HomeMy WebLinkAboutSHX2016-00042 Replace Bulkhead - SHX Permit / Conditions - 7/6/2016 srgTFO MASON COUNTY
�P C DEPARTMENT OF COMMUNITY DEVELOPMENT
o q o �N Planning Division
o N z 615 W Alder St, Shelton, WA 98584
7 N Y y (360)427-9670
OJ ap
1864
Exemption from Shoreline Management Act
Case No.: SHX2016-00042 Substantial Development Permit Requirement
The Proposal By: JENSEN REPLACEMENT BULKHEAD
C/O PACIFIC NORTHWEST BULKHEAD
P O BOX 11477
OLYMPIA, WA 98508
Parcel Number: 121087590012
Site Address: 263 E STRETCH ISLAND RD NORTH GRAPEVIEW
To undertake the following development:
REPLACE FAILING PILING BULKHEAD WITH ROCK,LANDWARD OF EXISTING PILING, APPROX.
76' LONG 7' TALL
Within CASE INLET 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
C-normal protective bulkhead
Please contact Kell McAboy at ext 365 if you have any questions.
Issued:7/6/2016
Authorized Local Government Official
'---------------------------------------i
AGENCY USE ONLY
t t
f M Date received:
US Army Corps '
of Engineers
Seattle District
WASHINGTON STATE : Agency reference#: X20f&-060yZ;
Tax Parcel#(s):
Joint Aquatic Resources Permit rl 5 - Sao 1 A
Application (DARPA) Form ,2 t
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USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW.
-------------------------------------
Part 1-Project Identification
1. Project Name (A name for your project that you create. Examples: Smith's Dock or Seabrook Lane Development) hel
Jensen Replacement Bulkhead
Part 2-Applicant
The person and/or organization responsible for the project. hel
2a. Name (Last, First, Middle)
PACIFIC NORTHWEST BULKHEAD INC.
2b. Organization (If applicable)
2c. Mailing Address (Street or PO Box)
P O BOX 11477
2d. City, State, Zip
OLYMPIA WA 98508
2e. Phone(1) 2f. Phone(2) 29. Fax 2h. E-mail
360-866-1608 360-888-6357 360-943-6879 acif[cnwbulkhead comcast.net
Additional forms may be required for the following permits:
• If your project may qualify for Department of the Army authorization through a Regional General Permit(RGP),contact the U.S.Army Corps of
Engineers for application information(206)764-3495.
• If your project might affect species listed under the Endangered Species Act,you will need to fill out a Specific Project Information Form(SPIF)or
prepare a Biological Evaluation. Forms can be found at
http:/Avww.nws.usace.army.miVMissions/CivilWorks/Regulatory/PeffndGuidebook/EndangeredSpecies 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
hftp:/Avww.epermftting.wa.gov/site/alias- resourcecentediarpa iarpa form/9984fiarpa form aspx.
For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or help(&,ora.wa.gov.
JARPA Revision 2012.2 Page 1 of 15
Part 3-Authorized Agent or Contact
Person authorized to represent the applicant about the project. (Note: Authorized agent(s) must sign 11 b of this
application.) [ ; ]
3a. Name (Last, First, Middle)
Kaufman Kim
3b. Organization (If applicable)
3c. Mailing Address (street or Po Box)
PO Box 11477
3d. City, State, Zip
Olympia WA 98508
3e. Phone(1) 3f. Phone(2) 3g. Fax 3h. E-mail
360-866-1608 360-888-6357 360-943-6879 paciicnwbulkhed@comcast.net
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. ( ,J ;]
❑ Same 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)
Jensen, Norman and Eileen
4b. Organization (if applicable)
4c. Mailing Address (street or Po Box)
263 Stretch Island Rd. N
4d. City, State, Zip
Grapeview, WA 98546
4e. Phone(1) 4f. Phone(2) 4g. Fax 4h. E-mail
(360 )801-6091 ( ) ( ) dicknruth@comcast.net
JARPA Revision 2012.2 Page 2 of 15
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 all that apply.) [help]
x❑ 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, provide other location information in 5p.) h[ elp]
263 Stretch Island Rd. N
5c. City, State, Zip(If the project is not in a city or town, provide the name of the nearest city or town.) [help]
Grapeview, WA 98546
5d. County [help]
5e. Provide the section, township, and range for the project location. [help]
'A Section Section Township Range
08 21 1
5f. Provide the latitude and longitude of the project location. [help]
• Example:47.03922 N lat_/-122.89142 W long. (Use decimal degrees-NAD 83)
47.329750, -122.828893
5g. List the tax parcel number(s) for the project location. hei
• The local county assessor's office can provide this information.
