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Home My WebLink AboutSHX99-0027 JARPA - SHX Inspections - 9/22/1999r -0017 MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Planning-Landfill-Utilities EXEMPTION FROM SHORELINE MANAGEMENT ACT SUBSTANTIAL DEVELOPMENT PERMIT REQUIREMENT The Proposal by: JOHN NORDSTROM 2000 43RD AVE EAST SEATTLE WA 98112 To undertake the following development : ADD TWO PILINGS TO SECURE AN EXISTING SYSTEM TO BETTER SECURE FLOATS IN STORMY WEATHER. within HOOD CANAL APPROX 1/4 MILE EAST OF ALDERBROOK INN ON STATE HWY 106 . and/or its associated wetlands is exempt from the requirement of substantial development because the development is Cost <= 2500 WAC 173-14-040- (A) . Corps Public Notice Reference Y ISSUED: 09/22/99 EXPIRE: 09/22/01 This exemption authorizing construction shall be valid for two (2) years provided construction has begun within two (2) years of approval date. This exemption may be extended to five (5) years upon request prior to expiration. Authorize(d PYoc6A Government Official cc: APPLICANT WDFW USACOE WDOE CMMRS/DIRECTOR OF DCD TRIBAL COUNCIL-- SHX_FORM, rev: 03/24/92 v y 1',niX�F g �'✓' A .Y �/ 1� r��yf ,��,c^'r: en"'"* tfG�f,[. JARPA FORM R "" r 1 1 (for use in Washington State) Alin ° PLEASE TYPE OR PRINT IN BLUE OR BLACK INK Based gr(fhe preceding checklist,I am sending copies of this application to the following: (check all that apply) Local Government for shoreline: ❑Substantial Development ❑Conditional Use ❑Vahance)21'Exemption;or,if applicable ❑Roodplain Management ❑Critical Areas Ordinance Washington Department of Fish and Wildlife for HPA /❑ Washington Department of Ecology for. ❑Approval to Allow Temporary Exceedance of Water Quality Standards ❑401 Water Quality Certification Nationwide Permits ❑ Washington Department of Natural Resources for.❑Aquatic Resources Use Authorization Notification ❑ Corps Engineers for: ❑Section 404 ❑Section 10 permit ❑ Coast Guard for. ❑Section 9 Bridge Permit SECTION A -Use for all permits covered by this application. Be sure to also complete Section C(Signature Block)for all permit applications. 1.APPUCANT NORDSTROM JOHN MAILING ADDRESS 2000 - 43RD EAST, SEATTLE, WA 98112-2759 WORK PHONE HOME PHONE FAX x 206-373-4057 If an agent is acting for the applicant during the permit process,complete#2. 