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SHR2021-00007 SHX2021-00008 SEP2021-00012 BLD2021-00347 Replace Dock - SHR Permit / Conditions - 3/10/2021
RECEIVED: 7!INIF, COUNTYRECEIVED CO ERV CE BAR 1Q 2021 lton,Wa 98584 515 W. Alder Street ♦Fax(360)427-7798 PERMIT NO.:S LINE PERMIT APPLICATION SHORELINE PERMITS COND AL SE* SUBSTANTIAL DEVELOPMENT VAR A 4CE" EXEMPTION The Washington State Sh a ne nagement Act (RCW 90.58) requires that substantial developments within designated shorelines of the state co play wit its administrative procedures (WAC 173-14) and the provisions of the Mason County Shoreline Management Master P ram. The purpose of this Act and local program is to protect the state's shoreline resources. The program uires that substantial development (any development of which the total cost or fair market value exceeds $7,047.00 r mat lly interferes with the normal public use of the water or shorelines of the State be reviewed with the goals, liaoes, d performance standards established in the Master Program. Answer all questions com eely. ttach any additional information that may further describe the proposed development. Incomplete applications wi I returned. *Shoreline Variances an( Cond ional uses require public hearings and have additional pages that shall be attached to this applicat APPLICANT: ADDRESS: Q !� ro )(-e �r'- ,(street) (city) ` (state) (Zip) TELEPHONE: (ho ho business} ,—me) �Y AUTHORIZED REPRES TATI ADDRESS: '" ` rGcNe LL:2, (street) v{ dt3f -�(1C'� 0 el (may) I (state) (ZIP) TELEPHONE: Z� Ll PROPERTY DESCRIPTI N: General location (include property address,water body and associated wetlands—identify the name of the shoreline): LC ACC (Vr,I, w Rev. March 1, 2018 c Include all parcel numbers: ProjecLc located in open water areas, away from land shall provide latitude/longitude. Contract OWNENERSHIP: / A V Owner Lessee Purchaser (identify) Other PP Owner: (street) (city) (state) (Z1P) DEVELOPMENT DESCRI TON: Development proposal (idenqy ani I describe the proposed project, including the type of materials to be used, construction methods, principle dimens rii5, ani I other pertinent information): e ✓ a c tJ=� c : oic -k V Existing Use (identify current use of property with exist improvements): r" 'f ( G. Cti eye n C Reason for requesting de elopm nt: f' 4 The applicant shall provide, at a minimum, the following information: a. SITE PI-AN -drawn to scale and including: i. I he boui dary of the parcel(s)of land upon which the development is proposed; ii. The ordinar I high water mark(OHWM). This may be an approximate location provided,that for any develo ment where a determination of consistency with the applicable regulations requires a precise to 'on of the OHWM the mark shall be located precisely and the biological and hyd o gi basis for the location as indicated on the plans shall be included in the development plat he the OHWM is neither adjacent to or within the boundary of the project,the plan shall indi a e th distance and direction to the nearest OHWM of a shoreline; iii. Wh an h app opriate,the proposed land contours using five-foot intervals in water area and ten-foot intervals or areas landward of OHWM, if development involves grading, cutting,filling, or other alteration o land contours; iv. The dmen ions and location of existing structures which will be maintained; V. The dimensions and locations of proposed structures; parking and landscaping; vi. The location of proposed utilities,such as sewer, septic tanks and drain fields,water, gas and ele tricity; vii. Thin, l cat' ,source, composition, and volume of fill material; viii. Th 10catiol i, composition and volume of any extracted materials, and proposed disposal area; b. CROSSSECTION,drawn to scale including: i. Th a existir g ground elevations; ii. The propo5ed ground elevations; iii. The locat' n and height of existing structures; iv. The ocatii in and height of proposed structures; V. The DHVY A. c. VICINIrf PRAP, ncluding: i. The ocat n of subject parcel using natural points of reference(roads,state highways, prominent la dma , etc.). ii. If he de lopment involves the removal of any soils by dredging or otherwise, identify the ptoposed disposal site on the map. If disposal site is beyond the confines of the vicinity map, p oxide a iother vicinity map showing the precise location of the disposal site and its distance to n arest y or town. iii. C n the m ip, or separately, give a brief narrative description of the vicinity of the proposed project it cl ding entification of the adjacent uses,structures and improvements, intensity of d vtop ent and physical characteristics. d. ADJACENT LANDOWNERS. Provide names and mailing addresses of all real property owners within O feel of property line boundaries where development is proposed. 1 al"?2LSr 'Ici( �� P(.ee rJ ACKOWLEDGEMENT: T 5,f���%4 1. 0A C F0 0 I hereby declare to the besl of rr y knowledge and belief,the forgoing information and all attached information is true and correct. M 1-1 or horized Representative) (date) i n P (Ap 1 Publication Cost Agreement Publication cost is the res n ibili of the applicant.Final permit processing will not occur untiladve dtising irectl fees have been paid to the newspaperb the plicant.The Shelton-Mason County Journal will bill the applicantY I/WE understand that I/NVI mug sign and date the attached acknowledgment indicating and that I/WE understand that is MY/OUR responsibihp,. /W1 must submit the signed page as part of application in order for it to be considered as complete. r 3 3 Ze `L Edj R2�- Signature of P operty�Wnerl; Date Print Name OR Signature of Applicant Date Print Name I South 351'Street RECEIVED Ta a Washington 98409 3192 {� ryq _ .__.NHftp �..Un.