HomeMy WebLinkAboutFPA2007-00022 multi-parcels - FPA Application - 10/19/2007 PS0N C06,
A MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Mason County Bldg. III, 426 West Cedar Street
- PO Box 186, Shelton,WA 98584
1854 www.co.masonma.us (360)427-9670 Belfair(360)275-4467 Elma(360)482-5269
R E GF;d E&CTICES APPLICATION/NOTIFICATION
OCT 1 2007, Type IV General
This application should*24cd*aLlft)&A Sonvironmental Checklist(SEPA)as well as an activity map/site plan which addresses
items listed below.
TYPE OR PRINT IN INK:
1. Landowner,Timber Owner and Operator information.
Legal Name of LANDOWNER Legal Name of TIMBER OWNER Legal Name of OPERATOR
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Mailing Address: Mailing Address: Mailing Address:
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City,State,Zip City,State,Zip City,State,Zip
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Phone(&4 7&? 5/57& Phone( ) Phone(W4 AR.'G I ZV?-
Email: Email: Email: W f-M Q 4-,/yer'
2. Contact person information.
Contact Person Phone%J y90 0 3 3 3
Joe_ 157A C.e Y Email: u.t 6 . HQ
3. If you are harvesting timber,enter the Forest Tax Reporting Account Number of the Timber Owner:
For tax reporting information or to receive a tax number,call the Department of Revenue at(800)548-8829.
4. Legal description where the forest practices will occur.
Parcel Number Sub Division(1/41/a) Section Township Range E/W
32Z85-7S- o/ oMW 3&-
IA/
5. Answer each question as it applies to your proposed forest practice.
a. M No. [I Yes. Is the activity within an urban growth area?
b. [4 No. [] Yes. Is the activity within a public park?
C. t4 No. [] Yes. Is the activity within 500 feet of a public park? Park name:
d. []No. PI] Yes. Is the activity located on lands platted after January 1, 1960?
e. Dq No. [] Yes. Is the activity within 200 feet of saltwater lake river/creek/stream pond
wetland seasonal runoff slopes which exceed 15%?
f. What is the expected duration of FPA? 2 4*4Q_s
Proposed start date: Szowr 30 .Zoo? Proposed end date: UiO i Bo ool 20cif3
Page 1 of 4
6. Are you cutting or removing timber?
[]No. Qd Yes. Complete the table below and identify all timber harvest and salvage activity boundaries on the
activity map.
Acres Volume to be Steepest Slope in
Unit# Harvest Type Yarding Method (net) Harvested(mbf) Harvest Unit(%)
1 -ye r h I 2 a_ n
If✓r Aswov Z y4 v yv
7. Are you constructing or abandoning roads?
Qd No. [] Yes. Complete the table below. Show locations and identify all road activities on the activity map.
Total Length Steepest Side Slope Abandonment Date
Type of Activity (feet) M (Mo/Yr)
Road Construction Does Not Apply
Temporary Road Construction
Road Abandonment
Work in or over typed water may require a Hydraulic Project Approval(HPA)from the Washington Department of Fish and Wildlife
(WDFW). If you have questions concerning the HPA,visit the WDFW website at www.wdfw.wa.gov/habitat.htm.
8. Are you installing or replacing water-crossings?
[�No. [] Yes. Complete the table below. Show locations and identify all proposed water-crossings on the activity map.
Crossing Crossing Dimensions Crossing Crossing Dimensions
Identifier Type (width x length) Identifier Type (width x length)
9. Mark the following activities that will be done in or over typed water.
Activity in or over: Type I Stream Type II Stream Type III Stream Type IV Stream Tvpe V Stream
Removing culverts of bridges
Equipment crossing
Ground skidding
Suspending cables
Cable yarding
Falling and bucking
Other
10. Is any activity in a wetland or wetland buffer?
Do No. [] Yes. Complete the table below. Show locations and identify all wetlands and buffers on the activity map.
Wetland Wetland Type Activity Type in Activity Type in Total Wetland Total Area Total Area
Identifier (1,11,111,IV, Wetland Buffer Area(acres) Drained(acres) Filled(acres)
other)
11. Describe how the following are identified on the ground.
• Harvest boundaries/unit corners: OrAaL-e /=L„eGGiivlr
• Right-of-way limits and centerlines for roadwork,culverts and bridges: NA
• Critical areas and critical area buffer boundaries: N/A
Page 2 of 4
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12. Have you reviewed this forest practices activity area to determine whether it may involve historic sites and/or Native American
cultural resources? bJ No. [] Yes.
