Loading...
HomeMy WebLinkAboutSHX2022-00025 Repair Boat Ramp - SHX Application - 6/23/2022 ESL D---__-__ us AMW core, Date received• _ WASHINGT©N STATE � - ; JUN 2 3 2022 Joint Aquatic Resources Permit Application (DARPA) orm'.2 het Agen�� t X�§� USE BLACK OR BLUE INK To ENTER ANSWERS IN THE WNITE SPACES BELOW. ------------' Part 1—Project Identification 1. Project Name(A name for your project that you create.Examples:Smith's bock or Seabrook Lane Development) 111M 60 VVI Part 2--Applicant The person and/or organization responsible for the project. LhLim 2a. Name(Last,First,Middle) 2b.Organization(if applicable) 2c. Mailing Address(Street or PO Box) 2d.City, State, Zip 2e.Phone(1) 2f. Phone(2) 2g. Fax 2h. E-mail 61t p .2$6.Zl _6 15 •t l � i MIAr �li t2tse a►c>fs n!ni c� 'Additional lotms 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(208)764-3406. • Not all cities and counties accept the JARPA for their focal 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 lheip)screens,go to httolt~epermiMng,w 11' a raanurhAten#—Aaroa iaroa form/9984/iama form.asox. For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or helID00ria.wa_aov Page 1 of 14 ARIA-revised 0212020 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.) el 3a. Name(Last,First,Middle) _ 3b.Organization (If applicable) uab mil 3c.Mailing Address(street or Po Box) r-[ S , poNS vim - 3d. City, State, Zip �kau 4 3e. Phone(t) 3f. Phone(2) 3g. Fax 3h. E-mail 215 0Iv C''i�til nP t rw2t Y1 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. thkim Same as applicant. (Skip to Part 5.) ❑ Repair or maintenance activities on existing rights-of-way or easements. (Skip to Part 5.) L-1 There are multiple upland property owners. Complete the section below and fill out JARPA Attach__ m_ent A for each additional property owner. n 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 o 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(i) 4f. Phone(2) 4g. Fax 4h. E-mail 771 Page 2 of 14 ORIA-mvi"d OW2020 Part 5-Project Location(s) Identifying information about the property or properties where the project will occur. hef There are multiple project locations(e.g. linear projects). Complete the section below and use JARP Attachment B for each additional project location. 5a. indicate the type of ownership of the property. (check all that apply.) LbOM a Private 0 Federal 0 Publicly owned (state,county,city,special districts like schools,ports,etc.) 0 Tribal 0 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.) llolpl 5c.City, State,Zip(if the project is not in a city or town,provide the name of the nearest city or town.) libgW 5d.County [b#Jtl M�sv� 5e. Provide the section,township, and range for the project location. M!;IQ1 1/4 Section Section Township Range 5f. Provide the latitude and longitude of the project location. &JPJ Example:47.03922 N lat./-122.89142 W long.(Use decimal degrees-NAD 83) 1 ti� 50,; -t .y qJ"1,q' 2Z-'k r" j j �()tk 5g. List the tax parcel number(s)for the project location. l S I • The local county assessor's office can provide this information. FSh Contact information for all adjoining property owners. (if you need more space,use DARPA Attachment C.) lee J Name Mailing Address Tax Parcel#(if known) ORIA-revisad 0212620 Page 3 of 14 51. List all wetlands on or adjacent to the project location. I elM 11 0 J v S . 5j. List all waterbodies(other than wetlands)on or adjacent to the project location.ft-IPJ 5k. Is any part of the protect area within a 1 gb-year floodplain? ftQk) ❑ Yes D No Don't know 51. Briefly describe the vegetation and habitat conditions on the property, ft!nj �rD DCA.t�-�d�'�U2.-. - p�tS �t U�i�'u .►�r�'�t��� 5m. Describe how the property is currently used. LDSM pr up �s Cu.r rx v�ty l�o� as p g-VIWA scams �f�v s 5n. Describe how the adjacent properties are currently used. b I�1 ;� �;' �1 ►v R, C"t -i hit S Gc 5o. Describe the structures(above and below ground)on the property, including their purpose(s) and current condition. hLgp1 i kbczx 5p. Provide driving directions from the closest highway to the project location, and attach a map, fh91D1 Page 4 of 14 ORIA-revised 0212020 N` Cf.l i CAMP ST. ALBANS Belfair 3 Mi Lake Devereaux Road s Gate Camp Entrance In Public ' Misty ' o Mis Acess Point Archery o Range S L W O O A O F o Skogly❑ of ` a Allyn j Trading Post v��s . 2 Mi P .';.•O R Parking F ¢O Y1 !ntirtnery Site O tiP r Hous LOL Huckleberry ._ .. .• .... W - •.