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Home My WebLink AboutSEP2009-00054 SHX2009-00028 GEO2009-00053 - SEP Determinations - 6/23/2009 ----------- --- --- 771- --, 2009 r A�fi�c��s>✓oN�� O r US Army Corps ; Date received• , WASHI GTON STATE seari o"c `5` r Joint Aquatic Resources Permit Application JARPA) Form hel Agencyreferenee r , Tax Parcel#(s): USE BLACK OR BLUE INK TO ENTER ANSWERS IN WHITE SPACES BELOW. " r Part 1-Project Identification r I Unique project information that makes it easy to identify. hel ---------`------- ---- --------- ----' in 1 Ininue Proiect Id6n ifier ', umher(I IPI #) rholpl Don't have one yet?', et one,at http llurww epermittinq.Wa".qov or call`the Washington Governor's Office of Regulatory Assistance, at(800)917 0041! 1 b. Project Name (Ex4mles- mith's.Dock or Seabrook Lane Development)•" hel Part 2-Applicant The person or organization legally responsible for the project. hel 2a.` Name(Last,"First,Middle)and Organization(if applicable) 2b. Mailing Address (street or PO Box) _ f 7,.�� Y: s lac/• 2c. City, State, Zip " ' 'RcuI�/Do WA 78-3 7 6 2d. Phone(1) e. P hone(2) ' ' 2f. Fax 2 . E-mail e � e e3 7 1215ro c.S P_(u Hvm, �±�? Part 3-Authorized Agent or Contact Person authorized to represent the applicant about the project. (Note: Authorized agent(s) must sign 11 b. of this application.) [bpjpl 3a. Name (Last, First, Middle)and-Organization (if applicable) 3b Mailing Address (street or PO Box) Ialier 3c City, State,,Zip 3d. Phone(1) 3e. hone(2) 3f: Fax 3g., E-mail JARPA 2009 Page 1 of 11 wneC s he Part 4-Property O ) [tea Contact information for people or organizations owning the property(ies)where the project will occur. heI Same as applicant. (Skip to Part 5.) ❑ Repair or maintenance activ ties on existing rights-of-way or easements. (Skip to Part 5.) ❑ There are multiple property wners. Complete the section below and use JARPA Attachment A for each additional property owner. 4a. Name (Last, First,Middle)and Organization (if applicable) 4b. Mailing Address (street or 110 Box)' 4c. City, State, Zip 4d. Phone(1) 4e. Phone(2) 0. Fax 4 E-mail. '~ r( Part 5—Project Location(s) Identifying information about th property or properties where the project will occur. [bPjPJ ❑ There are multiple properties or project locations (e.g., linear projects). Complete the section below and use JARPA Attachment B foreach additional property. 5a.'. Street Address (Cannot b a PO Box. If there is no'address,provide'otheF focation inforrnation`in 5n.) he! Matl~;i u Ld 5b City, State, Zip(If th proi ct is not in a city or town,provide the,name of the nearest city or town:) heI L A c 5c County LLelp' A,45,-,,A/ 5d'. Provide the section, township,ship, and range for the project location. heI 1/4 Section Section' Township Range' 31 a3 5e Provide the latitude and longitude of the project location. heI • Example:47.03922N lat./-122.89142 Wong n! JQ 5f. List the tax parcel number(s)for the project location. heI • The local county assesso s office'can provide this information. IL4 Dl'ilo 5g. Indicate the type of ownership of the property. (check all that apply.) heI ❑ State Owned Aquati Land ❑ Tribal XPrivate ❑ Other publicly owned (federal,state,county,city,special districts like schools, ports,etc.) JARPA 2009 Page 2 of 11 ICI I 5h. Contact information for all adjoining property owners, lessees, etc. (if you need more space,use JARPA` Attachment C. hel Name Mailing Address Tax Parcel # (if known) _...........____..___-_. I i 5' art of the {fir 'ect� `rea within:a 9 OQ-year flood 'lain? . hel ❑ Yes ❑ NoDon't know 5j. efly describe the Feget tion and habitat conditions on the property. [Lgjpl 5k. Describe how the p ope 'y is currently used. t , 51. Describe how the= Oace t properties are currently used. [bp.!pJ JARPA 2009 Page 3 of 11 5m. Describe the structures (' bove and below ground)on the property, including their,purpose(s). [Lei,, 5n. Provide driving dire tions-from the closest highwayJo the project location, and attach a map. hel Part 6—Project Descrip ion 6a. Summarize the overall prDject. You can provide more detail in 6d. h[ e� ' wL 'k,( (v /�u STo�ac�� O�,re�I ny 6b. Indicate the project category. (Check all that apply.) !)el ❑ Commercial ❑ R sidential ❑ Institutional ❑ Transportation ecreational ❑ Maintenance ❑ E vironmental Enhancement 6c.' Indicate the major'eleme its of