13. We affirm that the information contained herein is true,and understand that this proposed forest practice is subject to the Forest
Practices Act and Rules and Mason County Forest Practices Conversion Ordinance as well as all other federal,state or local
regulations. Compliance with the Forest Practices Act and Rules and the Mason County Forest Practices Conversion Ordinance
does not ensure compliance with the Endangered Species Act or other federal state or local laws.
Signature of LANDOWNER Signature o TIMBER OWNER mte:
(if diffe than 1 er)
pry r
t name: Print name: f Date: Date:
Additional information: (Optional)
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Per Mason County Ordinance 11.05,Section 11.05.120,a site trap shall accompany this application which includes the
following information.
I Harvest boundaries and tree retention areas.
H The approximate location of any structures.
III The location of all existing and proposed streets,right-of-ways,easements,skid roads,haul roads,and landings
within the proposal.
IV The location of future land development including stormwater management facilities and vegetation to be retained
for site landscaping,open space,wildlife habitat,screening,and/or buffers.
V Site topography at contour intervals of 40 feet.
VI Critical areas and critical area buffers regulated pursuant to the Critical Areas Ordinance.
VII Drainage ways and culverts.
VIII Site area targeted for further harvest including proposed timing.
IX North arrow and scale shall be shown on all site plans.The scale shall be no smaller than one inch to 200 feet.
Staff asks that,at a minimum,the comers of the harvest unit(s)be flagged for clear identification.
Page 3 of 4
FPA FEE: $220.00 with SEPA SEPA FEE: 0-9.99 Acres$560
$330.00 without SEPA 10 to 20 Acres$670
Over 20 Acres$840
EIS(DS)$2,245+62/hr
Departmental Review
(For Office Use Only)
Site visit:
Date approved:
Mason County Community Development
1/25/2007
Page 4 of 4
MASON CO. ENVIROMENTAL CHECKLIST
.,;KGROUND
Name of proposed project, if applicable:
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2. Name of applicant:
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3. Address and phone number of applicant and contact person:
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4. Date checklist prepared: 0130/ U- /
5. Agency requesting checklist:
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6. Proposed timing or schedule (including phasing, if applicable):
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7. Do you have any plans for future expansion, or further activity related to or connected with this
proposal: If yes, explain.
8. List any environmental information you know about that has been prepared, or will be
prepared, directly related to this proposal.
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9. Do you know whether applications are pending for governmental approvals of other proposals
directly affecting the property covered by your proposal? If yes, explain.
A16
10. List any government approvals or permits that will be needed for your proposal, if known.
11. Give a brief, complete description of your proposal, including the proposed uses and the size
of the project and site. There are several questions later in this checklist that ask you to
describe certain aspects of your proposal. You do not need to repeat those answers on this
page. (Lead agencies may modify this form to include additional specific information on
project description.)
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12. What is the location of the proposal? Give sufficient information for a person to understand the
precise location of your proposed project including a street address, if any, and section,
township, and range, if known. If a proposal would occur over a range of area, provide the
range or boundaries of the site(s). Provide a legal description, site plan, vicinity map, and
topographic map, if reasonably available. While you should submit any plans required by the
agency, you are not required to duplicate maps or detailed plans submitted with any permit
applications related to this checklist.
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B. ENVIRONMENTAL ELEMENTS:
1 . EARTH:
a. General description of the site (circle one): Flat, rolling, ill ee s opes mountainous, other
b. What is the steepest slope on the site (approximate percent slope)?
So- CPv P,.--ALLJ/-r-
c. What general types of soils are found on the site (for example, clay, sand, gravel, peat, muck)?
If you know the classification of agricultural soils, specify them and note any prime farmland.
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d. Are there surface indications or history of unstable soils in the immediate vicinity: If so,
describe.
No
Mason County Environmental Checklist Page 2
e. Describe the purpose, type, and approximate quantities of any filling or grading proposed.
Indicate source of fill.
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f. Could erosion occur as a result of clearing, construction, or use: If so, generally describe.
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g. About what percent of the site will be covered with impervious surfaces after project
constructions (for example, asphalt or buildings)?
h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any:
2. AIR:
a. What types of emissions to the air would result from the proposal (i.e. dust, automobile, odors,
industrial wood smoke) during construction and when the project is completed? If any,
generally describe and give approximate quantities, if known.
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T✓oN 40NA/NU iOt-�cfS G✓ic� /3t� Cc`vsiALC� /=cam /3c,✓iv�nr5 J /
b. Are there any off-site sources of emissions or odor that may affect your proposal? If so,
generally describe.
Nn.
Mason County Environmental Checklist Page 3
C. Proposed measures to reduce or control emissions or other impacts to air, if any:
3 WATER:
a. Surface:
1) Is there any surface water body on or in the immediate vicinity of the site (including
year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe
type and provide names. If appropriate, state what stream or river it flows into.
