HomeMy WebLinkAboutSHX2004-00043 ATF Bulkhead - SHX Permit / Conditions - 12/7/2004 0N.STA MASON COUNTY
BPS C ° DEPARTMENT OF COMMUNITY DEVELOPMENT
o A 0 N Planning Division
r'- S v z P O Box 279, Shelton, WA 98584
N Y y (360)427-9670
OJ �O
1864
Exemption from Shoreline Management Act
Case No.: SHX2004-00043 Substantial Development Permit Requirement
The Proposal By: DOUGLASA.SCHLYER TO BE KEPI IN Ti-ic
18142 NORMANDY TERR. SW
SEATTLES,WA 98166
i
To undertake the following development:
ATF REPLACEMENT OF EXISTING WOOD BULKHEAD WITH A ROCK BULKHEAD AND
PREVIOULSY EXISTING RETAINING STRUCTURES WITH ROCKERY
Within LAKE CUSHMAN and/or its associated wetlands is exempt from the requirement of substantial development because
the development is categorized under WAC 173-1-040(B) as being category
B-normal maintenance
Please contact Tammi Clark at ext 295 if you have any
Issued: 12/7/2004
Expires: 12/7/2005 Authorized Loca overnment Official
Iona
cc: APPLICANT WDFW ,ea C,rS USACOE
WDOE TRIBAL COUNCIL
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JARPA FORM 00040
00 �TA*�
M
��• r 0 6
(for use In Washington State)
PLEASE TYPE OR PRINT IN BLUE OR BLACK INK ��t uw+°r
Based on the preceding checklist,1 am sending copies of this application to the following: (check all that apply) �/
El Local Government for shoreline: El Substantial Development ❑ Conditional Use El Variance L11 Exemption;or,if applicable
❑ Floodplain Management ❑ Critical Areas Ordinance
❑ Washington Department of Fish and Wildlife for HPA
❑ Washington Department of Ecology for: ❑Approval to Allow Temporary Exceedance of Water Quality Standards
❑401 Water Quality Certification Nationwide Permits
❑ Washington Department of Natural Resources for:❑Aquatic Resources Use Authorization Notification
❑ Corps Engineers for:❑ Section 404 ❑ Section 10 permit
❑ Coast Guard for: ❑Section 9 Bridge Permit
SECTION A - Use for all permits covered by this application. Be sure to also complete Section C(Signature Block)for all permit
applications.
1.APPLICANT C-.^
-V 1
MAILING ADDRESS
l 1 Z N ntrr"anCL derr- U3
WORK PHONE HOME Z�`^)10N FAX tt C, 'to(_
ZUtp Z�t�-I-`5�� 2 —� <10 F'
Kan agent Is acting for the applicant during the permit process,complete#2.
2.AUTHORIZED AGENT
MAILING ADDRESS
WORK PHONE HOME PHONE FAX#
3.RELATIONSHIP OF APPLICANT TO PROPERTY. ❑OWNER ❑PURCHASER ❑LESSEE ❑OTHER:
4.NAME,ADDRESS,AND PHONE NUMBER OF PROPERTY OWNER(S),IF OTHER THAN APPLICANT:
S.LOCATION(STREET ADDRESS,INCLUDING CITY,COUNTY AND ZIP CODE,WHERE PROPOSED ACTIVITY EXISTS OR WILL OCCUR)
L� 1 �,,, c -liL\ 1'41ck i'% , ew V,'�r. t�oock or+ uO q.
WATERBODY TRIBUTARY OF
La-vie C ,5�1 wta(�
1/4 SECTION TOWNSHIP RANGE GOVERNMENT LOT SHORELINE DESIGNA110
/� Lot 11 t_ant Cu�tAmeA 0If hoil t(`/Jc,
Pti 9 GL Gt 77 `>'8 ZONING SIGNAnON// �
ld? /t-[�-S.
TAX PARCEL NO.. DNR STREAM TYPE,IF KNOWN
Z33 Z-�UavO 1 Z�
Application Page 1 of 4
S. DESCRIBE THE CURRENT
THE PROPERTY.AND STRUIC111RES
TM PROPERTY.INDICATE MMOONi�H AND YEAR OF COMPLETION DOSTYrG ON?HE PROPERTY. ANr POR710N Of T}E PROP0.SED ACTIVITY IS ALREADY COMipLETE�ON
9tr,�dz' ,4,ail) I-kxjS. , SA-,i:•L,) ,Qt0A:Z./ A, � e•�Q79' Rt4z'H
9 �!
