HomeMy WebLinkAboutSHX2004-00024 JARPA Cancelled - SHX Permit / Conditions - 1/15/2006 pN.STA MASON COUNTY
BPS c ° DEPARTMENT OF COMMUNITY DEVELOPMENT
o A OU N Planning Division
>. s N = P 0 Box 279, Shelton,WA 98584
P y ti - `� (360)427-9670
OJ ?O
7864 Z
Exemption from Shoreline Management Act
Case No.:
SHX2004-00024 Substantial Development Permit Requirement
The Proposal By: JANE MARTIN
240 N.AYOCK BEACH DRIVE
LILLIWAUP,WA 98555 L`
To undertake the following development: TO BE KEPT IN Tf IE
PARCEL FILE
Erosion-control concrete bulkhead of 121 linear feet.
Within HOOD CANAL and/or its associated wetlands is exempt from the requirement of substantial development because the
development is categorized under WAC 173-1-040(C)as being category
C-normal protective bulkhead
Please contact Rick Mraz at ext 577 if you have any cluestio s.
Issued: 7/15/2004
Expires: 1/15/2006 Authorize f6�ernment icial
cc: APPLICANT WDFW -vvyv�jlt USACOE
WDOE CMMR/DIRECTOR OF DCD
TRIBAL COUNCIL
I
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Courthouse Annex
P.O.Box 279,Shelton,WA 9858.40-
(360)427-9670
SHORELINE PERMIT APPLICATION
PERMIT NO. SHORELINE SUBSTANTIAL DEVELOPMENT
SHORELINE VARIANCE
DATE RECEIVED SHORELINE CONDITIONAL USE
o0
SHORELINE EXEMPTION
The Washington State Shoreline Management Act (RCW 90.58) requires that substantial development within
designated shorelines of the state comply with its administrative procedures(WAC 173-14)and the provisions of the
Mason County Shoreline Management Master Program. The purpose of this Act and local program is to protect the
state's shoreline resources. The program requires that substantial development(any development of which�he total
cost or fair market value exceeds $5,000.00 or materially interferes with the normal public use of the water or
shorelines of the State be reviewed with the goals, polices, and performance standards established in the Master
Program
Answer all questions completely. Attach any additional information that my further describe the proposed
development. Incomplete applications will be returned.
APPLICANT: _ 19/V J
ADDRESS: 2 KkX -lO e/k el
O
(city) (state) (zip)
TELEPHONE:
(home) (business)
AUTHORIZED REPRESENTATIVE:
ADDRESS:
(st179
c
(arty) (state) (zip)
TET EALI'ITTTE:
PROPERTY DESCRIPTION: i
General location(include property address,water body and associated wetlands—identify the name of the
shoreline):
A
Legal description (include section, township, and range to the nearest quarter, quarter section or latiti de and
longitude to the nearest minute. Projects located in open water areas away from land shall provide a longitude
location)-include all parcel numbers:
c.
OWNERSHIP: Contract
Applicant Owner Lessee Purchaser (Identify) Other _
Owner: � &of-
0
(city) (state)
9
(1�p)
I:\PLANNINGICHARELL&RENEE/SHORELINEPERMIT.APP REVISED: 06-25.03
i DEVELOPMENT DESCRIPTON'
Development(identify and describe the proposed project,including the type of materials to be used,construction
metthyods,principle dimensions, and
yother pertinent/information):
Use(identify current use ofproperty with exist improvements:
// 4!,e,�.i elP yCAL
Reason for requesting development:
, I
pro 4-e Utz
ACKOWLEDGEMENT
I hereby declare,to the best of my knowledge and belief,the forgoing information and all attached information is
true and correct.
C1
li t au ed representative) (date)
a E n 0 ff K 1
TO BE COMPLETED BY LOCAL OFFICIAL
Identify and describe existing features of the site and surrounding area:
If proposed structures will exceed a height of 35 feet above the existing grade level, indicate the location of any
residential units that will have an obstructive view:
If a Conditional Use or Variance is requested,make reference to the appropriate section in the Master Program:
I:\PLANNINGICHARELL&RENEE/SHORELINEPERMIT.APP REVISED: 06-25-03
to
AGENCY USE ONLY
Agency Reference#: Date Received:
Circulated by: (local govt. or agency)
JOINT AQUATIC RESOURCES PERMIT APPLICATION FORM (JARPA)
(for use in Washington State)
MPLEASE TYPE OR PRINT IN BLACK INK
❑ Application for a Fish Habitat Enhancement Project per requirements of RCW 77.55.290. You must submit a copy
of this completed JARPA application form and the(Fish Habitat Enhancement JARPA Addition)to your local
Government Planning Department and Washington Department of Fish &Wildlife Area Habitat Biologist on the same day.
