The URL can be used to link to this page

Home My WebLink AboutSHX2013-00070 Drainpipe Repair - SHX Permit / Conditions - 1/17/2014 P�ONe.STgT�O MASON COUNTY C DEPARTMENT OF COMMUNITY DEVELOPMENT o A c v� Planning Division Y o N z P O Box 279, Shelton, WA 98584 7 N y (360)427-9670 Y OJ �O 1864 Exemption from Shoreline Management Act Case No.: SHX2013-00070 Substantial Development Permit Requirement The Proposal By: HARSTENE POINTE WATER-SEWER DISTRIC 772 E CHESAPEAKE AVE SHELTON, WA 98584 To undertake the following development: Maintenance work will be performed on the existing outfall pipe. The bolts and hardware will be checked for corrrosion and the conditions of all the existing anchors will be inspected. In shore portion of the pipe will be inspected and if it reveals SS316 hardware was not used, the hardware will be replaced with SS316 hardware. Saddle straps on the original anchor blocks will be reinstalled with two 5/8" x 5 1/2" 316L wedge anchors which will be drilled into the existing anchor blocks which are laying on the bottom under the outfall pipe. The off shore portion of the pipe will be inspected and any of the stainless steel harware on the ecology blocks that are not SS#16 will be replaced. The flange connections at the makeup piece will be tightened and any bolts needing to be addressed will be replace. Up to 40 additional saddle bags will be placed on the outfall pipe as well as additional ecology blocks to achieve one block every 200' or less. Pk4s 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 �' B-normal maintenance �. t to Frio: 3 Please contact Grace Miller at ext 360 if you have any questions. Issued: 1/17/2014 Expires: 1/17/2016 Authorized Local Government Official ',j�N2-il�u,did�Sourccs cc: APPLICANT WDFW- LISACOE WDOE TRIBAL COUNCIL i, %%/, , E'_st,zu --------------------------------------- AGENCY USE ONLY Date recf US Army ers SeCorps WASHINGTON STATE Engineers• Seattle Distract , Xy� �'j'� ('� Joint Aquatic Resources Permit ; Agency reference#t�� Application (DARPA) Form'°2 Taxrcel#(s): 1 t l� -1 USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. e t , i L-------------------------------------- Part 1—Project Identification 1. Project Name (A name for your project that you create. Examples: Smith's Dock or Seabrook Lane Development) hel Hartstene Pointe WWTF Outfall Maintenance Part 2—Applicant The person and/or organization responsible for the project. hei 2a. Name (Last, First, Middle) Jeffreys Mont R 2b. Organization (If applicable) Hartstene Pointe Water-Sewer District 2c. Mailing Address (Street or PO Box) 772 Chesapeake Avenue 2d. City, State, Zip Shelton, WA 98584 2e. Phone(1) 2f. Phone(2) 2g. Fax 2h. E-mail (360) 427-2413 (360) 490-5971 ( ) gm@hpwatersewer.com 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•//www nws usace army mil/Missions/CivilWorks/Regulatory/PermitGuidebook/EndangeredSpecies asoxx. • 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.epermittina.wa.aov/site/alias resourcecenter/jarpa iaroa form/9984/'area form asp . For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or helpCa)ora.wa.gov. JARPA Revision 2012.2 Page 1 of 17 V 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.) heel l 3a. Name (Last, First, Middle) Miller, Adam, PE 3b. Organization (If applicable) Gray & Osborne, Inc. 3c. Mailing Address (street or PO Box) 701 Dexter Avenue North, Suite 200 3d. City, State, Zip Seattle, WA 98109 3e. Phone(1) 3f. Phone(2) 3g. Fax 3h. E-mail (206) 284-0860 ( ) (206) 283-3206 amiller@g-o.com 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. hel ❑ 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) 4b. Organization (If applicable) 4c. Mailing Address (street or PO Box) 4d. City, State, Zip 4e. Phone(1) 4f. Phone(2) 4g. Fax 4h. E-mail JARPA Revision 2012.2 Page 2 of 17 Part 5—Project Location(s) Identifying information about the property or properties where the project will occur. hl elo ❑ 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.) h[ elf ❑ 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.) hel Hartstene Pointe WWTF, 772 Chesapeake Drive 5c. City, State, Zip(If the project is not in a city or town, provide the name of the nearest city or town.) Lel Shelton, WA 98584-7001 5d. County hel l Mason 5e. Provide the section, township, and range for the project location. [help] 1/4 Section Section Township Range 19 21 North 1 West 5f. Provide the latitude and longitude of the project location. hel • Example:47.03922 N lat./-122.89142 W long. (Use decimal degrees-NAD 83) 47.2966 N lat. / -122.8439 W long. 5g. List the tax parcel number(s) for the project location. hell • The local county assessor's office can provide this information. 121195700048 (Hartstene Pt. WWTF) outfall is on subtidal lands under DNR jurisdiction 5h. Contact information for all adjoining property owners. (If you need more space, use JARPA Attachment C.) hel Name Mailing Address Tax Parcel #(if known) Kim, William NC & Sarah 789 E. Chesapeake Dr. .......____......_.........._.............. Henderson, Connie M & Paul S. 791 E. Chesapeake Dr. Rune & Nancy Tvedt 793 E. Chesapeake Dr. ......_.....-----.......... �._ Laura M. St. George 795 E. Chesapeake Dr. Susan M. Tyler 797 E. Chesapeake Dr. 11-1................................................ .................__._......._......._..........-...........