��L 1 :; POWER � � u TA COMA PUBLIC UTILITIES 615 W Alder Street October 26, 2020 VIA EMAIL Edwin Perry & D bprah Deterson 140 N Discovery Dr. Hoodsport, WA 9 3548 SUBJECT: Perry Paterson Shoreline Proposal on Tacoma Power Property Dear Mr. Perry & IV rs. Peterson: The City of Tac , D artment of Public Utilities, Light Division (Tacoma Power) was recently contacted to revi the nclosed drawings for proposed replacement of existing structures on Tacoma Power r pert fronting your development lot No.42318-50-00039 at 140 N Discovery Drive on Lake C s ma . Tacoma Power has no obiection to You moving forward with re ulato ermittin fort ropo, ed activities on Tacoma Power prope . The proposed action wi I require issuance of a short-term license from Tacoma Power before any work occurs on Ta ma Power property waterward of 742 feet elevation, and a new Shoreline Use Permit ce work is completed. Please provide copy f this letter to the regulatory agencies when you submit your plans to them. Feel free o on ct me at 253-318-2527 or v ri ht ci.tacoma a. t if you have any questions. Sincerely, t� Wynnae Wright Shoreline and Las ordinator rlhd Tacoma Power Enclosures cc: Dori Bis i8p, Si. Real Estate Specialist, City of Tacoma Travis eMon, nterim Wildlife and Lands Manager, Tacoma Power Kyrra Ikon, N Vildlife and Recreation Lands Officer, Tacoma Power -F&L_B Id 202 l - 0034-1 �EPZa21 - � Ia RECEIVED RECEIV ED MAR 10 2021 SEPA ECKLIST ENVIRONMENTAL CH MAR 10 202E 615 W. Alder Street ,- Y j F,, -f nr r c�,7�s 4 615 W. Alder Street Purpose of chec ist: Governmental agenc es use this checklist to help determine whether the environmental impacts of your proposal are signifia nt. This information is also helpful to determine if available avoidance, minimization or compensatory mit gation neasures will address the probable significant impacts or if an environmental impact statement wil be pr ared to further analyze the proposal. Instructions fora p►lica ts: This environmental c iecklis:asks you to describe some basic information about your proposal. Please answer each questic i accui ately and carefully, to the best of your knowledge. You may need to consult with an agency spec alist or private consultant for some questions. You may use "not applicable" or "does not a I " onl e vou can ex lain whv it does not apply and not when the answer is unknown. You may also attach i or in orate by reference additional studies reports. Complete and accurate answers to these questions often avoid delays with the SEPA process as well as later in the decision- making process. The checklist question app ly to atl parts of your proposal, even if you plan to do them over a period of time or on different r a cels f land. Attach any additional information that will help describe your proposal or its environmental ects The agency to which you submit this checklist may ask you to explain your answers or provide d Jitior I information reasonably related to determining if there maybe significant adverse impact. Instructions for Lead A gencies: Please adjust the fo mat of his template as needed. Additional information may be necessary to evaluate the existin envir ment, all interrelated aspects of the proposal and an analysis of adverse impacts. The chec list is nsidered the first but not necessarily the only source of information needed to make an adequate rasho determination. Once a threshold determination is made, the lead agency is responsible for the omple ness and accuracy of the checklist and other supporting documents. Use of checklist or no riproject proposals: For nonproject proposals ( uch as ordinances, regulations, plans and programs), complete the applicable parts of sections A nd B us the L � -EMENTA HEFT FOR_O PROJE ' A C�i0�a� ��art C�� Please completely answer ail que ions that apply and note that the words "project,""applicant," and "property or site should be rea as p posal, proponent, and affected geographic area," respectively. The lead agency may exclud or n in-projects) questions in Part B- Environmental Elements-that do not contribute meaning ul y to a analysis of the proposal. A. Backgrou L 1. Name of ro os pro ct, if applicable: L&kzC P p 1 pP J 2. Name of applic nth �.� , clr r 3. Address and phone number of applicant and contact person: to -- Y-a.7- qoq 7 (hit) A[_ ca Zttl fee)A e4I SEPA Environmental chec is (WAC 974 960) July 2016 Page 1 of 12 4. Date checklist pre aured: 5. Agency requesting dheck ist: /11 6. Proposed timing or$chec ule (including phasing, iff applicable): 7. Do you have any 14ns for future additions, e*a n, or further activity related to or connected with this proposa? If yes, explain. h0. 8. List any environm ntal in ormation you know about that has been prepared, or will be prepared, directly related to is proposal. w co,z- 9. Do you know wh her a lications are pending for governmental approvals of other proposals directly afledting a property covered by your proposal? If yes, explain. v\OvX C - 10. List any govern epnt a rovals or permits that will be needed for your proposal, if known. ry l�,c �� PP�c✓�� �z` r �e�erva� 1"I r�i+. C�h'� �' hlci�. s1� ` l�`l (� z 11. Give brief, comF le e d cription of your proposal, including the propozed uses and the size of the project and sil D. 'Thei a are several questions later in this checklist that ask you to describe certain as dts of lour proposal. You do not need to repeat those answers on this page. (Lead agenc s may modify this form to include additional specific information on project description.) (�.� (4,e o deck w,'-fk ����rs �^� deck �� ��. �, -f�P ar`�r�°a z �fa�fero, 12. Location of tM r pos I.�Give sufficient information or a person to understand the precise location of your pro o ed oject, including a street address, if any, and section, township, and range, if known. If p opo al would occur over a range of area, provide the range or boundaries of the si a ). rovide a legal description, site plan, vicinity map, and topographic map, if reasonably v 'ilab While you should submit any plans required by the agency, you are not required to u licat maps or detailed plans submitted with any permit applications related to this checkist. Z[��B. Environme Pita/ lements t L�'1 1. Earth 1pj a. General descripil on oft the site: (circle one): Flat, r [Iii ig, hilly, steep slopes, mountainous, they rv\4R b. What is the ste t sl peon the site (approximate percent slope)? G� c. What general ty et of ils are found on the site (for example, clay, sand, gravel, peat, muck)? If you know th classification of agricultural soils, specify them and note any agricultural land Df long-term commercial significance and whether the proposal results in removing any of these E oils. o ic � share SEPA Environmental chec ist�(WAC 9741-960) July 2016 Page 2 of 12 d. Are there surface 'nqicati4 ns or history of unstable soils in the immediate vicinity? If so, describe. e. Describe the pure se, type, total area, and approximate quantities and total affected area of any filling, excava ion, an grading proposed. Indicate source of fill. no,t& . f. Could erosion occ jr as a esult of clearing, construction, or use? If so, generally describe. YN - g. About what percent liof th site will be covered with impervious surfaces after project construction (for a arpple, asphalt or buildings)? 