12108-75-90012
5h. Contact information for all adjoining property owners. (If you need more space, use JARPA Attachment C.) [help]
Name Mailing Address Tax Parcel # (if known)
James and Nancy Montgomery 151 E. Wilkes Rd. Grapeview, Wa 98546 12108-75-90011
Teresa and Ed Hogland 261 E. Stretch Island Rd. N Grapeview, Wa 12108-75-90013
98546
JARPA Revision 2012.2 Page 3 of 15
5i. List all wetlands on or adjacent to the project location. hel
None
5j. List all waterbodies (other than wetlands) on or adjacent to the project location. pjgAl
51k. Is any part of the project area within a 100-year floodplain? [help]
❑ Yes ❑ No x❑ Don't know
51. Briefly describe the vegetation and habitat conditions on the property. ftqio
Typical shoreline vegetation, shrubs, grass, sand, gravel, various size rock.
Typical shoreline habitat, song birds, deer, fish.
5m. Describe how the property is currently used. h[ elpj
Single family residence.
5n. Describe how the adjacent properties are currently used. [het
Single family residence.
50. Describe the structures (above and below ground) on the property, including their purpose(s) and current
condition. [help]
Built 1996, total area 2,760 sq ft., Quality 3.0 avg. Condition 3.0 avg. Slab porch with roof, attached garage, 3
bedroom, 3 bathroom, single 2 story fireplace, frame siding.
5p. Provide driving directions from the closest highway to the project location, and attach a map. [help]
See Attached.
JARPA Revision 2012.2 Page 4 of 15
Part 6—Project Description
6a. Briefly summarize the overall project. You can provide more detail in 6b. [helps
Replace failing piling with rock. Landword of existing piling. Approximately 76' long 7' tall.
6b. Describe the purpose of the project and why you want or need to perform it.
See Attached photos.
6C. Indicate the project category. (Check all that apply) h[ elpl
❑ Commercial x❑ Residential ❑ Institutional ❑ Transportation ❑ Recreational
❑ Maintenance ❑ Environmental Enhancement
6d. Indicate the major elements of your project. (check an that apply) [
❑ Aquaculture ❑ Culvert ❑ Float ❑ Retaining Wall
❑ Bank Stabilization ❑ Dam /Weir ❑ Floating Home (upland)
❑ Boat House ❑ Dike / Levee / Jetty ❑ Geotechnical Survey ❑ Road
❑ Boat Launch ❑ Ditch ❑ Land Clearing ❑ Scientific
Measurement Device
❑ Boat Lift ElDock / Pier ❑ Marina / Moorage
❑ Bridge ❑ Dredging ❑ Mining ❑ Stairs
x❑ Bulkhead ElStormwater facility
❑ Fence ❑ Outfall Structure
❑ Swimming Pool
❑ Buoy ElFerry Terminal ElPiling/Dolphin
❑❑ Channel Modification ❑ Fishway ❑ Raft Utility Line
❑ Other:
JARPA Revision 2012.2 Page 5 of 15
6e. Describe how you plan to construct each project element checked in 6d. Include specific construction
methods and equipment to be used. [help]
• Identify where each element will occur in relation to the nearest waterbody.
• Indicate which activities are within the 100-year floodplain.
To construct bulkhead, barge will enter work corridor as HPA instructions. Barge will be grounded and all
equipment and construction materials will be from barge. All construction will be in the daylight hours during low
tides. Excavator from grounded barge will place rock in water. See attached site plan for rock placement. All
rock will be from upland quarry.
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 to list the start and end dates of each phase or
stage.
Start date: Permits available End date: 10 days from start. ❑ See JARPA Attachment D
6g. Fair market value of the project, including materials, labor, machine rentals, etc.
26,000.00
6h. Will any portion of the project receive federal funding? [ : :
• If yes, list each agency providing funds.
❑ Yes x❑ 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.) [ c �
7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. [help]
❑ Not applicable
I
i
JARPA Revision 2012.2 Page 6 of 15
7b. Will the project impact wetlands? (hep]
❑ Yes ❑ No ❑ Don't know
7c. Will the project impact wetland buffers? h[ eM
❑ 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? [help]
• 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. [help]
71h. 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. hel
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.
Z Ecology wetland category based on current Western Washington or Eastern Washington Wetland Rating System.Provide the wetland
rating forms with the JARPA package.
'Indicate the days,months or years the wetland will be measurably impacted by the activity.Enter"permanent"if applicable.
JARPA Revision 2012.2 Page 7 of 15
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:
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. [help]
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. [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]
0 Check here if there are waterbodies on or adjacent to the project area. (If there are none, skip to Part 9.)
8a. Describe how the project is designed to avoid and minimize adverse impacts to the aquatic environment.
[help]
❑ Not applicable
All work shall be conducted in accordance with relevant development standards and appropriate best
management practices to protect water quality and minimize aquatic area impacts.
8b. Will your project impact a waterbody or the area around a waterbody? [,, .::]
JARPA Revision 2012.2 Page 8 of 15
❑ Yes x❑ No
JARPA Revision 2012.2 Page 9 of 15
8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland
waterbodies? [hell
• 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 ❑ No x❑ Not 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. [heip]
n/a
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
waterbody
Case inlet 190 Ton 76' long 7' tall
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.
z 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.
'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. [ham]
n/a
DARPA Revision 2012.2 Page 10 of 15
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. hem
All Debris will be desposed at upland source.