� Hut .' L r Lodge t Lake Devereaux: T10; of FOkaahi Pla field 'Bureau' -•' Nations i Syks'a Uttla i A Acre •, . ; ressing Room O �-, b----------- Mti L � �,Tahoma • Chapel• Sho�w,r 2 Gate Fork M Mouae ter" Housa •� Camp St.Albans - G - Garbage Beaver-a r F Acre ,1 R - Recycling ;t= V'' Arboretum P , Program Shelter 4, i ;Y�•� o L '1\•y-�' / A = 'A'Frame T - Platform Tent W . WON F Gypsy I F - Fire CDcle P O� ,•�w L = Latrine % L Mariah �•.• whid, c� PH = Pump House �r Whispering 3 , Road , Winds O O O O L a r �-•- z Trail .; '- •• Chinook O f ;.•Fo 00 SW O Pion,ar N' 'Back 40' ��.. P t 1 a • 1 � Z •9 / Rock Momorid � .�,«..... • � .' o. O Wrar C abi�Nn F n r ' 2 T. T, Frontier Faoundu ; T/FT T L P` P •' E T TTT P ountat^oe a�oas ••-,�}} T L 9 900 i '� .,L ,o ••�� CAMP 10/97 Tro* my Gals — Part 6-Project Description 6a. Briefly summarize the overall project.You can provide more detail in 6b. MOPJ ( �►:t R ' vim qLl 1p-tu llkz I 61b. Describe the purpose of the project and why you want or need to perform it. lhs!P] Tft Qjt W + t "g 6c. Indicate the project category. (Check all that apply) [h€BJ 5�-Commercial L1 Residential 0 Institutional El Transportation El Recreational 0 Maintenance O Environmental Enhancement 6d. Indicate the major elements of your project. (Check an that apply) [help] ❑ Aquacultute ❑ Culvert r0FIoat ❑ Retaining Wall (upland) 0 Bank Stabilization ❑ Darn I Weir ating Home Road V.,Boat House V900- ❑ Dike/Levee/Jetty otechnical Survey ❑ Scientific 1�Boat Launch O Ditch ❑ Land Clearing Measurement Device Boat Lift 0 Dock/Pier O Marina/Moorage u Stairs ❑ Bridge O Dredging ❑ Mining 0 Stormwater facility D Bulkhead 0 Fence ❑ Outfall Structure p Swimming Pool [I Buoy 0 Ferry Terminal ❑ Failing/Dolphin p Utility Line 177 Channel Modification I rA Fishway 0 Raft ® Other: Page 6 of 14 ORIA-revised 0212020 Ftthods how you plan to construct each project element checked in 6d. Include specific construction and equipment to be used. [ll�j where each element will occur In relation to the nearest waterbody. e which activities are�w.iithin�thee10„0-year floodplain. �'t( `'� J (A- vdl._ rcXU 1�'l� .OV*X, e-�I �D�rn� UZ W M L& G" per , aua+. �1 uta�t, picul- ,L�s GLMVO - 6f.What are the anticipated start and end dates for project construction?(MonthNear) [brJO • 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: 2 OZ End Date: 'f�i ti �2X1/MtC7 See JARPA Attachment D 6g. Fair market value of the project, including materials, labor, machine rentals, etc. (ham �Su.r at 6h.Will any portion of the project receive federal funding? Mpim • if yes,list each agency providing funds. ❑ Yes I No 0 Don't know Part 7—Wetiands: Impacts and Mitigation IJ Check here if there are wetlands or wetland buffers on or adjacent to the project area. (if there are none, skip to Part 8.)Its M how the project has beendesigned to avoid and minimize adverse impacts to wetlands. ftlW pplicable 71b.Will the project impact wetlands? Ijglpj ❑ Yes 1�No ❑ Don't know 7c.Will the project impact wetland buffers? (bgjgj ❑ Yes No ❑ Don't know Page 8 of 14 ORIA-revUad 0212020 Has a wetland delineation report been prepared? fh a • If Yes,submit t t he report,including data sheets,with the JARPA package. D Yes (4No e Have the wetlands been rated using the Western Washington or Eastern Washington Wetland Rating System? [b�lal • if Yes,submit the wetiand rating forms and figures with the JARPA package. 0 Yes D No on't know f Have you prepared a mitigation plan to compensate for any adverse impacts to wetlands? ftm • 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. 0 Yes 0 No N Don't know g Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was used to design the plan. (help] O'. t'A2, Ga L I vmA C�Avu C ( -,u , bUZ 4t f✓i )4L6� IrU rPr u�+�i✓� �s nv t.12 -Y� W � .yam -rnt 2 t SN iP�CI r d S �tlJlf? SO h 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 in you are submitting a mitigation plan with a similar table,you can state(below)where we can find this information in the plan. ih1Me1 Activity(fill, Wetland Wetland Impact Duration Proposed Wetland drain, excavate, Name' type and area(sq. of impact' mitigation mitigation area flood, etc.) rating ft. or type4 (sq,ft.or category!