HomeMy WebLinkAboutJARPA 2009 - SHX Application - 8/31/2009 200 AGENCY USE ONLY
yn ,
US Army Corps ' Date received:
WASHINGTON STATE SAEeDI'ttrid
Joint Aquatic Resources Permit
Application (DARPA) Form [hel
Agency reference#:
USE BLACK OR BLUE INK TO ENTER ANSWERS IN WHITE SPACES BELOW. Tax Parcel#(s):
Part 1—Project Identification
Unique project information that makes it easy to identify. h[ gm '--------------------------------------
1 a. Unique Project Identifier Number (UPI #) hel
• Don't have one yet?Get one at http://www.epermittin.g.wa.aov or call the Washington Governor's Office of Regulatory Assistance
at(800)917-0043.
784947-09-01
1 b. Project Name (Examples: Smith's Dock or Seabrook Lane Development) [bglpj
Tacoma Power: Potlatch Transmission Line — North Bay Geotechnical Investigation
Part 2—Applicant
The person or organization legally responsible for the project. hel
2a. Name (Last, First, Middle)and Organization (if applicable)
Leach, Pat— Principal Engineer—Tacoma Power Utilities
2b. Mailing Address (Street or PO Box)
3628 South 35th Street
2c. City, State, Zip
Tacoma, Washington 98409-3192
2d. Phone(1) 2e. ,Phone(2) 2f. Fax 2 . E-mail
(253.502.8122) (cell: 253.307.2454) (253.396.3085) pleach@cityoftacoma.org
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.) Lneij)l
3a. Name (Last, First, Middle) and Organization (if applicable)
Swarts, Scott, Alan — Fish and Wildlife Biologist— David Evans and Associates, Inc.
3b. Mailing Address (Street or PO Box)
415 — 118th Avenue SE
3c. City, State, Zip
Bellevue, Washington 98005-3518
3d. Phone(1) 3e. Phone(2) 3f. Fax 3 . E-mail
(425.519.6593) (425.519.6500) (425.519.5361) sasw@deainc.com
JARPA 2009 Page 1 of 13 I
Part 4-Property Owner(s) Lel
Contact information for people or organizations owning the property(ies)where the project will occur. hel
❑ 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 use JARPA Attachment A for each
additional property owner.
4a. Name (Last, First, Middle)and Organization (if applicable)
Washington Department of Fish and Wildlife
4b. Mailing Address (Street or PO Box)
Capitol Way North
4c. City, State, Zip
Olympia, WA 98501-1091
4d. Phone(1) 4e. Phone(2) 0. Fax 4 . E-mail
(360.902.2200) ( ) (360.902.2156)
Part 5-Project Location(s)
Identifying information about the property or properties where the project will occur. hel
❑ There are multiple properties or project locations (e.g., linear projects). Complete the section below and use
JARPA Attachment B for each additional property.
5a. Street Address (Cannot be a PO Box. If there is no address,provide other location information in 5n.) h( eU
North Bay, southern Puget Sound.
5b. City, State, Zip(If the project is not in a city or town, provide the name of the nearest city or town.) h[ eU
Allyn, Washington is the nearest town.
5c. County hei
Mason
5d. Provide the section, township, and range for the project location. hei
'/. Section Section Township Range
SW 16 22N 1 W
5e. Provide the latitude and longitude of the project location. [help]
• Example:47.03922 N lat./-122.89142 W long
Approximate middle of line mid-way across North Bay = 47.390210 N by 122.818611 W.
5f. List the tax parcel number(s)for the project location. [heipi
• The local county assessor's office can provide this information.
122163280310
5g. Indicate the type of ownership of the property. (Check all that apply.) h[ eld
® State Owned Aquatic Land ❑ Tribal ❑ Private
❑ Other publicly owned (federal,state, county, city, special districts like schools, ports,etc.)
JARPA 2009 Page 2 of 13
5h. Contact information for all adjoining property owners, lessees, etc. (If you need more space, use JARPA
Attachment C.) [help]
Name Mailing Address Tax Parcel # (if known)
Aquatic lands in North Bay with no 122178888888
ownership data in Mason County
Assessor database.
122162222222
Aquatic lands in North Bay with no 122212180123
ownership data in Mason County
Assessor database.