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. help]
Agency Name Contact Name Phone Most Recent
Date of Contact
Mason county ( 360 )427-9670
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? [help]
• If Yes, list the parameter(s)below.
• If you don't know, use Washington Department of Ecology's Water Quality Assessment tools at:
h ttp Nwww.ecy.wa.gov/gr ograms/w 303 d/.
❑ Yes x❑ No
9C. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? [helms]
• Go to http://cfpub.epa.gov/surf/locate/index.cfm to help identify the HUC.
9d. What Water Resource Inventory Area Number (WRIA#) is the project in? [help]
• Go to hftp://www.ecV.wa.gov/services/gis/maps/wria/wria.htm to find the WRIA#.
16
JARPA Revision 2012.2 Page 11 of 15
9e. Will the in-water construction work comply with the State of Washington water quality standards for
turbidity? h[ elpl
• Go to http://www.ecy.wa.gov/programs/wq/swgs/criteria.html for the standards.
x❑ Yes ❑ No ❑ Not applicable
9f. If the project is within the jurisdiction of the Shoreline Management Act, what is the local shoreline
environment designation? ["I
• If you don't know,contact the local planning department.
• For more information,go to: http://www.ecy.wa.gov/programs/sea/sma/laws rules/173-26/211 designations html.
--*❑ Rural 40D Urban ❑ Natural ❑ Aquatic ❑ Conservancy ❑ Other
9g. What is the Washington Department of Natural Resources Water Type? h[ elpl
• Go to http://www.dnr.wa.gov/BusinessPermitsfTopics/ForestPracticesApplications/Pages/fp watertyping aspx for the Forest
Practices Water Typing System.
x❑ Shoreline ❑ Fish ❑ Non-Fish Perennial ❑ Non-Fish Seasonal
9h. Will this project be designed to meet the Washington Department of Ecology's most current stormwater
manual? [help]
• If No,provide the name of the manual your project is designed to meet.
x❑ Yes ❑ No
Name of manual:
9i. Does the project site have known contaminated sediment? [help]
• If Yes, please describe below.
❑ Yes x❑ No
9j. If you know what the property was used for in the past, describe below. [help]
Single Family Residence.
9k. Has a cultural resource (archaeological) survey been performed on the project area? hel
• If Yes,attach it to your JARPA package.
❑ Yes x❑ No
JARPA Revision 2012.2 Page 12 of 15
91. Name each species listed under the federal Endangered Species Act that occurs in the vicinity of the project
area or might be affected by the proposed work. [help]
Chinook salmon, bull trout listed. None affected by proposed work.
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. [he_tp]
None affected by proposed work.
Part 10—SEPA Compliance and Permits
Use the resources and checklist below to identify the permits you are applying for.
• Online Project Questionnaire at httpJ/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.) hel
• For more information about SEPA, go to www.ecy.wa.gov/programs/sea/sepa/e-review.html.
A copy of the SEPA determination or letter of exemption is included with this application.
❑A SEPA determination is pending with P%50K (lead agency). The expected decision date is
❑ I am applying for a Fish Habitat Enhancement Exemption. (Check the box below in 10b.) [hem]
❑ This project is exempt (choose type of exemption below).
x❑ Categorical Exemption. Under what section of the SEPA administrative code (WAC) is it exempt?
Shoreline exemption replacement bulkhead.
❑ Other: Expidited shoreline exemption for new erosion control rock bulkhead to protect residence.
❑ SEPA is pre-empted by federal law.
JARPA Revision 2012.2 Page 13 of 15
10b. Indicate the permits you are applying for. (Check all that apply.) [help]
LOCAL GOVERNMENT
Local Government Shoreline permits:
❑ Substantial Development ❑ Conditional Use ❑ Variance
x❑ Shoreline Exemption Type (explain): replacement landward of existing
Other City/County permits:
❑ Floodplain Development Permit ❑ Critical Areas Ordinance
STATE GOVERNMENT
Washington Department of Fish and Wildlife:
Ld Hydraulic Project Approval (HPA) ❑ Fish Habitat Enhancement 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#
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 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:
❑ Private Aids to Navigation (for non-bridge projects)
JARPA Revision 2012.2 Page 14 of 15
Part 11—Authorizing Signatures
Signatures are required before submitting the JARPA package. The JARPA package includes the JARPA form,
project plans, photos, etc.
11 a. Applicant Signature (required) [rei;]
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 autho ize the agent named in Part 3 of this application to act on my behalf in matters related to this
application. %� '' - (initial)
V
By initialing here, I state that I have the authority to grant access to the property. I also give my consent to the
permitting agencies entering the property where the project is located to inspect the project site or any work
related to the project. (initial)
Pacific Northwest Bulkhead Inc. Mark Roulst 6/1/16
Applicant Printed Name Applicant Signatdre6 Date
11 b. Authorized Agent Signature p 1
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) [nee]
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.
Eileen Jensen ' ��✓ V �Giu. '7 t %�_�_
Property Owner Printed Name Property Owner Signatur 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 15 of 15
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