NOTE: LOCAL GOVERNMENTS—You must submit any comments on these projects to WDFW within 15 working days.
Based on the instructions provided, I am sending copies of this application to the following: (check all that apply)
X Local Government for shoreline: ❑Substantial Development ❑Conditional Use ❑Variance X Exemption ❑ Revision
❑ Floodplain Management ❑Critical Areas Ordinance
X Washington Department of Fish and Wildlife for HPA(Submit 3 copies to WDFW Region)
❑ Washington Department of Ecology for 401 Water Quality Certification(to Regional Office-Federal Permit Unit)
❑ Washington Department of Natural Resources for Aquatic Resources Use Authorization Notification
❑ Corps of Engineers for: ❑Section 404 ❑Section 10 permit
❑ Coast Guard for General Bridge Act Permit
❑ For Department of Transportation projects only: This project will be designed to meet conditions of the most current Ecology/Department of
Transportation Water Quality Implementing Agreement
SECTION A-Use for all permits covered by this application. Be sure to ALSO complete Section C(Signature Block)for all permit applications.
1.APPLICANT
Jane Martin
MAILING ADDRES
240 N Ayock Beach Dr. Lilliwaup WA 98555
WORK PHONE EMAIL ADDRESS HOME PHONE FAX#
If an agent is acting for the applicant during the permit process,complete#2. Be sure agent signs Section C(Signature Block)for all permit
applications
AUTHORIZED AGENT
Japhet Bulkheading Inc.
MAILING ADDRESS
1407 Summit Lake Shore Rd.NW Olympia WA.98502
WORK PHONE E-MAIL ADDRESS HOME PHONE FAX#
360-866-0377 360-866-7702
3.RELATIONSHIP OF APPLICANT TO PROPERTY: X OWNER ❑PURCHASER ❑LESSEE ❑OTHER:
4.NAME,ADDRESS,AND PHONE NUMBER OF PROPERTY OWNER(S),IF OTHER THAN APPLICANT:
5.LOCATION(STREET ADDRESS,INCLUDING CITY,COUNTY AND ZIP CODE,WHERE PROPOSED ACTIVITY EXISTS OR WILL OCCUR)
240 N Ayock Beach Dr. Lilliwaup WA 98555
LOCAL GOVERNMENT WITH JURISDICTION(CITY OR COUNTY) Mason County
WATERBODY YOU ARE WORKING IN TRIBUTARY OF WRIA#
Hood Canal
Y,SECTION I SECTION I TOWNSHIP RANGE GOVERNMENT LOT SHORELINE DESIGNATION
3 23 3 Rural
LATITUDE&LONGITUDE: Lat.N 47.30.43 ZONING DESIGNATION
Rural
Long W123.03.24
TAX PARCEL NO: DNR STREAM TYPE,IF KNOWN
323035001013
6.DESCRIBE THE CURRENT USE OF THE PROPERTY,AND STRUCTURES EXISTING ON THE PROPERTY HAVE YOU COMPLETED ANY PORTION OF THE PROPOSED ACTIVITY ON THIS
PROPERTY? ❑YES X NO FOR ANY PORTION OF THE PROPOSED ACTIVITY ALREADY COMPLETED ON THIS PROPERTY,INDICATE MONTH AND YEAR OF COMPLETION.
Family residence
IS THE PROPERTY AGRICULTURAL LAND? ❑YES X NO ARE YOU A USDA PROGRAM PARTICIPANT? ❑YES XNO
7a. DESCRIBE THE PROPOSED WORK THAT NEEDS AQUATIC PERMITS: COMPLETE PLANS AND SPECIFICATIONS SHOULD BE PROVIDED FOR ALL WORK WATERWARD OF THE ORDINARY
HIGH WATER MARK OR LINE,INCLUDING TYPES OF EQUIPMENT TO BE USED. IF APPLYING FOR A SHORELINE PERMIT,DESCRIBE ALL WORK WITHIN AND BEYOND 200 FEET OF THE
ORDINARY HIGH WATER MARK IF YOU HAVE PROVIDED ATTACHED MATERIALS TO DESCRIBE YOUR PROJECT,YOU STILL MUST SUMMARIZE THE PROPOSED WORK HERE. ATTACH
A SEPARATE SHEET IF ADDITIONAL SPACE IS NEEDED.