---— --................__.........---.........._.............._....-_.._..---—..........--......_
122212222222
- - ------------
Aquatic lands in North Bay with no 122174480320
ownership data in Mason County
Assessor database.
Taylor United Inc. 130 SE Lynch Road 122164480320
(Oyster Lands on west side of North Shelton, WA 98584-8615 This parcel is not adjoining, but
Bay) very close.
5i. Is any part of the project area within a 100-year flood plain? hel
® Yes ❑ No ❑ Don't know
5j. Briefly describe the vegetation and habitat conditions on the property. LbeM
North Bay, in the vicinity of the transmission corridor, is mapped by the National Wetland Inventory as being estuarine
subtidal and intertidal wetlands. Intertidal wetlands occur along the shoreline and contain an aquatic bed(E2AB), while the
central area is subtidal with an unconsolidated bottom(EIUBL). Attachments 1 -4 contain site maps and photos.
A site visit of the project area was conducted on May 11,2009 during the period of a minus 1.9 low tide. A large percentage
of the substrate was exposed, except the bases of both towers were still submerged below water. The uplands along the
shoreline are generally forested and dominated by both coniferous and deciduous species, with Douglas fir (Pseudotsuga
menziesii), western red-cedar (Thuja plicata), and red alder(Alnus rubra) being the dominant species. Houses are present
but generally sparse in the immediate project vicinity. A Washington Department of Fish and Wildlife(WDFW)parking lot
and beach access point is located on the eastern shoreline. The vegetation in this area includes numerous non-native species
such as Japanese knotweed(Polygonum cuspidatum),poplar trees(Populus sp.), and introduced shrubs.The substrate along
the upper shoreline is dominated cobble and gravel where sloped, but once the topography becomes flat the substrate is
dominated by muck. Aquatic vegetation along the upper tide line consisted primarily of pickleweed (Salicornia virginica),
Lyngby sedge (Carex lyngbyei), and rockweed (Fucus gardneri). There are commercial oyster beds along the west side of
the bay and the surface is scattered with Pacific oysters (Crassostrea gigas) and the shells of cockles (Clinocardium
nuttallii), butter clams (Saxidomus giganteus), manila clams (Tapes philippinarum), snails, horse clams (Tresus capax),
bent-nose clams (Macoma nasuta), blue mussels (Mytilus edulus), and a few sand dollars (Dendraster excentricus) and
moon snail (Polinices lewisii) egg cases. Acorn barnacles (Balanus glandula) encrust most of the rocks and shells. Aquatic
vegetation is generally sparse but sea lettuce(Ulva fenestrata) is the dominant species, with smaller amounts of both brown .
and green filamentous algae, and laminaria (Laminaria saccharina) that probably washed up on the mud flats from deeper
waters. The shells of a few Dungeness crabs(Cancer magister), as well as a couple live sea stars(Pisaster ochraceus)were
observed.Numerous others species not observed during the site visit or mentioned above utilize the mud flats of North Bay.
5k. Describe how the property is currently used. hel
Land Use for Parcel Number 122163280310 is defined as oyster lands. There are two existing sets of power transmission
towers within the existing right-of-way.
JARPA 2009 Page 3 of 13
51. Describe how the adjacent properties are currently used. hel
Both sets of poles are in the mud flats of North Bay and defined as oyster lands, but other shellfish are present. Use is
primarily recreational along the eastern shoreline. Taylor United apparently has commercial oyster beds to the west of the
poles along the western shoreline. This parcel (122164480320) in not immediately adjacent to the transmission towers but
very close.
5m. Describe the structures (above and below ground) on the property, including their purpose(s). hI eM
Two sets of power transmission towers for the Potlatch Line are located in North Bay. The Potlatch transmission line was
originally constructed in 1925 to transmit electrical power from the Cushman Hydro Project to the City of Tacoma. Each
tower is approximately 120 feet tall and at least one of them is leaning. Attachment 5 is a copy of the Map and Profile from
1925.
