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HomeMy WebLinkAboutSHX2022-00028 J's Clearwater Shellfish - SHX Application - 8/24/2022 MASON COUNTY COMMUNITY SERVICES Building,Planning,Environmental Health,Community Health Pkase . August 11, 2022 Jose Salazar J's Clearwater Shellfish 600 Park ST OWe Shelton, WA 98584 " bt t®File: RE: Project Name: J's Clearwater Shellfish— Totten Inlet. (#SHX2022-00028) Application for an oyster farm on Totten Inlet, Puget Sound, Mason County. Parcel Number: 31911-52-00017. Dear Mr. Salazar: After review of your submitted JARPA application, Mason County concludes that the proposed cultivation of oysters on the private marine tidelands in Totten Inlet of Puget Sound, does not constitute development under the Mason County Shoreline Master Program and does not cause substantial interference with the normal public use of the water (AGO 2007 No. 1). Therefore, a Substantial Development Permit is not required nor a letter of Shoreline Exemption. The proposed development includes the establishment of commercial intertidal aquaculture farm for the cultivation of oysters. The proposed cultivation area is located between the +3.0 tidal level and -1.0 tidal elevations. The farm will be located on private tidelands, using hand harvest only. Mason County has determined that the proposed aquaculture operation is consistent with the Mason County Shoreline Master Program Policies and Use Regulations for Aquaculture and the Shoreline Management Act. Please let me know if you have any questions. Thank you. Sincerely,��� u Grace Miller, Planner DEPT OF COMMUNITY DEVELOPMENT -------------------------------------- �'sTa'i o i AGENCY USE ONLY US Army CorWASHINGTON STATE ofEngl eersp' RECEIVE® � of En In•er.• Date received: J U L - 8 2022 Joint Aquatic Resources Permit Application (JARPA) Form',2 h[ elpl Agency referA�"4W "{OcZ 28 USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. Tax Parcel#(s): 11-- 5�-oaoC`7 -------------------------------------- Part 1—Project Identification 1. Project Name (A name for your project that you create. Examples: Smith's Dock or Seabrook Lane Development) h[ elm J's Clear Water Shellfish—Totten Inlet Part 2—Applicant The person and/or organization responsible for the project. h[ gjg 2a. Name (Last, First, Middle) Salazar, Jose 2b. Organization (If applicable) J's Clear Water Shellfish 2c. Mailing Address (Street or Po Box) 600 Park St 2d. City, State, Zip Shelton, WA, 98584 2e. Phone(1) 2f. Phone(2) 2g. Fax 2h. E-mail 360.229.2901 jssalazar75@gmail.com t 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. • Not all cities and counties accept the JARPA for their local Shoreline permits. If you need a Shoreline permit,contact the appropriate city or county government to make sure they accept the JARPA. 2To access an online JARPA form with [help]screens,go to http://www.epermitting.wa.gov/site/alias resourcecenter/iarpa iarpa form/9984/iarpa form.aspx. For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or help(a)oria.wa.gov. 2 ORIA-revised 02/2020 Page 1 of 13 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.) hf elpl 3a. Name (Last, First, Middle) Villa, Racheal 3b. Organization (if applicable) Soundview Consultants LLC 3c. Mailing Address (street or PO Box) 2907 Harborview Drive, Suite #D 3d. City, State, Zip Gig Harbor, WA 98335 3e. Phone(1) 3f. Phone(2) 3g. Fax 3h. E-mail (253) 514-8952 (253) 514-8954 racheal@soundviewconsultants.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 PJ ❑ 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) Heather, Sherman and lolinda 4b. Organization (If applicable) 4c. Mailing Address (Street or Po Box) 4040 Southeast Kamilche Pt Rd 4d. City, State, Zip Shelton WA, 985847953 4e. Phone(1) 4f. Phone(2) 4g. Fax 4h. E-mail ORIA-revised 02/2020 Page 2 of 13 Part 5-Project Location(s) Identifying information about the property or properties where the project will occur. h[ elal ❑ 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[_elpl © 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[21PJ 4040 Southeast Kamilche Point Road 5c. City, State, Zip (If the project is not in a city or town, provide the name of the nearest city or town.) hf~ell Shelton, WA 98584 5d. County [Ltipj Mason County 5e. Provide the section, township, and range for the project location. hf eM 1/4 Section Section Township Range NE 11 19N 03W 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) 47.151656; -123.018621 5g. List the tax parcel number(s) for the project location. hf eM • The local county assessor's office can provide this information. Totten Inlet Grow Area: Mason County Tax Parcel Number 319115200017 Please note that there are discrepancies between the Mason County Tax Assessor data and a plat map provided by a landowner regarding intertidal land ownership. Information provided below is based on Mason County Tax Assessor data; the plat map is attached. 