Construct a concrete bulkhead to protect the family residence
Equipment to be used will include:Backhoe or excavator and hand tools
PREPARATION OF DRAWINGS: SEE SAMPLE DRAWINGS AND GUIDANCE 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 6-1/2 X 11 INCH SHEETS. LARGER DRAWINGS MAYBE REQUIRED BY OTHER AGENCIES.
b. DESCRIBE THE PURPOSE OF THE PROPOSED WORK AND WHY YOU WANT OR NEED TO PERFORM IT AT THE SITE. PLEASE EXPLAIN ANY SPECIFIC NEEDS THAT HAVE INFLUENCED
THE DESIGN.
Erosion is threatening the home,Bio-engineering has been tried with out success
7c. 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 OF FISH AND
AQUATIC LIFE. IDENTIFY WHICH GUIDANCE DOCUMENTS YOU HAVE USED. ATTACH A SEPARATE SHEET IF ADDITIONAL SPACE IS NEEDED.
The project will have no impact
7d. FOR IN WATER CONSTRUCTION WORK,WILL YOUR PROJECT BE IN COMPLIANCE WITH THE STATE OF WASHINGTON WATER QUALITY STANDARDS FOR TURBIDITY
WAC 173.201A-110? X YES ❑NO (SEE USEFUL DEFINITIONS AND INSTRUCTIONS)
WILL THE PROJECT BE CONSTRUCTED IN STAGES? ❑YES XNO
PROPOSED STARTING DATE:Summer 2004
ESTIMATED DURATION OF ACTIVITY: 2 Weeks
9.CHECK IF ANY TEMPORARY OR PERMANENT STRUCTURES WILL BE PLACED:
❑WATERWARD OF THE ORDINARY HIGH WATER MARK OR LINE FOR FRESH OR TIDAL WATERS,AND/OR
❑WATERWARD OF MEAN HIGHER HIGH WATER LINE IN TIDAL WATERS
10.WILL FILL MATERIAL(ROCK,FILL,BULKHEAD,OR OTHER MATERIAL)BE PLACED:
❑WATERWARD OF THE ORDINARY HIGH WATER MARK OR LINE FOR FRESH WATERS? IF YES,VOLUME(CUBIC YARDS) /AREA (ACRES
0 WATERWARD OF THE MEAN HIGHER HIGH WATER FOR TIDAL WATERS? NO IF YES,VOLUME(CUBIC YARDS) AREA (ACRES)
11.WILL MATERIAL BE PLACED IN WETLANDS? ❑YES X NO
IF YES:
A IMPACTED AREA IN ACRES:
B. HAS A DELINEATION BEEN COMPLETED? IF YES,PLEASE SUBMIT WITH APPLICATION. ❑YES X NO
C. HAS A WETLAND REPORT BEEN PREPARED? IF YES,PLEASE SUBMIT WITH APPLICATION. ❑YES XNO
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 LIST OF HYDRIC SOILS.SOILS INFORMATION CAN BE OBTAINED
FROM THE NATURAL RESOURCES CONSERVATION SERVICE(NRCS):
G WILL PROPOSED ACTIVITY CAUSE FLOODING OR DRAINING OF WETLANDS? ❑YES X NO
IF YES,IMPACTED AREA IS—ACRES OFDRAINED WETLANDS,
NOTE: If your project will impact greater than 14 of an acre of wetland,submit a mitigation plan to the Corps and Ecology for approval along with the JARPA form
NOTE:a 401 water quality certification will be required from Ecology in addition to an approved mitigation plan N your project impacts wetlands that are: a)greater than M acre in size,or
b)tidal wetlands or wetlands adjacent to tidal water Please submit the JARPA form and mitigation plan to Ecology for an individual 401 certification if a)or b)applies.
12. STORMWATER COMPLIANCE FOR NATIONWIDE PERMITS ONLY.
THIS PROJECT IS(OR WILL BE)DESIGNED TO MEET ECOLOGY'S MOST CURRENT STORMWATER MANUAL,OR AN ECOLOGY APPROVED LOCAL STORMWATER MANUAL ❑YES ❑NO
IF YES-WHICH MANUAL WILL YOUR PROJECT BE DESIGNED TO MEET
If NO-FOR CLEAN WATER ACT SECTION 401 AND 404 PERMITS ONLY-PLEASE SUBMITTO ECOLOGY FOR APPRO VAL, ALONG WITH THIS JARPA APPLICATION,DOCUMENTATION THA T
MONSTRATES THE STORMWA TER RUNOFF FROM YOUR PROJECT OR ACTIVITY WILL COMPLY WITH THE WATER QUALITY STANDARDS,WAC 173.201(A)
13.WILL EXCAVATION OR DREDGING BE REQUIRED IN WATER OR WETLANDS? ❑YES XNO
IF YES:
A. VOLUME: (CUBIC YARDS)/AREA (ACRES)
B. COMPOSITION OF MATERIAL TO BE REMOVED:
C. DISPOSAL SITE FOR EXCAVATED MATERIAL:
D. METHOD OF DREDGING:
14.HAS THE STATE ENVIRONMENTAL POLICY ACT(SEPA)BEEN COMPLETED? ❑YES XNO
SEPA LEAD AGENCY:Mason County SEPA DECISION: DNS,MDNS,EIS,ADOPTION,EXEMPTION
DECISION DATE(END OF COMMENT PERIOD):
SUBMIT A COPY OF YOUR SEPA DECISION LETTER TO WDFW AS REQUIRED FOR A COMPLETE APPLICATION
15.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,FEDERAL ENERGY REGULATORY
COMMISSION LICENSE(FERC),FOREST PRACTICES APPLICATION,ETC.)ALSO INDICATE WHETHER WORK HAS BEEN COMPLETED AND INDICATE ALL EXISTING WORK ON DRAWINGS.
