HomeMy WebLinkAboutSHX2019-00026 Bulkhead - SHX Application - 2/22/2001 -------------:-------------------------,
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WASHINGTON STATE ofEngirwers ; .I[P t R �111r
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Joint Aquatic Resources Permit
Agency reference#:_5ff)e ��ll el -C�CZsv;
Application (DARPA) Form
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USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW.
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Tax Parcel# ):s c ,
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Part 1—Project Identification
1. Project Name (A name for your project that you create. Examples: Smith's Dock or Seabrook Lane Development) hel
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Part 2—Applicant
The person and/or organization responsible for the project. f tj
2a. Name (Last, First, Middle)
2b. Organization (if applicable)
I
2c. Mailing Address (Street or PO Box)
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2d. City, State, Zip
16
2e. Phone(1) 2f. Phone(2) 2g. Fax 2h. E-mail
'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
wvvw.nws.usace.army.mil/Missions/CivilWorks/Reguia. rmitGuidebook/EndancleredSpe___
• 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.
ORIA-16-011 Page 1 of 14
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.) [ )
3a. Name Gast, First, Middle)
7 0
3b. Organization (If applicable)
3c. Mailing Address(street or Po Box)
3d. City, State, Zip
3e. Phone(1) 3f. Phone(2) 3g. Fax 3h. E-mail
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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. Lbelp
Q 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 DARPA Attachment E to
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(1) 4f. Phone(2) 4g. Fax 4h. E-mail
ORIA-16-011 Page 2 of 14
Part .5-Project Location(s)
Identifying information about the property or properties where the project will occur. [ ]
❑ There are multiple project locations (e.g. linear projects). Complete the section below and use
Attachment B for each additional project location. -F5a. icate the type of ownership of the property. (Check all that apply.) hel
ate
eral
❑ 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.) hel
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5C. City, State, Zip (If the project is not in a city or town, provide the name of the nearest city or town.)
5d. County he►
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5e. Provide the section, township, and range for the project location. [, n]
'/4 Section Section Township Range
9
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5f. Provide the latitude and longitude of the project location. hero
• Example:47.03922 N lat./-122.89142 W long. (Use decimal degrees-NAD 83)
'f7, 3/z--I-q� /[ 1, -/ZZ .0l -1.3;6 uJ Syr
5g. List the tax parcel number(s) for the project location. hgl
• The local county assessor's office can provide this information.
o a
5h. Contact information for all adjoining property owners. (if you need more space, use .ARPA Attachment C.) EeAl
Name Mailing Address Tax Parcel #(if known)
Y La rz�. jD rTYI 1a
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ORIA-16-011
Page 3 of 14
5i. List all wetlands on or adjacent to the project location. Le
5j. List all waterbodies (other than wetlands) on or adjacent to the project location. rheipi
1�-O—Se-- :T—n le (/Jo rtA z
5k. Is any part of the project area within a 100-year floodplain? Fein
❑ Yes P'No ❑ Don't know
51. Briefly describe the vegetation and habitat conditions on the property. fheipl
5gDescribe how the property is currently used.
I
5n. Describe how the adjacent properties are currently used. hei
5o. Describe the structures (above and below ground) on the property, including their purpose(s) and current
condition. heI
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5p. Provide driving directions from the closest highway to the project location, and attach a map. ei
ORIA-16-011
Page 4 of 14
Part•6—Project Description
6a. Briefly summarize the overall project. You can provide more detail in 6b. he1
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6b. Describe the purpose of the project and why you want or need to perform it. h[ elo
!J c-r c Lj I5 �r� a�l`s n o c e �nd
So l� a re 5 f u49�7ny ✓D cv n w- ell (,d4*yn a,
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6c. Indicate the project category. (check all that apply) 5[ ee ]
❑ Commercial D'Residential ❑ Institutional ❑ Transportation ❑ Recreational
❑ Maintenance ❑ Environmental Enhancement
6d. Indicate the major elements of your project. (Check all that apply) [help]
❑ Aquaculture ❑ Culvert ❑ Float 0 Retaining Wall
'Bank Stabilization ❑ Dam /Weir ❑ Floating Home (upland)
❑ Boat House ❑ Dike/ Levee / Jetty ❑ Geotechnical Survey ❑ Road
❑ Boat Launch ❑ Ditch ❑ Land Clearing ❑ Scientific
Measurement Device
ElBoat Lift El Dock / Pier El Marina / Moorage ❑ Stairs
❑ Bridge ❑ Dredging ❑ Mining ❑ Stormwater facility
J2/13ulkhead ❑ Fence ❑ Outfall Structure
❑ Swimming Pool
❑ Buoy ❑ Ferry Terminal ❑ Piling/Dolphin ❑ Utility Line
❑ Channel Modification ❑ Fishway ❑ Raft
❑ Other:
ORIA-16-011
Page 5 of 14
6e. Describe how you plan to construct each project element checked in 6d. Include specific construction
methods and equipment to be used. help
• Identify where each element will occur in relation to the nearest waterbody.