-............. --- Maynard, John & Misko 799 E. Chesapeake Dr. Larson TRS, Norman A & Lorna K. 467 E Chesapeake Dr. JARPA Revision 2012.2 Page 3 of 17 511. List all wetlands on or adjacent to the project location. h[ im None 5j. List all waterbodies (other than wetlands) on or adjacent to the project location. hei ] Case Inlet 5k. Is any part of the project area within a 100-year floodplain? n[ elp] ® Yes ❑ No ❑ Don't know 51. Briefly describe the vegetation and habitat conditions on the property. h[ elo] Minimal amounts of kelp and algae may be present on any hard substrate present on the benthic surface of Case Inlet. As the benthic surface is generally soft mud, little macro algae is present. Geoducks and other clams and invertebrates and a few fish may also be present. Salmonids migrate along the inshore portion of the project area. 5m. Describe how the property is currently used. hl elo] The property currently contains the outfall from the Hartstene Pointe Wastewater Treatment Facility, which was originally constructed in 1970, upgraded in 1993 and lengthened 2009. 5n. Describe how the adjacent properties are currently used. n[ ei�] Geoducks have been harvested from Tract 15500 — Dougall since the outfall was extended off-shore in 2009. 5o. Describe the structures (above and below ground) on the property, including their purpose(s) and current condition. hei The Hartstene Pointe WWTF Outfall consists of approximately 2,800 feet of 8-inch HDPE SDR 11 pipe that was installed in 2009. Some of the bolts and nuts on the anchors holding the outfall structure in place have corroded, disconnecting portions of the outfall pipe from the original anchors holding it on the benthic surface. The original concrete anchors were replaced with ecology block anchors and aggregate filled saddle bag anchors. 5p. Provide driving directions from the closest highway to the project location, and attach a map. Lei ] JARPA Revision 2012.2 Page 4 of 17 Part 6—Project Description 6a. Briefly summarize the overall project. You can provide more detail in 6b. h[ elo] Maintenance work will be performed on the existing outfall pipe. The bolts and hardware will be checked for corrosion and the conditions of all the existing anchors will be inspected. The in-shore portion of the pipe will be inspected and if the inspection reveals SS316 hardware was not used, the hardware will be replaced with SS316 hardware. Saddle straps on the original anchor blocks will be reinstalled with two 5/8"x 5-1/2" 316L wedge anchors which will be drilled into the existing anchor blocks which are laying on the bottom under the outfall pipe. The off-shore portion of the pipe will be inspected and any of the stainless steel hardware on the ecology blocks that are not SS316 will be replaced. The flange connections at the makeup piece will be tightened and any bolts needing to be addressed will be replaced. Up to 40 additional saddle bags will be placed on the outfall pipe as well as additional ecology blocks to achieve one block every 200' or less. 6b. Describe the purpose of the project and why you want or need to perform it. Leipj The wrong type of hardware was used on many of the original anchor blocks causing many of the anchors to corrode and fail. Ecology block anchors and aggregate filled saddle bag anchors were installed to keep the outfall pipe secured to the bottom. The maintenance work under this permit will consist of checking and replacing any corroded hardware with the correct SS316 hardware. The condition of the existing saddle bag anchors will be checked and re-installed as necessary. Additional saddle bag anchors and ecology block anchors will be installed to provide an extra factor of safety and keep the outfall pipe secured in the current location on the bottom of Carr Inlet. No construction will be performed. 6c. Indicate the project category. (check all that apply) help] ❑ Commercial ❑ Residential ❑ Institutional ❑ Transportation ❑ Recreational ® Maintenance ❑ Environmental Enhancement 6d. Indicate the major elements of your project. (check all that apply) [help] ❑ 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 ❑ Dock/ Pier ❑ Marina/ Moorage ❑ Stairs JARPA Revision 2012.2 Page 5 of 17 ❑ 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 2012.2 Page 6 of 17 6e. Describe how you plan to construct each project element checked in 6d. Include specific construction methods and equipment to be used. h[ gld • Identify where each element will occur in relation to the nearest waterbody. • Indicate which activities are within the 100-year floodplain. Hard-hat and SCUBA divers will be deployed from a vessel or diving barge to replace nuts, bolts and other outfall pipeline hardware. Additional anchors will be placed by crane from a vessel and secured to the existing outfall pipe. 6f. What are the anticipated start and end dates for project construction? (MonthNear) hel • 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: October 31, 2013 End date: March 15, 2014 ® See JARPA Attachment D 6g. Fair market value of the project, including materials, labor, machine rentals, etc. nei -$30,000 6h. Will any portion of the project receive federal funding? he[�l • If yes, list each agency providing funds. ❑ Yes ® 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.) [hel i 7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. hel ❑ Not applicable 7b. Will the project impact wetlands? hel JARPA Revision 2012.2 Page 7 of 17 ❑ Yes ❑ No ❑ Don't know 7c. Will the project impact wetland buffers? [help] ❑ Yes ❑ No ❑ Don't know 7d. Has a wetland delineation report been prepared? [help] • If Yes,submit the report, including data sheets,with the JARPA package. ❑ Yes ❑ No 7e. Have the wetlands been rated using the Western Washington or Eastern Washington Wetland Rating System? n[bel ] • 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? [help] • 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. [ham] i i i i 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. [help] 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 cate or 2 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. °Creation(C), Re-establishment/Rehabilitation(R), Enhancement(E), Preservation(P), Mitigation Bank/In-lieu fee(B) JARPA Revision 2012.2 Page 8 of 17 Page number(s) for similar information in the mitigation plan, if available: 71. 