5h. Contact information for all adjoining property owners. (If you need more space, use JARPA Attachment C.) hr 1w Name Mailing Address Tax Parcel # (if known) Berg, Jeri 2510 85th Ave NE .... _ ..__.._._ ___ ______--- 31911-13-00030 Clyde Hill WA 980041628 Guffanti Trse, Jennifer 4030 SE Kamilche Point Rd 31911-52-00018 Shelton 98584 Taylor, Judy 292 SE Wildcat Cove Rd 31911-52-00016 ORIA-revised o2/2020 Page 3 of 13 _._.... _...._..__................... ---....._ Shelton WA 98584-9240 5i. List all wetlands on or adjacent to the project location. nei No wetlands were identified. 5j. List all waterbodies (other than wetlands) on or adjacent to the project location. nei Totten Inlet (Puget Sound) 5k. Is any part of the project area within a 100-year floodplain? b@jPJ ❑ Yes ® No ❑ Don't know The proposed project is entirely located within intertidal sections of Totten Inlet. 51. Briefly describe the vegetation and habitat conditions on the property. nei Aquatic vegetation observed within the project area consists of drift green sea lettuce (Ulva species) and other seasonal macroalgae growth. No rooted, submerged aquatic vegetation (i.e. eelgrass or kelp) was observed in or adjacent to the shellfish beds. The Totten Inlet project area is located in the intertidal region of a single-family residential area. The shoreline is armored with a concrete bulkhead. Shoreline riparian vegetation consists of maintained lawn and landscaped ornamental shrub species. 5m. Describe how the property is currently used. [nLei The proposed project area is located on intertidal beach is used for oyster aquaculture, primarily of Pacific oysters. 5n. Describe how the adjacent properties are currently used. nei All upland properties surrounding the project areas support single-family residential land use. 50. Describe the structures (above and below ground) on the property, including their purpose(s) and current condition. [nLei Structures onsite are limited to in-water tumble bag lines fixed to T-posts installed to a depth of approximately 2 feet, bottom bag lines anchored to the beach, and bottom culture mesh nets secured to the ground. 5p. Provide driving directions from the closest highway to the project location, and attach a map. nei To access the subject property from US-101 North, heading west, take the WA-108 exit toward McCleary. In 0.2 mile, turn right onto Southeast Old Olympic Highway. Continue for 0.4 mile, then turn left onto Southeast Kamilche Point Road. Continue for 4.2 miles where the subject property will be on the right. Part 6—Project Description 6a. Briefly summarize the overall project. You can provide more detail in 6b. nei ORIA-revised 02/2020 Page 4 of 13 The Applicant proposes to continue small-scale, commercial shellfish aquaculture operations on tidelands that have been under cultivation for years. Project areas are limited to the intertidal regions of Totten Inlet at a tidal elevation of+3 feet to-1 feet. The proposed shellfish operations consist of oyster growing and harvest, primarily of Pacific oysters. Maintenance and harvest operations are conducted by hand; no mechanized harvest or frosting is proposed. The Applicant desires approval to continue tumble bag line, bottom line bag, and bottom culture methods for the preparation and maintenance of shellfish beds. Additional tumble bag lines and/or bottom line bags are proposed. The Applicant also proposes to install buoys 1 to demarcate the growing site. 6b. Describe the purpose of the project and why you want or need to perform it. h[ ela] The Applicant proposes to continue commercial shellfish aquaculture operations on tidelands that have been under cultivation for years by the Applicant and others. The Applicant grows oysters. Oysters are grown using tumble bag lines, bottom line bags, and bottom culture. Tumble bag lines consist of bags with attached floats that are suspended from lines attached to T-posts driven into the substrate. Bottom line bags consist of a row of bags attached by stakes to the beach. The Applicant proposes installing additional tumble bag lines and/or bottom line bags at the growing site. The Applicant proposes installing 1 buoy in the grow area, which will be utilized to demarcate the growing area and alert boat traffic to the presence of the growing area. Per Mason County Code (MCC) Shoreline Master Plan (SMP) 17.50.400.B.1.f, the construction of a navigational aid such as an anchor buoy is exempt from a Substantial Development permit. The buoy will utilize a helical anchor, and a mid-line float to minimize impact to the substrate. 