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HomeMy WebLinkAboutSHX2011-00019 Replace Bulkhead - SHX Permit / Conditions - 6/6/2011 PSON_STAA MASON COUNTY c DEPARTMENT OF COMMUNITY DEVELOPMENT n A o N Planning Division T s p z= P O Box 279 Shelton, WA 98584 r v ti (360)427-9670 OJ �O 1864 Exemption from Shoreline Management Act Case No.: SHX2011-00019 Substantial Development Permit Requirement The Proposal By: LOIS JEANE ROBERTS TO BE KEPT IN THE DES MOINESS, WA 98195 .L To undertake the following development: Replace rotten logs with rockery Within NORTH BAY 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 Please contact Allan Borden at ext 365 if you have any questions. Issued: 6/6/2011 Expires: 6/6/2013 Authorized Local Government Official cc: APPLICANT WDFW USACOE WDOE TRIBAL COUNCIL -----------RECEIVED--- ' AGENCY USE ONLY ' 2 0 1 ®� Date received: MAY 2 6 2011 US Army Corps ; ; WASHINGTON STATE Engineers ; 426 W. QEDAR T ; Joint Aquatic Resources Permit Agency reference#: �FI)C2r�lt-(xbc`1 Application (DARPA) Form' Tax Parcel#(s): 'Aa I t; - ?�I - [aray-'b USE BLACK OR BLUE INK TO ENTER ANSWERS IN WHITE SPACES BELOW. --------------------------- Part 1—Project Identification 1. Project Name (A name for your project that you create. Examples:Smith's Dock or Seabrook Lane Development) [221d 2 oI-Ft-1,J L0C-r- T-0 ROckelzo Part 2—Applicant The person or organization responsible for the project. LheM 2a. Name (Last, First, Middle)and Organization(if applicable) koeq`RTS L10 i 5 � 2b. Mailing Address (Street or PO Box) 11 ZS R;"lN6Ow LANs 2c. City, State, Zip 6js MOINIFS I WA 9 � 2d. Phone(i) 2e. Phone(2) 2f. Fax 2g E-mail (U(6 )g-78-771+ (2o6 )t�+--US4Z. ( -j rO)OCr-S 6)031{- �t11 ��►hW<<t it 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.) EILo 3a. Name (Last, First, Middle)and Organization (if applicable) s . N i6) U /V\DN PGE 3b. Mailing Address (Street or PO Box) F-1 3Q.- ';-I - 119 +k A-V E7 N C- KIIRKL�� 61 WA '7b-)03 +,---7 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 ^ttp:;nrrrow.nws.usace.army.mil/PublicNIenu/Menu.cfm?sitename=REG&pagename=mainpage_ESA • If you are applying for an Aquatic Resources Use Authorization you will need to fill out and submit an Application for Authorization to Use State- Owned Aquatic Lands form to DNR,which can be found at -ao:!%avww.drr wa.gov/Pubucationstagr_:se_a�,-_a:.,. ,:; • Not all cities and counties accept the JARPA for their local Shoreline permits.If you think you will need a Shoreline permit,contact the appropriate city or county government to make sure they will accept the JARPA. ZTo access an online JARPA form with[help]screens,go to ,ttc://www.eoermitUng.wa.gov;site.'alias_,esourcecenter;laroa jaroa_tc,m/9984.;arca torm.aspx. For other help,contact the Governor's Office of Regulatory Assistance at 1-800-917-0043 or help@ora.wa.gov. JARPA 2010 v1 3/30/2010 Page 1 of 13 3c. City, State, Zip KI R,KLAiu A 9F)03+ 3d. Phone(1) 3e. Phone(2) X Fax 3 . E-mail (+6 )21+-2P'F7 4-L!)1Zo-<zu9 J,'0beft5 7 6)03f@�AIYLX c,M Part 4-Property Owner(s) Contact information for people or organizations owning the property(ies)where the project will occur. [agjpj ❑ 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 property owners. Complete the section below and fill out JARPA Attachment A for each additional property owner. 