NO
2) Will the project require any work over, in, or adjacent to (within 200 feet) the described
waters? If yes, please describe and attach available plans.
4/0
3) Estimate the amount of fill and dredge material that would be placed in or removed from
surface water or wetlands and indicate the area of the site that would be affected.
Indicate the source of fill material.
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4) Will the proposal require surface water withdrawals or diversions? Give general
description, purpose, and approximate quantities if known.
ND._ N r—, /i✓ P/✓A T� .r
Mason County Environmental Checklist Page 4
5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan.
/1/0
6) Does the proposal involve any discharges of waste materials to surface waters? If so,
describe the type of waste and anticipated volume of discharge.
N0
b. Ground:
1) Will ground water be withdrawn, or will water be discharged to ground water? Give
general description, purpose, and approximate quantities, if known.
ve.rl' !n/IP NA a� .,Z' - 11A21e sT-
2) Describe waste material that will be discharged into the ground from septic tanks or
other sources, if any (for example; domestic sewage, industrial, containing the following
chemicals..., agricultural, etc.). Describe the general size of the system, the number of
such systems, the number of houses to be served (if applicable), or the number of
animals or humans the system(s) are expected to serve.
pp
C. Water runoff (including storm water):
1) Describe the source of runoff (including storm water) and method of collection and
disposal, if any (include quantities, if known). Where will this water flow? Will this flow
into other waters? If so, describe.
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2) Could waste materials enter ground or surface waters: If so, generally describe.
Alb .
Mason County Environmental Checklist Page 5
d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any:
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4. PLANTS:
a. Check or circle types of vegetation found on the site:
deciduous tree: alder, maple, aspen,
evergreen tree: fir, cedar, pine, other
shrubs
grass
pasture
crop or grain
wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other
water plants: water lily, eelgrass, milfoil, other
other types of vegetation
b. What kind and amount of vegetation will be removed or altered?
"c,VAL mF MHe��Mn?ABL� G't /�c�2//V,Q���+aoclS
C. List threatened or endangered species known to be on or near the site.
Mime-
d. Proposed landscaping, use of native plants, or other measures to preserve or enhance
vegetation on the site, if any:
Mason County Environmental Checklist Page 6
5. ANIMALS
a. Circle any birds and animals which have been observed on or near the site or are known to be
on or near the site:
Birds: hawk, heron, eagle, on bir ther
Mammals: deer bear, elk, beaver, other
Fish: bass, salmon, trout, herring, shellfish, other
b. List any threatened or endangered species known to be on or near the site.
C. Is the site part of a migration route? If so, explain.
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d. Proposed measures to preserve or enhance wildlife, if any:
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6. ENERGY AND NATURAL RESOURCES:
a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet the
completed project's energy needs? Describe whether it will be used for heating,
manufacturing, etc.
b. Would your project affect the potential use of solar energy by adjacent properties: If so,
generally describe.
/11�1
C. What kinds of energy conservation features are included in the plans of this proposal? List
other proposed measures to reduce or control energy impacts, if any:
Mason County Environmental Checklist Page 7
7. ENVIRONMENTAL HEALTH:
a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire
and explosion, spill, or hazardous waste, that could occur as a result of this proposal? If so,
describe.
1) Describe special emergency services that might be required.
lvcw,�5-
2) Proposed measures to reduce or control environmental health hazards, if any:
b. Noise.
1) What types of noise exist in the area which may affect your project (for example: traffic,
equipment, operation, other)?
1Vorv,5,
2) What types and levels of noise would be created by or associated with the project on a
short-term or a long-term basis (for example: traffic, construction, operation, other)?
Indicate what hour's noise would come from the site.
F�-
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3) Proposed measures to reduce or control noise impacts, if any:
8. LAND AND SHORELINE USE:
a. What is the current use of the site and adjacent properties? l
�c1ca T;c/�N.O i0^0
Mason County Environmental Checklist Page 8
b. Has the site been used for agriculture? If so, describe.
No
C. Describe any structures on the site.
MCWE
d. Will any structures be demolished? If so, what?
No
e. What is the current zoning classification of the site?
fLt/2,4� fZ�S/c�n�/AL
f. What is the current comprehensive plan designation of the site?
N/p
g. If applicable, what is the current Shoreline Master Program designation of the site?
N/A
h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify.
Nb
i. Approximately how many people would reside or work in the completed project?
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j. Approximately how many people would the completed project displace?
/1/0,V
k. Proposed measures to avoid or reduce displacement impacts, if any:
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Mason County Environmental Checkfist Page 9
I. Proposed measures to ensure the proposal is compatible with existing and projected land uses
and plans, if any:
/Pave ��ui,2�/J
9. HOUSING:
a. Approximately how many units would be provided, if any? Indicate whether high, middle, or
low-income housing.