11 L.J 5,)O(-e 0 (C A V (1,4D-W) In. Proposed measutej to r duce or control erosion, or other impacts to the earth, if any: 2. Air Lijitipl a. What types of emissions to the air would result from the proposal during construction operation, and m intenai ice when the project is completed? If any, generally describe and give approximate l quantites if known. Wz - b. Are there any off site soi irces of emissions or odor that may affect your proposal? If so, generally describe. o - c. Proposed measures to r duce or control emissions or other impacts to air, if any: o U►' - 3. Water [Iiipl 0 a. Surface Water: fl1ql121 1) Is there any surface Nater body on or in the immediate vicinity of the site(including year-round a d',sea onal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type and provide nai nes. If appropriate, state what stream or river it flows into. I' 2)Will the projeft requi re any work over, in, or adjacent to(within 200 feet) the described waters? If y s,,ple a describe and attach available plans. ��� 9 � Ye - r��� C�G33���� � LA C ;/Ikmeet-v� �p k e'k-j? eel , f !��f�jnvra ! Gn✓1� SLR a� G�r� ��'�(✓t 3) astimate the a ou of fill a d dredge p�atenal that would b�placed in or rem v from surface w 3ter r wetlands and indicate the area of the site that would be affected. Indicate the so rce f fill material. / ti 4)Will the proposal rei luire surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. (9. SEPA Environmental chec lisi(WAC 97-11-960) July 2016 Page 3 of 12 5) Does the proposal lie v ithin a 100-year floodplain? If so, note location on the site plan. Vk 0 1 6) Does the prop sal involve any discharges of waste materials to surface waters? If so, describe the ty e'of waste and anticipated volume of discharge. VIC. b. Ground Water: [LiE.Al 1)Will groundwat r be thdrawn from a well for drinking water or other purposes? If so, give a general Jescri 'on of the well, proposed uses and approximate quantities withdrawn fron i the w Al. Will water be discharged to groundwater? Give general description, p pose, and approximate quantities if known. 2) Describe wastO, matei ial that will be discharged into the ground from septic tanks or other sources,'if any I for example: Domestic sewage; industrial, containing the following chemicals. . . ; agricultural; etc.). Describe the general size of the system, the number of such systems, the number of houses to be served (if applicable), or the number of animals or humans the system(s) are expected to serve. c. Water runoff(including sl ormwater): 1) Describe thelsource f runoff(including storm water) and method of collection and disposal, if any(include quantities, if known). Where will this water flow? Will this water flow in o other waters? If so, describe. ►n 60►he . 2) Could waste rnateria s enter ground or surface waters? If so, generally describe. v`0'_ 3) Does the pro o al at er or otherwise affect drainage patterns in the vicinity of the site? If so, describe. ' d. Proposed measu a to r Iduce or control surface, ground, and runoff water, and drainage pattern impacts, if any: b y� 4. Plants lLeSlj a. Checkthetypej of vegetation found on the site: Page 4 of 12 SEPA Environmental check st AIAC 19741-960) July 2016 deciduousfree: "Ider, maple, aspen, other evergree ee: fir, cedar, pine, other :]/hrubs grass pasture crop or g ain Orchards, vineyards or other permanent crops. wet soilplants: cattail, buttercup, bullrush, skunk cabbage, other water plants: w4 r lily, eelgrass, milfoil, other other typ asiof v getation b. What kind and am tjnt of vegetation will be removed or altered? —f L ciu�r rw- i Ar �-e- lei«f`&P, j-P) 4.1 0 ��`� �r� 1 c. List threatened an J endai igered species known to be on or near the site. CfZ ( 1- - ek 0Ke d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if ny: e. List all noxious w eds an I invasive species known to be on or near the site. iN 5. Animals a. List any birds andlp#ier animals which have been observed on or near the site or are known to be on or nOlat the site. Examples include: birds: h a wtn, n agle ongbirds, other: V'\s jce-OC AIIC5 mam Is: e , beaver, other. fish: ass, trout, herring, shellfish, other b. List any threatene nd endangered species known to be on or near the site. r c. Is the site part of a migrat on route? If so, explain. d. Proposed measur s to pieserve or enhance wildlife, if any: e. List any invasive anilmal pecies known to be on or near the site. Page 5 of 12 SEPA Environmental checkli t(WAC 1174 1-%0) July 2016 6. Energy and Na ural sources r a. What kinds of ene y(el tric, natural gas, oil, wood stove, solar)will be used to meet the completed prof ct's a rgy needs? Describe whether it will be used for heating, manufacturing, etc h fY il` b. Would your proje affect he potential use of solar energy by adjacent properties? If so, generally de clbe. c. What kinds of enelgy con 5ervation features are included in the plans of this proposal? List other proposed measures to reduce or control energy impacts, if any. r%l0. e_1 7. Environmenta l ealt i �Lejpl a. Are there any env rdhm tal health hazards, including exposure to toxic chemicals, risk of fire and explosion, spill or hazardous waste, that could occur as a result of this proposal? If so, describe. vt0"ti 1) Describe any known or possible contamination at the site from present or past uses. Y\ V►ti a 2) Describe exi ting hazardous chemicals/conditions that might affect project development and design. this includes underground hazardous liquid and gas transmission pipelines located within the pioject area and in the vicinity. C) eq 4 3) Describe an I 11oxic r hazardous chemicals that might be stored, used, or produced during the pr DjOcts ievelopment or construction, or at any time during the operating life of the pro:jeMct. 