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SHX2016-00083 ATF Dock, Float, Boat Lift - SHX Application - 11/16/2016
r------------ AGEN `� V ED i t AGEN I Date received: NOVt _`, }a' US Army Corps ; N 14 2016 r;��_ <^ WASHINGTON STATE of Engineers a 4 Seattle District Joint Aquatic Resources Permit Agency reference#:615 W. Alder Street ,2 Application (DARPA) Form TaxP rcel# s): .�I- _ USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. t t t _ ' Part 1—Project Identification 1. Project Name (A name for your project that you create. Examples: Smith's Dock or Seabrook Lane Development) [ ] Stack Dock, Float and Boat Lift After the Fact Permitting Part 2—Applicant The person and/or organization responsible for the project. [ ] 2a. Name (Last, First, Middle) Stack, Gregory, Jon 2b. Organization (If applicable) NA 2c. Mailing Address (Street or PO Box) 9329 21st Ave NW 2d. City, State, Zip Seattle, WA 98117 2e. Phone(1) 2f. Phone(2) 2g. Fax 2h. E-mail 206 321-6126 NA gstack.sdm@comcast.net Additional forms may be required for the following permits: • If your project may qualify for Department of the Army authorization through a Regional General Permit(RGP),contact the U.S.Army Corps of Engineers for application information(206)764-3495. • If your project might affect species listed under the Endangered Species Act,you will need to fill out a Specific Project Information Form(BPIF)or prepare a Biological Evaluation. Fo ms can be found at n)yftf --_----- • Not all cities and counties accept the JARPA for their local Shoreline permits.If you need a Shoreline permit,contact the appropriate city or county government to make sure they accept the JARPA. 2To access an online JARPA form with[help]screens,go to Itijs:uwwvt_e ttr;tt�r� :i rrecenter/arpa_,_jarpa form/9984/jarpa form.aspx. For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or.help .oria.wa.gov. ORIA-16-011 Page 1 of 15 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.) [ 3a. Name (Last, First, Middle) NA 3b. Organization (If applicable) 3c. Mailing Address (street or PO Box) 3d. City, State, Zip 3e. Phone(1) 3f. Phone(2) 3g. Fax 3h. E-mail Part 4—Property Owner(s) Contact information for people or organizations owning the property(ies) where the project will occur. Consider both upland and aquatic ownership because the upland owners may not own the adjacent aquatic land. [ I 0 Same as applicant. (Skip to Part 5.) Upland leasehold owner—Tacoma power owns the land and the lake ❑ Repair or maintenance activities on existing rights-of-way or easements. (Skip to Part 5.) ❑ There are multiple upland property owners. Complete the section below and fill out for each additional property owner. ❑ Your project is on Department of Natural Resources (DNR)-managed aquatic lands. If you don't know, contact the DNR at (360) 902-1100 to determine aquatic land ownership. If yes, complete DARPA Attachment E to apply for the Aquatic Use Authorization. 4a. Name (Last, First, Middle) Wright, Wynnae 4b. Organization (if applicable) Tacoma Power 4c. Mailing Address (street or PO Box) PO Box 11007 4d. City, State, Zip Tacoma, WA 90411-0007 4e. Phone(1) 4f. Phone(2) 4g. Fax 4h. E-mail 253 318-2527 253 441-4180 wwright@cityoftacoma.org ORIA-16-011 Page 2 of 15 Part 5—Project Location(s) Identifying information about the property or properties where the project will occur. [ ) ❑ There are multiple project locations (e.g. linear projects). Complete the section below and use JARPA for each additional project location. 5a. Indicate the type of ownership of the property. (Check all that apply.) [ ] El Private (Leasehold) ❑ Federal 0 Publicly owned (state,county, city,special districts like schools, ports,etc.) ❑ Tribal ❑ Department of Natural Resources (DNR) — managed aquatic lands (Complete ) 5b. Street Address (Cannot be a PO Box. If there is no address,provide other location information in 5p.) [ ] 2700 West Cushman Ridge Road 5c. City, State, Zip (If the project is not in a city or town, provide the name of the nearest city or town.) [ Hoodsport, WA (Nearest Town) 5d. County [ ] Mason 5e. Provide the section, township, and range for the project location. [ ] 1/4 Section Section Township Range 19 23N 4W 5f. Provide the latitude and longitude of the project location. [ ] • Example:47.03922 N lat./-122.89142 W long. (Use decimal degrees-NAD 83) 47.46458N/-123.24300W 5g. List the tax parcel number(s)for the project location. [ • The local county assessors office can provide this information. 