your project. (Check all that apply.) hel ❑ Aquaculture ❑ Culvert ❑ Float ❑ Road ❑ Bank Stabilization ❑ Dam /Weir ❑ Geotechnical Survey ❑ Scientific Measurement ❑ Boat House ❑ Dike/ Levee/Jetty ❑ Land Clearing Device ❑ Boat Launch ❑ Ditch ❑ Marina / Moorage ❑ Stairs ❑ Boat Lift ock/ Pier ❑ Mining ElStormwater facility 1>1�0❑ Bridge El Dredging El Swimming Pool ❑ Outfall Structure ❑ Bulkhead ❑ Fence El Piling Utility Line ❑ Buoy ❑ Ferry Terminal ❑ Retaining Wall (upland) ❑ Channel Modification ❑ Fishway ❑ Other: DARPA 2009 Page 4 of 11 6d. Describe how you plan to construct each project element checked in 6c. Include speclflc co methods and equ(p enHib be used. help • Identify where each e�ementwill occur in relation to the nearest water �Rp !' "0 € r • 49 �,Indicate which activities are [thin the 100-year flood plaie1.v- . ,. .. .t . .. ..• ... . 6e. Wtiat artf sia t fo econsrUctt tm the eer1I E s • If the��ioaeC �ntilf d �e��s �� t � t t �'st ��+�({�� Start date End date:I)PW (m*r�OjQP(cVOt ❑ See JARPA Attachment D 6f. 'Describe the purpose'of the work and why you want or need to perform it. n[ ei� P\C —r° 6g. Fair market value of the 'roject, including materials, labor, machine rentals, etc. hel 6h.' Will any portion o tt e pr tecf receive If deral'funding? hei • If yes, list each agency pro'iding funds. ❑ Yes o ❑ Don't know Part 7—Wetlands: Impacts and Mitigation ❑ Check here if there are wetlands or wetland buffers on or adjacent to the project area. (If there are none, skip to Part 8.) 7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. hey Not applicable JARPA 2009 Page 5 of 11 7b. Will the project irnpa::t wetlands? Lgl l ❑ Yes ❑ No ❑ Don't know 7c. Will the project impact wetland buffers? hf gipl ❑ Yes ❑ No ODgn't know 7d. Has a wetland delineation report been prepared? hi ell • If yes,submit the report, including data sheets,with the JARPA package. ❑ Yes P 'No 7e. Have the wetlands been rated using the Western Washington or Eastern Washington Wetland Rating System? rf ell • If yes,submit the wet and rating forms and figures with the JARPA package. ❑ Yes ❑ No [❑ D n't know 7f. Have you prepared a miti ation plan to compensate for any adverse impacts to wetlands? of eIA • If yes,submit the plan with the JARPA package. ❑ Yes ❑ No ❑ N t applicable 7g. Use the table below to list the type and rating of each wetland that will be impacted; the extent and duration of the impact; and the type and amount of compensatory mitigation proposed. If you are submitting a compensatory mitigation plan with a similar table, you may;simply state (below)where we can find this information in the mitigation plan. [held Activity causing Wetland type Impact area Duration Proposed Wetland impact (fill, and rating (sq. ft. or acres) of impact2 mitigation mitigation area drain, excavate, category' type' (sq. ft. or acres) flood, etc. Ecology wetland category based on current Western Washington or Eastern Washington Wetland Rating System. Provide the wetland rating forms with the JARPA package. 2 Indicate the time(in months or years,as appropriate)the wetland will be measurably impacted by the activity. Enter"permanent"if applicable. 3 Creation (C), Re-establishment/Re abilitation(R), Enhancement(E), Preservation(P), Mitigation Bank/In-lieu fee(B) Page number(s)for simil r information in the mitigation plan, if available: 7h. For all filling activities identified in 7g., describe the source and nature of the fill material, the amount in cubic yards that will be used, and how and where it will be placed into the wetland. h[ ei7 7i. For allexcavating activities identified in 7g., describe the excavation method, type and amount of material in cubic yards you will r(:move, and where the material will be disposed. heel J JARPA 2009 Page 6 of 11 7j. Summarize what the compensatory mitigation plan is meant to accomplish, and describe how a watershed approach was used to design the plan., h[ eM Part 8—Waterbodies (other than wetlands): Impacts and Mitigation In Part 8, "waterbodies" refers to non-wetland waterbodies. (See Part 7 for information related to wetlands.) [Lpjpj Check here if there are wat rbodies on or adjacent to the project area. (If there are none, skip to Part 9.) 