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SHX2014-00022 SEP2014-00033 - SHX Permit / Conditions - 6/26/2014
ON_STATE MASON COUNTY BPS C ° DEPARTMENT OF COMMUNITY DEVELOPMENT o A o Planning Division S N = P O Box 279, Shelton, WA 98584 Y y (360)427-9670 OJ �O 1864 Exemption from Shoreline Management Act Case No.: SHX2014-00022 Substantial Development Permit Requirement The Proposal By: PAUL R. DRUMMOND 12913 ALTON SQUARE-413 HERNDON, VA 20170 To undertake the following development: Constructed recessed stairs within a concrete bulkhead. Within HOOD CANAL and/or its associated wetlands is exempt rom the requirement of substantial development because the development is categorized under WAC 173-27-04 (2) as being category C-normal protective bulkhead Please contact Grace Miller at ext 360 if you have any questions. Issued: 6/26/2014 ' Expires: 6/26/2016 Authorized Local Government Official cc: APPLICANT WDFW— USACOE DOE TRIBAL COUNCIL GiL- �o� y tax AI L m mappl w nsA ta YE " m m m i z �V �o woL• 1 S ,d� (d�`0•�b 9 l l£• 2 Z�' r 1 �g� -c � ldl L£•� �1 p 0 fill UP �c l � e • g� o �LD �, ��� DOIw iOz l m V6 —i ,�LO lj p m� mb l wu l � w o 'Ol 111 °'m u 6l•°� i s _ ll ty09 N m m �{ i°i v'4t O Z•Sl l ,?� W v V A_ o �► b lm� l Cl w 0 - m o o h m 6J p l 1 o n rnp � Ozy�Oz C1 In in o p� ® l l w tn� � miv � w �Ju D i® sn m wm 6 ® Om70 a sn i Z0.31 1 22.9E z N 03 i 00` )f 73.73(0) � r P�ON_3TgTFo� MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT O AO N U Planning Division o T = P O Box 279, Shelton, WA 98684 Zoo N Y OY (360)427-9670 J ? 1864 DETERMINATION OF N NSIGNIFICANCE (WAC 197-11-340) SEP2014-00033 Description of Proposal: Added recessed stairs into existing concrete bulkhead. Proponent: PAUL R DRUMM014D Location of Proposal: 250 N POTLATCH RD SHELTON Parcel Number: 422235000901 Legal Description: POTLATCH BEACH-1 TRACTS TR A OF TRS 68 & 69 & TL Directions to Site: US HIGHWAY 101 NORTH, R ON POTLATCH RD TO SITE ADDRESS ON THE RIGHT SIDE Lead Agency: Mason County The Lead Agency for this proposal has determined t at it does not have a probable significant adverse impact on the environment. An Environme tal 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 fil with the Lead Agency. This information is available to the public upon request. Please contact Grace Miller at ext. 360 with any qu stions. 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, P.O. Box 279, Shelton WA 98584 l 7/10/2014. Appeal of this determination must be filed within a 14-day period following this fi al determination date, per Mason County Code Chapter 15.11 Appeals. & r, �i Authorized Local Government Official; Date c CEIMD MAY 2 7 2014 SEPA CHECKLIST N26 9CEOA►R (Mason County Permit Center Use) $385 - Single Family SEP - e amity 0 to 9.99 Acres $755 -10 to 20 Acres Date Rcvd: N5•Z7- W $945 - Over 20 Acres $2,525+ 70/hr- EIS (DS) PN: a _S0 -oQ90 I Purpose of Checklist: The State Environmental Policy Act(SEPA), chapter 43.21 C RCW, requires all governmental agencies to consider the environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of this checklist is to provide information to help you and the agency Identify impacts from your proposal (and to reduce or avoid impacts from the proposal) and to help the agency decide whether an EIS is required. Instructions for Applicants: Governmental agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of an EIS. Answer the questions briefly, with the most precise information known, or give the best description you can. You must answer each question accurately and carefully, to the blest of your knowledge. In most cases, you should be able to answer the questions from your own observations or project plans without the need to hire experts. If you really .do not know the answer, or if a question does not apply to your proposal, write "do not know" or "does not apply" complete answers to the questions now may avoid unnecessary delays later. Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions if you can. If you have problems, the governmental agencies can assist you. The checklist questions apply to all parts of your proposal, evet 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 as< you to explain your answers or provide additional information reasonably related to determining if there may be sigriificant adverse impact. There is a fee required, for the processing of the checklist, see above for the appropriate fee. Please make your check payable to"Mason County Treasurer". A. BACKGROUND 1. Name of proposed project: SEAW`4LL �T`41�-S OI�TH PO7'`.x4TC}-' �CtQl� 2. Name of applicant: Property owner. Deum"OND F>AUL �. US N A 3. Applicant mailing address: 9 Z9 13 ALTO" 13.)f-�ERMDOKl.V4 'Z017O Applicant phone numbers: 03. 