4a. Name (Last, First, Middle)and Organization (if applicable) �Ge 5 L-015 T E 4b. Mailing Address (Street or PO Box) 112 5 (AIN GOW L/W 6 4c. City, State, Zip Des AAOIOS , I VJ A Y R /59 4d. Phone(1) 4e. Phone(2) 4f. Fax 4 . E-mail (2 G )�7� -'17if- 1 (406 )W+-7ZIR ( ) Part 5-Project Location(s) Identifying information about the property or properties where the project will occur. iet ❑ 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.) nei ❑ State Owned Aquatic Land (if yes or maybe,contact the Department of Natural Resources(DNR)at(360)902-1100) ❑ Federal ❑ Other publicly owned (state,county, city,special districts like schools, ports,etc.) ❑ Tribal Private 5b. Street Address (Cannot be a PO Box. If there is no address, provide other location information in 5p.) nel _302 H IGHW4Y 3 o Z 5c. City, State, Zip(If the project is not in a city or town, provide the name of the nearest city or town.) eel 5d. County nel FF AA .kS 04)/\J T IV JARPA 2010 v1 3/30/2010 Page 2 of 13 5e. Provide the section, township, and range for the project location. [heipi 1/4 Section Section Township Range �Li CST I '1- N 2 til 5f. Provide the latitude and longitude of the project location. [ J1QACT Z oe &0V- LvT 3 • Example::47.03922 N lat. /-122.89142 W long. (NAD 83) G 5g. List the tax parcel number(s)for the project location. [nel • The local county assessor's office can provide this information. i Z 2- 1 E -- 3 j a U©c) z (D 5h. Contact information for all adjoining property owners. (if you need more space, use JARPA Attachment C.) [yet Name Mailing Address Tax Parcel #(if known) M�Q• hMES RES (� 30 6 $ 0O-rc 302 1 ZZ16 �-�1L O 6e-LpkiR WA 4�;) 5- Zq? R• AOwhL b A% cM EL 3000 it,� '5T&* R.Wlt- 30Z I zz 16 -31- 9dv 60 L ENZ W A 195 z d 5i. List all wetlands on or adjacent to the project location. [nelpi 5j. List all waterbodies (other than wetlands) on or adjacent to the project location. [tL 1V �TN Rif "SLN Le 1 5k. Is any part of the project area within a 100-year flood plain? 2.Yes ❑ No ❑ Don't know 51. Briefly describe the vegetation and habitat conditions on the property. [hgl C=sue 5�5 JARPA 2010 v1 3/30/2010 Page 3 of 13 KM Describe how the property is currently used. Lgijj i - s I i\J I L v NI C I 5n. Describe how the adjacent properties are currently used. DtIRI 5o. Describe the structures (above and below ground)on the property, including their purpose(s). L irj �� IkAG'e T-EM 5p. Provide driving directions from the closest highway to the project location, and attach a map. [nLJW 3CYZ0 3GZ- C "-si S(Nt- or 5T, ROVTE� 302) IMT S � � rH � �- Cc�u��� c ���= r�sH V1yNc�c�.K Ov,S /1 i " N O\TN vI- NIG-M \,'tw kt J, ffiA-kyto t Y SIGn1\\ TIHE MNAC1j otv+ F 00' R6 q RO JiE T"E ©RI\JE wit . JARPA 2010 v1 3/30/2010 Page 4 of 13 Part 6—Project Description 6a. Summarize the overall project. You can provide more detail in 6d. [hei STD t l Ti G N W r f-J.,G K Ec 6b. Indicate the project category. (Check ail that apply) he; ❑ Commercial gResidential ❑ Institutional ❑ Transportation ❑ Recreational ❑ Maintenance ❑ Environmental Enhancement 6c. Indicate the major elements of your project. (Check all that apply) [help] ❑ Aquaculture ❑ Culvert ❑ Float ❑ Road Bank Stabilization ❑ Dam/Weir ❑ Geotechnical Survey ❑ Scientific ❑ Boat House ❑ Dike/ Levee/Jetty ❑ Land Clearing Measurement Device ❑ Boat Launch ❑ Ditch ❑ Marina / Moorage ❑ Stairs ❑ Boat Lift ❑ Dock/ Pier ❑ Mining ❑ Stormwater facility ❑ Bridge ❑ Dredging ❑ Outfall Structure ❑ Swimming Pool Dq Bulkhead ❑ Fence ❑ Piling ❑ Utility Line i ❑ Buoy ❑ Ferry Terminal ❑ Retaining Wall ❑ Channel Modification ❑ Fishway (upland) ❑ Other: 6d. Describe how you plan to construct each project element checked in 6c. Include specific construction methods and equipment to be used. Enei • Identify where each element will occur in relation to the nearest waterbody. • Indicate which activities are within the 100-year flood plain. ( -� R'6 X t ST1A)& /.O TT/N L0 s Z ) Co 61) 5 F,Of w ; T-I IN Tk 3 ) P L -k c E RC>LK ry R,u w S O Ui&4 TE A VC A V- 1 9 0 Al 6e. What are the start and end dates for project construction? (month/year) Lei 'ko • If the project will be constructed in phases or stages, use JARPA Attacnment