2 AUTHORIZED AGENT LINDA M. GILBREATH MAILING ADDRESS WORKPHONE HOMEPHONE FAX# 360-277-3715 1,360-427-5867 136'0-277-3715 I RELATIONSHIP OF APPLICANT TO PROPERTY: IXOWNER ❑PURCHASER ❑LESSEE ❑OTHER: 4.NAME,ADDRESS,AND PHONE NUMBER OF PROPERTY OWNER(S),IF OTHER THAN APPLICANT: S.LOCATION(STREET ADDRESS,INCLUDING CRY,COUNTY AND ZIP CODE,WHERE PROPOSED ACTIVITY EXISTS OR WILL OCCUR) 73b1 EAST SR 106, UNION, WA, MASON COUNTY 98592 WATERBODY TRIBUTARY OF HOOD CANAL 1/4 SECTION TOWNSHIP RANGE GOVERNMENT LOT SHORELINE DESIGNATION S/E URBAN RESIDENTIAL S/E ZONING DESIGNATION 33 22N 03W W 1/2 #1 TAX PARCEL NO.: DNR STREAM TYPE,IF KNOWN 32233-44-00040 Application Page 1 of 4 as 0.DESCRIBE THE CURRENT USE OF THE PROPERTY.AND STRUCTURES EXISTING ON THE PROPERTY. IF ANY PORTION OF THE PROPOSED ACTIVITY IS ALREADY COMPLETED ON THIS PROPERTY,INDICATE MONTH AND YEAR OF COMPLETION. SINGLE FAMILY RESIDENCE RAMP, FLOAT :SYSTEM, BULKHEAD IS THE PROPERTY AGRICULTURAL LAND?❑YEA NO ARE YOU A USDA PROGRAM PARTICIPANT? Cl YES J§NO 7a. DESCRIBE THE PROPOSED WORK:COMPLETE PLANS AND SPECIFICATIONS SHOULD BE PROVIDED FOR ALL WORK WATERWARD OF THE ORDINARY HIGH WATER MARK OR ADD TWO ( 2 ) PILINGS TO AN EXISTING SYSTEM TO SECURE MOORAGE SYSTEM IN STORMS PLANS ATTACHED 7D.DESCRIBE THE PURPOSE OF THE PROPOSED WORK PROTECT PROPERTY PREVENT NAVIGATIONAL HAZARD 70, DESCRIBE THE POTENTIAL IMPACTS TO CHARACTERISTIC USES OF THE WATER BODY. THESE USES MAY INCLUDE FISH AND AQUATIC LIFE.WATER QUALITY,WATER SUPPLY,RECREATION,and AESTHETICS. IDENTIFY PROPOSED ACTIONS TO AVOID,MINIMIZE,AND MITIGATE DETRIMENTAL IMPACTS.AND PROVIDE PROPER PROTECTION NO ADVERSE IMPACTS OR EFFECTS TO HABITAT OR SURROUNDINGS PREPARATION OF DRAWINGS: SEE APPENDIX A.SAMPLE DRAWINGS AND CHECKLIST FOR COMPLETING THE DRAWINGS. ONE SET OF ORIGINAL OR GOOD QUALITY REPRODUCIBLE DRAWINGS MUST BE ATTACHED. NOTE: APPLICANTS ARE ENCOURAGED TO SUBMIT PHOTOGRAPHS OF THE PROJECT SITE.BUT THESE DO NOT SUBSTITUTE FOR DRAWINGS. THE CORPS OF ENGINEERS AND COAST GUARD REQUIRE DRAWINGS ON 8-1/2 X 1 i WCH SHEETS. LARGER DRAWINGS MAY BE REQUIRED BY OTHER AGENCIES 6 WILL THE PROJECT BE CONSTRUCTED IN STAGES? ❑YES IX NO PROPOSED STARTING DATE IMMEDIATELY Application Page 2 of 4 ZsnmATEoDURA7IONOFACT1V1I Y: ONE DAY , DEPENDANT UPON CONDITIONS 9.CHECK IF ANY STRUCTURES WILL BE PLACED ^�WATERWARD OF THE ORDINARY HIGH WATERMARK OR LINE FOR FRESH OR TIDAL WATERS:ANO/OR Xl§WATERWARD OF THE MEAN HIGH WATER LINE IN TIDAL WATERS 10.WILL FILL MATERIAL(ROCK,FILL,BULKHEAD,PILINGS OR OTHER MATERIAL)BE PLACED:' WATERWARD OF THE ORDINARY HIGH WATER MARK OR LINE FOR FRESHWATERS? F YES,VOLUME(CUBIC YARDS) /AREA (ACRES WATERWARD OF THE MEAN HIGHER HIGH WATER FOR TIDAL WATERS? IF YES,VOLUME(CUBIC YARDS) %AREA (ACRES) N/A 11.'WILL MATERIAL BE PLACED IN WETLANDS? - -- - - - ❑YES MO IF YES: A.IMPACTED AREA IN ACRES: B.HAS A DELINEATION BEEN COMPLETED? IF YES,PLEASE SUBMIT WITH APPLICATION. ❑YES ❑NO C.HAS A WETLAND REPORT BEEN PREPARED? IF YES,PLEASE SUBMIT WITH APPLICATION. ❑YES ❑NO D.TYPE AND COMPOSITION OF FILL MATERIAL(E.G.,SAND,ETC.): E.MATERIAL