1Q 89. 9 895 CJ 90:7. 4. Date checklist prepared: 21 MA ZO NT 5. Agency requesting checklist: IVIP150t�1 COU Mason County SEPA Checklist 1 6. Proposed timing or schedule (including phasing, if applicable): PREsEnVT r-P i A4Ay Z015/> TO 15 NOV AL t-�( 7. Do you have any plans for future expansion, or further activity related to or connected with this proposal? If yes, explain. 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. Alo 9. Do you know whether applications are pending for governmental approvals of other proposals directly affecting the property covered by your proposal? If yes, explain. k1O 10. List any government approvals or permits that will be needed for your proposal, if known. MASOAJ CIX 15,WOREUn1E A-tAsTr=R. P)ZO9P—A M 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.) 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. 6,C1.1 14,4zoAj Coo Al TG/ .250 Al. POT�TCH SE �OAp� -f E�7�0�11,I,tJA 91 85 --� ?72 A of -TRS 68 ,a 69 ,F 7-4 339//8r) , E3.7Lo �� /ll 03�Z3 DO E3. 3 Tar g22.3 -SO -0©g o 1 Mason County SEPA Checklist 2 B. ENVIRONMENTAL ELEMENTS EARTH: a. General description of the site (circle one : Flat, olling, hill , steep slopes, mountainous, other(explain). b. What is the steepest slope on the site (approximate percent slope)? 5°f'b 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 prime farmland. 4 RAV E L-, sA IJ /, d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. A 8 e. Describe the purpose, type, and approximate quantities of any filling or grading proposed. Indicate source of fill /VoAl� f. Could erosion occur as a result of clearing, construction, c r use? If so, generally describe. NO g. About what percent of the site will be covered with impervious surfaces after project constructions (for example, asphalt or buildings)? *--I O h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: tllopiE 2. AIR: a. What types of emissions 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 describe and give approximate quantities, if known. b. Are there any off-site sources of emissions or odor that rT`ay affect your proposal? if so, generally describe. MOMS Mason County SEPA Checklist 3 c. Proposed measures to reduce or control emissions or other impacts to air, if any: l ONL RFgUIRga 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. &O off 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. Y e g By 1 khmc� C e-) nf"(:z e.x15+;n9 r3vlkheGd. , -f-a rnw/Ct sf-q-'r,S down fio !3Jlkhegc� 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 source of fill material. ` / 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. 5) Does the proposal fie within a 100-year floodplain? If so, note location on the site plan. AlO 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. M C) b. Ground: 1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, purpose,,AID approximate quantities, if known. G I Mason County SEPA Checklist 4 2) Describe waste material that will be discharged into the ground from septic tanks or other sources, if any (for example; domestic sewage, industrial, containing tt e 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. kOAJ,5 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 i his flow into other waters? /u o IV' 2) Could waste materials enter ground or surface waters If so, generally describe. d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: M/P 4. PLANTS: a. Check or circle types of vegetation found on the site: deciduous tree: alder, maple, aspen, other _VI/ 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 Itered? IQoIQI-= Mason County SEPA Checklist 5 c. List threatened or endangered species known to be on or near the site. d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: AIpAJ1- 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 Sc—�AQ (, "G Mammals: deer, bear, elk, beaver, other Fish: bass, salmon, trout, herring, shellfish, other ysID b. List any threatened or endangered species known to be on or near the site. A.lo Ale c. Is the site part of a migration route? If so, explain. AlC) d. Proposed measures to preserve or enhance wildlife, if any: NONE 6. ENERGY AND NATURAL 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. MIA b. Would your project affect the potential use of solar energy by adjacent properties: If so, generally describe. Alo 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: AJ/A Mason County SEPA Checklist 6 7. ENVIRONMENTAL HEALTH: a. Are there any environmental 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. l JC) 1) Describe special emergency services that might be required. /V()IQ 2) Proposed measures to reduce or control environment I health hazards, if any: /V/A b. Noise. 