8a. Describe how the project is designed to avoid and minimize adverse impacts to the aquatic environment.' heI Not applicable 8b'. Will your project impact a waterbody or the area around a waterbody? help Yes ❑ No 8c. Summarize,impa6t(s)to each waterbody in the table below. hel' Activity causing Wate body Impact Duration Amount of material Area (sq. ft. or impact (clear, na rne location' of impact2 to be placed in or linear ft.) of dredge, fill, pile removed from waterbody drive, etc.) waterbody directly affected L KE h 4o)t)c Indicate whether the impact will occur in or adjacent to the waterbody. If adjacent, provide the distance between the impact and the waterbody and indicate whether the impact will occur within the 100-year flood plain. 2 Indicate the time(in months or years,as appropriate)the waterbody will be measurably impacted by the work. Enter"permanent'if applicable. 8d. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland waterbodies? LeeM If yes,submit the plan with the JARPA package. ❑ Yes No Not applicable 8e.' Summarize what the compensatory mitigation plan is meant to accomplish. Describe how a watershed approach was used'to d sign the plan. If you already complted 7j,you do not need to restate your answer here. hel JARPA 2009 Page 7 of 11 8f. For all activities identified in 8c.,,describe the source and nature of the fill material, amount(in cubic yards) you will use, and how and where it will be placed into the waterbody. hei 8g. For all excavating or dredging activities identified in 8c., describe the method for excavating or dredging, ', type andamount of material you will remove, and where th`e natgq [,!be disposed'. h[ elph Part 9—Additional Infor ation Any additional information�you can provide helps the reviewer(s) understand your project. 9a. If you have already worked with any government agencies on this project, list them below. h( egM Agency Name Contact Name Phone Most Recent Date of Contact 1 t I ( ) 9b. Are any of the wetlands or waterbodies identified in Part 7 or Part 8 on the Washington Department of Ecology's 303(d) List? hem • If yes,list the parameter(s)below. • If you don't know,Use Wash'ngton Department of Ecology's Water Quality Assessment tools at: http a/www.ecy.wa.<1ov/programs/wg1303d1. ❑ Yes "[5; No 9c. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? hel • Go to http://cfDub.eDa.goy/surf/""ocate/index.cfm to help identify the HUC. 9d.;What Water Resource Inventory Area Number (WRIA#) is the project in? h[ eM • Go to 11 //www.ecy.wa.aoviservices/gis/maps/wria/wria.htm to find the WRIA#. JARPA 2009 Page 8 of 11 I! 9e'. Will the in-water construct on work comply with the State of Washington water quality standards for turbidity? Lees • Go to http://www.ecM-wv Oy�pri:)grams/wq/swgs/criteria.html for the standards. ❑ Yes ❑ No ,.� Not applicable 9f. If the project is within the jurisdiction of the Shoreline Management Act,what is the local shoreline environment designation? Lei • If you don't know, contact the local planning department. • For more information,go to: htto://www.ecy:wa gov/programs/sea/sma/laws rules/173-26/211 desi'nq nations.html. Rural ❑ Urbal1 ❑ Natural ❑ Aquatic ❑ Conservancy ❑ Other 9g. What is the Washington Department of Natural Resources Water Type? [help] • Go to httpaly�,vw.dnr.wa.gov/BusinessPermits/TopicslForestPracticesAppiications/Paces/fp watertvping.aspx for the Forest Practices Water Typing System. ❑ S ❑ F ❑ Np ❑ Ns 9h. Will this project be designed to meet the Washington Department of Ecology's most current stormwater manual? of elpl • If no, provide the name of the manual your project is designedto meet. ❑ Yes ❑ No Name of manual: 9i. If you know what the property was used for in the past, describe below. [Lei 9j. Has a cultural resource (archaeological) survey been performed on the project area? hel If yes,attach it to your JARPA package. ❑ Yes E'"No 9k. Name each speciEa listed under the federal Endangered Species Act that occurs in the vicinity of the project area or might be affected by the proposed work. her 91. Name each,species or habitat on the Washington Department of Fish and Wldlife's Priority Habitats and Species List that might be affected by the proposed work. heM JARPA 2009 Page 9 of 11 Part 10—Identify the Permits You Are Applying For Use the resources and checklist below to identify the permits you are applying for. • Online Project Questio naire at httl):Happs.ecy.wa.gov/opas/. • Governor's Office of Regulatory Assistance at (800) 