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HomeMy WebLinkAboutSHX2016-00071 MEP2016-00044 SEP2016-00105 - SHX Permit / Conditions - 1/6/2017 1 oN-STATE MASON COUNTY �P5 0 O 9 Department of Community Services o A N Planning Division r o N Z 615 W Alder St, Shelton, WA 98584 T 7 N (360)427-9670 Y ti OJ �O y 1864 Exemption from Shoreline Management Act Case No.: SHX2016-00071 Substantial Development Permit Requirement The Proposal By: NATHANIEL & JESSICA SCHLICHER C/O SCHLICHER DOCK REPLACEMENT 4615 77TH AVE NW GIG HARBOR, WA 98335 Parcel Number: 423075000060 Site Address: 140 N POTLATCH DR HOODSPORT To undertake the following development: Replace (permit as new due to no previous permits on file) a decaying pier/ramp/float on Lake Cushman. Pier is 6' by 21' (about 10 feet as measured from OHWM). Ramp is 3' by 7' (3' span between float and pier). Float is 6' by 12'. Also, permit an existing buoy with 12" high by 33" diameter concrete block anchor. Within LAKE CUSHMAN and/or its associated wetlands is exempt from the requirement of substantial development because the development is categorized under WAC 173-27-040(2) as being category: A-does not exceed dollar threshold Please contact Kell McAboy at ext 365 if you have any questions. Issued:1/6/2017 Authorized Local Governm nt`Official SHX2016-00071 January 06, 201 r --------------------------------------- AGENCY USE ONLY W ,Fo M Date received: Were WASHINGTON STATE ofEngi ees Seattle District Joint Aquatic Resources Permit ; Agency reference Application (JARPA) Form'°2 ej,] ; Tax Parcel#(s): -111 2 3 0 7- 5 -6W G,t USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW, --------FRECE-1��D--------- SEP 12 20ib Part 1—Project Identification 615 W,Alder Street 1. Project Name (A name for your project that you create.Examples:`Smith's Dock or Seabrook Lane Development) Lhelp] Part 2—Applicant The person and/or organization responsible for the project. ei 2a. Name (Last, First, Middle) 2b. Organization (If applicable) 2c. Mailing Address (Street or PO Box) M, ( . ' A L-k Vz V �_ 2d. City, State, Zip 2e. Phone(1) 2f. Phone(2) 2 . Fax 2h E-mail 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(SPIF)or prepare a Biological Evaluation. Forms can be found at htt ://www.nws.usace.ar n .mil/Missions/CivilWorks/Re ulato /PermitGuid book/Endan eredS ecies.as x. • Not all cities and counties accept the JARPA for their local Shoreline permit .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 http://www.epermitting.wa.-gov/site/alias resourcecenter/'ar a Mar pa form/99841d4rpa form.as x. For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or help(o oria.wa.00v. JARPA Revision 2015.1 Page 1 of 14 r 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.) Lhel; 3a. Name (Last, First, Middle) 3b. Organization (If applicable) 3c. Mailing Address (Street or Po Box) -1 to 15 'i-7 +1-N AYe— N VJ 3d. City, State, Zip 6�11 a C ' 'O� 3e. Phone(1 X Phone(2) 39. Fax 3h. E-mail ( 253) Sol . �� ( ) ( ) S�(n t i c��@ a�o� C,4 w., 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. IRS Same as applicant. (Skip to Part 5.) -- vV",%,,� ❑ Repair or maintenance activities on existing rights-of-way or.>aasements. (Skip to Part 5.) ❑ There are multiple upland property owners. Complete the section below and fill out JARPA Attachment A 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 JARPA Attachment E to apply for the Aquatic Use Authorization. 4a. Name (Last, First,Middle) 4b. Organization (if applicable) T-a-co vv\& bVowe y 4c. Mailing Address (Street or Po Box) ll0 0 4d. City, State, Zip �LL WA- -C18r 9 H --001 4e. Phone, ) 4f. Phone(2) 4g. Fax 4h. E-mail JARPA Revision 2015.1 Page 2 of 14 Part 5—Project Location(s) Identifying information about the property or properties where the project will occur. he► ❑ There are multiple project locations (e.g. linear projects). Complete the section below and use DARPA �Aaacnrnent i< for each additional project location. 