1) What types of noise exist in the area that may affect y ur project(for example: traffic, equipment, operation, other)? A/om tr 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)? Indicate what hour's noise would come from the site. T 7-IM E A.del. �►,r3 0 2 E s 3) Proposed measures to reduce or control noise impacts, if any: 111 U AJA5 B. LAND AND SHORELINE USE: a. What is the current use of the site and adjacent propertie ? REC9CA77 D ill A L I'se-Ad O A/A L. b. Has the site been used for agriculture? If so, describe. c. Describe any structures on the site. �50 u�a sQawoll: ho ise d. Will any structures be demolished? If so, what? Mason County SEPA Checklistb 7 e. What is the current zoningclassification of the site? RE`SI bOU 7�4L1RercR��TIQ iR 4- IZ1e- 5 f. What is the current comprehensive plan designation of the site? s2µ"d g. If applicable, what is the current Shoreline Master Program designation of the site? %5'H(3r,2_6"KlE 501P7- h. Has any part of the site been classified as an "environmentally sensitive"area? If so, specify. NO i. Approximately how many people would reside or work in the completed project? Z j. Approximately how many people would the completed project displace? k. Proposed measures to avoid or reduce displacement impacts, if any: /R I. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans: MAS6AI CTII SOORE1-I Nt S M Cymr Pt A AJ NA,4 QP1 9. HOUSING: a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income housing. k10 AJ+E. IVIA , b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or low-income housing. /V o til E, u/A . c. Proposed measures to reduce or control housing impacts, if any: AI IA 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? 3 1W-44CS( 3) ABOVE GRADE b. What views in the immediate vicinity would be altered or obstructed? A 0ME c. Proposed measures to reduce or control aesthetic impacts, if any: Z>ECO RATI V E RAVE aS Mason County SEPA Checklist 8 11. LIGHT AND GLARE a. What type of light or glare will the proposal produce? Wh t time of day would it mainly occur? tl CA(15 b. Could light or glarefrom the finished project be a safety h zard or interfere with views? l� c. What existing off-site sources of light or glare may affect ur proposal: IVIA d. Proposed measures to reduce or control light and glare impacts, if any: AJ/f 1 12. RECREATION: a. What designated and informal recreational opportunities re in the immediate vicinity? S TATE PA TZ FL b. Would the proposed project displace any existing recreati )nal uses? If so, describe. 1110 c. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: N/A 13. HISTORIC AND CULTURAL PRESERVATION: a. Are there any places or objects listed on, or proposed for, national, state, or local preservation registers known to be on or next Jto the site? If so, generally describe. x.('� 0 b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. A]DA�P c. Proposed measures to reduce or control impacts, if any: Mason County SEPA Checklist 9 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. 3E7"(3,4 chL Fr'od�-f s EA uJA LL 3 3 5 F 7: , l�/, �r�r cN �2 , 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. M0 c. How many parking spaces would the completed project have? How many would the project eliminate? d. Will the proposal require any new roads or streets, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate whether public or private). /]0 e. Will the project use (or occur in the vicinity of) water, rail, or air transportation? If so, generally describe. 0 f. How many vehicular trips per day would be generated by the completed project? If known, indicate when peak volumes would occur. MOM E g. Proposed measures to reduce or control transportation impacts, if any: 15. PUBLIC SERVICES: 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: U0 b. Proposed measures to reduce or control direct impacts on public services, if any: AJ/A 16. UTILITIES: a. Circle utilities currentfy available at the site: electricity, natural gas,QaD refuse service, telephone, sanitary sewer, 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 that might be needed. /ossl6/Q fufure. ! ELLCrR-t C The above answers are true nd complete to the best of my knowledge. I understand that the lead agency is relying on them to make its deci ion. Applicant Signature: Date: 21 MIA Mason County SEPA Checklist 10 I ESA LISTED SALMONIDS CHECKLIST This worksheet was designed to help project proponents, and go ernment agencies, identify when a project needs irther 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 Salmonidsn is defined as fish species listed as endangered, threatened or being considered for listing. If ESA listed species are present or ever were present in the watershed where your project will be located, your project has the potential for affecting them, and you need to comply with the ESA. The questions in this section will help determine if the ESA listings will impact your project. The Fish Program Manager at the appropriate Department of Fish and Wildlife (DFW) regional office can provide information for the following two questions. 