5n. Provide driving directions from the closest highway to the project location, and attach a map. hei
From Interstate 5 (1-5) in Tacoma, travel northwest on State Route (SR) 16 toward and past Gig Harbor to SR 302 near
Purdy. Stay on SR 302 west (also known as Gig Harbor-Longbranch Hwy). Stay on SR 302 west, which is referred to as
Elgin Clifton RD KP N to the west of Key Peninsula Highway. SR 302 follows the east side of North Bay. To access the
eastern tower, look for and park at the WDFW beach access parking lot, which is located approximately one mile north of
Victor, Washington on the right (beach side) of the road. To access the western tower, continue north on SR 302 toward
Coulter Creek Hatchery, which is located at the northern tip of North Bay. SR 302 changes to SR 3 on the west side of
North Bay. Travel south on SR 3 toward Allyn, Washington. To access the west tower, park at the Allyn Beach Park and
walk north along the shoreline. Note there are commercial oyster operations in this area. The beach is very mucky in the
intertidal zone.
Part 6—Project Description
6a. Summarize the overall project. You can provide more detail in 6d. hel
The project is a geotechnical investigation of the substrate near two sets of existing transmission towers. The substrate will
be investigated by drilling three holes approximately 100 feet deep. One hole will be drilled near each tower and a third will
be drilled between both towers. More specifically, the first boring will be 50 feet east of the west pair of structures and
between the two circuits. The second will be 50 feet west of the east pair of structures and between the two circuits. The
third boring will be mid-span between the east and west pairs of structures and off-set 50 feet south of the south circuit.
6b. Indicate the project category. (Check all that apply.) h
❑ Commercial ❑ Residential ❑ Institutional ❑ Transportation ❑ Recreational
® Maintenance ❑ Environmental Enhancement
6c. Indicate the major elements of your project. (Check all that apply.) hel
❑ Aquaculture ❑ Culvert ❑ Float ❑ Road
❑ Bank Stabilization ❑ Dam /Weir ® Geotechnical Survey ❑ Scientific Measurement
❑ Boat House ❑ Dike / Levee /Jetty ❑ Land Clearing Device
❑ Boat Launch ❑ Ditch ❑ Marina / Moorage ❑ Stairs
❑ Boat Lift ❑ Dock/ Pier ❑ Mining ❑ Stormwater facility
❑ Bridge ❑ Dredging ❑ Outfall Structure ❑ Swimming Pool
❑ Bulkhead ❑ Fence ❑ Piling ❑ Utility Line
❑ Buoy ❑ Ferry Terminal ❑ Retaining Wall (upland)
❑ Channel Modification ❑ Fishway
❑ Other:
JARPA 2009 Page 4 of 13
6d. Describe how you plan to construct each project element checked in 6c. Include specific construction
methods and equipment to be used. Leif
• Identify where each element will occur in relation to the nearest waterbody.
• Indicate which activities are within the 100-year flood plain.
Both sets of towers and the three proposed areas to be drilled are within North Bay, which is mapped as being within a 100-
year floodplain. The three borings will be completed using a barge with a truck-mounted drilling rig. The barge is
approximately 35 feet long by 20 feet wide. The barge will be launched at the public boat ramp in Allyn, Washington. The
boring depth will be approximately 100 feet below the mudline. Due to tidal fluctuations and shallow water, it will likely be
necessary to ground the barge during exploration.
The borings will be drilled using mud-rotary techniques. Drilling fluids will be bentonite, which lubricate and help reduce
equipment ware.The bore hole diameter will be approximately 8 inches.The drilling fluids,drill head,and drill rods will be
contained within a continuous 12-inch-diameter steel casing that extends from the barge to below the mudline.
To provide an indication of the density of soil, Standard Penetration Test (SPT) sampling will be performed at 2.5- and 5-
foot intervals. The SPT is conducted by lowering a 2-inch diameter split spoon sampler to the bottom of the 8-inch bore
hole, and driving the sampler 18 inches into the soil. The sampler is driven using a 140-pound hammer free-falling 30
inches.The hammer is operated by an automatic trip mechanism operating on the drill rig(i.e. auto hammer).
After boring is complete, the bore hole will be backfilled in accordance with Washington State Department of Ecology
(Ecology) standards with bentonite chips, and all drilling equipment will be retrieved and moved to the next drilling
location. The drill cuttings will be drummed and disposed of off site. When the last boring is complete, the drill rig and
associated equipment will be removed from the site.