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. nei 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. hf i 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.) h[ elpl ® 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. elgi ❑ Not applicable The proposed maintenance work will involve divers inspecting and repairing the anchors for the Harstene WWTF Outfall in Case Inlet. Maintenance will include the replacement of corroded hardware and the placement of some additional anchors. This maintenance will ensure that the outfall will remain permanently secured to the benthic surface. In-water work will be conducted during the WDFW In-water Work Window for this waterbody (June 15 to March 15). 8b. Will your project impact a waterbody or the area around a waterbody? hel ® Yes ❑ No JARPA Revision 2012.2 Page 9 of 17 8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland waterbodies? hf elp� • 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 ❑ Not applicable The proposed maintenance work would involve divers inspecting the Hartstene Pointe WWTF Outfall, which will maintain the discharge at its permitted location and protect more sensitive habitat in shallower water and along the shore of Case Inlet. 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. hel i The proposed outfall maintenance work is being undertaken to ensure that the Hartstene Pointe WWTF Outfall remains on the benthic surface of Case Inlet in its permitted location. 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 Outfall Case Inlet Hartstene Two 0 -2,800 linear inspection, Pointe weeks feet. anchor WWTF maintenance, Outfall additional anchors Uncover on- Case Inlet Hartstene 2 hours 0 - 10 linear feet. shore concrete Pointe anchor blocks WWTF Outfall 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. 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. a 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. heI I JARPA Revision 2012.2 Page 10 of 17 The proposed outfall maintenance project will inspect and replace corroded portions of the Hartstene Pointe WWTF outfall attaching the anchor system to the effluent pipeline/outfall. Additional anchors will be installed as required to keep the outfall anchored to the sea floor in its existing location. The on-shore concrete anchors securing the HDPE outfall pipe to the Cl outfall pipe will be uncovered and the hardware will be inspected and replaced with the correct SS316 hardware. 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. hel Not applicable. No dredging proposed. 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. hel Agency Name Contact Name Phone Most Recent Date of Contact WDFW Margie Schirato (360) 427-2179 10-18-2013 WDNR Rollin Christopherson (360) 584-8103 10-18-2013 US Army Corps of Darren Habel (206) 764-6583 10-22-2013 Engineers 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? LLeipl • 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.aov/programL/wq/303d/. ® Yes ❑ No Dissolved Oxygen & fecal coliform JARPA Revision 2012.2 Page 11 of 17 9C. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? [Leis] • Go to http://cfpub.epa.gov/surf/locate/index.cfm to help identify the HUC. 17110019 Puget Sound 9d. What Water Resource Inventory Area Number (WRIA#) is the project in? help] • Go to http://www.ecy.wa.gov/services/gis/maps/wria/wria.htm to find the WRIA#. 14 Upper Case Inlet 9e. Will the in-water construction work comply with the State of Washington water quality standards for turbidity? h[ el • Go to http://www.ecy.wa.gov/programs/wq/swgs/criteria.html for the standards. ® Yes ❑ No ❑ Not applicable 9f. If the project is within the jurisdiction of the Shoreline Management Act, what is the local shoreline environment designation? hell ] • 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 ❑ Urban ❑ Natural ❑ Aquatic [:1 Conservancy ❑ Other 9g. What is the Washington Department of Natural Resources Water Type? heI ] • Go to http://www.dnr.wa.gov/BusinessPermits/Topics/ForestPracticesApplications/Pages/fo watertyping asox 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 Department of Ecology's most current stormwater manual? eiel ] • If No, provide the name of the manual your project is designed to meet. ® Yes ❑ No Name of manual: 2012 Stormwater Design Manual for Western Washington 9L Does the project site have known contaminated sediment? hei • If Yes, please describe below. ❑ Yes ® No 9j. If you know what the property was used for in the past, describe below. hei JARPA Revision 2012.2 Page 12 of 17 Prior to being developed as the Hartstene Pointe WWTF Outfall alignment, the waters of Case Inlet in the area were used for marine transportation and fishing. 