1. Are ESA listed salmonids currently present in the watershed in Which your project will be located? YES X NO Please describe. S 2. Has there ever been an ESA listed salmonid stock present in tt is watershed? YES X, NO Uncertain_ Please describe. if you answered "yes" to either of the above qu stions, you should complete the remainder of this checklist. PROJECT SPECIFICES: The questions in this section are sp ific to the project and vicinity. 1. Name of watershed: ooD CANAL-- - ,OAK COSM14AM 2. Name of nearest waterbody: 'mod 0 D CANA i-- 3. What is the distance from this project to the nearest body of w ter: ,� M 1 Li✓S Often a buffer between the project and a stream can reduce the chance of a iegative impact to fish. 4. What is the current land use between the project and the po entially affected water body (parking lots, farmland, etc.)? ST-ArrE n1 R.K E RE S/OL N T/A L 5. Is the project above a: natural permanent barrier (waterfall) YES NO X natural temporary barrier (beaver pond) YES____ NO X man-made barrier (culvert, dam) YES NO— • other(explain): CUSMM AtV DAM 6. If yes, are there any resident salmonid populations above the blockage? YES— NO_ Don't know X 7. What percent of the project will be impervious surface (inblud�ng pavement& roof area)? Mason County SEPA Checklist 11 FISH MIGRATION: The following questions will help determine if this project could interfere with migration of adult and juvenile fish. Both increases and decreases in water flows can affect fish migration. 1. Does the project require the withdrawal of: a. Surface water? YES_ NO Amount Name of surface water body b. Ground water? YES_ NO Y Amount From where Depth of well 2. Will any water be rerouted: YES_ NO X If yes, will this require a channel change? 3. Will there be retention or detention ponds? YES_ NO X If yes, will this be an infiltration pond or a surface discharge to either a municipal storm water system or a surface water body? If to a surface waterbody, please give the name of the waterbody. YES_ NO 4. Will this project require the building of new roads? YES_ NO X Increased road mileage may affect the timing of water reaching a stream and may impact fish habitat. 5. Are culverts proposed as part of this project? YES_ NO X 6. Will topography changes affect the duration/direction of runoff flows? YES_ NO If yes, describe the changes. 7. Will the project involve any reduction of the floodway or floodplain by filling or other partial blockage of flows? YES_ NO X If yes, how will the loss of flood storage be mitigated by your project? WATER QUALITY: The following questions will help determine if this project could adversely impact water quality. Such impacts can cause problems for listed species. Water quality can be made worse by runoff from impervious surfaces, altering water temperature, discharging contaminants, etc. 1. Do you know of any problems with water quality, in any of the streams, within this watershed? YES_ NO If yes, describe. Mason County SEPA Checklist 12 2. Will your project either reduce or increase shade along or over,a waterbody? he YES— NO /� if yes, describe. Removal of shading vegetation or the building of structures Euch as docks or floats often results in a change in shade. 3. Will the project increase nutrient loading or have the potelhtial to increase nutrient loading or contaminants (fertilizers, other waste discharges, or runoff)to the waterbody? If yes, describe. YES _ NO 4. Will turbidity be increased because of construction of the proj t or during operation of the project? YES— NO=\ In-water or near water work will often increase turbidity. 5. Will your project require long-term maintenance, i.e. bridge cleaning, highway salting, and chemical sprays for vegetation management, clearing of parking lots? YES_ NO X If yes, please describe. VEGETATION: The following questions are designed to dete mine if the project will affect riparian vegetation, thereby, adversely impacting salmon. 1. Will the project involve the removal of any vegetation from the4stream banks: YES _ NO) If yes, please describe the existing conditions, and the amount and type of vegetation to be removed. 