_ Acres) acres W'li n0no omfici�a name�or the wet and exists,create a unique name(such as' et an t y. The name should be consistent with other project documents, such as a wetland delineation report. System.provide the wetland rating forms '€coiogy wetland category based Ott current Westem Washington or Eastern Washington Wetland Rating y wllh the JARPA package. Indicate the days,months or years the wetland will be meaeutably impacted by the activity.Enter"permanent"If applicable, Creation(C);Re-establishmenURehabilitation(Ft wancem2LA(E),PreseNatlon(P) Mtltt7ation Bank/ln-Neu fee(B) Page number(s)for similar information in the mitigation plan,if available: Page 7 of 14 ORIA-mvis•d 02rMC 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. tD&IM 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. I e Part $Waterbodies (other than wetlands): Impacts and Mitigation In Part 8, "waterbodies" refers to non-wetland waterbodies. (See Part 7 for information related to wetlands.) [hell 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 imp8cts to the aquatic environment. thviw 0 Not applicable Lpi 81b.Wlll your project impact a waterbody or the area around a waterbody? [h2lW Cl Yes EkNo - V` b Y QCJ_ fiibWX6LS Page 8 of 14 ORIA-mvfsad 0212620 8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland waterbodies?[helot • 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 ❑ Don't know VA-P r ov i -05� SCE- t Uri 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. th9W Be.Summarize impact(s)to each waterbody In the table below. he Activity(clear, Watrrrbody Impact Duration Amount of material Area(sq.ft. or dredge,fill, pile name' location of impact' (cubic yards)to be linear ft.)of drive; etc.) placed In or removed waterbody from watorbody directly affected J Nx5 '1f no orflcial name for the waterbody exists.71 crea�uniqueme(such as°Stream 1 The name should be consistent with other documents provided. Indicate whether the impact wilt occur In or adjacent to the waterbody. If adjacent,provide the distance between the Impact and the wafer y and indicate whether the impact will occur within the i oo-year hood plain. 'Indicate the da a months or an;the waterbod will be measurab im acted b the work. nier" rrnan@nt"if applicable. $f. 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. ftgo v 1Yry k� lw�pt 'Do.'u� Page 9 of to ORIA-revised 0212020 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 - 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. ItA.1pi Agency Name Contact Name Phone Most Recent Date of Contact �1-ZZ- �tnc Kyl s.Noh 9b.Are any of the wetlands or waterbodles identified in Part 7 or Part 8 of this JARPA on the Washington Department of Ecology's 3O3(d)List? her e If Yes,list the parameters)below. • If you don't know,use Washington Department of Ecology's Water Quality As tools at: httn��l&% V via Q—VWAter- ShorelinesMlater-aualitvlWater imnrovemen_t(As ;sment-of-state-waters- 03cf. Yes fD No L&k(- ' 9c.What U.S. Geological Survey Hydrological Unit Code(HUG)is the project in? LLeV e Go to http lirfnuh steer gQytOurfllncat8/ind@X CftY1 to help identify the HUC. + I Wk 9d,What Water Resource Inventory Area Number(WRIA#)is the project in? (hww • Go to ht[DS REcoIOgV W atPr fihnrpllrlesMater suOOlVNVAte►_availebilitvMfstershed=look-UD to find the WRIA#: ORIA-revised 0212020 Page 10 of 14 9e. :turbidity? =_qy.wa.aov/Water-Shq ction work comply with the State of Washington water quality standards for aov/Water Shovel' ' li `creti ter/Ciirface water-auallty-standardslC't r for the Yes ❑ No ❑ Not applicable 9f. if the project is within the jurisdiction of the Shoreline Management Act,what is the local shoreline environment designation? MW • If you don't know,contact the local planning department. • For more information,go to: " i' ^"" "^n`ANatar 4hnrelinPs/Shoreling-opastal manaste(Y1 8t1t/�hOr21in8-C9aSta)- nlanninn/Sho. line-laws-rules-and-oases. ❑ Urban 4 Natural ❑ Aquatic ❑ Conservancy ❑ Other: 9g.What is the Washington Department of Natural Resources Water Type? U&IM • Go to ''-'"""'"r wa aovfforestoractice$-water-tvnino for the Forest Practices Water-typing System. ❑ Shoreline ,Fish ❑ Non-Fish Perennial 0 Non-Fish Seasonal 9h.Will this project be designed to meet the Washington Department of Ecology's most current stormwater manual? ihkl l • If No,provide the name of the manual your project is designed to meet. Yes ❑ No - Name of manual 91. Does the project site have known contaminated sediment? itlp.1 • If Yes,please describe below. Yes VNo 9j. If you know what the property was used for in the past, describe below. tom] r 1 S UlS�d �1ty CJ' 1 SC.iJr�.t--5 4� W 25t e.te.N u t"4j 91k. Has a cultural resource(archaeological) survey been performed ors the project area? tt>ol • If Yes,attach it to your JARPA package. ❑ Yes �No Page 11 of 14 ORiA-revised 024029 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. [tgqg] "i t� O'bV3 i yu\ t 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. h[ ems) 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 oda.Wa,iaov/oaas/. • Governor's Office for Regulatory Innovation and Assistance at(800)917-0048 or helpQoria.wa.aov. For a list of addresses to send your JARPA to, click on agency addresses for completed JARPA. Oa. Compliance with the State Environmental Policy Act(SEPA). (Check all that apply.) lbol • For more information about SEPA,go to 1 //e vi ' " rmits/$EPA-environmental-review. 