New
b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or
low-income housing.
Mw r
C. Proposed measures to reduce or control housing impacts, if any:
10. AESTHETICS:
a. What is the tallest height of any proposed structure(s), not including antennas; what is the
principal exterior building material(s) proposed?
Nom&
b. What views in the immediate vicinity would be altered or obstructed?
A/ov&-
c. Proposed measures to reduce or control aesthetic impacts, if any:
Mason County Environmental Checklist Page 10
11. LIGHT AND GLARE
a. What type of light or glare will the proposal produce? What time of day would it mainly occur?
b. Could light or glare from the finished project be a safety hazard or interfere with views?
No
C. What existing off-site sources of light or glare may affect your proposal:
A16 vc'
d. Proposed measures to reduce or control light and glare impacts, if any:
/Va ve R&!gU1 &no
12. RECREATION:
a. What designated and informal recreational opportunities are in the immediate vicinity?
141KINe.
b. Would the proposed project displace any existing recreational uses? If so, describe.
C. Proposed measures to reduce or control impacts on recreation, including recreation
opportunities to be provided by the project or applicant, if any:
/1d,Vc:- / ✓J / /N/Nlol /�47N //4 ,QN1� !07 /dCG_.
Mason County Environmental Checklist Page 11
13. HISTORIC AND CULTURAL PRESERVATION:
a. Are there any places or objects listed on, or proposed for, national, state, or local preservation
registers known to be on or next to the site? If so, generally describe.
A/v
b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural
importance known to be on or next to the site.
,AIC_W e
C. Proposed measures to reduce or control impacts, if any:
14. TRANSPORTATION:
a. Identify public streets and highways serving the site and describe proposed access to the
existing street system. Show on site plans, if any.
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b. Is site currently served by public transit? If not, what is the approximate distance to the
existing street system? Show on site plans, if any.
//U -
C. How many parking spaces would the completed project have? How many would the project
eliminate?
Ncw 0
d. Will the proposal require any new roads or streets, or improvements to existing roads or
streets, not including driveways? If so, generally describe (indicate whether public or private).
Mason County Environmental Checklist Page 12
e. Will the project use (or occur in the immediate vicinity of)water, rail, or air transportation? If
so, generally describe.
A6
f. How many vehicular trips per day would be generated by the completed project: If known,
indicate when peak volumes would occur.
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g. Proposed measures to reduce or control transportation impacts, if any:
15. PUBLIC SERVICES:
a. Would the project result in an increased need for public service (for example: fire protection,
police protection, health care, schools, other)?
If so, generally describe:
A/o
b. Proposed measures to reduce or control direct impacts on public services, if any:
Mason County Environmental Checklist Page 13
16. UTILITIES:
a. Circle utilities currently available at the site: lectric1t natural gas, water, refuse service,
elephone sanitary sewer, septic system, other:
b. Describe the utilities that are proposed for the project, the utility providing the service, and the
general construction activities on the site or in the immediate vicinity which might be needed.
NLN/� /Q�'Qc��.2crt7 /=qC� �11i�Sc-f qN'� L.oGGiNG.
Signature:
The above answers are true and complete to the best of my knowledge. I understand that the
lead agency is relying on them to make its decision.
Signature: v
Date submitted: ,91-40/0-7
Mason County Environmental Checklist Page 14
ESA LISTED SALMONIDS CHECKLIST
Applicant Information Proiect Information
Name Q.-v A rmlw s Name 1Zwy AT'Kin/S
Phone ZoG 74 y 5-/Sa Location Nw5C rzr,R3c,.1
Description
cJtiJ AWW-X,/.N.d j L� I/A&Ag s
This worksheet was designed to help project proponents, and government agencies, identify when a project
needs further analysis regarding adverse effects on ESA (Endangered Species Act)listed salmonids. Salmonids
are salmon, trout and chars, e.g. bull trout. For our purposes, "ESA Listed Salmonids" is defined as fish species
listed as endangered, threatened or being considered for listing.
If ESA listed species are present or ever were present in the water shed where your project will be located, your
project has the potential for affecting them, and you need to comply with the ESA. The questions in this section
will help determine if the ESA listings will impact your project.
The Fish Program Manager at the appropriate Department of Fish and Wildlife (DFW) regional office can provide information for the
following two questions.
1. Are ESA listed salmonids currently present in the watershed in which your project will be located?
YES NO X Please describe.
2. Has there ever been an ESA listed salmonid stock present in this watershed?
YES NO Ne� Uncertain Please describe.
If you answered "yes" to either of the above questions, you should complete the remainder of this
checklist.
April 2003
Mason County Environmental Checklist Page 15
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