2. If any vegetation is removed, do you plan to-re-plant? YES _ NO_ If yes, what types of plants will you u e? J1A 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 ' d cision. ,I Applicant Signatures^ Date: ��ds�1f 1 Mason County SEPA Checklist 13 -------------------------------------- i AGENCY USE ONLY i Date received: k , WASHINGTON STATE S eAmC ' S€aMe Dismci Joint Aquatic Resources Permit Agency reference#: 1X20 �l'LYx�2Z Application (JARPA) Form '°2 ra Parcel#(s): USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BE LOW. RECE7ED► -------------------------------------- MAY 2 2 7 OIL Part 1—Project Identification _6 w,c 1. Project Name(A name for your project that you create. Examples:Smith's Dock or Seabrook Lane Development) he[ el ] 8,eAWA41 STA/ZS AUORTN POTL.A-rC ROAD Part 2—Applicant The person and/or organization responsible for the project. hei 2a. Name (Last, First, Middle) DR-UMMOND, PAUl- k, 2b. Organization (If applicable) P121 V A 7"i 2c. Mailing Address (Street or PO Box) I Z,918 Ai-TO&I SQ UAr2E 2d. City, State, Zip NEPAJr_>0 ) VA 2C1-Ta 2e. Phone(1) 2f. Phone(2) �CettL) 29. Fax 2h. E-mail (403)&89-9895 ( 96�) 903-Z�-_�ES ( ) UA1CgROUPAk6�XAHOO,C01j Additional forms may be required for the following permits: • If your project may qualify for Department of the Army authorization throug 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 http//www nws usace army mil/Missions/CivilWorks/Regulatory/PermitGuioebook/EndancieredSi)ecies aspx. • 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 http//www.epermitting.wa.gov/sitelalias resourcecenter/iarpa iarpa form/9984/Lpa form aspx. For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or help(c ora.wa.gov. JARPA Revision 2012.2 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.) hei 3a. Name (Last, First, Middle) REPPA R, R V CAT/I 3b. Organization (if applicable) Fi2I MTE A]oti_ Go X MEe_Ci,4J-- 3c. Mailing Address (Street or PO Box) 3(aZSto SE, FiSH HA7rC_H E,A,7'1" �'OA D 3d. City, State,Zip >C7ALL CITY; WA 98oZ4 3e. Phone(1) 3f. Phone(2) 3g. Fax 3h. E-mail (//Z5 )ZZZ-S 333 (42S)-7&5--/1 fb.1 ( ) 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. Ehpipj XSame as applicant. (Skip to Part 5.) ❑ 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 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) DR-UAIMCAID, PAUL �. CUsqu ,A . 4b. Organization (If applicable) 4c. Mailing Address (Street or PO Box) =-" 4d. City, 'State, Zip 4e. Phone(1) 4f. hone(2) 4g. Fax 4h. E-mail JARPA Revision 2012.2 Page 2 of 14 Part 5-Project Location(s) Identifying information about the property or properties where the project will occur. [help] ❑ There are multiple project locations (e.g. linear projects). Complete the section below and use JARPA Attachment B for each additional project location. 5a. Indicate the type of ownership of the property. (Check al that apply.) hel Private ❑ Federal ❑ Publicly owned (state, county, city, special districts like schools, ports,etc.) ❑ Tribal ❑ Department of Natural Resources (DNR) - managed aquatic lands (Complete JARPA Attachment E) 5b. Street Address (Cannot be a PO Box. If there is no address,pr vide other location information in 5p) ;hel Z6 0 A]. PaT/-flTCH 'OADO 5ygE'LTOA. , WA 8584 5c. City, State, Zip(If the project is not in a city or town, provide the iame of the nearest city or town.) hf elpl S H ELTO kt, \A/A 9 8s 8 4 5d. County hl eM MA SOAJ COOM 71 5e. Provide the section, township, and range for the projec location. hel '/<Section Section Township Range 'M A c 7-Rs b R 64 ,F rL s34 is 1J 5f. Provide the latitude and longitude of the project location hei • Example:47.03922 N lat./-122.89142 W'long. (Use decimal d Dgrees-NAD 83) AJ 03"-j3, y5° Z ir3.745(P) Al a3�Z3"00 ;t3.�3 �CJ 5g. List the tax parcel number(s)for the project location. fhaipi • The local county assessor's office can provide this information.' -41zz3 - 50 -Oo901 5h. Contact information for all adjoining property owners. (l ,you need more space, use JARPA Attachment C.) hell i Name Mailing Address Tax Parcel#(if known) _ WkxloWN- ----------------------------------------------------------------------------- JARPA Revision 2012.2 Page 3 of 14 5i. List all wetlands on or adjacent to the project location_ hf eipl /VOII.t I 5j. 'List all waterbodies (other than wetlands) on or adjacent to the project location. nei ,yCCID G4AJA L 5k. Is any part of the project area within a 100-year floodplain? hl eM X Yes ❑ No ❑ Don't know 51. Briefly describe the vegetation and habitat conditions on the property. hf eM RATChlt/ ClkASS gRAVEI-. 