5a. Indicate the type of ownership of the property. (check all that apply.) hel Private ❑ Federal t ❑ Publicly owned (state,county, city,special districts like schools, ports, etc.) ❑ Tribal ❑ Department of Natural Resources (DNR)-managed aquatic lands (Complete ,DARPA Attachment E) 5b. Street Address (Cannot be a PO Box. If there is no address, provide other location information in 5p.) h[ eM 5c. City, State, Zip (If the project is not in a city or town, provide the name of the nearest city or town.) [lgel Te 5d. County L I ] Wk" 6f. 5e. Provide the section, township, and range for the project location. Ltlpl 1/4 Section Section Township Range 5f. Provide the latitude and longitude of the project location. ['el] • Example:47.03922 N lat./-122.89142 W long. (Use decimal degrees-NAD 83) 5g. List the tax parcel number(sy or the project location. [ • The local county assessor's office can provide this information. 5h. Contact information for all adjoining property owners. (If you need more space, use PA Attachment C.) [help Name Mailing Address Tax Parcel # (if known) Lc�kc (-uAvvw .v�- ++�o�r�nt c 14� ev • �.► V f,, �+- vX ?CHA &, - . t©may 3.0 t'b►ntCa� Lit- sey M•��te9 �- �A�,+�i�te 1'�'+�w�u� 1'2-c7 'v '�1'k�-c{�. 4� . (�pL (�ro.:'�+nor����-''S VC.AA .A- did ,�� � tic v �z �►d , ► .. JARPA Revision 2015.1 Page 3 of 14 5i. List all wetlands on or adjacent to the project location. [;elf) 5j. List all waterbodies (other than wetlands) on or adjacent to the project location. heM 5k. Is any part of the project area within a 100-year floodplain? [ JCYes ❑ No ❑ Don't know �C;,r S �� � )h j VL 51. Briefly describe the vegetation and habitat conditions on the property. [' K�:,tkkLX,Ak ��;.i �tX�x -� y c 1 I�JC � r ► Z„_ , +aJ �. , l/�t cQ �.� i1 s L ,.— LAI lbL".2 14--AC4 5m. Describe how the property is currently used. [ ip] 5n. Describe how the adjacent properties are currently used. [help,] l-oNiC�C�' 1(A SCJ 4 S 4 S Fay L 5o. Describe the structures (above and below ground) on the property, including their purpose(s) and current condition. DoJC 5p. Provide driving directions from the closest highway to the project location, and attach a map. [ Ili) 1V1 t4r,,(Q, nn . (y, .1� ,,uc.Q. c-D o� L-Q Ft t� P -I a . D—. DARPA Revision 2015.1 Page 4 of 14 Part 6—Project Description 6a. Briefly summarize the overall project. You can provide ore detail in 6b. Lelp] . 6b. Describe the purpose of the project and why you want or need to perform it. LheM 6c. Indicate the project category. (check all that apply) [help] ❑ Commercial -QDResidential ❑ Institutional ❑ Transportation ❑ Recreational ❑ Maintenance ❑ Environmental Enhancement 6d. Indicate the major elements of your project. (Check all that apply) [zelp] ❑ Aquaculture ❑ Culvert ❑ Float Retaining Wall ❑ Bank Stabilization ❑ Dam /Weir ❑ Floating Home (upland)6>41 sf�1-n ❑ Boat House ❑ Dike/ Levee/Jetty ❑ Geotechnical Survey ❑ Road ❑ Boat Launch ❑ Ditch ❑ Land Clearing ❑ Scientific Measurement Device ❑ Boat Lift ock/ 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: JARPA Revision 2015.1 Page 5 of 14 6e. Describe how you plan to construct each project element checked in 6d. Include specific construction methods and equipment to be used. h[ elpl • Identify where each element will occur in relation to the nearest waterbody. �*=.may- •� �: �••+G .,�awr c �iC�ru--} `J1 • Indicate which activities are within the 100-year floodplain. l dry> ,.. 6f. What are the anticipated start and end dates for project construction? (Month/Year) [ • If the project will be constructed in phases or stages, use JARPi Attachment D to list the start and end dates of each phase or stage. Start date: 1 End date: -T-k_b ❑ See JARPA Attachment D 6g. Fair market value of the project, including materials, labor, machine rentals, etc. [help) 6h. Will any portion of the project receive federal funding? [ ) • If yes, list each agency providing funds. ❑ Yes K 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.)[help] 7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. [ XNot applicable 7b. Will the project impact wetlands? help] ❑ Yes ❑ No ❑ Don't know DARPA Revision 2015.1 Page 6 of 14 7c. Will the project impact wetland buffers? Lp] ❑ Yes ❑ No ❑ Don't know 7d. Has a wetland delineation report been prepared? [ • If Yes, submit the report, including data sheets,with the DARPA package. ❑ Yes ❑ No 7e. Have the wetlands been rated using the Western Washington or Eastern Washington Wetland Rating System? [ J • 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? [ • If Yes, submit the plan with the JARPA package and answer 7g. • If No, or Not applicable,explain below why a mitigation plan should not be required. ❑ Yes ❑ No ❑ Not applicable 7g. Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was used to design the plan. [ 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. [ I 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. 