917-0043 or help(a)ora.wa.gov. 10a. Compliance with the State Environmental Policy Act (SEPA). (Check all'that apply.) he► • For more information about SEPA,go to www.ecv.wa.gov/programs/sea/sepa/e-review.html. A copy of the SEPA del ermination or letter of exemption is included with this application. ❑ A SEPA determination s pending with (lead agency). The expected decision date is ❑ 1 am applying for a Fish Habitat Enhancement Exemption. (Check the box below in 10b.) • Submit the Fish Habitat Enhancement Project form with this application. The form can be found at http://www.eDermittina.wa.gi)v/Portals/ Jar aResourceCenter/ima es/default/fishenhancement.doc ❑ This project is exempt ( hoose type of exemption below). ❑ Categorical Exemption. Under what section of the SEPA administrative code (WAC) is it exempt? ❑ Other: ❑ SEPA is pre-empted by federal law. h[ eM 10b. Indicate the permits you are applying for. (Check all that apply.) h( e►p] LOCAL GOVERNMENT Local Government Shoreline permits: ❑ Substantial Development ❑ Conditional Use ❑ Variance Shoreline Exemption Type (explain): Other city/county permits: ❑ Floodplain Development Permit ❑ Critical Areas Ordinance STATE GOVERNMENT Washington Department of Fish and Wildlife: ❑ Hydraulic Project Appro al (HPA) ❑ Fish Habitat Enhancement Exemption Washington Department of Ecology: ❑ Section 401 Water Quality Certification Washington Department of Natural Resources: ❑ Aquatic Resources Use Authorization FEDERAL GOVERNMENT United States Departmen of the Army permits (U.S. Army Corps of Engineers): ❑ Section 404 (discharges into waters of the U.S.) ❑ Section 10 (work in navigable waters) United States Coast Guard permits: ❑ General Bridge Act Permit ❑ Private Aids to Navigation (for non-bridge projects) JARPA 2009 Page 10 of 11 Part 11—Authorizing Signatures natures Signatures required before sut mitting the JARPA package. 11 a. Applicant Signature (req ired) hel I certify that to the best of my knowledge and belief, the information provided in this application is true, complete, and accurate. I also certify that I have the authority to carry out the proposed activities, and I agree to start work only after I have received all necessary permits. I hereby authorize the agent named in Part 3 of this application to act on my behalf in matters related to this application. IN5 (initial) By initialing here, I state that I have the authority to grant access to the property. I also give my consent to the permitting agencies entering the property where the project is located to inspect the project site or any work related to the project. (initial) Applicant Date 11 b. Authorized Agent Signature hel I certify that to the best of my knowledge and belief, the information provided in this application is true, complete, and accurate. I also certify that I have the authority to carry out the proposed activities and I agree to start work only after all necessary permits have been issued. Authorized Agent Date 11 c. Property Owner Signature (if not applicant) hel I consent to the permitting agencies entering the property where the project is located to inspect the project site or any work. These inspections shall occur at reasonable times and, if practical, with prior notice to the landowner. Property Owner Date 18 U.S.0§1001 provides that:Whoever, in any manner within the jurisdiction of any department or agency of the United States knowingly falsifies,conceals,or covers up by any trick,scheme,or device a material fact or makes any false,fictitious,or fraudulent statements or representations or makes or uses any I alse writing or document knowing same to contain any false,fictitious,or fraudulent statement or entry,shall be fined not more than$10 000 or imprisoned not more than 5 years or both. If you require this document in another format, contact The Governor's Office of Regulatory Assistance(ORA). People with hearing loss can call 711 for Washington Relay Service. People with a speech disability can call(877)833-6341. ORA publication number: ENV-019-0 JARPA 2009 Page 11 of 11 ASON CO. ENVIROMENTAL CHECKLIST A. BACKGROUND 1. Name of proposed project, if applicable: 2. Name of applicant: 3. Address and phone n imber of applicant and contact person: 36 v - ' 1 (- s-vc 3 6U - o 1.S "AIWA r'j 4. Date checklist prepared: L - Z-5 - 0 el 5. Agency requestir g checklist: 6. Proposed timing orschedule (including phasing, if applicable): 7. Do you have any plans for future expansion, or further activity related to or connected with this proposal: If yes, explain. Na 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. 