5m. Describe how the property is currently used. hLgM f`E6iDEIJTIA L - PRIVATE 5n. Describe how the adjacent properties are currently used. ni eipl K->E,5IDENT1AL - PP-IV147-8 5o. Describe the structures (above and below ground) on the property, including their purpose(s) and current condition. hf elpl pEiV T/AL f�OUS� - .250 ' S�rL3f1Ck F�2oM wATE�2 6" 02�LINE 73 u i ,L,r 19&0 5p. Provide driving directions from the closest highway to the project location, and attach a map. hei l Al an o w� 101 -66rn cS/, Am -7urn off on Po�lafch /woad AlouS2 on sid2 fulQf2r i�2 . JARPA Revision 2012.2 Page 4 of 14 Part 6—Project Description 6a. Briefly summarize the overall project.You can provide nore detail in 6b_ rhelpl SEAWALL S7"A 1P-S AOCATED 1,A"b ,4,e.A OF EXIST/!V C T VLk,4E/1 b ('CEA1,ElV 6b. Describe the purpose of the project and why you want or need to perform it. hl e!o E3EACH ,4ccFss -5EAI/OR L.l w1 / TE A468l�l7`� 6c. Indicate the project category. (Check all that apply) hf e ❑ Commercial Residential ❑ Institutional ❑ Transportation ❑ Recreational ❑ Maintenance ❑ Environmental Enhancement 6d. Indicate the major elements of your project. (Check all that apply) [help] ❑ Aquaculture ❑ Culvert El Float ❑ Retaining Wall ❑ Bank Stabilization ❑ Dam /Weir Floating Home (upland) ❑ Boat House ❑ Dike/ Levee/Jetty El Geotechnical Survey ❑ Road ❑ Boat Launch ❑ Ditch El Land Clearing ❑ Scientific Measurement Device ❑ Boat Lift ❑ Dock/ Pier El 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: ,7-&(,5rA1.1.. pAVE6.6 6M kANL11VC7 (APAJDwAe-6 Foe ACCES up To N O USE JARPA Revision 2012.2 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. hl elp] • Identify where each element will occur in relation to the nearest waterbody. • Indicate which activities are within the 100-year floodplain. / dZ 0(/� C,� m4J4-4 Y t,e, 9,2; ci� �� Zo ZT,a, 0ICC- .J JVo09- 6f. What are the anticipated start and end dates for project construction?(Month/Year) help] • If the project will be constructed in phases or stages, use JARPA Attachment D to list the start and end dates of each phase or stage. Start date: End date: ❑ See JARPA Attachment D 6g. Fair market value of the project, including materials, labor, machine rentals, etc. h[ elpl 61h. Will any portion of the project receive federal funding? Chi] • If yes,list each agency providing funds. ❑ Yes K No ❑ Don't know Part 7—Wetlands: Impacts and Mitigation P 9 ❑ Check here if there are wetlands or wetland buffers on or adjacent to the project area. (If there are none, skip to Part 8.) hC eip] 7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. h( elp] ❑ Not applicable 7b. Will he project impact wetlands? [help] ❑ Y ❑ No ❑ Don't know JARPA Revision 2012.2 Page 6 of 14 7c. Will the project impact wetland buffers? [help l ❑ Yes ❑ No ❑ Don't know 7d. Has a wetland delineation report been pre;th y d? hel i • If Yes,submit the report, including data sheets; the JARP package. ❑ Yes ❑ No 7e. Have the wetlands been rated using e Western Washington or Eastern Washington Wetland Rating System? het • If Yes,submit the wetland rating fo sand figures with the JAP PA package. ❑ Yes ❑ No ❑ Don't now 7f. Have you prepared a miti tion plan to compensate fo any adverse impacts to wetlands? he! • If Yes,submit the plan wi the JARPA package and answer 7g • If No,or Not applicab ,explain below why a mitigation plans ould not be required. ❑ Yes ❑ No Not applicable 7g. Summ ize what the mitigation plan is meant to accom Ash, and describe how a watershed approach was used o design the plan. of elpl 7h. Use the table below to list the type and rating of each etland impacted, the extent and duration of the impact, and the type and amount of mitigation propose Or if you are submitting a mitigation plan with a similar table, you/can state (below) where we can find i his information in the plan. [help] Activity (fill, Wetland Wetland Im act Duration Proposed Wetland drain, excavate; Name' type and are (sq. of impact3 mitigation mitigation area flood, etc.) rating or type4 (sq. ft. or category' Ares) acres) I no official name for the wetland exists,create a unique name(such as"Wetla 1"). The name should be consistent with other project documents,such a wetland delineation report. Ecology wetland category based on current Western Washington or Eastern Wa 5hington Wetland Rating System.Provide the wetland rating forms with the JARPA package. 