9k. Has a cultural resource (archaeological) survey been performed on the project area? [help] • If Yes, attach it to your JARPA package. ❑ Yes ® No Marine subtidal lands JARPA Revision 2012.2 Page 13 of 17 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] Marbled murrelet (Threatened) Puget Sound chinook salmon (Threatened) Puget Sound steelhead (Threatened) Puget Sound bull trout (Threatened Orca Southern Resident Pod (Endangered) Puget Sound rockfish Bocaccio (Endangered) Yellow-eye rockfish and canary rockfish (Threatened) 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. heel ) Marbled murrelet, chinook salmon, chum salmon, pink salmon, coho salmon, steelhead, cutthroat trout, bull trout, rockfish. Other species present include bald eagle, harbor seal, waterfowl concentrations, common loon, great blue heron & osprey. 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.clov/opas/. • Governor's Office for Regulatory Innovation and Assistance at (800) 917-0043 or help@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. Mason County SEP99-00071 (attached) JARPA Revision 2012.2 Page 14 of 17 ❑ A SEPA determination is pending with (lead agency). The expected decision date is ❑ 1 am applying for a Fish Habitat Enhancement Exemption. (check the box below in 1 Ob.) he[All ❑ 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 2012.2 Page 15 of 17 10b. Indicate the permits you are applying for. (Check all that apply.) Ihell I LOCAL GOVERNMENT Local Government Shoreline permits: ❑ Substantial Development ❑ Conditional Use ❑ Variance 21Shoreline Exemption Type (explain): Maintenance Other City/County permits: ❑ Floodplain Development Permit ❑ Critical Areas Ordinance STATE GOVERNMENT Washington Department of Fish and Wildlife: ® 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# 017837 Attach check made payable to Washington Department of Fish and Wildlife. ❑Charge to billing account under agreement with WDFW. Agreement# ❑ 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) #200500432 United States Coast Guard permits: ❑ Private Aids to Navigation (for non-bridge projects) JARPA Revision 2012.2 Page 16 of 17 Part 11—Authorizing Signatures Signatures are required before submitting the DARPA package. The JARPA package includes the JARPA form, project plans, photos, etc. hl elp] 11a. Applicant Signature (required) h[ eIp] 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 e 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 enterin Ve 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 ham] 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. Adam Miller, PE Authorized Agent Printed Name Authorized Agent Signature Date 11 c. Property Owner Signature (if not applicant) help] 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 DARPA Ravicion 9n19 9 Page 17 of 17 --------------------------------------- AGENCY USE ONLY Date received: 3 USArmy Col ps WASHINGTON STATE of Engineers Seatlle Drshict #: Joint Aquatic Resources Permit Agency reference 1,2 Tax Parcel#(s): Application (DARPA) Form USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. L-------------------------------.-------I Part 1—Project Identification 1. Project Name (A name for your project that you create. Examples: Smith's Dock or Seabrook Lane Development) h[ gld Hartstene Pointe WWTF Outfall Maintenance Part 2—Applicant The person and/or organization responsible for the project. hel 2a. Name (Last, First, Middle) Jeffreys Mont R 2b. Organization (If applicable) Hartstene Pointe Water-Sewer District 2c. Mailing Address (Street or PO Box) 772 Chesapeake Avenue 2d. City, State, Zip Shelton, WA 98584 2e. Phone(1) 2f. Phone(2) 2g. Fax 2h. E-mail (360) 427-2413 (360) 490-5971 ( ) grnphpwatersewer.com 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://www.nws.usace.army.miI/Missions/Civi[Works/Regulatory/PermitGuidebook/EndangeredSoecies.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.epermittina.wa.gov/site/alias resourcecenter/japa jarpa form/9984/iarpa form.asn . For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or helpC�ora.wa.aov. JARPA Revision 2012.2 Page 1 of 17 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.) tel 3a. Name (Last, First, Middle) Miller, Adam, PE 3b. Organization (if applicable) Gray & Osborne, Inc. 3c. Mailing Address (street or PO Box) 701 Dexter Avenue North, Suite 200 3d. City, State, Zip Seattle, WA 98109 3e. Phone(1) 3f. Phone(2) 3g. Fax 3h. E-mail (206) 284-0860 ( ) (206) 283-3206 amiller@g-o.com 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. nLel.� ❑ 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) 4b. Organization (If applicable) 4c. Mailing Address (Street or PO Box) 4d. City, State, Zip 4e. Phone(1) 4f. Phone(2) 4g. Fax 4h. E-mail JARPA Revision 2012.2 Page 2 of 17 Part 5—Project Location(s) Identifying information about the property or properties where the project will occur. LbelM ❑ 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.) 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,provide other location information in 5p.) h[ gM Hartstene Pointe WWTF, 772 Chesapeake Drive 5c. City, State, Zip(If the project is not in a city or town, provide the name of the nearest city or town.) hel Shelton, WA 98584-7001 5d. County hel Mason 5e. Provide the section, township, and range for the project location. h[ eel '/4 Section Section Township Range 19 21 North 1 West 5f. Provide the latitude and longitude of the project location. he[ ei • Example:47.03922 N lat./-122.89142 W long. (Use decimal degrees- NAD 83) 47.2966 N lat. /-122.8439 W long. 5g. List the tax parcel number(s) for the project location. h[ elf • The local county assessor's office can provide this information. 