4) Describe sp dial emergency services that might be required. 5) Proposed m ures to reduce or control environmental health hazards, if any: p e- C.v\� V b. Noise 1) What types ol noise exist in the area which may affect your project(for example: traffic, equipment, o eration, other)? 2)What types and leve s of noise would be created by or associated with the project on a short-term or a{ ng-te basis (for example: traffic, construction, operation, other)? indi- cate what ho noise ould come from the site. r fw� v\O(Sc: A-vr' -6D(I e e�4eurr �ur jl3) Proposed m aJures to reduce or control noistc"Sev— impacts, if any: f_ b 0 C— (dOL%k"_e4 Jul 2016 Page 6 of 12 $EPA Environmental check st AC 7-11-960) Y S. Land and Shor Iffie L se w i l a. What is the current'use of the site and adjacent properties?Will the proposal affect current land uses on near y or a Jjacent properties? If so, describe. r bwv :1�. ��� dcG�( , Air) �►MF���ay. c �t2�eh�Pt1��`rlf�S: b. Has the project site been i ised as working farmlands or working forest lands? If so, describe. How much agricul real or orest land of long-term commercial significance will be converted to other uses as a re ult of a proposal, if any? If resource lands have not been designated, how many acres ir farmlaid or forest land tax status will be converted to nonfarm or nonforest use? 1)Will the propos I Oect or be affected by surrounding working farm or forest land normal business operations, si ich as oversize equipment access, the application of pesticides, tilling, and harvesting? If so, how: ` \Q G c. Describe any stru tures c n the site. ,l t�zd L j Y �i~� d. Will any structures be de olished? If so, what? e. What is the curre it Ininclassification of the site? f. What is the curre t qom ehensive plan designation of the site? Wfl Vvk g. If applicable, what ii the current shoreline master program designation of the site? m <- ! but r Cl h. Has any part oft a site been classified as a critical area by the city or county? if so, specify. i. Approximately how man) people would reside or work in the completed project? z 6c a4 61 O-A e--- j. Approximately hoN many people would the completed project displace? Oe k. Proposed measures to avoid or reduce displacement impacts, if any: Page 7 of 12 SEPA Environmental check st(WAC 741-960) July 2016 L. Proposed measure to en ure the proposal is compatible with existing and projected land uses and plans, if 4 ny: I /\ f CGL'Yh�t OiJa?� ^C' —A- it-c"( m. Proposed measur s to re uce or control impacts to agricultural and forest lands of long-term commercial signifi rice, ' any: /vtPr,e 9. Housing jl-ll l a. Approximately ho many units would be provided, if any? Indicate whether high, mid- dle, or low-income hpusin . b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or lo w-inc hoi ising. c. Proposed measuresto re duce or control housing impacts, if any: l --"ln 10. Aesthetics . el a. What is the tallest height of any proposed structure(s), not including antennas; what is the principal exterior builc ing material(s) proposed? 6G( c c t' � v,.� -,,.`.. ✓1 Ior�e G�Te T c �c(q IM4- b. What views in th i mediate vicinity would be altered or obstructed? 1 !) b. Proposed meas r to uce or control aesthetic impacts, if any: MM 11. Light and GI wo lie pl a. What type of ligh o�gla will the proposal produce? What time of day would it mainly occur? r eI b. Could light or gla a from the finished project be a safety hazard or interfere with views? c. What existi�ngfoff site so roes of light or glare may affect your proposal? / V rs . d. Proposed measures to r Bduce or control light and glare impacts, if any: A/- e - Page 8 of 12 SEPA Environmental checklist�AC r 1 7-11-960) July 2016 12. Recreation 114T11 a. What designated and info al recreational opportunities are in the immediate vicinity? C ��„yyk Y of(�f e/1��'4 Vl d✓ oZ dY� J f le G LTV do b. Would the proposed 6ject displace any existing recreational uses? If so, describe. Ah c. Proposed measure s ito reJuce or control impacts on recreation, including recreation opportunities to be ptovid d by the project or applicant, if any: 13. Historic and du�turaf preservation Tel a. Are there any buildings, structures, or sites, located on or near the site that are over 45 years old listed in or eligible for listing in national, state, or local preservation registers ? If so, specifically/descil e.' b. Are there any Ian marks features, or other evidence of Indian or historic use or occupation? This may include I iutnan urials or old cemeteries. Are there any material evidence, artifacts, or areas of cultura, iO ripoil ance on or near the site? Please list any professional studies conducted at the its to i entify such resources. f � 'Cefc'-'�-Ce ri'�Vel c. Describe the mett ods us 9d to assess the potential impacts to cultural and historic resources on or near the pro ei site. Examples include consultation with tribes and the department of archeology and hit ric eservation, archaeological surveys, historic maps, GIS data, etc. Fawer �J'ill ti I d. Proposed measur s to avoid, minimize, or compensate for loss, changes to, and disturbance to resources. Ple s ill ide plans for the above and any permits Lthat may be required. h r` c-.M oe,te- L+ G�• C'�J ("f tl�rC i II 2��'�f-O 14. Transportati gel a. Identify public streets and highways serving the site or affected geographic area and describe proposed acce s to the existing street system. Show on site plans, if any. b. Is the site or affe tod g graphic area currently served by public transit? If so, generally describe. If not, what is the approximate distance to the nearest transit stop? c. How many additional p ing spaces would the completed project