3 Indicate the days,months or years the wetland will be measurably impacted by Ine 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 mitigatior plan, if available: JARPA Revision 2012.2 Page 7 of 14 7i. For all filling activities identified in 7h, descri the source and nature of the fill material, the amount in cubic yards that will be used, and how and wher it will be placed into the wetland. hf elpl 7j. For all excavating acti6ties identified in 7h, describe the excavation method,type and amount of material in cubic yards you will emove, and where the material will be disposed. [help] 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.) [help] ,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. [help] ❑ Not applicable f/0ot) C-4AJAL - �X /STAJ(S 6EA►AJALL ll(JTl) cT - 1-AAJbWA1ZL) 8b. Will your project impact a waterbody or the area around a waterbody? hl elpl ❑ Yes X No JARPA Revision 2012.2 Page 8 of 14 8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland waterbodies? help] • if Yes,submit the plan with the JARPA package and answer 8d • If No,or Not applicable,explain below why a mitigation plan stlould not be required. ❑ Yes ❑ No KNot applicable 8d. Summarize wha�thit igation plan is meant to accom fish. Describe how a watershed approach was used to design the p • If you alread ompleted 7g you do not need to restate your anc wer here. h( pjp] -Z i 8e. Summarize impact(s)to each waterbody in the table bE low. h( elal Activity (clear, Waterbody Impact Dura tion Amount of material Area (sq. ft. or dredge, fill, pile name' location of im act3 (cubic yards) to be linear ft.) of drive, etc.) placed in or waterbody removed from directly affected waterbody M i.1 C If no official name for the waterbody exists,create a unique name(such as"Strebm 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 100-year flood plain. 3 Indicate the days,months or years the waterbody will be measurably impacted the work. Enter"permanent"if applicable. 8f. For all activities identified in 8e, describe the source anc nature of the fill material, amount (in cubic yards) you will use, and how and where it will be placed into the waterbody. h�l /1J//1` JARPA Revision 2012.2 Page 9 of 14 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. h(�el I 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. hf eipl Agency Name Contact Name Phone Most Recent Date of Contact MA 50kl CoW711 COMMUll1/ DEU J.0 e LE88Ee9 COKER (3(00)Nz-7-9670X510 p5-,ZO-,ZOI - PLAUNING ( ) X 35 05-13 -201-el WA. Gr DE 1. of aETT ,2EMeOP, (3(oO )A10� - ir�f1� 05- 1(o -2014 ECOLOGY 9b. Are any df the wetlands or waterbodies identified in Part 7 or Part 8 of this DARPA on the Washington Department of Ecology's 303(d) List? hel • If Yes,list the parameter(s)below. • If you don't know, use Washington Department of Ecology's Water Quality Assessment tools at: http://www.ecy.wa,gov/programs/wq/303d/. ❑ Yes K No 9c.What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? hi elpj' • Go to http://cfpub.epa-gov/surf/locate/index.cfm to help identify the HUC. 111 10018 9d.What Water Resource Inventory Area Number(WRIA#) is the project in? LLLeM • Go to.http://www.ecV.wa.gov/seMces/gis/maps/wria/wria.htm to find the WRIA#. WRIA 1b JARPA Revision 2012.2 Page 10 of 14 9e. Will the in-water construction work comply with the StatB of Washington water quality standards for turbidity? [help] • Go to http://www.ecV.wa. ovq /programs/wq/swgs/criteria htmI fo i the standards. ❑ Yes ❑ No ® Not applicable 9f. If the project is within the jurisdiction of the Shoreline Monagement Act, what is the local shoreline environment designation? [help ) • If you don't know, contact the local planning department. • For more information,go to: hftip://www.ecy.wa.gov/programs/qea/sma/laws rules/173-26/211 designations.htmL 1. Rural ❑ Urban ❑ Natural ❑ Aquatic ❑ Conservancy ❑ Other 9g. What is the Washington Department of'Natural Resources Water Type? he( e • Go to http://www.dnr.wa.gov/BusinessPerrnits/Topies/ForestPrEcticesApplications/Pages/fp watertVping.aspx 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? rhelpl • If No, provide the name of the manual your project is designed io meet. Yes ❑ No Name of manual: 9i. Does the project site have known contaminated sedime t? LhLeM • If Yes, please describe below. ❑ Yes ® No 9j. If you know what the property was used for in the past, describe below. ln�l 1�E5/I.�EIUTI AL 8,EA CH/RECREZ} U AI AL 9k. Has a cultural resource (archaeological) survey been performed on the project area? Lh@jPJ • If Yes,attach it to your JARPA package. ❑ Yes .K No JARPA Revision 2012.2 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. he �)/A 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. hf pipl l//A - NO A]E 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.ecy.wa.gov/opas/. • Governor's Office for Regulatory Innovation and Assistance at (800) 917-0043 or help(a)ora.wa.gov. • For a list of addresses to send your JARPA to, click on agency addresses for completed JARPA. 