121195700048 (Hartstene Pt. WWTF) outfall is on subtidal lands under DNR jurisdiction 5h. Contact information for all adjoining property owners. (if you need more space, use JARPA Attachment C.) hel Name Mailing Address Tax Parcel #(if known) Kim, William NC & Sarah 789 E. Chesapeake Dr. Henderson, Connie M & Paul S. 791 E. Chesapeake Dr. Rune & Nancy Tvedt 793 E. Chesapeake Dr. Laura M. St. George 795 E. Chesapeake Dr. Susan M. Tyler 797 E. Chesapeake Dr. Maynard, John & Misko 799 E. Chesapeake Dr. Larson TRS, Norman A & Lorna K. 467 E Chesapeake Dr. JARPA Revision 2012.2 Page 3 of 17 5i. List all wetlands on or adjacent to the project location. nei None 5j. List all waterbodies (other than wetlands) on or adjacent to the project location. nei Case Inlet 5k. Is any part of the project area within a 100-year floodplain? LtLeM ® Yes ❑ No ❑ Don't know 51. Briefly describe the vegetation and habitat conditions on the property. Minimal amounts of kelp and algae may be present on any hard substrate present on the benthic surface of Case Inlet. As the benthic surface is generally soft mud, little macro algae is present. Geoducks and other clams and invertebrates and a few fish may also be present. Salmonids migrate along the inshore portion of the project area. 5m. Describe how the property is currently used. of eM The property currently contains the outfall from the Hartstene Pointe Wastewater Treatment Facility, which was originally constructed in 1970, upgraded in 1993 and lengthened 2009. 5n. Describe how the adjacent properties are currently used. n[ ei Geoducks have been harvested from Tract 15500 — Dougall since the outfall was extended off-shore in 2009. 50. Describe the structures (above and below ground) on the property, including their purpose(s) and current condition. nei The Hartstene Pointe WWTF Outfall consists of approximately 2,800 feet of 8-inch HDPE SDR 11 pipe that was installed in 2009. Some of the bolts and nuts on the anchors holding the outfall structure in place have corroded, disconnecting portions of the outfall pipe from the original anchors holding it on the benthic surface. The original concrete anchors were replaced with ecology block anchors and aggregate filled saddle bag anchors. 5p. Provide driving directions from the closest highway to the project location, and attach a map. LeM JARPA Revision 2012.2 Page 4 of 17 Part 6—Project Description 6a. Briefly summarize the overall project. You can provide more detail in 6b. LneM Maintenance work will be performed on the existing outfall pipe. The bolts and hardware will be checked for corrosion and the conditions of all the existing anchors will be inspected. The in-shore portion of the pipe will be inspected and if the inspection reveals SS316 hardware was not used, the hardware will be replaced with SS316 hardware. Saddle straps on the original anchor blocks will be reinstalled with two 5/8" x 5-1/2" 316L wedge anchors which will be drilled into the existing anchor blocks which are laying on the bottom under the outfall pipe. The off-shore portion of the pipe will be inspected and any of the stainless steel hardware on the ecology blocks that are not SS316 will be replaced. The flange connections at the makeup piece will be tightened and any bolts needing to be addressed will be replaced. Up to 40 additional saddle bags will be placed on the outfall pipe as well as additional ecology blocks to achieve one block every 200' or less. 6b. Describe the purpose of the project and why you want or need to perform it. hei The wrong type of hardware was used on many of the original anchor blocks causing many of the anchors to corrode and fail. Ecology block anchors and aggregate filled saddle bag anchors were installed to keep the outfall pipe secured to the bottom. The maintenance work under this permit will consist of checking and replacing any corroded hardware with the correct SS316 hardware. The condition of the existing saddle bag anchors will be checked and re-installed as necessary. Additional saddle bag anchors and ecology block anchors will be installed to provide an extra factor of safety and keep the outfall pipe secured in the current location on the bottom of Carr Inlet. No construction will be performed. 6c. Indicate the project category. (check all that apply) of elpl ❑ Commercial ❑ Residential ❑ Institutional ❑ Transportation ❑ Recreational ® Maintenance ❑ Environmental Enhancement 6d. Indicate the major elements of your project. (check all that apply) [help] ❑ 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 ❑ Dock/ Pier ❑ Marina/ Moorage ❑ Stairs JARPA Revision 2012.2 Page 5 of 17 ❑ 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 2012.2 Page 6 of 17 6e. Describe how you plan to construct each project element checked in 6d. Include specific construction methods and equipment to be used. hel • Identify where each element will occur in relation to the nearest waterbody. • Indicate which activities are within the 100-year floodplain. Hard-hat and SCUBA divers will be deployed from a vessel or diving barge to replace nuts, bolts and other outfall pipeline hardware. Additional anchors will be placed by crane from a vessel and secured to the existing outfall