66)7�G0N cA L, -et;ODld 7-"- 9. Do you know wh the applications are pending for governmental approvals of other proposals Y � pp p 9 9 pP P p directly affecting he r roperty covered by your proposal? If yes, explain. Nb 10. List any government pprovals or permits that will be needed for your proposal, if known. 11. Give a brief, complete description of your proposal, including the proposed uses and the size of the project and Site. There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not need to repeat those answers on this page. (Lead agencies may modify this form to include additional specific information on project description.) AF% (Z 7?-l1 C./` � ar'1 �/�(s U� I. /Q X Q I `K . 1-0 SIMvtG-TL,IZE / ti 12. What is the location of the proposal? Give sufficient information for a person to understand the precise location of your proposed project including a street address, if any, and section, township, and range, if known. If a proposal would occur over a range of area, provide the range or boundaries of the site(s). Provide a legal description, site plan, vicinity map, and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications related to this checklist. B. ENVIRONMENTALELEMENTS: 1. EARTH: a. General description o the site (circle one): Flat, rolling, hil , steep slopes, ountainous, other b. What is the steepest lope on the site (approximate percent slope)? 'y TD U —4 -U, N . C. What general types o soils are found on the site (for example, clay, sand, gravel, peat, muck)? If you know the classification of agricultural soils, specify them and note any prime farmland. d. Are there surface indi ations or history of unstable soils in the immediate vicinity: If so, describe. ni U Mason County Environmental Checklist Page 2 e. Describe the purpose type, and approximate quantities of any filling or grading proposed. Indicate source of fill. OIA f. Could erosion occur e s a result of clearing, construction, or use: If so, generally describe. ry �' g. About what percent o the site will be covered with impervious surfaces after project constructions (for example, asphalt or buildings)? h. Proposed measures t reduce or control erosion, or other impacts to the earth, if any: 2. AIR: a. What types of emissi ns to the air would result from the proposal (i.e. dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describ a and give approximate quantities, if known. b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. Pb Mason County Environmental Checklist Page 3 C. Proposed measures tD reduce or control emissions or other impacts to air, if any- 3 WATER: a. Surface- 1) Is there any surface water body on or in the immediate vicinity of the site (including year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type and provide names. If appropriate, state what stream or river it flows into. k. 6WASIVIAIQ 96,:�5. 2) Will the project require any work over, in, or adjacent to (within 200 feet) the described waters? If yes please describe and attach available plans. X&-%OVE Noelw 'Pr _ . r A` 3) Estimate the amount of fill and dredge material that would be placed in or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicate the so rce of fill material. N 6�J' 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. PU Mason County Environmental Checklist Page 4 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. ,3 6) Does the proposal involve any discharges of waste materials to surface waters? If so, describe the type of waste and anticipated volume of discharge. ty b. Ground: 1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, purpose, and approximate quantities, if known. Na �' 2) Describe WaStE material that will be discharged into the ground from septic tanks or other sources, f any (for example; domestic sewage, industrial, containing the following chemicals..., agricultural, etc.). Describe the general size of the system, the number of such systems, the number of houses to be served (if applicable), or the number of animals or humans the system(s) are expected to serve. C. Water runoff (including storm water): 1) Describe the source of runoff (including storm water) and method of collection and disposal, if any (include quantities, if known). Where will this water flow? Will this flow into other wate s? If so, describe. ^' 2) Could waste materials enter ground or surface waters: If so, generally describe. Mason County Environmental Checklist Page 5 f d. Proposed measures tc reduce or control surface, ground, and runoff water impacts, if any: 4. PLANTS: a. Check or circle types of vegetation found on the site: -X deciduous tree: alder, maple, aspen, other evergreen tree: fir, cedar, pine, other shrubs grass pasture crop or grain wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other water plants: water lily, eelgrass, milfoil, other ?� other types of vegetation b. What kind and amount of vegetation will be removed or altered? &JOejC C. List threatened or endangered species known to be on or near the site. d. Proposed landscapin , use of native plants, or other measures to preserve or enhance vegetation on the site if any: Mason County Environmental Checklist Page 6 5. ANIMALS a. Circle any birds and animals which have been observed on or near the site or are known to be on or near the site: Birds: hawk, heron, eagle.,songbirds, other Mammals: deer, bear, elk, beaver -ofher Fish: bass, salm trout;, herring, shellfish, other b. List any threatened or endangered species known to be on or near the site. C. Is the site art of migration route. If so explain. p P tj h) d. Proposed measures to preserve or enhance wildlife, if any: d/4 6. ENERGY AND NATURA RESOURCES: a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet the completed project's energy needs? Describe whether it will be used for heating, manufacturing, etc. i+ b. Would your project affect the potential use of solar energy by adjacent properties. If so, generally describe.' C. What kinds of energy conservation features are included in the plans of this proposal? List other proposed measures to reduce or control energy impacts, if any: Mason County Environmental Checklist Page 7 7. ENVIRONMENTAL HEALTH: a. Are there any environ ental 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. ND 1) Describe special emergency services that might be required. 11rl 2) Proposed mea 3ures to reduce or control environmental health hazards, if any: b. Noise. 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? 2) What types an levels of noise would be created by or associated with the project on a short-term or a long-term basis (for example: traffic, construction, operation, other)? Indicate whathour's noise would come from the site. "J, 3) Proposed measures to reduce or control noise impacts, if any: 8. LAND AND SHORELINE USE: a. What is the current uE e of the site and adjacent properties? 9F,uU !' P Mason County Environmental Check ist Page 8 b. Has the site been use J for agriculture? If so, describe. C. Describe any structurE s on the site. L vlr S� 6v�ie,Q 10Y i0 ' d. Will any structures be demolished? If so, what? AIOR.-o-f A e. What is the current zo iing classification of the site? f. What is the current co prehensive plan designation of the site? g. If applicable, what is the current Shoreline Master Program designation of the site? ..J J .j. h. Has any part of the sit= been classified as an "environmentally sensitive" area? If so, specify. NO i. Approximately how many people would reside or work in the completed project? #vAlif j. Approximately how many people would the completed project displace? N®,AIE k. Proposed measures to avoid or reduce displacement impacts, if any: N% Mason County Environmental Checkl st Page 9 I. Proposed measures t ensure the proposal is compatible with existing and projected land uses and plans, if any: 19ICSllc.�J fog �,iKE r�sE Op ,40j—ACe-d7' JIM96e741575 9. HOUSING: a. Approximately how m ny units would be provided, if any? Indicate whether high, middle, or low-income housing. �f b. Approximately how mEiny units, if any, would be eliminated? Indicate whether high, middle, or low-income housing. C. Proposed measures to reduce or control housing impacts, if any: 10. AESTHETICS: a. What is the tallest height of any proposed structure(s), not including antennas; what is the principal exterior building material(s) proposed? b. What views in the immediate vicinity would be altered or obstructed? c. Proposed measures to reduce or control aesthetic impacts, if any: p Mason County Environmental Check ist Page 10 . II 11. LIGHT AND GLARE a. What type of light or g are will the proposal produce? What time of day would it mainly occur? NONE: b. Could light or glare from the finished project be a safety hazard or interfere with views? C. What existing off-site sources of light or glare may affect your proposal: NO Nl d. Proposed measures to reduce or control light and glare impacts, if any: 11404 12. RECREATION- a. What designated and nformal recreational opportunities are in the immediate vicinity? 