IS THE PROPERTY AGRICULTURAL LAND?❑YES VNO
ARE YOU A USDA PROGRAM PARTICIPANT? ❑YES❑NO,
7a. DESCRIBE THE PROPOSED WORK COMPLETE PLANS AND SPECIFICATIONS SHOULD BE PROVIDED FOR ALL WORK WATERWARD OF THE ORDINARY HIGH WATER MARK OR
7b.DESCRIBE THE PURPOSE OF THE PROPOSED WORK /
'^K 5 ��i z c��,o ti E✓n C "o H CL a,(-6eG S 1Pv r d,
7C. DESCRIBE THE POTENTIAL IMPACTS TO CHARACTERISTIC USES OF THE WATER BODY. THESE USES MAY INCLUDE FISH AND AQUATIC LIFE,WATER QUALITY,WATER
SUPPLY,RECREATION,and AESTHETICS. IDENTIFY PROPOSED ACTIONS TO AVOID,MINIMIZE,AND MITIGATE DETRIMENTAL IMPACTS,AND PROVIDE PROPER PROTECTION
PREPARATION OF DRAWINGS: SEE APPENDIX A-SAMPLE DRAWINGS AND CHECKLIST FOR COMPLETING THE DRAWINGS. ONE SET OF ORIGINAL OR GOOD QUALITY
REPRODUCIBLE DRAWINGS Mj BE ATTACHED NOTE. APPLICANTS ARE ENCOURAGED TO SUBMIT PHOTOGRAPHS OF THE PROJECT SITE,BUT THESE DO NOT SUBSTITUTE
FOR DRAWINGS. THE CORPS OF ENGINEERS AND COAST GUARD REQUIRE DRAWINGS ON 8-112 X 11 INCH SHEETS. LARGER DRAWINGS MAYBE REQUIRED BY OTHER
AGENCIES
S.WILL THE PROJECT BE CONSTRUCTED IN STAGES?
/ — /
PROPOSED STARTING DATE: 4�t"�✓ -Al Ni-{ ��G� . Lt��K GLJ�f �v� � J ❑YES OAIZUD
ESTIMATED DURATION OF ACTIVITY:
9.CHECK IF ANY STRUCTURES WILL BE PLACED:
❑WATERWARD OF THE ORDINARY HIGH WATER MARK OR LINE FOR FRESH OR TIDAL WATERS;AND/OR
❑WATERWARD OF THE MEAN HIGH WATER LINE IN TIDAL WATERS
10.WILL FILL MATERIAL(ROCK,FILL,BULKHEAD,PILINGS OR OTHER MATERIAL)BE PLACED:
❑WATERWARD OF THE ORDINARY HIGH WATER MARK OR LINE FOR FRESH WATERS? U IF YES,VOLUME(CUBIC YARDS) /AREA (ACRES
❑WATERWARD OF THE MEAN HIGHER HIGH WATER FOR TIDAL WATERS?
IF YES,VOLUME(CUBIC YARDS) /AREA (ACRES)
11.WILL MATERIAL BE PLACED IN WETLANDS? 11 J
L/ ❑YES O
IF YES:
A.IMPACTED AREA IN ACRES:
B.HAS A DELINEATION BEEN COMPLETED? IF YES,PLEASE SUBMIT WITH APPLICATION.
❑YES ❑NO
C.HAS A WETLAND REPORT BEEN PREPARED? IF YES,PLEASE SUBMIT WITH APPLICATION.
❑YES ❑NO
D.TYPE AND COMPOSITION OF FILL MATERIAL(E.G.,SAND,ETC.):
E.MATERIAL SOURCE:
f.UST ALL SOIL SERIES(TYPE OF SOI TH�PROJECT`SITE,t INDICATE IFEY ARE ON THE COUNTYS UST OF IIYDRK SOILS. SOILS INFORMATKNd CAN BE
FROMTHTURAL RE �QLOCA�TEDAT
CE(NRCS7:12. OPOSEDCTIVITY CAUETLANDS?
❑YES eNO
Application Page 2 of 4
r
. SECT1,714 C-This section MUST be completed for any Permit covered by this application.
