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Home My WebLink AboutSHX2016-00054 JARPA - SHX Permit / Conditions - 9/12/2016 y014-STATFO MASON COUNTY �P C Department of Community Services AL Mo a o N Planning Division o Z T 615 W Alder St, Shelton, WA 98584 P N Y Y (360)427-9670 OJ �O 1864 Exemption from Shoreline Management Act Case No.: SHX2016-00054 Substantial Development Permit Requirement The Proposal By: JOSETTE CATRON 701 E CRONGQUIST RD ALLYN, WA 98524 Parcel Number: 122321092032 Site Address: 701 E CRONQUIST RD ALLYN To undertake the following development: ROCK BULKHEAD REPLACEMENT Within CASE INLET 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: C-normal protective bulkhead Please contact Kell McAboy at ext 365 if you have any questions. Issued-9/12/2016 Authorized Local G v rnment Official SHX2016-00054 September 12, 2016 � &qd 961(o cx�7� D-- MDate received: - s US Army Corps ; AUG 10 2016 i WASHINGTON STATE of Engineers• Same DOWO Joint Aquatic Resources Permit Agency refe$4by5 Application (JARPA) Form',2 Tax Parcel#(s): USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE 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) [hell ] r-AT Rn N4 B "U'r9 D 12MPLA.C-GMQ:ty T Part 2—Applicant The person and/or organization responsible for the project. he[ ei 2a. Name (Last, First, Middle) CAT"R0t1 3o SETTS 2b. Organization(If applicable) 2c. Mailing Address (Street or PO Box) --D ( 9. c#.PNQovtT 2d. City, State, Zip AL4.uoi , w A 995`�¢ 2e. Phone(1) 2f. Phone(2) 2g. Fax 2h. E-mail 1 Additional forms maybe 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 http://www.nws.usace.a rmy.mi I/Missions/Civi lVVorks/Regulatory/Perm RGuidebook/EndanoeredSpecies.aspx. • 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. 2 To access an online JARPA form with[help]screens,go to http://www.epermitting.wa.gov/site/alias resourcecenter/iarpa iarpa form/9984harpa form.aspx. For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or helpOora.wa.00v. JARPA Revision 2012.2 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.) hey 3a. Name (Last, First, Middle) D (iLL.%f MicHi46L_ W 3b. Organization (If applicable) M w D Coos 0 i--TAA/ 'S I-L C 3c. Mailing Address (Street or Po Box) �- ) N r. L_4 AJ o®n1 R J5 3d. City, State, Zip gEL-PA I -1 WA 191 S SZO 3e. Phone(1) 3f. Phone(2) 3g. Fax 3h. E-mail (360 1 keal(4 tact✓exq bi e.cw� 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. hel X 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 JARPA Attachment E to apply for the Aquatic Use Authorization. 4a. Name (Last, First, Middle) 41b. 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 JARPA Revision 2012.2 Part 5—Project Location(s) Identifying information about the property or properties where the project will occur. h[ ell ❑There are multiple project locations (e.g. linear projects). Complete the section below and use JARPA Attachment B for each additional project location. 5a. Indicate the type of ownership of the property. (Check all that apply.) n[ elol �. Private ❑ Federal ❑ 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.) h[ elp] -�+01 F.. CP'O N q u l C T- Ci D 5c. City, State, Zip(If the project is not in a city or town,provide the name of the nearest city or town.) [hell ] hILVIJ I WA IS 5-.2-4- 5d. County nel /4 A-5 o14 5e. Provide the section, township, and range for the project location. h� eM 1/4 Section Section Township Range Iv w 32. t War W. 5f. Provide the latitude and longitude of the project location. nel • Example:47.03922 N lat./-122.89142 W long. (Use decimal degrees-NAD 83) -(: 41 • 15 39 O 3 AJ "A)er. : -- 1�2.- 8Z.71-GS w 5g. List the tax parcel number(s)for the project location. hm ] - The local county assessor's office can provide this information. 