot (40 ) )on rote bulkhead with two wing walls of twelve feet (12') and api rpx. neteen feet(18' 8") on the south and north ends, re 0ctiv ly, an approx. three-foot(XV) by eighteen-foot(181) alu lnu ramp, an approx. eight by twenty-foot(8'3" x 201") float wit i four(4), ten inch (1011) PVC encapsulated and steel reinforced coi icrete oat positioning pilings, a concrete paver fire pit(less than 36' diam ter), four(4) concrete anchors,two that are ecology blocks (2' 2' x ') and two that are poured concrete (2'x 21), and a buoy. d. Wil I ny ructures be demolished? If so, what? Ex 'ng oncrete anchors will be removed from the site. e. W at is the current zoning classification of the site? Unknown. MASON COON RNVIR NMENTAL CHECKLIST 8 f. Wh t is th current comprehensive plan designation of the site? Un qwn. g. If a I cab , what is the current Shoreline Master Program designation of the'l ito? L Irban residential. f the site been classified as an "Environmentally sensitive" I h Has any y rt o are ? Ifs , specify. Lake Cushman is a "lake of statewide sigi ifica e." i. AN oxim tely how many people would reside or work in the completed proj at? /A. j. App roximetely how may people would the completed project displace? N/A. impacts, if any: i o reduce displacementY asures to avo d rP k. Pro sed e NIA. I. Pr prolposed measure to ensure the prop osal is compatible atible with existing and �ted and uses and plans, if any: NIA. 9. HO SIN : a. Ap roxim tely how many units would be provided, if any? Indicate who,ther gh, middle, or low-income housing. NIA. b. ApI proxim tely how many units, if any would be eliminated? Indicate wh t er h gh, middle, or low-income housing. NIA. C. Pr p sed measures to reduce or control housing impacts, if any: N/ . MASON COUN HNVIR NMENTAL CHECKLIST 9 10, AEO THETI S: a. Wha t is th tallest height of any proposed structure(s), not including ante nas; hat is the principal exterior building material(s) proposed? The A F k ulkhead is approx. 6 feet in height. he immediate vicinity b. Wh t vi ew; in t would be altered or obstructed? The project does not obstruct any views. C. Pro o$ed ineasure to reduce or control aesthetic impacts, if any: N/ 11. LIG TAN GLARE a. Whi it type of light or glare will the proposal produce? What time of day WOL Id it m 3inly occur? b. The roj t does not produce any light or glare. b.0 uld lit ht or glare from the finished project be a safety hazard or interfere m ith views? NIA. C. Wh i at:existing off-site sources of light or glare may affect your proposal : NI . tare impacts, if any: reduce or control light and p Y measures to 9 d. Pr p©sed g NI . 12. R� REA ION a. Wt iat designated and informal recreational opportunities are in the im odia vicinity? B fAng, fishing, hiking, etc. MASON COU11i ENVIRC NMENTAL CHECKLIST 10 project displace an existing recreational uses? If so, b. Wo d theproposedp ) p Y des ribe. rho project enhances recreational opportunities. r s to reduce or control impacts on recreation, including C. Pro o ed easu e p . recr a ion I opportunities to be provided by the project or applicant, if any: NIA I 13. HIS ORI AND CULTURAL PRESERVATION: a. Are there g ny places or objects listed on, or proposed for, national, state, or Icical prf iservation registers known to be on or next to the site? If so, gen Irally c escribe. Not that the applicants know of. I b. Geri a ally escribe any landmarks or evidence of historic, archaeological, scientific, er cultural importance known to be on or next to the site. No e C. Pro osed measures to reduce or control impacts, if any: NI . 14. TPU NISP RTATION a. Ide tify pit iblic streets and highways serving the site and describe pro osed cress to the existing street system. Show on site plans, if any. NIJ L. b. Is E ite cur ently served by public transit? If not, what is the approximate disice t 3 the existing street system? Show on site plans, if any. Unknowr . C. Ho mans parking spaces would the completed project have? How many woA the project eliminate? NIA. MASON COUN SNVIR NMENTAL CHECKLIST w roads or streets or improvements to r osal require ire an p d. Will �: p q Y ne exisl ing roe cis or streets, not including driveways? If so, generally describe (if idicate whether public or private). No. e. Will h p' r 'ect use or occur in the immediate vicinity of)water, rail, or air tran IpDrtat on? If so, generally describe. No. f. Hom, many vehicular trips per day would be generated by the completed project. If cnown, indicated when peak volumes would occur. NIA. s ortation impacts, if any: or control trap Y o redu ce P g. Pro o�sed measures t P NIA. 15. PUBLIC SERVICES a. Wo lid the project result in an increased need for public service (for ex ple: fire protection, police protection, health care, schools, other)? If so, jenen illy describe: No. b. Pr 1pqsed measures to reduce or control direct impacts on public services, if a iy, NI k. 16. UT LI`flE a. Cir le util ies currently available at the site: electricity, natural gas, wa r, r se service, telephone, sanitary sewer, septic system, other: b. Del clribe the utilities that are proposed for the project, the utility providing the, servic B, and the general construction activities on the site or in the irrif'riddiati vicinity which might be needed. NIA. Signature • MASON COUN E]NVIR NMENTAL CHECKLIST 12 The above onswers are true and complete to the best of my knowledge. I understandsi that the lead agency is relying on them to make its decision. Signature: Date submitted: i i