4 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: JARPA Revision 2015.1 Page 7 of 14 7L 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 eip] 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.) [Lei ] '] 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. LP-121 ❑ Not applicable c ',r f l oo 11".' �c ' Q,.LJ�"1 � 0.�—tt_ �.7 �Yl.::s '1-t� L�l S��1% �(,�` 1 8b. Will your project impact a waterbody or the area arounc a waterbody? 12ei ❑ Yes -< No 1�. 'a cl rvi; + kc-4_ L'Suel taa4{ , 'S . DARPA Revision 2015.1 Page 8 of 14 8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland waterbodies? [!?Pip] • 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 .+t�No of applicable� ---- 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. [; ] 8e. Summarize impact(s) to each waterbody in the table below. [help] Activity (clear, Waterbody Impact Duration Amount of material Area (sq. ft. or dredge, fill, pile name' location of impact3 (cubic yards) to be linear ft.) of drive, etc.) placed in or waterbody removed from directly affected waterbod 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. 2Indicate 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. 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. [ ] JARPA Revision 2015.1 I Page 9 of 14 i 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. [heipd 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 4t7 )Utz-1•-�t v-1 O ► ..��r 2� kj 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 Waler Quality Assessment tools at: ❑ Yes -2�No 9c. What U.S. Geological Survey Hydrological Unit Code ( UC) is the project in? [ ei i • Go to f/locate/index.ctm to help identify tlhe HUC. 9d. What Water Resource Inventory Area Number (WRIA#) is the project in? [t2eel ] • Go to!iftp://www.ecy.wa.gov/services/gis/maps/wria/wria.htn- to find the WRIA#. JARPA Revision 2015.1 Page 10 of 14 9e.Will the in-water construction work comply with the StatN, of Washington water quality standards for turbidity? h[hei l • Go to http://www.ecy.wa.gov/programs/wg/swgs/criteria.htmi for the standards. es ❑ No Not applicable 3:�.\�'•. ,,� REF :;:, z1,u` 9f. If the project is within the jurisdiction of the Shoreline Mz nagement Act, what is the local shoreline environment designation? i,�l • If you don't know,contact the local planning department. • For more information,go to: http://www.ecy.wa.gov/programs/sea/sma/laws rules/173-26/211 designations.htmi. „Mural ❑ Urban ❑ Natural ❑ Aquatic ❑ Conservancy ❑ Other 9g. What is the Washington Department of Natural Resources Water Type? [help/ • Go to http://www.dnr.wa.gov/forest-practices-water-typing 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 D partment of Ecology's most current stormwater manual? [i,elp] i • If No, provide the name of the manual your project is designed t�meet. , Yes ElNo Name of manual: 9L Does the project site have known contaminated sedime t? Lei] • If Yes, please describe below. ❑ Yes No 9j. If you know what the property was used for in the past, lescribe below. hel 9k. Has a cultural resource (archaeological) survey been p rformed on the project area? [help] • If Yes,attach it to your JARPA package. ❑ Yes ❑ No - � :..�<}t i zc�,v 1��v ►��' vvv JARPA Revision 2015.1 Page 11 of 14 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. hel iU` �-\ ti.Cr-V. `��l�►iaC7� U�,S, " .'t 1t'�1.. T"o�:.r�,�,�f� �"011t.-..t,.�-t,a-l.� 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. [hei Part 10—SEPA Compliance and Permits Use the resources and checklist below to identify the permits you are applying for. • Online Project Questionnaire at http://apps.oria.wa lov/moo a�s/. • Governor's Office for Regulatory Innovation and As istsl ante at (800) 917-0043 or helpCa-oria.wa.gov. • For a list of addresses to send your JARPA to, click on agency addresses for completed DARPA. 