1 ':2-231- 10 - 9'20 32 5h. Contact information for all adjoining property owners. (If you need more space, use DARPA Attachment C.) h( elpl Name 1 CC Mailing Address Tax Parcel #(if known) VrA"5,�O/�AS �. ��• F-- C-RciNQUIS'r P-P 1S�3^ '.1dwcM Aw-` tt i tv A q % 5 24 MulLplkY iwo"AC (o(oo E. c(-toNcputvr XD I2232- �o- 92�31 GyP-1171}IAr A l-LYN , 4/1r 9 8 524 JARPA Revision 2012.2 z Z�OZ UOISinaa ddadr �.t 5 a 1- ss� v✓ i_'o ov Q%tJ 01. --1 I W i.L V-q ' 4Vd dam-, r-19 I n adt7t.!� •4 oy £-VM -dew e goepe pue `uoijeool joafoid ay} o}Aemg5iq Isasolo aqj woij suoijoaaip buiniap apinoJd -dg [ 7 'uoI}ipuoo }uairno pue (s)asodmd nagj 5uipnloui `Aliadoid ay}uo (punoi6 moloq pue anoge) sain;onils aqj aguosaa •og [ iay 'pass Alluaiino aje sai}jadojd juaoefpe aqj nnoq aquosaa •ug [Tie-41 'pasn Alluaimo sl 4adoid aqj nnoq aquosaa •uag aqj uo suoilipuoo jejigeq pue u01jeja6an eqj equosap Appo 'Ig nnou� 1,uoa ❑ oN g sGA❑ �74eQ LL2 Fd-jaq-] �uieldpoolj jeoA-001, e uigl!m ease loofoid aq}jo fed Aue sl •)19 -1-9 m 95 7 [ P-q ,uoijeool joafojd aqj of lueoefpe jo uo (spuellam uegj jaq}o) saipogjajenn Ile }sib JS -WIN [di—eq] ,uoijeool joafoid eq}o}lueoefpe jo uo spueljann Ile Isis •ig Part 6—Project Description 6a. Briefly summarize the overall project. You can provide more detail in 6b. of eip] AEPA) 01 E!{bs1 0 rJ "", oI- P-"'C-t-- BvL K-hLE7A D • 5-tt-(te14NjC l:3v�KttGA D , )6 d i"OnQa , 4' Ff<14" , .4' w ( DE AT BASS/ 3' ,4T. "faP1 4 3 MAA) R-eC*-- . L-0C+4-�D "A-A.,D WMLD o t+w 6b. Describe the purpose of the project and why you want or need to perform it. [help] 6c. Indicate the project category. (Check all that apply) hf eiM ® Maintenance ❑ Environmental Enhancement 6d. Indicate the major elements of your project. (Check all that apply) [help] ❑ Aquaculture El Retaining Wall ❑ ❑ Culvert El Float Bank Stabilization ❑ Dam /Weir ❑ (upland)Floating Home❑ Boat House Dike / Levee/JettyGeotechnical ❑ Road ❑ Boat Launch Survey ❑ ❑ ❑ Scientific ❑ Ditch ❑ Measurement ❑ Boat Lift El Land Clearing ❑ Device Bride Dock/ Pier ❑ 9 ❑ ❑ Marina / Moorage El Stairs ® Bulkhead ❑ Dredging Mining Stormwater facility ❑ Ferry Terminal Fence Buoy ❑ ❑ Outfall Structure ❑ Swimming Pool Channel ❑ ❑ Piling/Dolphin ❑ Utility Line ❑ Modification ❑ Fishway ❑ Raft ❑ Other: JARPA Revision 2012.2 z'ZLOZ uoisiAaa ddwr MOUE l,uoa OND sad Fd-ieq-1 �spuellann loedwi loafojd aql II!M -qL algeo!l e ION [aiag7 -spuellann of sloedwi asJanpe az!w!u!w pue pone of pau6!sap uaaq seq loafoid aql moq aquosa4 TL [mil (-g lied of digs 'auou aie aiagl ll) -ease loofoid agl of lueoefpe jo uo sjallnq puellann jo spuellem aae ajagl l! ajaq �Oago❑ uoije6ij!W pue spedwi :spueIIOM-1 :PBd nnou� 000 0 oN X saA❑ spun;6wpiAoad Aouabe pea Isil 'saA;1 • [ i� �buipunl JeJapal eA!aoaJ loafojd aql to uo!ljod Aue ll!M 'ug ,�1..1r w 1.15� �121�*ac..rrvo� Q�y lL7 PP-q-1 ola 'sleluai au!goew 'jogel 'sleualew 6u!pnlou! 'loafojd agl to anleA la�Jew J!ed •69 a luawgoelly dd2N aaS :alep pub :ajep :pejs /"o 0 iM -VrvAgr bat -,-j 'YFiIu eye;s jo asegd goea jo salep pua pue liels eqj Isil of Cl 4uawgoe}}y dd2]df asn 'sabels jo sasegd uw palonj;suoo eq ll!m joafoid ag;;i . Piagl Oeakq}uon) �uollonjlsuoo loefoid jol salep pue pue }jets paled!o!lue eql aie legM •19 S-II V-L:26 -d';Y 1—S Wn1MWd 5 • ;t Tara z10 49-L 1V ar40(74-19 H$n'7j s1 7j�zl zjo j oj� -7i1nn S�'►Vdis �,v��n s�x�� a (5�3yalnv� `7 M`�L 14 d 1�' Qd}� rylvt" jc 3� d c1 rr CrdV ?.LV j VZ)x-g 1 rl NV Q '1 S 1�C5 uieldpoog jeaA-oo� eql uwgl!m aje sal;IAIIOe goigM aIeoipUI . ApogaalenA lsajeau aql of uoilelaj ui jn000 limn luawala goea ajagm Ali;uapI . [ ieq -pasn aq of luawd!nbe pue spoglaw uoilonjlsuoo oil!oads apnloul -pg ui pa�oago luawale loafoid pea lonilsuoo of ueld nog(nnoq aquosaQ •ag 7c. Will the project impact wetland buffers? Ihelpl ❑ Yes [A No ❑ Don't know 7d. Has a wetland delineation report been prepared? hel • If Yes,submit the report, including data sheets,with the JARPA package. ❑ Yes X No 7e. Have the wetlands been rated using the Western Washington or Eastern Washington Wetland Rating System? hel • If Yes, submit the wetland rating forms and figures with the JARPA package. ❑ Yes g No ❑ Don't know 7f. Have you prepared a mitigation plan to compensate for any adverse impacts to wetlands? help] • If Yes,submit the plan with the DARPA package and answer 7g. • If No,or Not applicable, explain below why a mitigation plan should not be required. ❑ Yes RNo ❑ Not applicable _ 7g. Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was used to design the plan. h[ elp] 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. h[ elp 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 type4 (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. �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. 4Creation(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: JARPA Revision 2012.2 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. h[ eij "f,6' 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. h[ eppj 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.) hf eM 9 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. [held ❑Not applicable s V14< CA b L S L--t-ru D 4)k R-O FP.-OM d",NaP.Y bN 8A kWrEM Co ttw) 8b. Will your project impact a waterbody or the area around a waterbody? hel ❑Yes VSNo JARPA Revision 2012.2 8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland waterbodies? [help] • 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 KNo ❑ Not applicable 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. [help] Be. Summarize impact(s) to each waterbody in the table below. h( elp] Activity (clear, Waterbody Impact Duration of Amount of material Area (sq. ft. or dredge, fill, pile name' location' impact' (cubic yards) to be linear ft.) of drive, etc.) placed in or waterbody removed from directly affected j waterbody C CkrE s&Mwrje l WSW< V '>4 166 FeCT RE u+c.E 8 -YO 3 If no official name for the waterbody exists,create a unique name(such as"Stream V)The name should be consistent with other documents provided.2 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. 3 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. hf eM $¢- YD 3 R,&c K P&qm Lo ck L (P u,*R Xy PLACE l-AN D "A- D r FUM OR-PI NARY W r:rfi w,4T v r LAup F"AA S #o Rs "fUE-7 JARPA Revision 2012.2 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. [heipl 2.1- YO 3 "ATWO Sa!L 7V SPAEA.O A-cRo SS 5 t TS 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. [helgi Agency Name Contact Name Phone Most Recent vv��r Date of Contact M ASON ow—p K<-Li• MCA 90Y (360 )42�•—`]6� �vr.aE 30� ?O►b 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? [help] • 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.ecy.wa.qov/programs/wq/303d/. ❑Yes ❑ No N/A- 9c. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? h[ eM - Go to http://cfpub.epa.gov/surf/locate/index.cfm to help identify the HUC. ? Dig rJ'r KNo-t,) 9d. What Water Resource Inventory Area Number (WRIA#) is the project in? [help] Go to http://www.ecy.wa.gov/services/gis/maps/wria/wria.htm to find the WRIA#. W Pq A 14- JARPA Revision 2012.2 9e. Will the in-water construction work comply with the State of Washington water quality standards for turbidity? [help] • Go to http://www.ecy.wa.gov/programs/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? [help] • If you don't know, contact the local planning department. • For more information, go to: http://www.ecy.wa.gov/programs/sea/sma/laws rules/173-26/211 designations.html. ❑ Rural XUrban ❑ Natural ❑Aquatic ❑Conservancy ❑ Other 9g. What is the Washington Department of Natural Resources Water Type? [help] • Go to httn://www.dnr.wa.gov/BusinessPermits/Topics/ForestPracticesApplications/Pages/fp watertypinq.aspx for the Forest Practices Water Typing System. X 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? [help] • If