G to list the start and end dates of each phase or stage. / Start date: f ' End date: b- �" See JARPA Attachment D JARPA 2010 v1 3/30/2010 Page 5 of 13 6f. Describe the purpose of the project and why you want or need to perform it. nei vt EK(STINCr Rio TTi; lk) LOG- wL" (2F7) PAtii< Tkgi L i 2 PrTW AN 0 R PLk-Ct Ttl R,oCr, 6g. Fair market value of the project, including materials, labor, machine rentals, etc. hel I Z c?0c) N C LU iNL--T �G I u\i C�c cr�ivM -f s 6h. Will any portion of the project receive federal funding? De-!PI • If yes, list each agency providing funds. ❑ Yes ANo ❑ Don't know i 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.) nei 7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. [,ei fZ Not applicable W0Rk W )-rliIN Exi5-TIti& Q � STAZ+L I Z ktuz� rsj 7b. Will the project impact wetlands? nel ❑ Yes No ❑ Don't know 7c. Will the project impact wetland buffers? [nei ] ❑ Yes X No ❑ Don't know 7d. Has a wetland delineation report been prepared? ,,ei • If yes,submit the report, including data sheets,with the JARPA package. ❑ Yes J4 No 7e. Have the wetlands been rated using the Western Washington or Eastern Washington Wetland Rating System? Lei ] • If yes,submit the wetland rating forms and figures with the JARPA package. ❑ Yes ❑ No Don't know JARPA 2010 v1 3/30/2010 Page 6 of 13 7f. Have you prepared a mitigation plan to compensate for any adverse impacts to wetlands? [2t!I • 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. [aei si/k 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. [hel 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 , category2 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/ln-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. Tel Iv A I I 1 JARPA 2010 v1 3/30/2010 Page 7 of 13 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,ei I 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.) nel ❑ 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. eLn] ❑ Not applicable 1. c Pt Pv-c x t s A tj rC S I L i Z NTt%V�. �U P,RPtOTCli ff-Ph ivu 3. CoV-E-iZ e:k t 0S E 1) 5 R F -CE< w Y'N c� Tr;X TI trC F�'I c Si g 7" � �' I N�- L-o t� eP_ TI E S - �P: �T Z IE A ci. u, 6 j'r A-F c.env ` '� r-{ 1 C-N t7 , Tt-( . I*.�3 -4�+ 1�1641 Tt Of) I I 8b. Will your project impact a waterbody or the area around a waterbody? [nelrj ❑ Yes X No 8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland waterbodies? qei • 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. I ❑ Yes �S No ❑ Not applicable lU S E1� SA AISO✓IE) JARPA 2010 v1 3/30/2010 Page 8 of 13 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. [lei j 8e. Summarize impact(s)to each waterbody in the table below. [ Activity (clear, Waterbody Impact Duration Amount of material Area (sq. ft. or dredge, fill, pile name' location of impact3 to be placed in or linear ft.) of drive, etc.) removed from waterbody waterbody directlyaffected 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 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. [le!_ 5 (6 6v61t OS) 0 UM1 A S Koo KIJM B �"); -C -r QNC mAkV R.OcK WILL IRE Tire E- t,eV-c, or Gv�67 :PJ LET 9 A--( R EPCA-c)ti'6- �Xc 5 i ti 8 A tiJ/� 57�S/C.I Z `rI,� t� i Cat S I rry 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. [2tj I II A JARPA 2010 v1 3/30/2010 Page 9 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. Agency Name Contact Name Phone Most Recent Date of Contact ,l dEk (:360 4z7 9670 ( ) K ( ) 9b. Are any of the wetlands or waterbodies identified in Part 7 or Part 8 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: http://www.ecV.wa.gov/programs/wq/303d.l. ❑ Yes $�r No 9c. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? [lei ] • Go to http://cfpub.epa.gov/surf/locaterindex.cfm to help identify the HUC. 9d. What Water Resource Inventory Area Number(WRIA#) is the project in? heir] • Go to http://www.ecy.wa.gov/senjices/gis/maps/wna/wna.htm to find the WRIA#. 9e. Will the in-waster construction work comply with the State of Washington water quality standards for turbidity? :,ei ] • Go to http:/iwww.ecy.wa.gov/l)rograms/wq/swgs/criteria.htmi 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? ne+^] • If you don't know,contact the local planning department. • For more information,go to:http://www ecv 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? hei • Go to http://www.dnr.wa.gov/BusinessPermitsrTopics/ForestPracticesAI)plications/Pages/fl) watertvping.aspx for the Forest Practices Water Typing System. Shoreline ❑ Fish ❑ Non-Fish Perennial ❑ Non-Fish Seasonal JARPA 2010 v1 3/30/2010 Page 10 of 13 9h. Will this project be designed to meet the Washington Department of Ecology's most current stormwater manual? [ • If no, provide the name of the manual your project is designed to meet. i?ilyes ❑ No Name of manual: 9i. If you know what the property was used for in the past, describe below. [ _ � iJca,iii�- � l �`� �t� � �WC 9j. Has a cultural resource (archaeological) survey been performed on the project area? [heipi • If yes, attach it to your JARPA package. ❑ Yes No 9k. 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. [l] / M10 Iry T n P�TIECT ZW-PR-O VI CS M-M R-O N A k�Jr �N G� RIOIG( DN OF Sibiu• 91. 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. [ �r- N/"\ i JARPA 2010 v1 3/30/2010 Page 11 of 13 Part 10—SEPA Compliance and Permits Use the resources and checklist below to identify the permits you are applying for. • Online Project Questionnaire at nttp:/;apps.ecy.wa.gov/opas%. • Governor's Office of Regulatory Assistance at (800) 917-0043 or help(a�ora.wa.gov. • For a list of agency addresses to send your application, click on the"where to send your completed JARPo" at httc-!/ wwr/.epermitting.wa.gov. 10a. Compliance with the State Environmental Policy Act (SEPA). (Check all that apply.) nei • 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. ❑ 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 1Ob.) �e ❑ 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.) nel LOCAL GOVERNMENT Local Government Shoreline permits: ❑ Substantial Development ❑ Conditional Use ❑ Variance R 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 Washington Department of Ecology: ❑ Section 401 Water Quality Certification Washington Department of Natural Resources: ❑ Aquatic Resources Use Authorization 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) United States Coast Guard permits: ❑ General Bridge Act Permit ❑ Private Aids to Navigation (for non-bridge projects) JARPA 2010 v1 3/30/2010 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. neLc 11 a. Applicant Signature (required) [jjeLj 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 tj a 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 ente 'ng he property where the project is located to inspect the project site or any work related to the project. (initial) Applicant Printed Name Applicant Sig tune Date 11 b. Authorized Agent Signature LagTj 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 Iq Authorized Agent Printed Name Authorize/AglentEpriature Ddte 11 c. 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 Own, 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 of Regulatory Assistance(ORA). People with hearing loss can call 711 for Washington Relay Service. People with a speech disability can call (877)833-6341. ORA publication number: ENV-019-09 JARPA 2010 v1 3/30/2010 Page 13 of 13 J'1• a Y • o 1 41 .16 -:,1� �+�.�`'• ' � � "•fir ., �. ..`` Ile" " Are. •, t ! 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