11 A copy of the SEPA determination or letter of exemption is included with this application. t A SEPA determination is pending with UAL (lead agency).The expected decision date is _ I am applying for a Fish Habitat Enhancement Exemption. (Check the box below in 10b.)11kalpi © This project is exempt(choose type of exemption below). ❑ Categorical Exemption. Under what section of the SEPA administrative code (WAC)is it exempt? ® Other: Cl SEPA is pre-empted by federal law. ORIA-rwrssd 0=020 Page 12 of 14 10b. Indicate the permits you are applying for. (Check all that apply.) t tl&l LOCAL GOVERNMENT Local Government Shoreline permits: ❑ Substantial Development 0 Conditional Use ❑ Variance ❑ Shoreline Exemption Type(explain): — -- Other City/County permits: ❑ Floodplain Development Permit n Critical Areas Ordinance STATE GOVERNMENT Washington Department of Fish and Wildlife: ❑ Hydraulic Project Approval(HPA) ❑ Fish Habitat Enhancement Exemption—Attach Exemption Form Washington Department of Natural Resources: T Aquatic Use Authorization Complete JARPAAltachmonlE and submit a check for$25 payable to the Washington Department of Natural Resources. t)o not send cash. Washington Department of Ecology: Section 401 Water Quality Certification ❑ Non-Federally Regulated Waters FEDERAL AND TRIBAL GOVERNMENT United States Department of the Army(U.S. Army Corps of Engineers): ❑ Section 404 (discharges into waters of the U.S.) L3 Section 10(work in navigable waters) United States Coast Guard: For projects or bridges over waters of the United States,contact the U.S.Coast Guard at:d13-12f-d13bridges@uscg.mil ❑ Bridge Permit ❑ Private Aids to Navigation (or other non-bridge permits) United States Environmental Protection Agency: ❑ Section 401 Water Quality Certification (discharges into waters of the U.S.)on tribal lands where tribes do not have treatment as a state(TAS) Tribal Permits: (Check with the tribe to see if there are other tribal permits,e.g.,Tribal Environmental Protection Act,Shoreline Permits,Hydraulic Project Permits,or other in addition to CWA Section 401 WQC) fat Section 401 Water Quality Certification (discharges into waters of the U.S.)where the tribe has treatment as a state(TAS). ORIA-revised OWN page 13 of 14 Part 11—Authorizing Signatures Signatures are required before submitting the JARPA package. The DARPA package includes the DARPA form, project plans, photos, etc. hel 11a. Applicant Signature (required) [help) I certify that to the best of my knowledge and belief, the information provided in this application is true, complete, and accurate. I also certify that I have the authority to carry out the proposed activities, and I agree to start work only after I have received all necessary permits. I hereby authorize the agent named in Part 3 of this application to act on my behalf in matters related to this application. -_ _ (initial) By initialing here, I state that I have the authority to grant access to the property. I also give my consent to the permitting agencies entering the property where the project is located to inspect the project site or any work related to the project. _ (initial) Applicant Printed Name Applicant Signature Date 11 b. Authorized Agent Signature [help) I certify that to the best of my knowledge and belief, the information provided in this application is true, complete, and accurate. I also certify that I have the authority to carry out the proposed activities and I agree to start work only after all necessary permits have been issued. ) Authorized Agent Printed Name i Authorized Agent Signature Date 11 c. Property Owner Signature (if not applicant) h( elpi Not required if project is on existing rights-of-way or easements (provide copy of easement with JARPA). 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 /P�rrtyer Signature Date 18 U.S.0§1001 provides that:Whoever,in any manner within the jurisdiction of any department or agency of the United Stales 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 Govemors 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- ORI 63 A publication number: ORIA-16-011 rev.0912018 ORIA-revised 0212020 Page 14 of 14