or non-project proposal have? How many woul the project or proposal eliminate? NOr,e 4 N Page 9 of 12 SEPA Environmental check) t AC 1 7-11- 60) July 2016 d. Will the proposal require i iny new or improvements to existing roads, streets, pedestrian, bicycle or state transport tion facilities, not including driveways? If so, generally describe (indicate whA ether public r private). e. Will the project or proposal use (or occur in the immediate vicinity of) water, rail, or air transportation? If o ge rally describe. / Vr f. How many vehicular trips Der day would be generated by the completed project or proposal? If known, indicate en p Dak volumes would occur and what percentage of the volume would be trucks (such aE cpm rcial and nonpassenger vehicles). What data or transportation models were usec to mal a these estimates? g. Will the proposal i t 'rfer with, affect or be affected by the movement of agricultural and forest products o r ads or streets in the area? If so, generally describe. lto r uce or control transportation impacts, if any: h. Proposed measur s P 15. Public Services Ll :I a. Would the projec result an increased need for public services (for example: fire protection, police protection, public t,ansit, health care, schools, other)? If so, generally describe. Aro b. Proposed measu a to r duce or control direct impacts on public services, if any. 16. Utilities Lhpjjl a. Circle utilities cu r ntly available at the site: e ectric' atura g to refuse service, elephon anitary sewer, eptic s s o er b. Describe the util tics that are proposed for the project, the utility providing the service, and the general constri,iction activities on the site or in the immediate vicinity which might be needed. 7 SEPA Environmental check St AC 741-960) July 2016 Page 10 of 12 C. Signature The above answers EIre true and complete to the best of my knowledge. I understand that the lead agency is relyin on, to make its decision. Signature: ` S ' Name of signee Position and Agency. r'gani tion Date Submitted: ' D. Supplemen al sheet for nonproject actions L (IT IS NOT NECESSARY tc use this sheet for project actions) Because these ique., tions are very general, it may be helpful to read them in conjunction with the list o the elements of the environment. When answe irg these questions, be aware of the extent the proposal, or the types of activities like)f to result from the proposal, would affect the item at a greater intensity or at a faster ral a Ithan f the proposal were not implemented. Respond briefly and in general termi i. 1. How would the p oposal be likely to increase discharge to water; emissions to air; pro- duction, storage, r ilrelea se of toxic or hazardous substances; or production of noise? Proposed measu e$to a void or reduce such increases are: 2. How would the pl-000sal be likely to affect plants, animals, fish, or marine life? Proposed m ee sure 10 to protect or conserve plants, animals, fish, or marine life are: 3. How would the r pos I be likely to deplete energy or natural resources? Proposed rr easure to protect or conserve energy and natural resources are: 4. How would the propos be likely to use or affect environmentally sensitive areas or areas designate (nor eligible or under study)for governmental protection; such as parks, July 2016 Page 11 of 12 SEPA Environmental chec list(WAC 9741-960) wilderness, wild and sceni rivers, threatened or endangered species habitat, historic or cultural sites, wetlands, ficodplains, or prime farmlands? Proposed me s�res I o protect such resources or to avoid or reduce impacts are: 5. How would the pr posal a likely to affect land and shoreline use, including whether it would allow o eanco age land or shoreline uses incompatible with existing plans? Proposed me spres o avoid or reduce shoreline and land use impacts are: 6. How would the proposal be likely to increase demands on transportation or public services and utiliti s? Proposed m 0ures o reduce or respond to such demand(s) are: 7. Identify, if possible, whet er the proposal may conflict with local, state, or federal laws or requirements for a,prof kction of the environment. SEPA Environmental checkli it( VAC 11 41-60) July 2016 Page 12 of 12 i 262 l -w314 � - Z------------- US Army ING ON STATE gr E} -___- Da'creceivodJ* MAR 1 a 2021 Semite iAstrict d Joint Aqu tic esources Permit Agency 5N. Alder Street Applicati Irk (J RPA) Form' 2 hi Zt�21+In USE BLACK OR BLUE INKTO ENTE ANSWERS IN THE WHITE SPACES BELOW Tag Parcel#(s): � a --------------------------------------- Part 1—Project Ide tific tion 1, Project Name (Ana f r yo project that you create.Examples:Smith's Dock or Seabrook Lane Development) [?! oor 0 LAC Part 2—Applicant The person and/or orgy i2 atio responsible for the project [Lc.:�zl 2a, Name(Last,First,Mi dl�) ft 2b. prgan]zation`(if ap ble} 2C. Mailing Address( reetoe 0 Box) 2d. city, Mate, Zip 6� HO CILIC-12, WA Ze.'Phone(�J one#2) 2g. Fax 2h. E-mail 'Ian, lAdditional forms may be reqL re J for tt following permits: . If your project may quay r Dertment of the Army authorization through a Regional General Permit(RGP),contact the U.S.Army Corps of Engineers for applicatioi in format n(206)764-3495. local Shoreline permits.If you need a Shoreline permit,contact the appropriate city or county • Not all cities and countiept JARPA for their government to make sui a t iey a pt the JARPA. 2To access an online JARPA with I ielp]screens,go to For other help,contact the G ernor's ffice for Regulatory Innovation and Assistance at(800)917-0043 or he g._wEL�'V- Page 1 of 14 ARIA-revised 0212020 i I Part 3-Authorized Agent or Contact Person authorized to rep esent a applicant about the project. (Note: Authorized agent(s) must sign 11 b of this application.) [Lre 3a. Name(Fast,First, WOW). 3b. Organization (►f appt 6le) r3d. Mailing Address (s eit or Box) City, State, Zip 3e. Phone(1) . P ne(2) 3+g. Fax 3h E-mail Part 4-Property C iwnei(s) Contact information for eople r organizations ners may not own the ad acprojecent will ic landr.