SOURCE F.LIST ALL SOIL SERIES(TYPE OF SOIL)LOCATED AT THE PROJECT SITE,&INDICATE IF THEY ARE ON THE COUNTY'S UST OF HYDRIC SOILS. SOILS INFORMATION CAN BE OBTAINED FROM THE NATURAL RESOURCES CONSERVATION SERVICE(NRCS): 12 WILL PROPOSED ACTIVITY CAUSE FLOODING OR DRAINING OF WETLANDS? ❑YESANNO IF YES,IMPACTED AREA IS_ACRES 13.WILL EXCAVATION OR DREDGING BE REQUIRED IN WATER OR WETLANDS? [3 YES ]0XO IF YES: A.VOLUME:_(CUBIC YARDS)IAREA_(ACRES) B.COMPOSITION OF MATERIAL TO BE REMOVED- C.DISPOSAL SITE FOR EXCAVATED MATERIAL- D.D.METHOD OF DREDGING: 14.LIST OTHER APPLICATIONS,APPROVALS,OR CERTIFICATIONS FROM OTHER FEDERAL,STATE OR LOCAL AGENCIES FOR ANY STRUCTURES,CONSTRUCTION,DISCHARGES, OR OTHER ACTIVITIES DESCRIBED IN THE APPLICATION(I.E.,PRELIMINARY PLAT APPROVAL.HEALTH DISTRICT APPROVAL,BUILDING PERMIT,SEPA REVIEW,FERC LICENSE, FOREST PRACTICES APPLICATION,ETC.)ALSO INDICATE WHETHER WORK HAS BEEN COMPLETED AND INDICATE ALL EXISTING WORK ON DRAWINGS. TYPE OF APPROVAL ISSUING AGENCY IDENTIFICATION NO. DATE OF APPLICATION DATE APPROVED COMPLETED? BUILDING- PERMIT MASON COUNTY 8-99 PENDING SEPALEADAGENCY MASON COUNTY SEPADECISION: PENDING SEPA DECISION DATE. 15. HAS ANY AGENCY DENIED APPROVAL FOR THE ACTIVITY DESCRIBED HEREIN OR FOR ANY ACTIVITY DIRECTLY RELATED TO THE ACTIVITY DESCRIBED HEREIN?❑YES XyNO IF YES,EXPLAIN: Application Page 3 of SECTION B-Use for Shoreline and Corps of Engineers permits only: q 16. TOTAL COST OF PROJECT,THIS MEANS THE FAIR MARKET VALUE OF THE PROJECT,INCLUDING MATERIALS,LABOR,MACHINE RENTALS,ETC. 2,4001-40 4+/— _ 17. LOCAL GOVERNMENT WITH JURISDICTION: MASON COUNTY Pq;"T_;.P. 18. FOR CORPS.COAST GUARD,AND ONR PERMITS,PROVIDE NAMES,ADDRESSES,AND TELEPHONE NUMBERS OF ADJOINING PROPERTY OWNERS,LESSEES.ETC.PLEASE NOTE: SHORELINE MANAGEMENT COMPLIANCE MAY REQUIRE ADDITIONAL NOTICE—CONSULT YOUR LOCAL GOVERNMENT. NAME ADDRESS PHONE NUMBER SECTION C-This section MUST be completed for any permit covered by this application. 19. APPUCATION IS HEREBY MADE FOR A PERMIT OR PERMITS TO AUTHORIZE THE ACTIVITIES DESCRIBED HEREIN. I CERTIFY THAT I AM FAMILIAR WITH THE INFORMATION CONTAINED IN THIS APPLICATION,AND THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF,SUCH INFORMATION IS TRUE,COMPLETE,AND ACCURATE. I FURTHER CERTIFY THAT I POSSESS THE AUTHORITY TO UNDERTAKE THE PROPOSED ACTIVITIES. I HEREBY GRANT TO THE AGENCIES TO WHICH THIS APPLICATION IS MADE,THE RIGHT TO ENTER THE ABOVE-DESCRIBED LOCATION TO INSPECT THE PROPOSED,IN-PROGRESS OR COMPLETED WORK.I AGREE TO START WORK ONLY AFTER ALL NECESSARY PERMITS HAVE BEEN RECEIVED. SIG R/E OF APPLICANT A=' D DATE C�/C E I HEREBY DESIGNATE DA M. GILBREATH TO 4NATU — AGENT IN MATTERS RE D TO THIS APPUCATION FOR PERMIT(S). I UNDERSTAND THAT IF A FEDERAL PERMIT IS ISSUED,I MUST SIGN THE PERMIT. OFAPPUCANT DATE SIGNATURE OF LANDOWNER(EXCEPT PUBLIC ENTITY LANDOWNERS,E.G.DNR) DATE THIS APPLICATION MUST BE SIGNED BY THE APPLICANT AND THE AGENT,IF AN AUTHORIZED AGENT IS DESIGNATED. 