No, provide the name of the manual your project is designed to meet. ❑Yes ❑ No NA Name of manual: 9i. Does the project site have known contaminated sediment? [help] If Yes, please describe below. ❑Yes 9 No 9j. If you know what the property was used for in the past, describe below. h( eM iiA- 9k. Has a cultural resource (archaeological) survey been performed on the project area? hf eM- If Yes, attach it to your JARPA package. ❑Yes WNo JARPA Revision 2012.2 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. hf elpl P-vJO*T Sovwsp Gtt l NO01G 13W..L, —MOOT 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. hf eM 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.ecy.wa.gov/opas/. • Governor's Office for Regulatory Innovation and Assistance at (800) 917-0043 or help _ora.wa.gov. • For a list of addresses to send your JARPA to, click on agency addresses for completed JARPA. 10a. Compliance with the State Environmental Policy Act(SEPA). (Check all that apply.) Ll M For more information about SEPA,go to www.ecy.wa.gov/programs/sea/sepa/e-review,htmi. ❑A copy of the SEPA determination or letter of exemption is included with this application. ®,A SEPA determination is pending with µ ASP#J GO• (lead agency). The expected decision date is q/ ❑ I am applying for a Fish Habitat Enhancement Exemption. (Check the box below in yob.) h( elpl ❑ 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. JARPA Revision 2012.2 10b. Indicate the permits you are applying for. (Check all that apply.) h( elp) LOCAL GOVERNMENT Local Government Shoreline permits: ❑ Substantial Development ❑ Conditional Use ❑ Variance Shoreline Exemption Type (explain): Other City/County permits: ❑Floodplain Development Permit ❑Critical Areas Ordinance STATE GOVERNMENT Washington Department of Fish and Wildlife: R Hydraulic Project Approval (HPA) ❑Fish Habitat Enhancement Exemption —Attach Exemption For, Effective July 10, 2012, you must submit a check for$150 to Washington Department of Fish and Wildlife, unless your project qualifies for an exemption or alternative payment method below. Do not send cash. Check the appropriate boxes: ❑$150 check enclosed. Check# Attach check made payable to Washington Department of Fish and Wildlife. ❑ Charge to billing account under agreement with WDFW. Agreement# ❑My project is exempt from the application fee. (Check appropriate exemption) [] HPA processing is conducted by applicant-funded WDFW staff. Agreement# ❑ Mineral prospecting and mining. ❑ Project occurs on farm and agricultural land. (Attach a copy of current land use classification recorded with the county auditor, or other proof of current land use.) Pqe ect is a modification of an existing HPA originally applied for, prior to July 10, 2012. HPA# Washington Department of Natural Resources: ❑ Aquatic Use Authorization Complete JARPA 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: ❑Private Aids to Navigation (for non-bridge projects) JARPA Revision 2012.2 Part 11—Authorizing Signatures Signatures are required before submitting the JARPA package. The JARPA package includes the JARPA form, project plans, photos, etc. [tpjpJ 11 a. Applicant Signature (required) him 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 the 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 the property where the project is located to inspect the project site or any work related to the project. (initial) Vk Applicant Printed Name Applicant ignature Date 11 b. Authorized Agent Signature h[ elp] 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 11 c. Property Owner Signature (if not applicant) Lelpi 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. C OL liL 0 V\) 40 (0 Property Owner Printed Name Property O er 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: ENV-019-09 rev. 08/2013 JARPA Revision 2012.2