42331-50-02020 5h. Contact information for all adjoining property owners. (If you need more space, use.1ARPA Attachment C.) [, ems] Name Mailing Address Tax Parcel # (if known) Kathrine Knorr 7524 35th Ave SW Apt S205 42331-50-02021 ...............I............... Seattle, WA 98126 MikeLawrence PO Box171......................_.................._............._.................._................_......._.............__.............................---....................................._................ 42331-50-92193 Suquamish, WA98392 Christina and Christopher Artman 11012. Canyon.yon Road E Suite 8#177 42331-50-92191 .................................._.___...... . ... ......._.....--.........................._._......................_............................__..............._..........._.__..._............._..... Puyallup, WA 98373 City of Tacoma Department of 3628 S 35th Street................._................................................................................................................ 42319-88-88888 Public Utilities Taoma, WA 98409 42319-00-60000 ORIA-16-011 Page 3 of 15 5i. List all wetlands on or adjacent to the project location. [ No wetlands 5j. List all waterbodies (other than wetlands) on or adjacent to the project location. [ Lake Cushman 5k. Is any part of the project area within a 100-year floodplain? [ ❑ Yes © No ❑ Don't know 51. Briefly describe the vegetation and habitat conditions on the property. [ i The upland property has second or third growth forest of douglas fir, fir, hemlock and cedar along with big leaf maples and alder. Low shrubs of himalayan blackberries, salal, ferns, and other indigenous NW plants. Many fallen trees on a rugged forest floor. 5m. Describe how the property is currently used. [ The property is currently a seasonal vacation residence with a 640 SF 1 bedroom cabin on the lot 5n. Describe how the adjacent properties are currently used. [ North —Vacation property with campsite South - 1 Seasonal residence South - 2 Seasonal residence West— Forest Tacoma Power East— Lake Cushman 5o. Describe the structures (above and below ground) on the property, including their purpose(s) and current condition. [ ] 640 SF Cabin w/300 SF Deck—Good condition 30 SF Wood Shed — Fair condition 30 SF Storage Shed — Fair condition 343 SF Dock—Good condition 80 SF Swim Float— Good Condition 48 SF Boat Lift—Good Condition 5p. Provide driving directions from the closest highway to the project location, and attach a map. [ 1 See attached Map ORIA-16-011 Page 4 of 15 Part 6—Project Description 6a. Briefly summarize the overall project. You can provide more detail in 6b. [ ] Trying to permit existing Dock and Float built in 1997 and existing boat lift installed in 2007 6b. Describe the purpose of the project and why you want or need to perform it. [ , I am trying to permit existing structures to comply with Tacoma Power's Shoreline Use Permit requirements in preparation to the property containing the improvements. 6c. Indicate the project category. (check all that apply) [ I ❑ Commercial 0 Residential ❑ Institutional ❑ Transportation 0 Recreational ❑ Maintenance ❑ Environmental Enhancement 6d. Indicate the major elements of your project. (Check all that apply) [ ❑ Aquaculture ❑ Culvert 0 Float ❑ Retaining Wall ElBank Stabilization ❑ Dam /Weir ❑ Floating Home (upland) ❑ Geotechnical Survey El Road ❑ Boat House El Dike/ Levee/Jetty y ❑ Land Clearing El Scientific El BoatLaunch ❑ Ditch Measurement Device 0 Boat Lift 0 Dock/ Pier ❑ Marina/ Moorage ❑ Stairs ❑ Bridge ❑ Dredging ❑ Mining ❑ Stormwater facility ❑ Bulkhead ❑ Fence ❑ Outfall Structure ❑ Swimming Pool ❑ Buoy ❑ Ferry Terminal ❑ Piling/Dolphin ❑ Utility Line ❑ Channel Modification ❑ Fishway ❑ Raft ❑ Other: ORIA-16-011 Page 5 of 15 6e. Describe how you plan to construct each project element checked in 6d. Include specific construction methods and equipment to be used. [ • Identify where each element will occur in relation to the nearest waterbody. • Indicate which activities are within the 100-year floodplain. Improvements already exist. Dock is made from 6 x6 wood posts embedded 2.5 feet into the lakebed. Three of the posts are embedded in concrete formed by 1 foot diameter sonotubes embedded 2.5 feet in the lakebed. 6 x 6 beams support 2 x 10 joists. 2 x 6 wood decking with a Y4 in space between deck planks spans the joists. Posts are cross based. Dock was constructed using hand tools and shovels. Swim float is 8' x 10' with a wood deck supported by encapsulated flotation material below. It is kept in place by a rope attached to a 5 gallon bucket of concrete which rests on the lakebed. The solar powered galvanized steel boat lift was assembled on site and rests on the lakebed without excavation. Improvements are not in the 100 year flood plain. 