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. COMPLETED BY LOCAL QFFICIAL A Nat€�t[eo iEe:exls rtgsho lie (Describe type of shoreline,such as marine, svrearn, lake;lagoon, marsh,tog, swamp,flood piarn 'fy ge a flood tay detta; beach,such as accretion,erosion, high bank,low bank or dike;material such as sand,gravel, � � Y.. �Rm et and' type of bulkheading,i,°any:)_ b In the event that any of the proposed buildings or structures will exceed a height of thirty-five feet above the average grade a level,indicate the approximate location of and nu tdent rnber of resiat units,existing and potential,that will have an obstructed 1 r C, ,if the application involves a Condfonal use or variance,set forth in full that portion'of the roaster program which provides that the,proposed use may be Wc&idi final use or,In I le case of a variance,from which the variance is being sought z�� . XI X"" _ These Agencies are Equal Opportunity and Affirmative Action employers. For special accommodation needs,please contact the appropriate agency from Appendix B. Application Page 4 of 4 NORDSTROM, John PARCEL: #32233-44-00040 SITE: 7301 East SR 106 SE 1/4 of SE 1/4 Sec 33 Union, WA 98592 TWP 22N R 03VV W1/2 Gov Lot #1 PERMIT AGENT: REPAIR AND MAINTENANCE Linda NI. Gilbreath Add Two (2) Pilings to Secure Post Office Box 1370 an Existing System Allyn, WA. 98524-1370 No Change in Footprint Phone/Fax: 360-277-3715 No Enlargement of System z 0 EBB Q Pilings to be Douglas Fir 1 .5# Retention Scale: 1 ." = 20.' c; ACZA (Chemonite). Treatment to be 0 J done under current BMP's. Uj Pilings to be attached to system with 0 Galvanized Pile Hoops = Hardware to be Galvanized FLOOD PLAN VIE\' ` O O 3.5' ! Iry 27.' = E Y • �' 77.' �C„ m N (� w � Z 14 U Z CL l z - 106.' pry 1214.' OA c� z z � x ELEVATION VIEW W W 0.0' TE -3.0' 1 10 SECURE EXISTING SYSTEM IN STORNIY WEATHER ' The system has a tendancy to st1vay and travel in heavy viinds NO CHANGE IN OVER-ALL LENGTH OR SYSTEM FOOTPRINT '?L it k3+e � _ }.,,vY:k1 T- � "�}i* '�•� -.'^�,yy".. : ..r'ice•„-C ��y.: .. +i�� i+ r�L�'"rr .�taKB.•.,,a �,.�'� `� �i".�-� %tiO A JC_�ti a` - 'ir• c w r'.y,� r��•�;y&.�,} s►:s1� of �"`� - ``-t"' ,.:4�ti .,, 1 l l • y � ,{r �yy �� •l ,,1;"fix'. ...� . • I; ia'ajk9�11111Ri`� is to a.vyf Ntii•�W+. . ..r- .�,,..,� s . '".•i� j. `�`' �..1.0Awt' ..+ � Y .rt.K92%'K2s•.:t��fiiJ.. A.7�a• M'i�/r�F,," il�s+s^ . :a`s�c Sri' »�—•.ti `.