pipe. 6f. What are the anticipated start and end dates for project construction? (MonthNear) hel • 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: October 31, 2013 End date: March 15, 2014 ® See JARPA Attachment D 6g. Fair market value of the project, including materials, labor, machine rentals, etc. h[ elp] -$30,000 6h. Will any portion of the project receive federal funding? h[ elP] • If yes, list each agency providing funds. ❑ Yes ® 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.) [hel 7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. hel ❑ Not applicable 7b. Will the project impact wetlands? hel JARPA Revision 2012.2 Page 7 of 17 ❑ Yes ❑ No ❑ Don't know 7c. Will the project impact wetland buffers? hf eM ❑ Yes ❑ No ❑ Don't know 7d. Has a wetland delineation report been prepared? hel • 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? hel • 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? hel • 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. hel 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. [help] 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 category' 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. 2 Indicate the days, months or years the wetland will be measurably impacted by the activity. Enter"permanent"if applicable. `Creation (C), Re-establishment/Rehabilitation(R),Enhancement(E). Preservation(P), Mitigation Bank/In-lieu fee(B) JARPA Revision 2012.2 Page 8 of 17 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. n[ gip] 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. h( emp] 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.) hem ® 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. el ❑ Not applicable The proposed maintenance work will involve divers inspecting and repairing the anchors for the Harstene WWTF Outfall in Case Inlet. Maintenance will include the replacement of corroded hardware and the placement of some additional anchors. This maintenance will ensure that the outfall will remain permanently secured to the benthic surface. In-water work will be conducted during the WDFW In-water Work Window for this waterbody (June 15 to March 15). 8b. Will your project impact a waterbody or the area around a waterbody? n[ elp) ® Yes ❑ No JARPA Revision 2012.2 Page 9 of 17 '8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland waterbodies? heI • If Yes,submit the plan with the DARPA package and answer 8d. • If No,or Not applicable,explain below why a mitigation plan should not be required. ❑ Yes ® No ❑ Not applicable The proposed maintenance work would involve divers inspecting the Hartstene Pointe WWTF Outfall, which will maintain the discharge at its permitted location and protect more sensitive habitat in shallower water and along the shore of Case Inlet. 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. h[ elp� The proposed outfall maintenance work is being undertaken to ensure that the Hartstene Pointe WWTF Outfall remains on the benthic surface of Case Inlet in its permitted location. 8e. Summarize impact(s) to each waterbody in the table below. hel 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 Outfall Case Inlet Hartstene Two 0 -2,800 linear inspection, Pointe weeks feet. anchor WWTF maintenance, Outfall additional anchors Uncover on- Case Inlet Hartstene 2 hours 0 10 linear feet. shore concrete Pointe anchor blocks WWTF Outfall 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. 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. s 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. heI JARPA Revision 2012.2 Page 10 of 17 The proposed outfall maintenance project will inspect and replace corroded portions of the Hartstene Pointe •WWTF outfall attaching the anchor system to the effluent pipeline/outfall. Additional anchors will be installed as required to keep the outfall anchored to the sea floor in its existing location. The on-shore concrete anchors securing the HDPE outfall pipe to the CI outfall pipe will be uncovered and the hardware will be inspected and replaced with the correct SS316 hardware. 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. [hep] Not applicable. No dredging proposed. 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. h[ elpl Agency Name Contact Name Phone Most Recent Date of Contact WDFW Margie Schirato (360) 427-2179 10-18-2013 WDNR Rollin Christopherson (360) 584-8103 10-18-2013 US Army Corps of Darren Habel (206) 764-6583 10-22-2013 Engineers 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? hf eM • If Yes, list the parameter(s) below. • If you don't know, use Washington Department of Ecology's Water Quality Assessment tools at: hftp://www,ecy.wa.gov/programs/wq/303d/. ® Yes ❑ No Dissolved Oxygen & fecal coliform JARPA Revision 2012.2 Page 11 of 17 9C. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? heel • Go to http://cfpub.epa.gov/surf/locate/index.cfm to help identify the HUC. 17110019 Puget Sound 9d. What Water Resource Inventory Area Number (WRIA #) is the project in? hel • Go to http://www.ecV.wa.gov,/services/gis/maps/wria/wria.htm to find the WRIA#. 