�4
19. APPLICATION IS HEREBY MADE FOR A PERMIT OR PERMITS TO AUTHORIZE THE ACTIVITIES DESCRIBED HEREIN. 1 CERTIFY THAT 1 AM FAMILIAR WITH THE
INFORMATION CONTAINED IN THIS APPLICATION.AND THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF,SUCH INFORMATION IS TRUE,COMPLETE,AND
ACCURATE I FURTHER CERTIFY THAT I POSSESS THE AUTHORITY TO UNDERTAKE THE PROPOSED ACTMTIES. 1 HEREBY GRANT TO THE AGENCIES TO
WHICH THIS APPLICATION IS MADE,THE RIGHT TO ENTER THE ABOVE-DESCRIBED LOCATION TO INSPECT THE PROPOSED,IN-PROGRESS OR COMPLETED
WORK I AGREE TO START WORK ONLY AFTER ALL NECESSARY PERMITS HAVE BEEN RECEIVED
SIGNATURE APPLICANT OR A All
/ DATE
7 AA
F✓
I HEREBY DESIGNATE
TO ACT AS MY AGENT IN MATTERS RELATED TO THIS APPLICATION FOR PERMrT(S). I UNDERSTAND THAT IF A FEDERAL PERMIT IS ISSUED,I MUST SIGN THE PERMIT -
SIGNATURE OF APPLICANT DATE --
SIGNATURVOF LANDOWNER(EXCEPT PUB E LANDOWNERS,E.G.ONR)
DATE
THIS APPLICATION)MUST 13E SIGNED BY THE APPLICANT AND THE AGENT,IF AN AUTHORIZED AGENT IS DESIGNATED.
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,tictrtious,or
fraudulent statement or entry,shall be fined not more than$10,000 or imprisoned not more than 5 years or both. -
COMPLETED BY LOCAL�31 FiCiAL
:A IVa#ur$af the e�cistingsh€ireiirae. {Cescribetypetafishare(Ine;su�Ftasarine, strew ri lake lagoon, mash bog, s; amp. [ovd....
` plain #ioadway, siefta; type ofdaach such Ssccre#ion erosion,#iig batik, taty bank, or dike; material sLi has sand, grvef .:
mud,slay rock, riprap, and�x#ent and ty, ' of iuCicheacling if any;}
to the ve it that sny of Vie Proposed#�uildings or structures . exce a ttelght of thirty-five feed above the eve;a e grade
Levelntli ate#he`appro)tirnafe Coca#iatsf and tumernf�resen#►at unt#s; exist;ng ar�3 taotntia;r that will have an nrs# uctcd; .:;
VfyY
ifth8 I atwrt tvotvtis lrottdstC l t tlse 4i xatiancO,'set forth in fult that portion Of the n�a:ster program which provides that
ttta ropc�sec€Liss may t a condlti6ftl rise at,i t the case of a variance,from which the.variance is t eing sough
�ckl > roeOeveiamenz
CI Fk dv yi> 'I.... .al ,n:Ej CFk�dsfp ld Ehrtsi{�Study Art ra var ncR
:. -XXX
�tu#A�tftM Cotntacut#y.hntet 3tutrsber" ':
ji�
`t'fte base��4-yesr fksvdpc�u ��va4:ot or> #h;uurtbeC ar try rTtem afL�is $wet
':_ha lowela pwsuate&Ali:14 ek vatro»is Y tecE,
BUtldlrtg��tid Canstructoxt Uo�t�tT`;sr�tatior,:
Ceflrficallttt Required C ertiCrcabraro f2ece uRd
....,StRYel+tu(A ac,�it aeL`Er1gi r.ea f
Flood-Proottng � Pre-Ctxtstn3cia�rz per.
�1evaEedfibus+rlq s ::.Ate�ans(ruriiartv... '€�rs�st-C;czras9r,�c3iat�
1(�stnitoit t< Waf,etway
IA
NU iFS
These Agencies are Equal Opportunity end AMrrnaUm Action employers.
For special eacwnnadeUon needs,please contact the appropriate agency from Appendix B.
Application Page 4 of 4
_
IF YES,IMPACTED AREA IS ACRES
13.WILL EXCAVATION OR DREDGING BE REQUIRED IN WATER OR WETLANDS? ,, ❑YES NO
IF YES: `
A.VOLUME_(+CUBIC YARDS)/AREA_(ACRES)
B.COMPOSITION OF MATERIAL TO BE REMOVED:
C.DISPOSAL SITE FOR EXCAVATED MATERIAL:
D.METHOD OF DREDGING:
14.LIST OTHER APPLICATIONS,APPROVALS,OR CERTIFICATIONS FROM OTHER FEDERAL,STATE OR LOCAL AGENCIES FOR ANY STRUCTURES,CONSTRUCTION,DISCHARGES,
OR OTHER ACTIVITIES DESCRIBED IN THE APPLICATION O.E.,PRELIMINARY PLAT APPROVAL,HEALTH DISTRICT APPROVAL,BUILDING PERMIT,SEPA REVIEW,FERC LICENSE,
FOREST PRACTICES APPLICATION,ETC.)ALSO INDICATE WHETHER WORK HAS BEEN COMPLETED AND INDICATE ALL EXISTING WORK ON DRAWINGS.