• Indicate which activities are within the 100-year floodplain. �^
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6f. What are the anticipated start and end dates for project construction? (MonthNear) E_;_ j
• If the project will be constructed in phases or stages, use DARPA Attachment D to list the start and end dates of each phase
or stage.
Start Date: 5 End Date: ❑ See DARPA Attachment D
69. Fair market value of the project, including materials, labor, machine rentals, etc. h[ Ai
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6h. Will any portion of the project receive federal funding?
fE
If yes, list each agency providing funds.
Yes ❑ No El 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.)[- -
7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. [hetp�
❑ Not applicable
7b. Will the project impact wetlands? h��
❑ Yes ❑ No ❑ Don't know
7c. Will the project impact wetland buffers? LqgiW
❑ Yes ❑ No ❑ Don't know
ORIA-16-011 Page 6 of 14
7d. Has a wetland delineation report been prepared? [_,- ]
• 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?
• 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? nel
• 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
I�
7g. Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was
used to design the plan.
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. [
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
category' 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.
3 Indicate 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/In-lieu fee B
Page number(s) for similar information in the mitigation plan, if available:
ORIA-16-011
Page 7 of 14
7L 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. nelp
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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. :,ei
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
El 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.
[nel
❑ Not applicable 0-IJ- m� dT� stir 6x-U--cik L, W H OT fr'A-m-�tk
rl �b e
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8b. Will your project impact a waterbody or the area around a waterbody? , el
❑ Yes ❑ No
ORIA-16-011
Page 8 of 14
8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland
waterbodies?
• 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 p
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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. !I
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8e. Summarize impact(s) to each waterbody in the table below. 21
Activity (clear, Waterbody Impact Duration Amount of material Area (sq. ft. or
dredge, fill, pile name' locationz of impact3 (cubic yards) to be linear ft.) of
drive, etc.) placed in or removed waterbody
from waterbody directly affected
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e D o-
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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.
1 Indicate 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.
Indicate 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. hei
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ORIA-16-011
Page 9 of 14
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. -,ei
lop, L.OGe,& i n CA-
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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.
19a. 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
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:
http://ww v.ecy.wa.gov/programs/wq/303d/.
❑ Yes No
9c. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in?
• Go to_ittp:Hcfpub.epa.gov/surf/locate/index cfr to help identify the HUC.
I11OD
9d. What Water Resource Inventory Area Number (WRIA#) is the project in? [ )
• Go to htti)://www.ecy.wa-gov/water/Eria/index.html to find the WRIA#.
ORIA-16-011
Page 10 of 14
9e. Will the'in-water construction work comply with the State of Washington water quality standards for
turbidity? ]
• Go to ,ittp://www.ecy.wa.goviprograms/wq/swqs/criteria.htmI for the standards.
❑ Yes ❑ No 9 Not applicable
9f. If the project is within the jurisdiction of the Shoreline Management Act, what is the local shoreline
environment designation? [ I
• 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.htm1.
❑ Urban ❑ Natural ❑ Aquatic ❑ Conservancy ❑ Other: ti? .�
9g. What is the Washington Department of Natural Resources Water Type?
• Go to http:i/vAvw.dnr.wa.goviforest-practices-,,eater-typirc for the Forest Practices Water Typing System.
❑' 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? _ ,
• If No, provide the name of the manual your project is designed to meet.
�J Yes ❑ No
Name of manual:
9i. Does the project site have known contaminated sediment?
• If Yes, please describe below.
❑ Yes P'No
9j. If you know what the property was used for in the past, describe below. LUl
9k. Has a cultural resource (archaeological) survey been performed on the project area? heI
• If Yes, attach it to your JARPA package.