10a. Compliance with the State Environmental Policy Act ( EPA). (Check all that apply.) hel • For more information about SEPA, go to www.ecV.wa.gov/procal tms/sea/sepa/e-review.html. ❑ A copy of the SEPA determination or letter of exemption is included with this application. .N3A SEPA determination is pending with (lead agency). The expected decision date is k 0 zo l ❑ I am applying for a Fish Habitat Enhancement Exemption. (Check the box below in 10b.) hf elpl ❑ 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. JARPA Revision 2015.1 Page 12 of 14 10b. Indicate the permits you are applying for. (Check all that pply.) Lljelp] LOCAL DOVE NMENT Local Government Shoreline permits: ❑ Substantial Development ❑ Conditional Use ! ❑ Variance ;FZShoreline Exemption Type (explain): 0ALty— Other City/County permits: ❑ Floodplain Development Permit ❑ Critical Areas Ordinance STATE GOVERNMENT Washington Department of Fish and Wildlife: fK Hydraulic Project Approval (HPA) ❑ Fish Habitat Enhancement Exemption—Attach Exemption Form 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 a modification of an existing HPA originally applied for, prior to July 10, 2012. HPA# Washington Department of Natural Resources: ❑ Aquatic Use Authorization Complete JARPA Attachment E and submit a check for$25 payable to the Washington Department of Natural Resources. Do not send cash. Washington Department of Ecology: ❑ Section 401 Water Quality Certification FEDERAL GOV RNMENT United States Department 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: ❑ Private Aids to Navigation (for non-bridge projects) JARPA Revision 2015.1 Page 13 of 14 Part 11—Authorizing Signatures Signatures are required before submitting the JARPA package. The JARPA package includes the JARPA form, project plans, photos, etc. [help] 11a. Applicant Signature (required) [t,_elp] 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 e .property where the project is located to inspect the project site or any work related to the project. �' (initial) Applicant Printed Name Applicant Signature Date 11 b. Authorized Agent Signature [help] 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 Printed Name Authorized Agent Signature Date 11 c. Property Owner Signature (if not applicant) [1p1p,l Not required if project is on existing rights-of-way or easements. 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. y 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 materiel 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 thanf 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: ENV-019-09 rev. 09/2015 JARPA Revision 2015.1 Page 14 of 14 oN-STATE MASON COUNTY �Py 4 M O o �� DEPARTMENT OF COMMUNITY DEVELOPMENT � A NU Planning Division 7 N Y Y 615 W Alder St, Shelton, WA 98584 of (360)427-9670 1864 MASON COUNTY ENVIRONMENTAL PERMIT January 20, 2017 NATHANIEL & JESSICA SCHLICHER C/O SCHLICHER DOCK REPLACEMENT 4615 77TH AVE NW Parcel Number(s): 423075000060 Expiration Date: 1/20/2019 12:00:OOA Date Issued: 1/20/2017 Case Number: MEP2016-00044 Project Description: Replace (permit as new due to no previous permits on file) a decaying pier/ramp/float on Lake Cushman. Pier is 6' by 21' (about 10 feet as measured from OHWM). Ramp is 3' by 7' (3' span between float and pier). Float is 6' by 12'. Also, permit an existing buoy with 12" high by 33" diameter concrete block anchor. The following critical areas are present on this property: Long-Term Commercial Forest XXFWHCA Ch. 17.10.060; Ch. 17.01.110; Mineral Resource Lands Frequently Flooded Areas Ch. 17.01.066; Ch. 17.01.090; Inholding Lands Landslide Hazard Areas Ch. 17.01.062; Ch. 17.01.100; Wetlands Seismic Hazard Areas Ch. 17.01.070; Ch. 17.01.102; Critical Aquifer Recharge Erosion Hazard Areas Ch. 17.01.080; q Ch. 17.01.104. This permit, with conditions, is granted pursuant to the Mason County Resource Ordinance (Chapter 17.01 MCC.) Nothing in this permit shall excuse the applicant from compliance with any other federal, state, or local statutes, ordinances, or regulations applicable to this project. This permit may be rescinded if the permitee fails to complete the project as proposed or fails to comply with the standards of this ordinance. 6. - ( (-'?,0 /l -7 Authorized Local Government Off i Date 1/20/2017 Page 1 of 2 MEP2016-00044 MASON ENVIRONMENTAL PERMIT($630 o 38 /other permit) Mason County Permit Center Use: ❑ CONDITIONAL USE($1520) MEP _ 0 Y ❑ HABITAT MANAGEMENT PLAN REVIEW($445) Date Rcvd MASON C UNTY DEPARTMENT OF COMM NITY DEVELOPME#f' 1 �15 w Mason County Resource Ordin ice(Chapter 17.01 MCC) -Ald6r S"�tl�t ENVIRONMENTAL PEIR MIT APPLICATION The purpose of the Resource Ordinance is to protect Mason ounty's natural resource lands and critical areas and is under the authority of Chapters 36.32, 36.70A, 39.34, 58.17, 6.09, 84.33, 84.34 and 90.58 RCW. PLEASE PRINT ( ' ' 1. PROPERTY OWNER Name: �-o Ca.