6e. What are the start and end dates for project construction? (month/year)
• If the project will be constructed in phases or stages, use JARPA Attachment D to list the start and end dates of each phase or
stage.
Start date: August 31, 2009 End date: September 4, 2009 ❑ See JARPA Attachment D
6f. Describe the purpose of the work and why you want or need to perform it. heI
The Potlatch Line was originally constructed in 1925 to transmit the electrical output from the Cushman Hydro Project to
the City of Tacoma. There are two sets of towers in North Bay,and the western most set of tower foundations have settled,
causing them lean towards each other.The purpose of the proposed geotechnical investigation is to provide data for the
geotechnical report, foundation analysis,and alternative selection process.The data collected during the geotechnical
investigation will also be used to assist in determining seismic and wave loading criteria.
6g. Fair market value of the project, including materials, labor, machine rentals, etc. LtLeU
$5,000,000
6h. Will any portion of the project receive federal funding? heI
• If yes, list each agency providing funds.
❑ Yes ® No ❑ 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.)
JARPA 2009 Page 5 of 13
7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. nei
❑ Not applicable
After drilling is complete,the bore hole will be backfilled in accordance with Ecology standards with bentonite chips, and
all drilling equipment will be retrieved and moved to the next drilling location.The drill cuttings will be drummed and
disposed of off site.
Construction Conservation and Performance Measures
• A Spill Prevention Control and Countermeasures(SPCC)Plan will be developed and implemented for the project to
ensure that all pollutants and products will be controlled and contained.
• Construction impacts will be confined to the minimum area necessary to complete the project.
• All Best Management Practices(BMPs)will be installed according to Ecology standards and will be inspected and
maintained throughout the life of the project.
• There will be no discharge of oil,fuels,or chemicals to surface waters,or onto land where there is a potential for
reentry into surface waters.
• No cleaning solvents or chemicals used for tools or equipment cleaning will be discharged to surface waters.
• The contractor will regularly check fuel hoses,oil drums, oil or fuel transfer valves, fittings,etc. for leaks,and will
maintain and store materials properly to prevent spills.
No pollutants are expected to be discharged during sampling. However, the SPCC Plan will provide methods to minimize
spillage and address spillage should that occur.The SPCC Plan will include the following elements:
• Site-and project-specific information;
• Spill prevention,control and contamination methods;
• Response protocols and reporting procedures for construction-related leaks or spills;
• Contingency plan and provisions;
• Waste disposal methods and locations;
• Proper management of oil, gasoline, and solvents used in the operation and maintenance of construction
equipment.
The SPCC Plan will also ensure that equipment remains free of external petroleum-based products prior to entering the
work area and during the work, and for making any necessary repairs prior to returning the equipment to operation in the
work area.The SPCC Plan will be consistent with the State of Washington Oil Spill Contingency Plan.
JARPA 2009 Page 6 of 13
7b. Will the project impact wetlands? hei
® Yes ❑ No ❑ Don't know
7c. Will the project impact wetland buffers? heM
❑ Yes ® No ❑ Don't know
7d. Has a wetland delineation report been prepared? hei
• 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? bei ]
• 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? hf elpl
• If yes,submit the plan with the JARPA package.
❑ Yes ❑ No ® Not applicable
7g. Use the table below to list the type and rating of each wetland that will be impacted; the extent and duration
of the impact; and the type and amount of compensatory mitigation proposed. If you are submitting a
compensatory mitigation plan with a similar table, you may simply state (below) where we can find this
information in the mitigation plan. hel
Activity causing Wetland type Impact area Duration Proposed Wetland
impact (fill, and rating (sq. ft. or acres) of impact' mitigation mitigation area
drain, excavate, category type (sq. ft. or acres)
flood, etc.)
Drilling Estuarine 1.05 square feet One week Backfill holes 1.05 square feet
Category I
Ecology wetland category based on current Western Washington or Eastern Washington Wetland Rating System. Provide the wetland
rating forms with the JARPA package.
'Indicate the time(in months or years, as appropriate)the wetland will be measurably impacted by the activity. Enter"permanent"if
applicable.
3 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:
7h. For all filling activities identified in 7g., 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. hei
Drilling activities will result in removal of approximately 35 cubic feet of substrate from each boring(105 cubic feet total).