14 Upper Case Inlet 9e. Will the in-water construction work comply with the State of Washington water quality standards for turbidity? h[eM • Go to http://www.ecy.wa.gov/programsiwg/swgs/criteria.html for the standards. ® Yes ❑ No ❑ Not applicable 9f. If the project is within the jurisdiction of the Shoreline Management Act, what is the local shoreline environment designation? hheellp] • 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 ❑ Urban ❑ Natural ❑ Aquatic ❑ Conservancy ❑ Other 9g. What is the Washington Department of Natural Resources Water Type? [help] • Go to http://www dnr wa qov/BusinessPermits/Topics/ForestPracticesApplications/Pages/fp watertyping 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 Department of Ecology's most current stormwater manual? hel • If No, provide the name of the manual your project is designed to meet. ® Yes ❑ No Name of manual: 2012 Stormwater Design Manual for Western Washington 9i. Does the project site have known contaminated sediment? b� eM • If Yes, please describe below. ❑ Yes ® No 9j. If you know what the property was used for in the past, describe below. h[ m JARPA Revision 2012.2 Page 12 of 17 Prior to being developed as the Hartstene Pointe WWTF Outfall alignment, the waters of Case Inlet in the area 'were used for marine transportation and fishing. 9k. Has a cultural resource (archaeological) survey been performed on the project area? h( eM • If Yes,attach it to your JARPA package. ❑ Yes ® No Marine subtidal lands JARPA Revision 2012.2 Page 13 of 17 •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. elp Marbled murrelet (Threatened) Puget Sound chinook salmon (Threatened) Puget Sound steelhead (Threatened) Puget Sound bull trout (Threatened Orca Southern Resident Pod (Endangered) Puget Sound rockfish Bocaccio (Endangered) Yellow-eye rockfish and canary rockfish (Threatened) 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. Del Marbled murrelet, chinook salmon, chum salmon, pink salmon, coho salmon, steelhead, cutthroat trout, bull trout, rockfish. Other species present include bald eagle, harbor seal, waterfowl concentrations, common loon, great blue heron & osprey. 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 help0ora.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 (SEPA). (check all that apply.) h[ eld • For more information about SEPA,go to www.ecy.wa.gov/r)rograms/sea/seoa/e-review.html. ® A copy of the SEPA determination or letter of exemption is included with this application. Mason County SEP99-00071 (attached) JARPA Revision 2012.2 Page 14 of 17 ❑ A SEPA determination is pending with (lead agency). The expected decision date is ❑ I am applying for a Fish Habitat Enhancement Exemption. (check the box below in 1 ob.) hel ❑ 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 2012.2 Page 15 of 17 10b. Indicate the permits you are applying for. (Check all that apply.) h(_eip� LOCAL GOVERNMENT Local Government Shoreline permits: ❑ Substantial Development ❑ Conditional Use ❑ Variance I]Shoreline Exemption Type (explain): Maintenance Other City/County permits: ❑ Floodplain Development Permit ❑ Critical Areas Ordinance STATE GOVERNMENT Washington Department of Fish and Wildlife: ® 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#__017837 Attach check made payable to Washington Department of Fish and Wildlife. ❑Charge to billing account under agreement with WDFW. Agreement# ❑ 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) #200500432 United States Coast Guard permits: ❑ Private Aids to Navigation (for non-bridge projects) JARPA Revision 2012.2 Page 16 of 17 Part 11--Authorizing Signatures 'Signatures are required before submitting the JARPA package. The DARPA package includes the JARPA form, project plans, photos, etc. hel 11 a. Applicant Signature (required) h[ elpt 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 1 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 ffie 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 enterin e property where the project is located to inspect the project site or any work related to the project. (initial) 40 ! , Applicant Printed Name Applicant Signature : 1 7U 1 Date 11 b. Authorized Agent Signature [bLipj 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. Adam Miller, PE r Q�23�2- /3 Authorized Agent Printed Name Authorized Agent Signature Date 11c. Property Owner Signature (if not applicant) hel 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 IARPA Rauicinn 9n19 9 Page 17 of 17 15H'� SEPA-Contact List MASON COUNTY DCD Sent SEPA to(check all that apply)on i Skokomish Tribal Nation � WA Department of Ecology f�lMa/ Natural Resources Dept. Environmental RevievdSection ATTN: Randy Lumper PO BOX 477p N 541 Tribal Center Rd. Olympia,WA 98504-7703 Skokomish Nation, WA 98584 separ"ister@ecy.wa.gov rlumper@skokomish.org WA Department of Commerce Tribal Historic Preservation Officer reviewteam@commerce.wa.gov ATTN: Kris Miller 80 N Tribal Center Rd U.S.Army Corps of Engineers Skokomish Nation,WA 98584 SEPA Reviewer-Darren Habel shlanayl@skokomish.org PO Box C-3755 Seattle,WA 98124 Quinault Indian Nation darren.habel@usace.army.miI ATTN: Mark Mobbs PO Box 189 WA Dept. of Fish and Wildlife Tahola,WA 98587 ATTN: Margie Schirato(saltwater) mmobbs@quinault.org 2391 W Deegan Rd. Shelton,WA 98584 Squaxin Tribal Nation schirmms@dfw.wa.gov Natural Resources Dept. 2952 SE Old Olympic Highway WA Dept. of Fish&Wildlife Shelton,WA 98584 ATTN: Gloria Rogers,Area Habitat Biologist jdickison@squaxin.nsn.us 48 Devonshire Rd Montesano,WA 98563-9618 The Confederated Tribe of the Chehalis gloria.rogers@dfw.wa.gov ATTN: SEPA Reviewer-Glen Connelly 420 Howanut Rd. a WA Dept. of Transportation Oakville,WA 98568 ATTN: Dale Severson gconnelly@chehalistribe.org P.O. Box 47440 Olympia,WA 98504-7440 WA DNR, South Puget Sound Region