�i-\j `- �,.f CO- < c j Mailing Address: r t S -)-) aj, Work Phone: `ZS 3 S©C(%%%Q E mail Address: - i i L t,.-) R p , c,t Home/Cell Phone: ZS 3 5 OO� %%%0 Fix#: If'an agent is acting for the property owner during the permit pro ess, complete#2. 2.AUTHORIZED AGENT Name: �) Mailing Address: Work Phone: Email Address: Home/Cell Phone: Fax# 3.PROJECT SITE Site Address: � y Parcel#: LA 23 (3- S doh\�Vp I egal Description: Directions to Site: L©+- UO 1 /w. (Lds'e CJ'k vo wo v--' b(- 4"kC. C�„�,,1.►w�v�- Attach a site plan showing the following: Lot Dimensions,Flood Zones,Existing Structures,Fences, Water Lines,Driveways,Drainage Plans,Shorelines,S ptic System,Topography,Proposed Improvements,Easements,North Arrow,and Scale. Also draw a separate topography diagram. ,.'�.z,rzr.;i=.i?, `)cc! ,,m�•rat`.^AC`'�tE€' rage if 1Revise;l)uneZOlf) i yoN_srgTFo� MASON COUNTY aP C Department of Community Services M o s° Planning Division r o T �? 615 W Alder St, Shelton, WA 98584 �J Y 0 (360)427-9670 1864 R DETERMINATION OF NONSIGNIFICANCE (WAC 197-11-340) SEP2016-00105 Description of Proposal: Replace (permit as new due to no previous permits on file) a decaying pier/ramp/float on Lake Cushman. Pier is 6' by 21' (about 10 feet as measured from OHWM). Ramp is 3' by 7' (3' span between float and pier). Float is 6' by 12'. Also, permit an existing buoy with 12" high by 33" diameter concrete block anchor. Proponent: NATHANIEL & JESSICA SCHLICHER Location of Proposal: 140 N POTLATCH DR HOODSPORT Parcel Number: 423075000060 Legal Description: LAKE CUSHMAN #2 TR 60 Directions to Site: LAKE CUSHMAN NEXT TO BOAT LAUNCH Lead Agency: Mason County The Lead Agency for this proposal has determined that it does not have a probable significant adverse impact on the environment. An Environmental Impact Statement (EIS) is not required under RCW 43.21 C.030(2)(c). This decision was made after review of a completed Environmental Checklist and other information on file with the Lead Agency. This information is available to the public upon request. Please contact Kell McAboy at ext. 365 with any questions. This DNS is issued under WAC 197-11-340(2). The Lead Agency will not act on this proposal for 14 days from the date shown below, when the determination is final. Comments must be submitted to Dept. of Community Development, 615 W Alder St, Shelton WA 98584 by 1/20/2017. Appeal of this determination must be filed within a 14-day period following this final determination date, per Mason County Code Chapter 15.11 Appeals. Authorized Local Government Official Date 1- f �� 30750 000�(� SEPA Environmental Checklist Mason County Permit center use: SEP Single Family DNS: $385 Date Rcvd: ❑ Other DNS: 0 to 9.99 acres: $630 l0 to 20 acres: $755 Over 20 acres: $945 ❑ DS/EIS: $2,525+70 Per hr Purpose of checklist: %iacts Governmental agencies use this checklist to help determine whether the environmental of your proposal are significant. This information is also helpful to determine if available avoidance, minimization or compensatory mitigation measures will address the probable significant impacts or if an environmental impact statement will be prepared to further analyze the proposal. Instructions for applicants: This environmental checklist asks you to describe some basic information about your proposal. Please answer each question accurately and carefully, to the best of your knowledge. You may need to consult with an agency specialist or private consultant for some questions. You may use "not applicable" or "does not apply" only when you can explain why it does not apply and not when the answer is unknown. You may also attach or incorporate 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 questions apply to all parts of your proposal, even if you plan to do them over a period of time or on different parcels of land. Attach any additional information that will help describe your proposal or its environmental effects. The agency to which you submit this checklist may ask you to explain your answers or provide additional information reasonably related to determining if there may be significant adverse impact. Instructions for Lead Agencies: Please adjust the format of this template as needed. Additional information may be necessary to evaluate the existing environment, all interrelated aspects of the proposal and an analysis of adverse impacts. The checklist is considered the first but not necessarily the only source of information needed