[+Consider both upland and aquatic o ershi because the upland ow Same as applicant. kip to Part 5.) ❑ Repair or maintenance actil ities on existing rights-of-way or easements. (Skip to Part 5.) ❑ There are multiple u land aperty owners. Complete the section below and fill out.IARpA, ttachme t A for each additional property ov ner. is on D p�artm nt of Natural Resources (DNR)-managed aquatic lands. If you don't know, contact ❑ Your project the DNR at(is 9 2 110 to determine aquatic land ownership. If yes, complete SPA tta2 �" �� . to apply for the Aquatic Ose Authorization. 4a. Name (Last,first, idole) 4b Organization (if a pl cabie 4C`. Mailing Address)$treet o PO Box; 4d. City, State, Zip 4e. Phone(1) 7 4 Phone;(2) 4g. Fax 4h. E-mail ii Page 2 of 14 ORiA-revised 0212020 i Part 5-Project Lo tion s) Identifying information ab out the property or properties where the project will occur. fte! ❑ There are multiple pro e0t locations (e.g. linear projects). Complete the section below and use .'A PA Atiachment q for eacl i additional project location. 5d. Indicate the type of a hip of the property. (Cheek all that apply.} Iel Private ❑ Federal ❑ Publicly owned (state county,city, special districts like schools, ports, etc.) ❑ Tribal iAl Attac nient E ElDepartment of Natui al",Res urces (DNR)—managed aquatic{ands (Complete 5b. Street Address ( n t be' PO Box. If there is no address,provide other location information in 5p.) het V40 'AJY scc Or, 5C. City, Mate, Zip(If t rode is not in a city or town, provide the name of the nearest city or town) (hcl dd 5d. County LeI 5e. 'provide the; ectio ,,ko hip, and range for the project location. here] -1/4 Sec#ion Section Township Range W 5f. Provide the in Ind ngitude of the project location. ;bi 3 • Example:47.038 to# 1-122.89142 W long.(Ilse decimal degrees-NAD 83) H-7 "-f T 7 i 2 3 13 7� 5g.'List the tax parce rn ` r(s)for the project location.. hel } The local county,; s"+ess s office can provide this information. 1 Z I c7"S '0 0 C 5h Contact informati for' 11 adjoining property owners. (If you need more space,use WiP �t aci7ier�r Name Mailing Address Tax Parcel >�if known} a � : 9,�31 — r�-0� q© Page 3 of 14 ORIA-revised 02/2020 Si. List all wetlands on",Or djac hnt to the project location. inn Y\oAe- 5j. List all waterbodies er an wetlands) on or adjacent to the project location. t el 5k. Is any part of the p j ct a within a 'I�€�-year flaodplain? "et ❑ Yes kNo Don't know 51. Briefly describe the e�et on and habitat conditions on the property. ite1 5m. Describe how the proped`V is currently used. i,Lei l cA LA e.C�2 ��G'Y� S L v\ e-C- GM L f 1 ------------ 5n. Describe how the:adiacei it properties are currently',used ire l do So. Describe the stru res bove and below ground) on the property, including their purpose{s) and current condition. i1 r r,m� 1 60ur►1 5p. Provide driving d ion s from the closest highway to the project locationL and attach a map. h-r l (( w ( + �1�:: � "�ra'+v� ��$6�-T Q.,r"�J � �c.�-�,m�� `� ✓�n e��.�, .�urn. �E'� Vc IJ t'�r CCrT Dti. Page 4 of 14 ORIA-revised 02/2020 i Part 6—Project Des r'ipti n 6a. Briefly summarize t I 40jover., 11 project. You can provide more detail in 6b. Eel ' 1 /t 1 6b. Describe the purpo oft project and why you want or need to perform it. SDI Ao (( ��icce vim@�1 dvL� cJ i�I a� r�ev� �aua bee,r� ► t �'"roll 6c. Indicate the proje tegc dry.:(Check all that apply) [ncl ❑ Commercial X Residential ❑ Institutional ❑ Transportation XRecreational ❑ Maintenance ❑ En ironmental Enhancement :::6d. Indicate the major el�mer'ts of your project. (Check all that Wly) [heip] ElAquaculture Culvert 'Float ❑ Retaining Wall (upland) ElBank Stabilization 0 Dam /Weir ElFloating Home ❑ Road ElBoat House ❑ Dike/ Levee/Jetty ❑ Geotechnical Survey ❑ Scientific ❑ Boat Launch ❑ Ditch ❑ Land Clearing Measurement Device ❑ Boat Lift Dock/ Pier ❑ Marina/ Moorage ❑ Stairs ❑ Bridge ❑ Dredging ❑ Mining ❑ Stormwater facility ❑ Bulkhead ❑ Fence ❑ Outfall Structure ❑ Swimming Pool ❑ Buoy ❑ Ferry Terminal ❑ Piling/Dolphin ❑ Utility Line ❑ Channel Modifica ion ❑ Fishway ❑ Raft i`n�i, �`l�y �lGiv. J Other: (� �� rvd. l v N/ l is Page 5 of 14 ORIA-revised 02/2020 6e. Describe how you ai to ' nstruct each project element checked in ed- Include specific construction methods and equippil.nent to, be used. lhpi identify where each lament will occur in relation to the nearest waterbody. • indicate which actin ie are I Ahin the 100-year flo dpiain. WO<jJ i 1 n �. all ►�. ti ��cr r �C S�°� l fry W !�� PC � r r 6f. What are the anticiPaled s art and end dates for project construction?(MonthlYear) ['ig r If the project will b c nstru ted in phases or stages,use PA Aft 61 rr ,er�t�to list the start and end dates of each phase or stage. Start Date: p L i 2�Ze End Date: 2-021 ❑ See JARPA Attachment D 6g. Fair market value fi he oject, including materials, labor, machine rentals, etc. V it- 6h.Will any portion of hie pr ect receive federal funding`? ee If yes,list each a ncy pr ding funds. ❑ Yes KNo 1, Do t know Part 7-Wetlands:Jwet is and Mitigation ❑ Check here if there arends or wetland buffers on or adjacent to the project area. (If there are none, s t 8.) .ei 7a,'Descr►be how the rbje , has been designed to avoid and minimize adverse impacts to wetlands, (I:gipj --------------- tNot applicable 7b. Will the project i pact lands? lhei ❑ Yes %No ❑ D 't know 7c Will the project irnpOct #land buffers? l e' ❑ Yes INo C7 Dc n't know Page 6 of 14 ORIA-revised 02/2020 7d. Has a wetland delin aation 1 eport been prepared? 1hi If Yes,submit the r olt,in ding data sheets,with the JARPA package. ❑ Yes KNo 7e, Have the wetlands n r ed using the Western Washington or Eastern Washington Wetland Dating System? Mpl . if Yes,submit the w atl nd ` 'ng forms and figures with the JARPA package. ❑ Yes g No bon' know 7f. Have you prepared itj ion plan to compensate for any adverse impacts to wetlands? [LeIz,I If Yes,submit the ril with JARIPA package and answer 1g. + If No or Not appli ,e lain below why a mitigation plan should not be required. ❑ Yes No IDon' know AIJ 7g. Summarize what tj ie�',mittg`ation plan is"meant to accomplish, and describe how a watershed approach was used to design theplan hI 10 7h. Use the table bel ` llto li the type and rating of each wetland impacted, the extent and duration of the impact, and the an amount of mitigation proposed. Car if you are submitting a mitigation plan with a similar table; you ` r s e (below)where we can find this information in the plan. l�l Activity(fill, etl nd Wetland Impact Duration Proposed Wetland drain, excavate, Nan iel type and area (sq. of impact3 mitigation mitigation area flood, etc.) rating ft. or type" (sq. ft. or sate o 2 Acres) acres JA 'If no official name for the la;d exi create a unique name(such as"Wetland 1 name should be consistent with other project documents, such as a wetland deiineatic in report. 