❑ Yes d No
ORIA-16-011 Page 11 of 14
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. n� eAi
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. hel
I
ORIA-16-011 Page 12 of 14
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.oi-ic as .
• Governor's Office for Regulatory Innovation and Assistance at (800) 917-0043 or hell)(o)..oria.wa.gov.
• For a list of addresses to send your JARPA to, click on agency addresses for completed DARPA.
j10a. Compliance with the State Environmental Policy Act (SEPA). (Check all that'apply.) hei
• For more information about SEPA,go to -PNw.ecy.wa.goviprograms/sea/sepa/e-review.htmi.
❑ A copy of the SEPA determination or letter of exemption is included with this application.
Z A SEPA determination is pending with/_�A (TYL (lead agency). The expected decision date
is
❑ I am applying for a Fish Habitat Enhancement Exemption. (Check the box below in tob.) L
❑ 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.) [
LOCAL GOVERNMENT
Local Government Shoreline permits:
❑ Substantial Development ❑ Conditional Use ❑ Variance
-A-
❑Z Shoreline Exemption Type (explain): —5( r 0 �A\o j_. Pp
Other City/County permits:
❑ Floodplain Development Permit ❑ Critical Areas Ordinance
STATE GOVERNMENT
Washington Department of Fish and Wildlife:
LI Hydraulic Project Approval (HPA) El Fish Habitat Enhancement Exemption -Attach Exemption Form
Washington Department of Natural Resources:
❑ Aquatic Use Authorization
Complete _!ARPA Attachment E and submit a check for$25 payable to the Washington Department of Natural Resources.
Do not send cash.
Washington Department of Ecology:
❑ Section 401 Water Quality Certification
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)
ORIA-16-011 Page 13 of 14
Part 11—Authorizing Signatures
Signatures are required before submitting the JARPA package. The JARPA package includes the JARPA form,
project plans, photos, etc. ,eio]
11 a. 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 h 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 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 [ ;__j
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) [_
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 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.07/2017
ORIA-16-011 Page 14 of 14
MASON COUNTY
COMMUNITY SERVICES DEPARTMENT
Mason County Bldg. 8,
615 W.Alder Street, Shelton, WA 98584
www.co.mason.wa.us (360)427-9670 x352 Belfair(360)275-4467 Elma(360)482-5269
UPLAND ROCKERY and SHORELINE
Prescriptive Design and Installation Standard
finished
e�
80 _ Maximum Rockery Height 6'0"
m c Max 3'rise in 8'
_E 0 s finished grade.
y, w g 1 I' C t• .
Washed granular
m m j �drainage material
A�
IjIJ .:a.
15°min Undisturbed sail
(not 91)
4V
q
Min.12"layer of
drainage material
Specify rock sizes y ranging from
3'0' - coarse(1-1/2")to
fine(3/8").
U U — Approved filter fabric
0a
m o
2'0' - E o /
c� f
Mason County Dept.of Community
9 Development may require that any rockery
be designed by a licensed soil engineer,
m 2 ! - —.� especially in soil-sensitive areas.
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Ind ? �E
l G \ Min.4"diameter perforated drain
12"
_ the to an approved discharge
s Upland wall only
Permits Required
A building permit is require for all upland rockeries over four feet in height. Rockeries less than four feet in height do not require a
permit unless: 1) Located on a site containing an Environmentally Critical Area (See Mason County Critical Area Ordinance. 2)There
is a surcharge such as a driveway, building footing,etc, 3)impoundment of Class I, II, or III-A liquids(IBC 105.2) OR #4) Possible
failure that could cause damage to adjoining properties or structures.
Even when rockeries do not require a permit, rockery installers are advised to follow the rockery design principles outlined in this
publication. Permit applications for rockeries must include a site plan showing the location of the rockery and a cross section of the
rockery showing the proposed design details. Rockery designs must either be prepared by a Washington State licensed engineer or
comply with the Prescriptive Rockery Installation Design.
Rockeries over 6-feet in height must be designed by a Washington State licensed engineer or architect to ensure stability against
overturning,sliding, excessive foundation pressure and water uplift. Upland rockery retaining walls shall be designed for a safety factor
of 1.5 against lateral sliding and overturning IBC 1806.
Rockery-Bulkhead Handout-Alder.docx Rev:Feb 2016
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