6f. What are the anticipated start and end dates for project construction? (MonthNear) • If the project will be constructed in phases or stages, use to list the start and end dates of each phase or stage. Start Date: Dock: Feb, 1997, End Date: Dock: Mar, 1997, ❑ See JARPA Attachment D Lift: Mar 2007 Lift: April 2007 6g. Fair market value of the project, including materials, labor, machine rentals, etc. [ ) $9300 6h. Will any portion of the project receive federal funding? [ j • If yes, list each agency providing funds. ❑ Yes RI No ❑ Don't know Part 7—Wetlands: Impacts and Mitigation ❑ Check here if there are wetlands or wetland buffers on or adjacent to the project area. (If there are none, skip to Part 8.) [ 7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. [ ❑ Not applicable 7b. Will the project impact wetlands? [ : I ❑ Yes ❑ No ❑ Don't know 7c. Will the project impact wetland buffers? ( j ❑ Yes ❑ No ❑ Don't know ORIA-16-011 Page 6 of 15 7d. Has a wetland delineation report been prepared? [ • If Yes, submit the report,including data sheets,with the JARPA package. ❑ Yes ❑ No 7e. Have the wetlands been rated using the Western Washington or Eastern Washington Wetland Rating System? • If Yes, submit the wetland rating forms and figures with the JARPA package. ❑ Yes ❑ No ❑ Don't know 7f. Have you prepared a mitigation plan to compensate for any adverse impacts to wetlands? ( I • If Yes, submit the plan with the DARPA package and answer 7g. • If No,or Not applicable,explain below why a mitigation plan should not be required. ❑ Yes ❑ No ❑ Don't know 7g. Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was used to design the plan. ( _ I 7h. Use the table below to list the type and rating of each wetland impacted, the extent and duration of the impact, and the type and amount of mitigation proposed. Or if you are submitting a mitigation plan with a similar table, you can state (below) where we can find this information in the plan. [ Activity (fill, Wetland Wetland Impact Duration Proposed Wetland drain, excavate, Name' type and area (sq. of impact3 mitigation mitigation area flood, etc.) rating ft. or type' (sq. ft. or category2 Acres) acres) If no official name for the wetland exists,create a unique name(such as"Wetland 1"). The name should be consistent with other project documents,such as a wetland delineation report. 2 Ecology wetland category based on current Western Washington or Eastern Washington Wetland Rating System.Provide the wetland rating forms with the JARPA package. 3Indicate the days,months or years the wetland will be measurably impacted by the activity.Enter"permanent"if applicable. °Creation C ,Re-establishment/Rehabilitation R ,Enhancement E ,Preservation P ,mitigation Bank/in-lieu fee B Page number(s) for similar information in the mitigation plan, if available: ORIA-16-011 Page 7 of 15 7i. For all filling activities identified in 7h, describe the source and nature of the fill material, the amount in cubic yards that will be used, and how and where it will be placed into the wetland. ( I 7j. For all excavating activities identified in 7h, describe the excavation method, type and amount of material in cubic yards you will remove, and where the material will be disposed. 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.) [ l 0 Check here if there are waterbodies 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. [" ❑ Not applicable The project used minimum excavation of the lakebed, and minimum disturbance to the surrounding vegetation. 8b. Will your project impact a waterbody or the area around a waterbody? [ ; 0 Yes ❑ No Page 8 of 15 ORIA-16-011 8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland waterbodies? [ • If Yes, submit the plan with the JARPA package and answer 8d. • If No,or Not applicable,explain below why a mitigation plan should not be required. ❑ Yes Q No ❑ Don't know The project has been in place for 20 years on a seasonal reservoir/lake. Areas under the dock are completely dry for 8 months each year. The Habitat Management Plan by Bio Resources LLC determined that since the uplands adjacent to the project are left in a natural condition, no mitigation is required for the project. 