2 Ecology wetland category b ised on rrent Western Washington or Eastern Washington Wetland Rating System.Provide the wetland rating forms with the JARPA package. 3 Indicate the days,months o years t wetland will be measurably impacted by the activity.Enter"permanent"if applicable. 4 Creation C ,Re-establishrr enVReh ii1ftation R,Enhancement E, Preservation P,Miti ation Bank/In-lieu fee B Page number(s) for E imilar i iformation in the mitigation plan, if available: Page 7 of 14 ORIA-revised 0212020 h source and nature of the fill material, the amount in 7t. For all filling act�vitie en#i d to 7h, describe the cubic yards that will e'us ; and how and where it will be placed into the wetland. ['-r l /V 7�. For all excavating a ` tt�es dentified in 7h,describe the excavation method, type and amount of material in J cubic yards you will ov;; and where the material will be disposed. �I ) tAJ ( i Part 8—Waterbodi s (ol her than wetlands): Impacts and Mitigation In Part 8, "waterbodies"refers iD non-wetland waterbodies. (See Part 7 for information related to wetlands.) [i M) Check here if there are wat odies on or adjacent to the project area. (if there are none, skip to Part 9.) --------------- f avoid and minimize adverse impacts to the aquatic environment. Ba. Describe how the reject.;S.designed o [h9jP� i ❑ Not applicable I / Jke t e ice:: (-)e VK,(d,,c-jdc iAl � CC11Y1 -" -11C_ ,-eve -71 81b. Will:your project' act waterbody or the area around a waterbody? f et l Yes ❑ No Page 8 of 14 ORIA-revised 02/2020 i 8c. Have you prepared >Init' ` ian plan to compensate far the project's adverse impacts to non-wetland waterbodies?ices * If Yes; submit the p t1writh e JARPA package and answer 8d. • If No,or Not app## b ,e lain Wow why a mitigation plan should not be required. ❑ Yes XNo bon' know 8d. Summarize what t Irrliti Lion plan is meant to accomplish. Describe haw a watershed approach was used to design the ptn. + If,you already co . e dig ou do not need to restate your answer hers. [hei AIM 8e, Summarize impac( to ch waterbody in the table below. llLe ] Activity (clear, sate dy Impact Duration Amount of material Area (sq. fi. or dredge, fill, pile nam ' locationz of impact3 paced in or remocubic yards)to ved linear waterb waterbody drive, etc.) from waterbodydirectlyaffected &0 ( � �. air Go e - ►— '� �C �., eb _ If no official n e for the wa r dy fists,create a unique name(such as"Stream 1")The name should be consistent with other documents provided. z Indicate whether the impact wiiii occur n or adjacent to the waterbody. If adjacent,provide the distance between the impact and the waterbody and indicate whether the impact Nill occur Nithin the 100-year flood plain. 3Indicate the da months o rs t waterbodywill be measurablyim cited b the work. Enter"permanent"if applicable. 8f. For all activities i rttrfi in Be,'describe the source and nature of the fill material, amount(in cubic yards) you will use, and *a where it will be placed into,the waterbody. l n Page 9 of 14 ORIA-revised 0212020 8g. For all excavating o edg g actin€ties identified in 8e, describe the method for excavating or dredging, type and amount of m ter t you will remove, and where the material wilt be disposed. helj i� Part 9-Additional Infonnation Any additional information you an provide helps the reviewer(s) understand your project. Complete as much of this section as you can. t is ok f you cannot answer a question. 9a. if you have alread rk ' with any government agencies on this project, list them below: i,ei Contact Name Phone Most Recent Agency Name Date of Contact �I Z7 Z Z f 91b.Are any of the we aids `r waterbodies identified in Part 7 or,Fart 8 of this JARPA on the Washington' pepartment of Ec 1 y`s` 03(d) List? eel #f Yes,list the pa rT 6tef( below. • if you don't know,:u vV , ington Department of Ecology's Water Quality Assessment tools at: _f?col u ,"'l f ; xhtti 's.ne ter aifi atgr:,i,n r_p_ vement/Assess€�e,,A state-wa{e;°s-303d. tKyes ❑ No or r )� 9c.what'U.S. Geolo al S rvey Hydrological Unit Code(HUC) is the project in? [te-,tp Go to; ;f"lofty .e a.00 s ffiocaterip iex cfrn to help identify the HUC. Z ? 6 Mid 9d What Water Res ce f ventory Area Number (WR #) is the pro ect ire? Go to h s:lleco "Wa `�ata'-ShoraL,,gsl Vater- u"t meter-ai ailabilit llytars ec-€cerk-�c to find the WRIA 1 16 Page 10 of 14 ORIA-revised 02f202O 9e. 1lUill the in-water co sl�ruct' n work comply with the Mate of Washington water quality standards for turbidity? ft.P.101 : ' Go to IT, .1i coioQ o pater sizoreline-,ivvater- u-,Ii _ eshwaterl a tag e�+eter ��auli#� s a d�r�s;( �:terie for the standards. ❑ Yes ❑ No otapplicable 9f. If the project is with of e sdicton of the Shoreline Management Act, what is the local shoreline environment design It1 n? hel + If you don't know, c n�wc t th local planning department., • For more infbrmati �o to; t es/Shoreline .sra.00vf#llatei tore€ir� crelire-coasta!