10a. Compliance with the State Environmental Policy Act (SEPA). (Check all that apply.) n[ elpl • For more information about SEPA,go to www.ecy.wa.gov/programs/sea/sepa/e-review,htmi. ❑ A copy of the SEPA determination or letter of exemption is included with this application. [�A SEPA determination is pending with MASON C / (lead agency). The expected decision date is ❑ 1 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: a ❑ SEPA is pre-empted by federal law. JARPA Revision 2012.2 Page 12 of 14 10b. Indicate the permits you are applying for. (Check all that apply:) [helpl LOCAL COVE NMENT Local Government Shoreline permits: ❑ Substantial Development ❑ Conditional Use ❑ Variance ® Shoreline Exemption Type (explain): jC__X1ST/NG U[.9HEAD MOv/FICAT/o&( �ANDWAV) Conu'TIPuc71oN Other City/County permits: ❑ Floodplain Development Permit ❑ Critical Ares Ordinance STATE GOVE NMENT Washington Department of Fish and Wildlife: ' r ❑ Hydraulic Project Approval (HPA) ❑ Fish Habi UEnhancement Exemption —Attach Exemption Form Effective July 10, 2012, 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# '1 139 Attach check made payable to Washington Department of Fis and Wildlife. ❑Charge to billing account under agreement with WD . Agreement# ❑ My project is exempt from the application fee. (Chec�appropriate exemption) ❑ HPA processing is conducted by applicant-fund�d 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: 1�1� ❑ 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.) Section 10 (work in navigable waters) United States Coast Guard permits: N ❑ Private Aids to Navigation (for non-bridge projects) JARPA Revision 2012.2 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. hf eM 11 a. Applicant Signature (required) n[�el j 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 aut ize 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 ent in property where the project is located to inspect the project site or any work related to the project. j (initial) Applicant Printed Name Applicant Sig ur Date CUSAAI Ok IJ A040 b � 11 b. Authorized Agent Signature h( 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 all necessary permits have been issued. Authorized Agent Printed Nam Authorized Agent Signature Dat 11 c. Property Owner Signature (if not applicant) h[�el j 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. 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: ENV-019-09 rev. 08/2013 JARPA Revision 2012.2 Page 14 of 14 2 _ y ti 8, 9 _10- �10 - 3 15 14 : ' 18 17 16 15 14 4T Qicv 1 22 23, .,�i '1:9' 20 21 22 8 27 -T0 ip;. 4 3 1_ O' MANZANITA DR. 3: 2 � I i S OKOMISH fiNDIAN 9 �3ES RV A ON 7 .9 10 11 - t Q sh I umocher Cn Q. 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F3 � zZ pWQ 21 O l� EO (Y I oQ V� u U q R f' ha " 3Be C\ 61 3 d , 3 ... . • - _ r w s X 9 , r € t i a k .�t............F.,......+...y�...-..+%.mow-• .....,....-.�. -......'.- ' � 1 - t t 5 f f F i : :.. .._ _.. ........... ...... ..—................._..y.i.-.__...... y: ...... ...,.. .._.N................ ..._....... .,..... _ ..:.__.._ _. ..e..._ .. ...__tgE ._..Y,.. .. .... .._ S i� Ste! Guilt i L ...... .... _ _....... 3 f �T• 4 !• � f t { f i T. r I r r , { 3 n 4 on"" •, "9 g afP# F,.J�+,�✓ �S�S,iry, cb � VMA ,1R1 id E'�f -VI Aq. Ltd Y f s d.'d `rt f t Oft— wx �yy} �i/3vF.3g�,�� tt��l }/sty.,•.. � o 3 f+ Page 1 of 1 s _.+ Grace Miller- Drummond, 250 N Potlatch Road, BCC2014-00037 From: Debbera Coker To: Grace Miller Date: 5/20/2014 8:59 AM Subject: Drummond, 250 N Potlatch Road, BCC2014-000 7 Hello Grace, Mr. Drummond called me this am to discuss his plans to re odel/repair the existing structure at 250 N Potlatch Road. He told me that he is not planning to add to the structure but hopes to change a window, or windows, add insulation, and remove an existing flat roof and replace with a pitched roof. He is really concerned about doing something that will cause a problem. When you get a change would you call him to discuss the roof modification? His phone number is 703.689.9895. Because of his work schedule in Virginia the best time to call him is in the AM. Thanks! file:///C: Users/gbm/AppData/Local/Temp/XPgrpwise 537B1979Masomnail100167376E1... 5/20/2014 I Ilu s �" R No A fi pg M e w MI E , f f � i a a { l � S39i x s,e y ot CAW r III kY � ,p �4 X ills k i XV1 �,£ y�• S t t .s*+^ e. >w1rl.'F" Y f i r 2/t r 3 Ti o � ,aa p/ � F�� '�. ik � ° ' s ' n r , r` t> r re trk u �'"k/! .✓- t f, # ��,��' .� ;t► � `�,a "r�p..w`{"�'a�`�+�rt�! . r• .,�. '�° ,'.'# r* oil it4 AMR M. .'. 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