6c. Indicate the project category. (Check all that apply) h[ e © 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 ❑ Scientific ❑ Boat Launch ❑ Ditch ❑ Land Clearing Measurement Device ❑ Boat Lift ❑ Dock/ Pier ❑ Marina / Moorage ❑ Stairs ❑ Bridge ❑ Dredging ❑ Mining ❑ Stormwater facility ❑ Bulkhead ❑ Fence ❑ Outfall Structure ❑ Swimming Pool © Buoy ❑ Ferry Terminal ❑ Piling/Dolphin ❑ Utility Line ❑ Channel Modification ❑ Fishway ❑ Raft ® Other: 6e. Describe how you plan to construct each project element checked in 6d. Include specific construction methods and equipment to be used. h[ip] • Identify where each element will occur in relation to the nearest waterbody. • Indicate which activities are within the 100-year floodplain. ORIA-revised 02/2020 Page 5 of 13 Please see Part 5m for details on the current and proposed use. No change in aquaculture use is proposed. The proposed buoy and tumble bag lines or bottom bag lines will be installed using hand tools. 6f. What are the anticipated start and end dates for project construction? (MonthNear) heI 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: 2021 End Date: Qn going ❑ See JARPA Attachment D 6g. Fair market value of the project, including materials, labor, machine rentals, etc. heI [xx] 6h. Will any portion of the project receive federal funding? heI • If yes, list each agency providing funds. ❑ Yes X No ❑ Don't know Part 7—Wetlands: Impacts and Mitigation ❑ Check here if there are wetlands or wetland buffers on or adjacent to the project area. (If there are none, skip to Part 8.) h[ elp) 7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. [!IeI ® Not applicable 71b. Will the project impact wetlands? heI ❑ Yes ® No ❑ Don't know 7c. Will the project impact wetland buffers? heI ❑ Yes Z No ❑ Don't know 7d. Has a wetland delineation report been prepared? heI • 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? [tpjpJ • 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 ❑ Don't know ORIA-revised 02/2020 Page 6 of 13 �7g. Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was used to design the plan. h[,>et NiA 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. h[ epa Activity (fill, Wetland Wetland Impact Duration Proposed Wetland drain, excavate, Name' type and area (sq. of impact3 mitigation mitigation flood, etc.) rating ft. or type' area (sq. ft. or cate or 2 Acres) acres) N/A 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 , Miti ation Bank/In-lieu fee B Page number(s) for similar information in the mitigation plan, if available: 7i. 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. hf elo N/A 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. hC�l N/A 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.) hf kig © 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. hel W ❑ Not applicable The proposed project consists of water-dependent oyster aquaculture operations. The Applicant proposes to continue existing tumble bag line, bottom bag line, and bottom culture techniques. To fully utilize the existing grow area, additional tumble bag lines and/bottom bag lines will be installed. The buoy will be installed using a helical screw anchor to demarcate the grow site. The proposed project avoids and minimizes adverse impacts by limiting maintenance and harvest operations to work done by hand. No frosting or mechanized harvest is proposed. 8b. Will your project impact a waterbody or the area around a waterbody? h[ elp] Z Yes ❑ No ORIA-revised 02/2020 Page 7 of 13 8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland waterbodies? [LeI • 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 The proposed project is designed to avoid and minimize impacts to the shoreline by limiting the project area to areas currently used for shellfish aquaculture and avoiding frosting and mechanized harvest operations. No adverse effects will occur, and no mitigation is proposed for compensation. 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 N/A 8e. Summarize impact(s) to each waterbody in the table below. h[ eM Activity Waterbody Impact location2 Duration of impact3 Amount of Area (sq. ft. (clear, name' material (cubic or linear ft.) dredge, fill, yards) to be of waterbody pile drive, placed in or directly etc.) removed from affected waterbody 225 linear feet of tumble Install bag line additional Totten Inlet Within intertidal Permanent N/A (Totten Inlet) tumble bags 1 buoy with Install buoy Totten Inlet Intertidal Permanent N/A helical screw anchor 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. 2Indicate 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. 3Indicate the days, months or years the waterbody will be measurably impacted by the work. Enter"permanent"if applicable. 8f. For all activities identified in Be, 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 N/A— no fill is proposed. 