-rsarxa et�So=3 lire-coastal pian�in Ishoreiine a s ru4` -and-*vases. ❑ Urban ❑ Nat rail I I Aquatic ❑ Conservancy Other: -ic 9g.What is the Washl goon partment of`Natural Resources Water Type? hei Go to t wile }P�i i -r. «. o Brest roc ices water typing for the Forest Practices Water Typing System. Shoreline ❑ Fish Non-Fish Perennial ❑ Non-Fish Seasonal 9h.Will this project bed slg d to meet the Washington Department of Ecology's most current stormwater manual? T~tI 'p-1 •:. If No,provide the r arhe of a manual Your,project is designed to meet. XYes ❑ No Name of manual: 9L Does the project si a av known contaminated sediment? eel • If Yes, please de ri a be ❑ Yes o 9j. If you know: erty was used for in the past, describe below_ gel 9k. Has a cultural re oarce: archaeological) survey been performed on the project area? ��;;I, )f Yes, attach it11 your J RPA package. ❑ Yes XNo r v,fL f<r �rJt f"C.hrr ., Page 11 of 14 ORIA-revised 02/2020 91. Name each species I sted der the federal Endangered Species Act that occurs in the vicinity of the project area or might t aff ted by the proposed work. [ L-/ 9m. Name each specie4�h *at on the Washington Department of Fish and W ldlife's Priority Habitats and Species List that affected by the proposed work.. [i)ei h DAB. V' Part 10—SEPA Co MOW ce and Permits Use the resources and eckli t below to identify the permits you are applying for. Online Project C uqstior Haire at htt :i!a�s. ria-vasoar'oaa . Governor's office for Regulatory Innovation and Assistance at(800) 917-0043 or !3e1 • For a list of add �ses lo send your JARPA to, click on®agency addresses for corn lefed JARPA. 10a. Compliance with a Sta Environmental Policy Act (SEPA)- (check all that apply-) Jhei� For rriare in#armat' SbQut EPA,go tosl�EPA er iro €r� [A-af-evieVi- ❑ A copy of the SEPA de rmination or letter of exemption is included with this application. A SEPA determination pending with �� car � (lead agency). The expected decision date is F111 am applying fo a FistHabitat Enhancement Exemption. (checkthe box below in yob.) [i�4'c ❑ This project is a empt choose type of exemption below). ❑ Categorical empti n. Under what section of the SEPA administrative code (WAC) is it exempt? ❑ Other: ❑ SEPA is pre-errptIed by federal law. Page 12 of 14 ORIA-revised 02/2020 10b. indicate the perms you r,6 applying for. (Check all that apply,) [!ILe_IPJ LocAL GOVERNMENT Local Government Sbo ne permits: Substantial Deve opme ❑ Conditional Use ElVariance ❑ Shoreline Exem ioIn Ty e (explain): Other City/County' 0rmi : ❑ Floodplain Devel pimen Permit ❑ Critical Areas Ordinance STATE GOVERNMENT Washington Depalitment f Fish and Wildlife: VHydraulic Projec.Appro al (HPA) ❑ Fish Habitat Enhancement Exemption-?,tt ch TEM- fig-n—Fo-n-n. Washington Depai tMent f Natural Resources: ❑ Aquatic Use Authorization Complete JAPA AL �tE71 nt h and submit a check for$25 payable to the Washington Department of Natural Resources. Do not send cash. Washington Depa tment of Ecology: ❑ Section 401 Wa er Qu ity Certification ❑ Non-Federally Regulated Waters FEDERAL AND TRIBAL GOVERNMENT United States Departmer it of the Army(U.S. Army Corps of Engineers): ❑ Section 404 (dis horges i ito waters of the U.S.) ❑ Section 10 (work in navigable waters) United States Coast Guard: For projects or bridges over waters of the United States, contact the U.S. Coast Guard at: 13 w. 'idRt ?? ❑ Bridge Permit ❑ Private Aids to Navigation (or other non-bridge permits) United States En v irbnIt tal Protection Agency: ElSection 401 W ter Qy Certification (discharges into waters of the U.S.) on tribal lands where tribes do not have treatmen as a ate (TAS) Tribal Permits: (c eck wit i the tribe to see if there are other tribal permits, e.g.,Tribal Environmental Protection Act, Shoreline Permits, Hydraulic Pro ec Perr its,or other in addition to CWA Section 401 WQC) ❑ Section 401 WE teir Qu lity Certification (discharges into waters of the U.S.) where the tribe has treatment as a state (TAS). Page 13 of 14 ORIA-revised 0212020 Part 11—Authorizing Sig natures Signatures are required before s bmitting the JARPA package. The JARPA package includes the JARPA form, project plans, photos, etci 11a. Applicant Signature I(requir d) h l I certify that to the best of my knowledge and belief, the information provided in this application is true, complete, and accurate. I also certif V that I have the authority to carry out the proposed activities, and I agree to start work only after I have received all necassary permits. I hereby authorize the ag nit nan ed in Part 3 of this application to act on my behalf in matters related to this application. (ii I itial) By initialing here, I state t iat I he ve the authority to grant access to the property. I also give my consent to the permitting agencies enter property where the project is located to inspect the project site or any work related to the project. (initial) Edo ,- i(r,J Applicant Printed m Applicant Signature Date 11 b. Authorized Agent%natun hgi I certify that to the best of my knowledge and belief, the information provided in this application is true, complete, and accurate. I also certify that I have the authority to carry out the proposed activities and I agree to start work only after all necessary permits I lave been issued. Authorized Agent Printed Nam Authorized Agent Signature Date 11 c. Property Owner Signature if not applicant) [Lei-pa Not required if project is or existing rights-of-way or easements (provide copy of easement with JARPA). I consent to the permitting open ies entering the property where the project is located to inspect the project site or any work. These inspe Ions 1hall occur at reasonable times and, if practical, with prior notice to the landowner. C Property Owner Printed Name Property Owner ignatur Date FY �( c�`� <"f j- 18 U.S.0§1001 provides that: Whoeve , in any manner within the jurisdiction of any department or agency of the United States knowingly falsifies, conceals, or covers up by any rick, scheme, or device a material fact or makes any false,fictitious, or fraudulent statements or representations or makes or ui ies any Ise writing or document knowing same to contain any false, fictitious, or fraudulent statement or entry, shall be fined not more t ian$10, 00 or imprisoned not more than 5 years or both. If you require this document i i nothe format, contact the Governor's Office for Regulatory Innovation and Assistance(ORIA)at(800) 917-0043. People with heari g loss n . call 711 for Washington Relay Service. People with a speech disability can call(877)833- 6341. ORIA publication num e OR -16-011 rev. 09/2018 i ORIA-revised 02t2020 Page 14 of 14