1: dd&n Al6- b. Would the proposed project displace any existing recreational uses? If so, describe. �J- c. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: I Mason County Environmental Check] st Page ]] 13. HISTORIC AND CULTURAL PRESERVATION: a. Are there any places r objects listed on, or proposed for, national, state, or local preservation registers known to be on or next to the site? If so, generally describe. PO b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. r C. Proposed measures t reduce or control impacts, if any: N/4_� 14. TRANSPORTATION: a. Identify public streets and highways serving the site and describe proposed access to the existing street system Show on site plans, if any. /J/A b. Is site currently served by public transit? If not, what is the approximate distance to the existing street system Show on site plans, if any. N $ ° C. How many parking spaces would the completed project have? How many would the project eliminate? d. Will the proposal requ re any new roads or streets, or improvements to existing roads or streets, not including C riveways? If so, generally describe (indicate whether public or private). J1I Mason County Environmental Checklist Page 12 e. Will the project use (o occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe NJ f. How many vehicular tips per day would be generated by the completed project: If known, indicate when peak vc lumes would occur. g. Proposed measures t reduce or control transportation impacts, if any: is e'y 15. PUBLIC SERVIC�S: a. Would the project result in an increased need for public service (for example: fire protection, police protection, health care, schools, other)? If so, generally describe-. N� b. Proposed measures to reduce or control direct impacts on public services, if any: Mason County Environmental Check] st Page 13 16. UTILITIES: a. Circle utilities currently available at the site: electricity, natural gas, water, refuse service, telephone, sanitary sevver, septic system, other: b. Describe the utilities that are proposed for the project, the utility providing the service, and the general construction activities on the site or in the immediate vicinity which might be needed. kl() N)c Signature: The above answers a e true and complete to the best of my knowledge. I understand that the lead agency is relying on them to make its decision. Signature: Date submitted: G 6 Mason County Environmental Checklist Page 14 ESA LISTED SALMONIDS CHECKLIST Applicant Information Project Information Name 6 i Name Phone _ Location 57/ All t'%6,4cj y,4`11 /ZO. Description_ This worksheet was designied help project proponents, and government agencies, identify when a project needs further analysis regarding adverse effects on ESA (Endangered Species Act) listed salmonids. Salmonids are salmon, trout and chars e.g. bull trout. For our purposes,"ESA Listed Salmonids" is defined as fish species listed as endangered, threatened or being considered for listing. If ESA listed species are p esen or ever were present in the water shed where your project will be located, your project has the potential f6i affe ting them, and you need to comply with the ESA. The questions in this section will help determine if the SA 1 stings will impact your project. The Fish Program Manager a the ap ropriate Department of Fish and Wildlife (DFW) regional office can provide information for the following two questions. 1. Are ESA listed al n ids currently present in the watershed in which your project will be located? YES N Please describe. 2. Has there ever b an SA listed salmonid stock present in this watershed? YES N Uncertain Please describe. If you answered "yes" to either of the above questions, you should complete the remainder of this checklist. April 2003 Mason County Environmenta C eckli t Page 15