8g. For all excavating or dredging activities identified in Be, describe the method for excavating or dredging, type and amount of material you will remove, and where the material will be disposed. [te!Pj N/A. No dredging is proposed ORIA-revised 02/2020 Page 8 of 13 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[eii Agency Name Contact Name Phone Most Recent Date of Contact 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? heI • If Yes, list the parameter(s) below. • If you don't know, use Washington Department of Ecology's Water Quality Assessment tools at: https://ecologv wa gov/Water-Shorelines/Water-quality/Water-improvement/Assessment-of-state-waters-303d. ❑ Yes X❑No 9c. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? hf elpl • Go to http://cfpub.epa.gov/surf/locate/index.cfm to help identify the HUC. 171100190900 — South Puget Sound 9d. What Water Resource Inventory Area Number (WRIA#) is the project in? hLeM • Go to https://ecologv wa aov/Water-Shorelines/Water-supply/Water-avai lab i lity/Watershed-look-up to find the WRIA#. 14 Kennedy - Goldsborough 9e. Will the in-water construction work comply with the State of Washington water quality standards for turbidity? hLeM • Go to https://ecologv wa gov/Water-ShorelinesfWater-quality/Freshwater/Surface-water-quality-standards/Criteria for the standards. iX Yes ❑ No ❑ Not applicable 9f. If the project is within the jurisdiction of the Shoreline Management Act, what is the local shoreline environment designation? hel • If you don't know, contact the local planning department. • For more information,go to: httr)s//ecologv wa govANater-Shorelines/Stioreline-coastal-manaciement/Shoreline-coastal- planning/Shoreline-laws-rules-and-cases. El Urban ❑ Natural C Aquatic ❑ Conservancy M Other: Totten Inlet: Residential 9g. What is the Washington Department of Natural Resources Water Type? h[ eM • Go to htti)://www.dnr.wa.gov/forest-practices-water-tVping for the Forest Practices Water Typing System. Z 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? hLgjp] ORIA-revised 0212020 Page 9 of 13 • If No, provide the name of the manual your project is designed to meet. ❑ Yes and ❑ No Not applicable Name of manual: 91i. Does the project site have known contaminated sediment? hel • If Yes, please describe below. 1-1 Yes Zx, No 9j. If you know what the property was used for in the past, describe below. heI The proposed project area has been previously used for shellfish cultivation. 9k. Has a cultural resource (archaeological) survey been performed on the project area? h • If Yes, attach it to your JARPA package. ❑ Yes © No 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. heI ESA-listed species that occur within Puget Sound and may occur within the project vicinity: • Southern Resident Killer Whale (Orcinus orca) • Humpback Whale (Megaptera novaeangliae) • Steelhead Trout (Oncorhynchus mykiss) • Chinook Salmon (Oncorhynchus tshawytscha) • Bull Trout (Salvelinus confluentus) • Bocaccio Rockfish (Sebastes paucispinis) • Yelloweye Rockfish (Sebastes ruberrimus) • Marbled Murrelet (Brachyramphus marmoratus) 9m. Name each species or habitat on the Washington Department of Fish and Wiildlife's Priority Habitats and Species List that might be affected by the proposed work. hel The WDFW PHS map identifies the following priority habitats and species on or near the project site: • Estuarine and marine aquatic habitat • Hardshell clam • Little brown bat (Myotis lucifugus) within the township • Surf smelt (Hypomesus pretiosus) • Oyster Beds 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.oria.wa.gov/opas/. ORIA-revised 02/2020 Page 10 of 13 • Governor's Office for Regulatory Innovation and Assistance at (800) 917-0043 or help aoria.wa.clov. • 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.) hf elpl • For more information about SEPA, go to https://ecolo-gy.wa.gov/regulations-permits/SEPA-environmental-review. ❑ A copy of the SEPA determination or letter of exemption is included with this application. © A SEPA determination is pending with Mason (lead agency). The expected decision date is August 2022 ❑ I am applying for a Fish Habitat Enhancement Exemption. (Check the box below in 1 ob.) h[ elm ❑ 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. 