TYPE OF APPROVAL ISSUING AGENCY IDENTIFICATION NO. DATE OF APPLICATION DATE APPROVED COMPLETED?
SEPA LEAD AGENCY �SEPADESION: SEPA DECISION DATE:
15. HAS ANY AGENCY DENIED APPRQVAL FOR THE ACTMTY DESCRIBED HEREIN OR FOR ANY ACTMTY DIRECTLY RELATED TO THE ACTIVITY
DESCRIBED HEREIN?❑YES ONO IF YES,EXPLAIN:
SECTION B -Use for Shoreline and Corps of Engineers permits only:
16 TOTAL COST OF PROJECT. THIS MEANS THE FAIR MARKET VALUE OF THE PROJECT,INCLUDING MATERIALS,LABOR,MACHINE RENTALS,ETC.
17. LOCAL GOVERNMENT WfT}i JURISDICTION:
18. FOR CORPS,COASTGUARD,AND DNR PERMITS,PROVIDE NAMES,ADDRESSES,AND TELEPHONE NUMBERS OF ADJOINING PROPERTY OWNERS,LESSEES,ETC.PLEASE
NOTE: SHORELINE MANAGEMENT COMPLIANCE MAY REQUIRE ADDITIONAL NOTICE—CONSULT YOUR LOCAL GOVERNMENT.
NAME ADDRESS PHONE NUMBER
Application Page 3 of 4
I Staking Line—__I .
' (Per plat) 1 I SCALE: 1-20 FEET
` Edge of water as - 0 10 20 40
_ - located 1-19-07 -
I
9asis
Mums A rldlah: Record of Surroy as recorded
In hgton,ecorda of Mason
County, Wa Page
... I O Set 1/2"mbar wkh-cop
uWIC E rJzr s. - LS 36792 -
'2 $1 r wge of I •. Found Iron pipe
Calculated position
C,otch basin
/ Y O
x---x--x Fence line
<p ��
,,y Concrete'
/ _l ...................... Asphalt
E
{*Pk-6•
le/ VERMAL 8 - -
1 =i
h / ..r.•..:• NM Assumed
Contour Interval 5'
o House ,
CURVE TABLE
I r a 7.1 W. DELTA RADIUS LEMM
o g II V'
4 ,c0'Y' 10'b'i5' �:0000 97:83 elk,
1 ;1:
1 .. law-a.
�.•
i gS
J I Shed
1 so
�-Edge o/water as ; r tO.
.located eeg.1-19-01 1 J
I
�_1g� 'caeca fa-n-a
I
- Staking Line—� 1 .... \\ �+
\ � - Shclyer 01-02 2-5-01
(vef cat) \ BU L.ER SURVEYING INC.
DT ° NNTTNG
y
m
OCT 06 2004
ITAP
��' r �'. C_,.-awrr:.""„ •,./( +mot �,f 7 dj a•>
'��'-.�r - «,ter � - �,*- '� .r. a �.�" '�- � ..•- Y
t
i
L �JiF
s
�-
+x '
1>` } lZi
.;
lr :-
y
r
M
:2
Staking Line I j
(per plat) —_�1 I SCALE: 1"=20 FEET
ll` Edge of water as 0 10 20 40
/I located 1-19-01 I I
survey as recorded
Basis in ume 8 Meridian: Record f of Flats Page
d 38, Records of Mason
I I County, Washington,
I I
I O = Set 112"rebar with-cap
ak LS 36792
b9e of I • Found iron pipe
w9s =
01 I.
&I�
21 ® Calculated position
Qatch basin
`hCh $ X x Fence line
No
tir
•4":.':a Concrete'
n
I l ..................... Asphalt
rl
�. l 4'plastic `/16
b VERTICAL DATUM
Assumed
Contour Interval 5'
o House
o ,I CURVE TABLE.
I a bl ,4, NO. DELTA RAL)Ius LEhCTH
Cf 4;35'24: 520.00 41.88
92� 10.46'45 520.00 97.83
I a
I TBM- r
' - CO �oT'
C 4
J Shed
I Edge of water as
located'1-19-01 I *tO°d9e of'�et N 727%!,4 •E'(R) 1►te
I - at/� t-19_0J -E�swEs 12-09-a 1'
I '
Staking Una---I 5
\\ l� Schlyer 01-02 2-5-01
(per plat) \ BUTLER SURVEYING INC.