to make an adequate threshold determination. Once a threshold determination is made, the lead agency is responsible for the completeness and accuracy of the checklist and other supporting documents. A. BACKGROUND 1. Name of proposed project, if applicable: IsC� 2. Name of applicant: tt. ct1� � t � 3. Address and phone number of applicant and contact person: 'hey f h v t.I 4UJ SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2014 Page 1 of 11 B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (circle one): Flat, rolling, hilly, steep slopes, mountainous, other: b. What is the steepest slope on the site (approximate percent slope)? c. What general types of 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 agricultural land of long-term commercial significance and whether the proposal results in removing any of these soils. d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. , e. Describe the purpose, type, total area, and approximate quantities and total affected area of any filling, excavation, and grading proposed. Indicate source of fill p f. Could erosion occur as a result of clearypg, construction, or use? If so, generally describe. �Z, . KDt�vu (�!AV)VV: C l g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: 2. Air a. What types of emissions to the air would result from the proposal during construction, operation, and maintenance when the project is completed? If any, generally describe 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. c. Proposed measures to reduce or control emissions or other impacts to air, if any: SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2014 Page 3 of 11 2) Could waste materials enter ground or surface waters? If so, generally describe. 3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If so, describe. d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage pattern impacts, if any: 4. Plants a. Check the types of vegetation found on the sit _ `deciduous tree: alder, maple, aspen, other `evergreen tree: fir, cedar, pine, other .�-shrubs grass pasture crop or grain orchards, vineyards or other permanent crops wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other water plants: water lily, eelgrass, milfoil, other other types of vegetation i b. What kind and amount of vegetation will be removed or altered? c. List threatened and endangered species known to be on or near the site. jkM d. Proposed landscaping, use of native plants, or ther measures to preserve or enhance vegetation on the site, if any: e. List all noxious weeds and invasive species known to be on or near the site. 5. Animals a. List any birds and other animals which have b en observed on or near the site or are known to be on or near the site. Examples include: i birds: hawk, heron, eagle, songbirds, other: ��tL mammals: deer, bear, elk, beaver, other: 7 .y fish: bass, salmon, trout, herring, shellfish, other: I SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2014 Page 5 Of 11 b. Noise 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? QeAt&Jt.Oj 2) What types and levels of noise would be created by or associated with the project on a short-term or a long-term basis (for example: traffic, construction, operation, other)? Indi- cate what hours noise would come from the site. �'D o vN-k 3) Proposed measures to reduce or control noise impacts, if any: 4NK 8. Land and shoreline use a. What is the current use of the site and adjacent properties?Will the proposal affect current land uses ont n�ea`y or adjacecnt prop� �properties? If so,�describe. b. Has the project site been use as working farm ands or working forest lands? If so, describe. How much agricultural or forest land of long-term commercial significance will be converted to other uses as a result of the proposal, if any? -C)v"_Q_ If resource lands have not been designated, how many acres in farmland or forest land tax status will be converted to nonfarm or nonforest use? 1D )A-- 1) Will the proposal affect or be affected by surrounding working farm or forest land normal business operations, such as oversize equipment access, the application of pesticides, tilling, and harvesting? If so, how: 130 c. Describe any structures on the site. _ipj d. Will any structures.be demolished? If sR, what JheM 1--D 0 ( _")OL L 'V_r(&LL& \V\fsa O'U_ fo CJ e. What isa the current zg4iing classification of thesite? of eipl f. What is the current comprehensive plan desig ation of the site? >JP_1 IA, g. If applicable, what is the current shoreline masler program designation of the site? h. Has any part of the site been classified as a critical area by the city or county? If so, specify. '.i e> SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2014 Page 7 of 11 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? b. Would the pro se proje displac ny existing recreational uses? If so, describe. c. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: 13. Historic and cultural preservation 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 located on or near the site? If so, specifically describe. b. Are there any landmarks, features, or other evidence of Indian or historic use or occupation? This may include human burials or old cemeteries. Are there any material evidence, artifacts, or areas of cultural importance on or near the site? Please list any professional studies conducted at the site to identify such resources. c. Describe the methods used to assess the potential impacts to cultural and historic resources on or near the project site. Examples include consultation with tribes and the department of archeology and historic preservation, archaeological surveys, historic maps, GIS data, etc. _ I d. Proposed measures to avoid, minimize, or compensate for loss, changes to, and disturbance to resources. Please include plans for the above and any permits that may be required. 14. Transportation a. Identify public streets and highways serving the site or affected geographic area and describe proposed access to the existing street system. Show on site plans, if any. CV, b. Is the site or affected geographic area currentIN served by public transit? If so, generally describe. If not, what is the approximate distar ce to the nearest transit stop? c. How many additional parking spaces would the completed project or non-project proposal have? How many would the project or proposal eliminate? �; Gd-" SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2014 Page 9 Of 11 C. SIGNATURE The above answers are 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 Signed: Print Name of Signee: If applicable, Position and Agency/Organization: Date Submitted: `k SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2014 Page 11 of 11 F Searg a aH�1899 STATE OF WAS INGTON DEPARTMENT OF ECOLOGY PO Box 47775 •Olympia, Washingto 98504-7775 •(360)407-6300 711 for Washington Relay Service •Persons with a speech disability can call 877-833-6341 January 20, 2017 Kell McAboy, Senior Planner Mason County Department of Community Development Planning Division PO Box 279 Shelton, WA 98584 Dear Ms. McAboy: Thank you for the opportunity to comment on the 4-termination of nonsignificance for the Schlicher Dock Replacement Project(SEP2016-00 05) located at 140 North Potlatch Drive in Hoodsport as proposed by Nathaniel and Jessica Sc ilicher. The Department of Ecology (Ecology)reviewed the environmental checklist and has the following comment(s): WATER QUALITY: Chris Montague-Brea ell(360)407-6364 The following construction activities require co erage under the Construction Stormwater General Permit: 1. Clearing, grading and/or excavation that results in the disturbance of one or more acres and discharges stormwater to surf tce waters of the State; and 2. Clearing, grading and/or excavation on ites smaller than one acre that are part of a larger common plan of development or ale, if the common plan of development or sale will ultimately disturb one acre or ore and discharge stormwater to surface waters of the State. a) This includes forest practices (incluc ing, but not limited to, class IV conversions) that are part of a construction activit that will result in the disturbance of one or more acres, and discharge to surfacc waters of the State; and 3. Any size construction activity discharge ig stormwater to waters of the State that Ecology: a) Determines to be a significant contri utor of pollutants to waters of the State of Washington. b) Reasonably expects to cause a violat ion of any water quality standard. 