8d. Summarize what the mitigation plan is meant to accomplish. Describe how a watershed approach was used to design the plan. • If you already completed 7g you do not need to restate your answer here. [; No mitigation is required per the Habitat Management Plan prepared by Bio Resources LLC (enclosed) 8e. Summarize impact(s) to each waterbody in the table below. [ I Activity (clear, Waterbody Impact Duration of Amount of material Area (sq. ft. or dredge, fill, pile name' location impact3 (cubic yards) to be linear ft.) of drive, etc.) placed in or removed waterbody from waterbody directly affected Lakebed 1 month Post hole Lake adjacent to 343 SF Dock during .87 Cu Yd's excavation Cushman high water construction line If no official name for the waterbody exists,create a unique name(such as"Stream 1")The name should be consistent with other documents provided. 2 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 1o0-year flood plain. 3 Indicate the days,months or years the waterbody will be measurably impacted by the work. Enter"permanent"if applicable. 8f. For all activities identified in 8e, describe the source and nature of the fill material, amount (in cubic yards) you will use, and how and where it will be placed into the waterbody. [ I ORIA-16-011 Page 9 of 15 All construction was performed during the 8 months that the lakebed of Lake Cushman is dry at the project site. No fill material was used. One-foot diameter postholes were dug with spoils (cobbles, gravel and sand) distributed on the adjacent dry lakebed. Three of the twelve posts used concrete Sonotubes (one foot diameter) 2' —6" below the dry lakebed in which 6 x 6 posts were embedded. The remaining posts were embedded directly in the dry lakebed. 8g. For all excavating or dredging activities identified in 8e, describe the method for excavating or dredging, type and amount of material you will remove, and where the material will be disposed. [ - ] 0.87 Cu Yd's of cobbles, gravel and sand were excavated with a hand posthole digger and any material not used for back fill was distributed on the dry lakebed adjacent to the excavated holes. Part 9—Additional Information Any additional information you can provide helps the reviewer(s) understand your project. Complete as much of this section as you can. It is ok if you cannot answer a question. 9a. If you have already worked with any government agencies on this project, list them below. [ ) Agency Name Contact Name Phone Most Recent Date of Contact Tacoma Power Wynnae Wright 253 318-2527 5/20/16 Mason County Rebecca Hersha 360 427-9670 5/25/16 9b.Are any of the wetlands or waterbodies identified in Part 7 or Part 8 of this JARPA on the Washington Department of Ecology's 303(d) List? [ ] • If Yes,list the parameter(s)below. • If you don't know, use Washington Department of Ecology's Water Quality Assessment tools at: r t •i ❑ Yes RI No Page 10 of 15 ORIA-16-011 9c. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? hel • Go to i,ttp://cfpub.e fdocate/index.ch to help identify the HUC. 17110017 and 17110018 9d. What Water Resource Inventory Area Number (WRIA#) is the project in? [ } • Go to http://www.ecy:w ov4ater/wria/index.htm� to find the WRIA#. 16 9e. Will the in-water construction work comply with the State of Washington water quality standards for turbidity? • Go to httpa/www.e, q/swgs/criteria.html for the standards. RI Yes ❑ No ❑ Not applicable 9f. If the project is within the jurisdiction of the Shoreline Management Act, what is the local shoreline environment designation? I • If you don't know,contact the local planning department. • For more information,go to: ttp_//www.ecy.wa_govlprorams/sea/sma/laws rules/173-26/211 designations.html. 2 Urban ❑ Natural ❑ Aquatic ❑ Conservancy ❑ Other: 9g. What is the Washington Department of Natural Resources Water Type? [ } • Go to http://www.dnr.w ov/orest-practices-water-tVpinc for the Forest Practices Water Typing System. ❑ Shoreline ❑ Fish ❑ Non-Fish Perennial ❑ Non-Fish Seasonal 9h. Will this project be designed to meet the Washington Department of Ecology's most current stormwater manual? [ } • If No,provide the name of the manual your project is designed to meet. EI Yes ❑ No Name of manual: 9i. Does the project site have known contaminated sediment? het • If Yes, please describe below. ❑ Yes RI No 9j. If you know what the property was used for in the past, describe below. [help] ORIA-16-011 Page 11 of 15 Site was forest prior to the construction of Cushman Dam. 9k. Has a cultural resource (archaeological) survey been performed on the project area? • If Yes, attach it to your JARPA package. ❑ Yes 0 No ORIA-16-011 Page 12 of 15 91. Name each species listed under the federal Endangered Species Act that occurs in the vicinity of the project area or might be affected by the proposed work. Bull Trout Marbled Murrelet Northern spotted Owl Streaked Horned Lark 9m. Name each species or habitat on the Washington Department of Fish and Wildlife's Priority Habitats and Species List that might be affected by the proposed work. [ Kokanee Puget sound Coastal Cutthroat Trout Part 10—SEPA Compliance and Permits Use the resources and checklist below to identify the permits you are applying for. • Online Project Questionnaire at ittp-.j/qpp s.oriama.gov/mas-4- • Governor's Office for Regulatory Innovation and Assistance at (800) 917-0043 or help oria.wa.gov. • For a list of addresses to send your DARPA to, click on �enc a�iclresses fog completed DARPA. 