NOTE:FOR USE WITH CORPS NATIONWIDE PERMITS,IDENTIFY WHETHER YOUR PROJECT HAS OR WILL NEED AN NPDES PERMIT FOR DISCHARGING WASTEWATER AND/OR STORMWATER
TYPE OF APPROVAL ISSUING AGENCY IDENTIFICATION DATE OF APPLICATION DATE APPROVED COMPLETED?
NO.
PA WDFW
horeline Exemption Mason County
uilding Permit Mason County
16.HAS ANY AGENCY DENIED APPROVAL FOR THE ACTIVITY YOU'RE APPLYING FOR OR FOR ANY ACTIVITY DIRECTLY RELATED TO THE ACTIVITY DESCRIBED
HEREIN?❑YES X NO IF YES,EXPLAIN:
SECTION B-Use for Shoreline and Corps of Engineers permits only:
7a. TOTAL COST OF PROJECT. THIS MEANS THE FAIR MARKET VALUE OF THE PROJECT,INCLUDING MATERIALS,LABOR,MACHINE RENTALS,ETC.
$22,000.00
17b. IF A PROJECT OR ANY PORTION OF A PROJECT RECEIVES FUNDING FROM A FEDERAL AGENCY,THAT AGENCY IS RESPONSIBLE FOR ESA CONSULTATION. PLEASE INDICATE IF YOU
ILL RECEIVE FEDERAL FUNDS AND WHAT FEDERAL AGENCY IS PROVIDING THOSE FUNDS SEE INSTRUCTIONS FOR INFORMATION ON ESA—
FEDERAL FUNDINIG ❑YES XNO IF YES,PLEASE LIST THE FEDERAL AGENCY
8.LOCAL GOVERNMENT WITH JURISDICTION:
Mason County
9.FOR CORPS,COAST GUARD,AND DNR 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
APPLICATION IS HEREBY MADE FOR A PERMIT OR PERMITS TO AUTHORIZE THE ACTIVITIES DESCRIBED HEREIN. I CERTIFY THAT I AM FAMILIAR WITH THE
NFORMATION CONTAINED IN THIS APPLICATION,AND THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF,SUCH INFORMATION IS TRUE,COMPLETE,AND
CCURATE. I FURTHER CERTIFY THAT I POSSESS THE AUTHORITY TO UNDERTAKE THE PROPOSED ACTIVITIES. I HEREBY GRANT TO THE AGENCIES TO WHICH
HIS 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.
SIGNATURE OF APPLICANT DATE
I NAl41RE O UTHORIZED GENT ATE
DATE
I H EB DESIG TE
TO CT MY A ENT MATTERS RELATED TO THIS APPLICATION FOR PERMIT(S). I UNDERSTAND THAT IF A FEDERAL PERMIT IS ISSUED,
I UST SI TH PERMIT.
SIGNATURE OF APPLICANT DATE
SIGNATURE OF LANDOWNER(EXCEPT PUBLIC ENTITY LANDOWNERS,E.G.DNR)
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 OFFICIAL
A. Nature of the existing shoreline. (Describe type of shoreline, such as marine,stream, lake, lagoon, marsh, bog,swamp,flood
plain,floodway, delta;type of beach, such as accretion,erosion, high bank, low bank,or dike; material such as sand,gravel, mud,clay,
rock, riprap;and extent and type of bulkheading, if 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
level, indicate the approximate location of and number of residential units,existing and potential,that will have an obstructed view:
C. If the application involves a conditional use or variance,set forth in full that portion of the master program which provides that
the proposed use may be a conditional use, or, in the case of a variance,from which the variance is being sought:
These Agencies are Equal Opportunity and Affirmative Action employers.
For special accommodation needs,please contact the appropriate agency in the instructions.