3628 South 35"'Street Tacoma,Washington 98409-3192 TACO POWER TACOMA PUBLIC UTILITIES TACOMA PUBLIC UTILITIES December 13, 2016 Nathaniel and Jessica Schlicher VIA EMAIL and USPS 4615 77'"Ave NW Gig Harbor, WA 98335 Subject: Tacoma Power Shoreline Use Permit Application Review Lot 60, Plat of Lake Cushman No. 2 (Tax Parcel No. 42307-50-00060) Reference: Project No. 2016-135/SUP315 Dear Mr. and Mrs. Schlicher, Thank you for applying for a Shoreline Use Permit I SUP)for your existing shoreline structures and/or uses associated with Lot 60, Plat of Lake CL shman No. 2. As you know, Tacoma Power's Cushman Hydroelectric Project area (Project) includes all lands located below the 742-foot elevation Project boundary. Tacoma POWE r also retains a 10-foot lateral easement between your leased development lot and the Proj ct boundary. All structures and uses located below 742-foot elevation, and all structures and fill placed within the 10-foot lateral easement require authorization from Tacoma Power. A pre-application site inspection was conducted by Tacoma Power on August 9, 2016. Your SUP application and drawings were received Sept mber 13, 2016. Tacoma Power has reviewed your SUP application package for conformance with Tacoma Power's Shoreline Use Specifications and Permitting Guidelines (SUSPG) and has the following comments: Items Reviewed: • SUP application dated 9/07/2016 • Drawings (8 pages), not dated, sent with application dated 9/07/16 • Tacoma Power Records 1. Dock Structure. Allowed as proposed. You propose to renovate your existing fixed pier, ramp, float, and pilings. The proposed final dock structure will consist of 1 fixed section, 1 ramp, 1 floating section, and 8 pilings. The fixed section is 21 feet x 6 feet (126 square feet) supported by four(4) steel pilings. The ramp measures 7 feet by 3 feet (21 square feet). The floating section is 24 feet x 6 feet(144 square feet) and is supported by four (4) steel pilings located at the corners of the float. All structures are timber framed with composite and light penetrating decking. Total proposed dock structure is approximately 291 square feet. Schlicher Shoreline Use Permit Application Review December 13, 2016 Page 3 of 3 Permitting Requirements: 1. Regulatory Permits. Required. Regulatory Ilermits are required from Mason County and the Department of Fish and Wildlife for your existing structures and your proposed work. Include the off shore anchor and possible concrVte footer work in your regulatory permit applications. Per Section 1 of SUSPG, copies ol your acquired permits are required before Tacoma Power can issue an SUP. As you receive your regulatory permits and/or waivers please send copies to Tacoma Power to satisfy this requirement. 2. Cultural Resources Survey. Required. A cultural resources survey is required per Section 6.2 of SUSPG. You have submitted a $900.00 deposit for this survey, received by Tacoma Power September 14, 2016. Tacoma Power will schedule your survey during this low lake level season. Your survey is tentatively scheduled for the first week of January, 2017. Once complete, you will receive a letter regarding the results and any refund that is due. Do not initiate any further ground disturbing activities on Tacoma Power property(below 742-foot elevation) until the survey has been completed and your SUP is issued. Next Steps: 1. Cultural Resources Survey. Tacoma Power will be scheduling the survey, as detailed above, during this low lake season. 2. Shoreline Use Permit. Once you have provided copies of your required regulatory permits Tacoma Power will issue a 5-year Shoreline Use Permit for the allowed uses and structures described above. You will be authorized to commence with construction and/or modification of your shoreline uses and structures after Tacoma Power issues your Shoreline Use Permit. If you have questions regarding this review of your application, please don't hesitate to contact me at(253)441-4180 or via email at wwright(ocityoftacoma.org. Sincerely, Wynna right Shoreline and Lands Coordinator Tacoma Power WW: cb Schlicher Shoreline Use Permit Application Revi 1w Enclosures cc: Bret Forrester, Wildlife and Lands Manager, Taiiacoma oma Power Kyrra Wilson, Wildlife and Recreation Lands Ocer, Tacoma Power Dori Bishop, Sr. Real Estate Specialist, City of w c IP 1 6 J 4 o ty Ss fi oc fl r;I e SS d i i , , r s , , , � 1, « r + 4 , l F - Y` i i ! z� f t Y 3 t i F i V 'L r i d i 1 , F t cno lu i ar + -+ _. , , t t t ] , i F ) t _ t � [ t f a. t a r , � t : t r i i i 7 t { t � r , , ; L I _r 1 , , 1}. ' r � , , , } , , i a . _ T �IG I 4_11 J-1-1 -t v , w_ t _ 1 } G � } 1 1 ; , f F }_. �,. < d� f -.-i }-._.,_.�,... � � •r }. r. f. 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