SEVERSD@wsdot.wa.gov ATTN: South Puget Sound Region 950 Farman Avenue North City of Shelton Enumclaw,WA 98022-9282 525 West Cota St. southpuget.region@dnr.wa.gov Shelton,WA 98584 jasond@ci.shelton.wa.us WA DNR,Aquatic Resources ATTN:Aquatic Resources Port of Shelton PO BOX 47027 ATTN: Brandon Palmer Olympia,WA 98504-7027 21 West Sanderson Way and@dnr.wa.gov Shelton, WA 98584 BrandonP@portofshelton.com WA DNR, SEPA Center ATTN: External Coordinator Office of Archaeology& Historic Preservation PO BOX 47015 ATTN: Lance Wollwage Olympia,WA 98504-7015 P.O. Box 48343 sepacenter@dnr.wa.gov Olympia,WA 98504-8343 Lance.Woliwage@dahp.wa.gov Olympic Region Clean Air Agency Fran McNair Tacoma Public Utilities 2940-B Limited Ln. NW Real Property Services Olympia, WA 98502 ATTN: Dave Letterman fran.mcnair@orcaa.org 3628 S 35th St,Tacoma,WA 98409-3192 diefterm@cityoftacoma.org aMason County Transit Mike Oliver School District: PO Box 1880, Shelton,wa 98584 Mason Cty P.W. ATTN: moliver@masontransit.org Mason Cry E.H.ATTN: n Mason County Bldg Attn: Applicant: �cFai++Miller �Ci'rrOSia�r Agent: Cl M1Ileir com 2a/,3 � . G Gray � Osborne, Inc. CONSULTING ENGINEERS .DATE: November 5,2013 TO: Mason County Permit Assistance ATTN: Grace Miller Center PO Box 279 Shelton, WA 98584 FROM: Adam Miller PROJECT#: SUBJECT: Shoreline Exemption WE ARE TRANSMITTING: THE FOLLOWING: FOR: ® Herewith ❑ Prints ❑ Review&Comment ❑ Under Separate Cover ❑ Construction Drawings ❑ Approval ❑ Specifications ❑ Signature Number of Copies: _ ❑ Shop Drawings ❑ Your Use&Files ❑ Change Order ❑ As Requested ❑ Legal Description ❑ Action Noted Below ❑ Letters ❑ ❑ ❑ COMMENTS: Grace, Per our previous discussions I am applying for a Shoreline Exemption for maintenance and repair of the original Hartstene Pointe Outfall project. I have included a check for$255, a JARPA application describing the work, figures showing the existing anchors and the proposed maintenance and repairs, and a copy of the HPA we have received for this work. I have also included a copy of the email you sent to me regarding this application. Please let me know if you have any questions or need any additional information. Thank you. Adam 701 Dexter Avenue N.,Suite 200 Seattle,Washington 98109 (206)284-0860 Fax: (206)283-3206 24 19 MEANDER CORNER 1' IRON PIPE W/I.D. TAGS ON BLAZED TREES, ACCEPTED AS MEANDER CORNER, AS NOTED ON PLAT OF HARTSTENE POINTE, ADDITION 10. PLAT MON CALC POSITION PER PLAT OF HASTENE POINTE f102 N 723678.849, E 1053503.189 GRID LOT 47 /ysT MASON COUNTY eyN WASTE WATER PLAT MON TREATMENT PLANT Ml/c y ORTH 11O1 \ MAKE-UP CONNECTION :a. _ (INSTALLED BY RPM) qq 1 n—J00' _ — 30' SEWER EASEMENT AS NOTED N / LCT IB ON PLAT OF HARTSTENE POINTE _ HARSTENE POINTE ADDITION 10 ADDInON 10 100' 200' 400 �Q' VOL9, PG 131-132 /✓ ORDINARY HIGH WATER (O.H.W.) a, ~ J{ ELEVAnON 11.5', LOCATED 6-25-2008 Q .= Z U P.O.B. 24 19 / DNR EASEMENT e \ 25 30 / SEWER OUTFALL SECTION CORNER / 2' IRON PIPE W/TAGS ON TREES, ACCEPTED AS CORNER, AS NOTED ON PLAT OF HARTSTENE POINTE, ADDITION 10. CALC POSITION PER PLAT / OF HARTSTENE/ POINT.\� N 721208.981, E 1053359.756 GRID PUGET SOUND APPROXIMATE GEODUCK 0� LEASE LANDS BETWEEN GOV. LOT 1, SECTION 19, T 21 N, R 1 W, W.M. 0� ELEVATIONS -18 TO -70 SECTION SUBDIMSION DETAIL AS PER PLAT OF HARTSTENE POINTE. ADDITION 10, AS RECORDED ;pf GQ� \ IN VOLUME 9 OF PLATS AT PAGE 131-132. -10 N.T.S. / PUGET SOUND v / A v \ t�N / 7b g \\ r2O E^ ENT . ovjiva 0 � 10'� ��N LEGEN>. m CONTINUED FROM DETAIL 3 (UPPER LEFT) • SADDLE BAG ANCHOR ti 2 ECOLOGY BLOCKS W/NYLON STRAPS ti N� 3 SADDLE BAG ANCHOR SINGLE ECOLOGY BLOCK W/ NYLON STRAPS a AOpGp 5 SURD WRVEYOR'S NOTE: /20 2FOP,T� g PLAT OF HARTSTENE POINTE, ADDITION 10 WAS ROTATED 040 AND TRANSLATED AROUND PLAT MONS 101 AND 102. I N a OUTFALL PIPE LOCATION AND ASSOCIATED CONTOURS 0 l PROVIDED BY R. PHIWPS MARINE, INC. USING LAT/LONG o POSITIONS, WHICH WERE DIRECTLY IMPORTED INTO THIS DRAWING. PLAT MONS 101 AND 102, IN CHESAPEAKE DR., WERE LOCATED USING GPS ON WSRN, NAD 83/91, SOUTH o ZONE, GEOD '03. _o CONTOURS: \\ -4.5 - EXTREME LOW TIDE - STATE OWNED LANDS r -18 TO -70 - GEODUCK BEDS (DNR AQUATIC LANDS) u (PER PHONE CONVERSATION WITH MIKE CHEVALIER, DNR) g IS MEAN VERTICAL TIDAL DATAA(NMFT) FROM LOWER LOW WATER OF ENGINEERS M OR MASON COUNTY elfSTATION 8OA - BALLOW(SOUTH END MCMICKEN ISLAND) FIGURE 1 NOTES EXISTING ANCHOR LOCATIONS APPLICATION NO.: 51-07 489 2 Cam ) o fR� CE 3/ Y TERMINUS OF 0 N�35� DNR EASEMENT CONSULTING ENGINEERS o coNnrlueD FROM DETAIL (UPPER LEFT S PLAT MON #102 LOT 47 INSPECT EXISTING ANCHORS CE ANY MASON COUNTY NOND 3165E HARDWARE WASTE WA PLAT MON ` TREATMENT PPLANT ORTH �01 j CHECK EXISTING MAKE-UP PIECE FLANGES. TIGHTEN OR REPLACE 1»_q 00 BOLTS AS NECESSARY tl / �r An HARSTE?E POIiTE ADDITION 10 0 100' 2w 4011 VOL G, PG 131-132 f / M � .�' ONR EA�IT,�O / � ' SEMRR OUIFALL PUGET SOUND APPROXIMATE SUCK CHECK LOCATION AND SPACING OF LEASE LANDS BETWEEN EXISTING ANCHORS. INSPECT EXISTING ELEVATIONS-10 TO-70 ANCHORS AND REPLACE ANY NON-316SS HARDWARE. PLACE UP TO 40 ADDITIONAL SADDLE BAGS AS WELL AS ADDITIONAL ECOLOGY BLOCK ANCHORS TO ACHIEVE �►0 ONE BLOCK EVERY 200' OR LESS. PUGET SOUND o1rTF 10— LEGENDS 1� L.-j tk,4 S ADDLE BAG ANCHOR ■■ 0057M 2 ECOLOGY BLOCKS W/NYLON STRAPS 4NHat EGOSIING 3 SADDLE BAG ANCHOR ■ E707M SINGLE ECOLOGY BLOCK W/NYLON STRAPS NEW SINGLE ECOLOGY BLOC( W/NYLON STRAPS B NEW SADDLE BAG ANCHOR MASON COUNTY FIGURE 2 PROPOSED MAINTENANCE CST �Off.I>, CONSULTING ENGINEERS