10a. Compliance with the State Environmental Policy Act (SEPA). (check all that apply.) [;ielp] • For more information about SEPA,go to www.ecy.wa.gov/programs/sea/sepa/e-review.html. ❑ A copy of the SEPA determination or letter of exemption is included with this application. 21 A SEPA determination is pending with Mason County (lead agency). The expected decision date is Unknown at this time. ❑ I am applying for a Fish Habitat Enhancement Exemption. (check the box below in 10b.) [ l ❑ This project is exempt (choose 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. ORIA-16-011 Page 13 of 15 10b. Indicate the permits you are applying for. (Check all that apply.) ( ) LOCAL GOVERNMENT Local Government Shoreline permits: Tacoma Power shoreline Use Permit ❑ Substantial Development ❑ Conditional Use ❑ Variance Shoreline Exemption Type (explain): c�e << qz( Other City/County permits: ❑ Floodplain Development Permit ❑ Critical Areas Ordinance STATE GOVERNMENT Washington Department of Fish and Wildlife: ❑ Hydraulic Project Approval (HPA) ❑ Fish Habitat Enhancement Exemption — No HPA is required since improvements are existing. See letter from Joshua Benton of WDFW attached. You must submit a check for $150 to Washington Department of Fish and Wildlife, unless your project qualifies for an exemption or alternative payment method below. Do not send cash. Check the appropriate boxes ❑ $150 check enclosed. Check# Attach check made payable to Washington Department of Fish and Wildlife. © My project is exempt from the application fee. (Check appropriate exemption): ❑ HPA processing is conducted by applicant funded WDFW staff. Agreement# ❑ Mineral prospecting and mining ❑ Project occurs on farm and agricultural land. (Attach a copy of current land use classification recorded with the county auditor,or other proof of current land use) ❑ Project is modification of an existing HPA originally applied for, prior to July 10, 2012. HPA# Washington Department of Natural Resources: ❑ Aquatic Use Authorization NA Complete and submit a check for$25 payable to the Washington Department of Natural Resources. Do not send cash. Washington Department of Ecology: NA ❑ Section 401 Water Quality Certification FEDERAL GOVERNMENT United States Department of the Army permits (U.S. Army Corps of Engineers): ❑ Section 404 (discharges into waters of the U.S.) 0 Section 10 (work in navigable waters) United States Coast Guard permits: NA ❑ Private Aids to Navigation (for non-bridge projects) ORIA-16-011 Page 14 of 15 Part 11—Authorizing Signatures Signatures are required before submitting the JARPA package. The JARPA package includes the JARPA form, project plans, photos, etc. [l 11a. Applicant Signature (required) 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. (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) Gregory J. Stack 11/10/16 Applicant Printed Name li an ig Date 11 b. Authorized Agent Signature [ ) 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. NA Authorized Agent Printed Name Authorized Agent Signature Date 11c. Property Owner Signature (if not applicant) [ i Not required if project is on existing rights-of-way or easements (provide copy of easement with JARPA). I consent to the permitting agencies entering the property where the project is located to inspect the project site or any work. These inspections shall occur at reasonable times and, if practical, with prior notice to the landowner. Same as applicant Property Owner Printed Name Property Owner Signature Date 18 U.S.0§1001 provides that:Whoever, in any manner within the jurisdiction of any department or agency of the United States knowingly falsifies,conceals, or covers up by any trick, scheme,or device a material fact or makes any false,fictitious, or fraudulent statements or representations or makes or uses any false 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 for Regulatory Innovation and Assistance(ORIA)at(800) 917-0043. People with hearing loss can call 711 for Washington Relay Service. People with a speech disability can call(877)833-6341. ORIA publication number: ORIA-16-011 rev. 09/2016 ORIA-16-011 Page 15 of 15