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O_ S O O 0 0 � — CD o 3 O CD 7 7 :3 to n CD v > � O_ co m �. CD s' CD 0co 0 oW 0 0 _ anQi O < cn 0 m o N Q =: O 0 O 2 3 q O' _ 'O O O O O O' 7 O O cn N. to CS O CD Cn N CAD a Q O (D < O CD + Q O CD N O� � (D O O CS Q_ O 0- — (a (p O CD N Q N O CD N U1 O n N 0 7 C `G CD 3 Qo -so' coU��� MASON COUNTY PERMIT NO DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 Mason County Bldg. III,426 West Cedar Street (360)275-4467 Belfair e .352 rRis PO Box 279,Shelton,WA 98584 (360)482-5269 Elma e .352 LAND MODIFICATION PERMIT OWNER INFORMATION: CONTRACTOR INFORMATION: �f NAME: rC'd-A NAME: MAILING ADDRESS: Pb i3 - 1710 MAILING ADDRESS: CITY: STATE: '1A.1,"' ZIP: CITY: E: ZIP: PHONE: ELL: PHONE: CELL: EMAIL: rc�cL of rjj ,,, r t c EMAIL : L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) LI Z O Z ZLf ° r " FIRE DISTRICT LEGAL DESCRIPTION(ABBREV ATED) : L611" 1 0 SITE ADDRESS :5'0 101 �� e.� r,nr 2d. CITY DIRECTIONS TO SITE ADDRESS ,ti. �e — ftd�,, o, ! ©^ IS PROPERTY WITHIN 200 FT: P. SALTWATER❑ LAKE ❑ RIVER/CREEK❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF❑ STREAM❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES❑ NO K WILL TIMBER BE CUT AND SOLD IN PARCEL PREPARATION? YES ❑ NO ? TYPE OF JOB: EXCAVATION D� FILLING e GRADING& CUTTING ❑ OTHER ❑ TOTAL SIZE OF PARCEL Z,53 CRI% /SQ FT SIZE OF AREA TO BE EFFECTED CRE Q FT ESTIMATED AMOUNTY OF CUBIC YARDz ' 3d DOES THE SITE HAVE SLOPES 14%OR GREATER YES❑ NO,� ,/ / f DES RIBE SCOPE OF WORK x C Fvw"T�a— , d� - � ;� �'� t)ee l �rr� WILL FILL BE BROUGHT ON SITE? IF YES,SITE ADDRESS: WILL EXCAVATED MATERIAL BE TAKEN OFF SITE?IF YES,SITE ADDRESS: DOES FILL CONTAIN POTENTIAL HAZARDOUS MATERIALS? YES ❑ NO HAS A SOILS REPORT BEEN COMPLETED ON SITE?IF YES,INCLUDE A COPY. YES 0 NO❑ WILL PROPSAL RESULT IN REDIRECTION OF ANY SURFACE WWATER RUNOFF? YES ❑ NO WILL WORK ALTER WHERE STORMWATER OF GROUND WATER ENTERS OR EXISTS THE SITE? YES ❑ NO WILL QUALITY,QUANTITY OR VELOCITY OF STORM/GROUND WATER BE ALTERED? YES❑ N WILL THE RUNOFF BE COLLETED/CONTROLLED BY INTERCEPTORS,CURTAIN DRAINS OR OTHER DEVICES? YES NO❑ WILL THE LAND BE REPLANTED UPON COMPLETION? YESn NO WILL THE PROPOSAL RESULT IN SLOPES STEEPER THAN THOSE CURRENTLY ON SITE? YES ❑ NO IS THE SITE WITHIN 200 FT OF A DESIGNATED SHORELINE OR A WETLAND? YES❑ NO or OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative,or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. NACTIV Y OF THIS PERMIT APPLICATION OF 180 DAYS WILL I VA (DATE THE APPLICATION. X -- C,rI� Si n ture of Applicant Date X OWNER/REPRESENTATIVE /CONTRACTOR Print Name n CI TQ INDICATE) 2 � 4 €: o' STATE OF WASHINGTON DEPARTMENT OF ECOLOGY PO Box 47775 •Olympia, Washington 98504-7775 •(360)407-6300 711 for Washington Relay Service °Persons with a speech disability can call 877-833-6341 September 23, 2015 Ms. Grace Miller Mason County Department of Community Development Planning Division PO Box 279 Shelton, WA 98584 Dear Ms. Miller: Thank you for the opportunity to comment on the determination of nonsignificance for the ADI Office 2015 Project(SEP2015-00068) located at 21 West Westfield Court,Building `B' in Shelton as proposed by Jason Zack,Arcadia Drilling Inc. The Department of Ecology(Ecology) reviewed the environmental checklist and has the following comment(s): REVIEWER: Sonia Mendoza WATER QUALITY: Deborah Cornett (360) 407-7269 The following construction activities require coverage 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 surface waters of the State; and 2. Clearing, grading and/or excavation on sites smaller than one acre that are part of a larger common plan of development or sale, if the common plan of development or sale will ultimately disturb one acre or more and discharge stormwater to surface waters of the State. a) This includes forest practices (including,but not limited to, class IV conversions) that are part of a construction activity that will result in the disturbance of one or more acres, and discharge to surface waters of the State; and 3. Any size construction activity discharging stormwater to waters of the State that Ecology: a) Determines to be a significant contributor of pollutants to waters of the State of Washington. b) Reasonably expects to cause a violation of any water quality standard. September 23, 2015 Page 2 If there are known soil/ground water contaminants present on-site, additional information (including, but not limited to: temporary erosion and sediment control plans; stormwater pollution prevention plan; list of known contaminants with concentrations and depths found; a site map depicting the sample location(s); and additional studies/reports regarding contaminant(s))will be required to be submitted. You