10b. Indicate the permits you are applying for. (Check all that apply.) hel LOCAL GOVERNMENT Local Government Shoreline permits: ❑ Substantial Development ❑ Conditional Use ❑ Variance ❑ Shoreline Exemption Type (explain): 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 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: ZI 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.) ❑X 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: dl3-pf-dl3bridaes@uscg.mil ❑ Bridge Permit ❑ Private Aids to Navigation (or other non-bridge permits) ORIA-revised 02/2020 Page 11 of 13 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) ❑ Section 401 Water Quality Certification (discharges into waters of the U.S.) where the tribe has treatment as a state (TAS). ORIA-revised 02/2020 Page 12 of 13 'Part 11—Authorizing Signatures Signatures are required before submitting the JARPA package. The JARPA package includes the JARPA form, project plans, photos, etc. hLe 11a. Applicant Signature (required) h[ eM 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 [be I certify that to the best of my knowledge and belief, the information provided in this application is true, complete, and accurate. I also certify that I have the authority to carry out the proposed activities and I agree to start work only after all necessary permits have been issued. Authorized Agent Printed Name Authorized Agent Signature Date 11C. Property Owner Signature (if not applicant) hLelpl 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. See Attachment A 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: ORIA-16-011 rev. 09/2018 ORIA-revised 0212020 Page 13 of 13 Part 11—Authorizing Signatures Signatures are required before submitting the JARPA package. The JARPA package includes the DARPA form, project plans, photos, etc. Lheipj 11 a. Applicant Signature (required) el 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 cant' out the proposed activities, and I agree to start work only after I have received all necessary permits. I hereby auth a the agent named in Part 3 of this application to act on my behalf in matters related to this application. !S' (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 entej�n the property where the project is located to inspect the project site or any work related to the project .) � (initial) y t,5 S-Ct.I GJ z-a i/ Applicant Printed Name Applicant Signature Date 11 b. Authorized Agent Signature Lheipl I certify that to the best of my knowledge and belief, the information provided in this application is true, complete, and accurate. I also certify that I have the authority to carry out the proposed activities and I agree to start work only after all necessary permits have been issued. Authorized Agent Printed Name Authorized Agent Signature Date 11 c. Property Owner Signature (if not applicant) tg eip] 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 Property Owner Signature Date 18 U.S.0§1001 providee 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: ORIA-16-011 rev.0912018 nPIAs. 1-4 nonnen Part 11—Authorizing Signatures Signatures are required before submitting the JARPA package_ The JARPA package includes the JARPA form, project plans, photos, etc. fheipl 11 a. Applicant Signature (required) Ihelpl 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 auth a the agent named in Part 3 of this application to act on my behalf in matters related to this application. J � (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 ente in the property where the project is located to inspect the project site or any work related to the project. (initial) --- _.__.__-_ --------_---_ -__ Applicant Printed Name A icant Signature gate 11 b. Authorized Agent Signature lheipl 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. U Racheal Villa, Soundview Consultants LLC 5-9-2022 Authorized Agent Printed Name Authorized Agent Signature Date 11 c. Property Owner Signature (if not applicant) hheeM 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 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 Staten 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: ORIA-16-011 rev.09/2018 � ."""� Vie, �C"1i t•?.a ,�•,a WASHINGTON STATE ;� N D'te Metyrd Joint Aquatic Resources Permit , I Agtacy refereocr Application (JARPA) immi �. 4 Tax Fare l#Is): ' _ a Attachment A: 4 For additional property owner(s) t�+ii+ ��r..ta a 11 Frees .+per 1t'.t�i tom! i Project Name: e Location dame)t!`applkable): Use this attachment MLV If you have more than one property owner. Complete am attachment for emb additional property owner ....... -................... Impacted by the project. Signatures of property owners are not needed for repair or maintenance activities on existing rights-of-way or easements. Use black or blue ink to enter answers in white spaces betow. 1. Name OAR,FkW,MxM)and Organization(it applicable) Heathers Tr, Sherman G8 jplifle-,2:0 ° — J 2. Maiitinp Address(Street or po Box) - 4040 Se Kamiiche Pt Rd Shelton.WA 98584-7953 F� Ph on" 710 .+ =W�rtlel rMmhber of property You own: ,�- titting agencies entering the property 9 s pe Y e pr ct is located to Inspect the project site .. �napecUotts shag occur at reasonable ' es and, if pre cal,with prier notice to the t ry' t &> tf na oo^ ►Gove!nor'tiCNAce for Rc+Aul�t4r, :e;frtOvation and AssistarKe IG►FtIA),at --- -"_1 . ' x a Y�M � •