may apply online or obtain an application from Ecology's website at: http://www.ecy.wa.gov/programs/wq/stormwater/construction/-Application. Construction site operators must apply for a permit at least 60 days prior to discharging stormwater from construction activities and must submit it on or before the date of the first public notice. WATER RESOURCES: Vicki Cline(360) 407-0278 Any ground water withdrawals in excess of 5,000 gallons per day or for the irrigation of more than one-half acre of lawn or noncommercial garden, requires a water right permit from Ecology. All water wells shall be constructed in accordance with the provisions of Chapter 173-160 WAC by a driller licensed in the State of Washington. Well reports must be submitted to Ecology within 30 days after completion of a well. All water wells that may be drilled must be a minimum of 100 feet from any known, suspected, or potential source of contamination. Wells shall not be located within 1,000 feet of a solid waste landfill. WAC 173-160-171(1) The proposed water well shall be located where it is not subject to ponding and is not in the floodway, except as provided in Chapter 86.16 RCW. (2) It shall be protected from a one hundred year flood and from any surface or subsurface drainage capable of impairing the quality of the ground water supply. Ecology's comments are based upon information provided by the lead agency. As such,they may not constitute an exhaustive list of the various authorizations that must be obtained or legal requirements that must be fulfilled in order to carry out the proposed action. If you have any questions or would like to respond to these comments,please contact the appropriate reviewing staff listed above. Department of Ecology Southwest Regional Office (SM:15-4645) cc: Vicki Cline, WR Deborah Cornett, WQ Joyce Smith,HQ/WQ Arcadia Drilling Inc. (Proponent) MASON COUNTY (360) 427-9670 Shelton ext.352 DEPARTMENT OF COMMUNITY DEVELOPMENT (360) 275-4467 Belfair ext. 352 BUILDING•PLANNING•FIRE MARSHAL (360)482-5269 Elma ext. 352 Mason County Bldg. III, 426 West Cedar Street xs, Shelton, WA 98584 www.co.mason.wa.us Sept 10, 2015 TO: Loretta Swanson FROM: Grace Miller, Planning Dept. RE: Permit#GRD 2015-00014 and#SEP2015-00068 Dear Loretta, Attached please find the Construction Stormwater Pollution Prevention Plan and Checklist for Arcadia Drilling Inc.'s proposal to excavate and grade as needed to install utilities, storm drainage system, driveways and buildings. I have also enclosed the SEPA and hope to issue the Grading Permit once the SEPA comments period is complete on Sept 24th. Thank you. 1 Grace Miller- stormwater review for Arcadia Drilling '„+,�. s3'6,,'1/6A';;� _.� ;�;14/.'/�1�N,a,�.l:,•,'ywr'9.i From: Grace Miller To: Loretta Swanson Date: 10/12/2015 10:07 AM Subject: stormwater review for Arcadia Drilling Hi Loretta, Wondering if you have had a chance to review the stormwater plan for Arcadia Drilling that I sent to you on Sept loth? The permit#'s are: #GRD2015-00014 and #SEP2015-00068. See attached SEPA comment from ECY. Thank you. Grace about:blank 10/l 2/2015 V %JILI� I IuII ��►. TOWN Sl Co 16521 Highway 99,suite C•Lynnwood,WA 98037-3161 Please Check After Doing Site Plan: 61 Septic and drainfield EO,Lot size Draw North Arrow in Circle POST FRAME BUILDINGS Everett:(425)258-4171 • Puyallup:(253)840-9552 Z Property dimensions [ property lines Elevation of rop ert Administrative Headquarters: (425)743.1555 Existing buildings �',Setbacks of proposed&existing buildings El Bodies of water MIL _ ® FAX: (425)742-4378• 800-824-9552 roposed building ,Main road with name ,❑I-Ioorplan DM M01 Contractors Lic.#:TOWNCPF099LT Easements C Access to proposed building LJ Slopes&Contours(5 increments) r Our Future Depends On It.- permabilt.com•facebook.com/permabilt �,. Quality: h up. 3 ^ k: Job Name: � �� �` ' Job.Site Address: ; Legal Description: Tax Account#. PV r" f 4 ..wp Y� F- 0 REIm Of,AI CEi 0 iRu y p� 426 W CEDAR , PLANNIN • V ALL SETBACKS ARE MEASURED � C� FROM THE FURTHEST a PROJECTION OF THE BUILDIN`3 r ( i'i- `!,�'��y �f •Y Aa �nah.a-evert+""!Y`•w �v4a6.�'+�..hw+..e-..nrr.+xa twr+-+w fury k �, Ate'4 Y"• .d r r. _ -col, i74 9Ac , oc/'6 r. i // � b...,. ...•.a,,.s... .a.w .. 'f`{,^� 4 Y"5•�p�3� vex.�.P 4 v✓,'.m.-.tip 3 (P61 �.�,.:...�=,...s . } � a. 2t+ij 06"+t4 A 1' h�j� U C Y: 66,j- non ce lat'LiaACL none' c�dL • no n i -Ad A DO NOT SIGN INCOMPLETE SITE PLAN! Customer has verified and approved the 196ation of the bw!ildirl orientation of the building to the North,and verifies that all Grid White-Customer Copy Plain White-Office Copy utilities are shown on this drawing in the Vbrrect location. CUSTOMER SIGNATURE '- LEAD#—, ,�_; -'• ' '• '' f • n 9n19 Parma-Rilt(i9 Industries FR-34 07/12