Each boring hole will displace approximately 0.35 square feet of substrate per hole (plan view). After drilling is complete,
the bore hole will be backfilled in accordance with Ecology standards with bentonite chips.
7L For all excavating activities identified in 7g., describe the excavation method, type and amount of material in
cubic yards you will remove, and where the material will be disposed. hei
No excavation is proposed. Drilling of holes will be as described under Part 6 - Project Description.
JARPA 2009 Page 7 of 13
I
J. Summarize what the compensatory mitigation plan is meant to accomplish, and describe how a watershed
approach was used to design the plan. h[ pAi
None proposed.
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.) h[ ell J
® 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.
hel
❑ Not applicable
Same as 7a.
81b. Will your project impact a waterbody or the area around a waterbody? [helpi
❑ Yes ® No
8c. Summarize impact(s) to each waterbody in the table below. [help]
Activity causing Waterbody Impact Duration Amount of material Area (sq. ft. or
impact (clear, name location' of impact2 to be placed in or linear ft.) of
dredge, fill, pile removed from waterbody
drive, etc.) waterbody directly affected
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.
z Indicate the time (in months or years,as appropriate)the waterbody will be measurably impacted by the work. Enter"permanent"if
applicable.
8d. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland
waterbodies? hel
• If yes, submit the plan with the JARPA package.
❑ Yes ❑ No ® Not applicable
8e. Summarize what the compensatory mitigation plan is meant to accomplish. Describe how a watershed
approach was used to design the plan.
• If you already completed 7j.,you do not need to restate your answer here. [helpl
None proposed.
JARPA 2009 Page 8 of 13
8f. For all activities identified in 8c., 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. h[ eM
Drilling activities will result in removal of approximately 35 cubic feet of substrate from each boring(105 cubic feet total).
Each boring hole will displace approximately 0.35 square feet of substrate per hole(plan view).After drilling is complete,
the three 8-inch-diameter bore holes will be backfilled in accordance with Ecology standards with bentonite chips.
8g. For all excavating or dredging activities identified in 8c., describe the method for excavating or dredging,
type and amount of material you will remove, and where the material will be disposed. hel
None proposed.
Part 9—Additional Information
Any additional information you can provide helps the reviewer(s) understand your project.
9a. If you have already worked with any government agencies on this project, list them below. [help]
Agency Name Contact Name Phone Most Recent
Date of Contact
U.S. Army Corps of Randel Perry (206.764.6985) 5/18/09
Engineers
Washington Margaret Bigelow (Margaret.BigelowSchirato@dfw.wa.gov) 5/6/06
Department of Fish and Schirato
Wildlife
U.S. Army Corps of Amy Klien (206.766.6438) 3/12/09
Engineers
Washington Theresa Mitchell (360.895.6123) 2/25/09
Department of Fish and
Wildlife
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? hl elpl
• If yes, list the parameter(s)below.
• If you don't know, use Washington Department of Ecology's Water Quality Assessment tools at:
ht4)://www.ecv.wa.qov/pro. rams/wg1303d/.
® Yes ❑ No
Multiple fecal coliform listings in North Bay.
9c. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? h( eipl
• Go to http://cfpub.epa.gov/surf/locate/index.cfm to help identify the HUC.
Puget Sound Watershed= 17110019
9d. What Water Resource Inventory Area Number (WRIA#) is the project in? Lbgld
• Go to http://www.ecy.wa.gov/services/gis/maps/wria/wria.htm to find the WRIA#.
North Bay is split by Kennedy/Goldsborough WRIA#14(west side)and Kitsap East WRIA#15 (east side).
JARPA 2009 Page 9 of 13
9e. Will the in-water construction work comply with the State of Washington water quality standards for
turbidity? hel
• Go to htti)://www.ecy.wa.gov/programs/wq/swgs/criteria,html 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? hei
• 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.htm1.
❑ Rural ❑ Urban ❑ Natural ❑ Aquatic ® Conservancy ❑ Other
9g. What is the Washington Department of Natural Resources Water Type? he!
• Go to http://www.dnr.wa._qov/BusinessPermits/Topics/ForestPracticesApplications/Pages/fp watertyping.asp for the Forest
Practices Water Typing System.
® S ❑ F ❑ Np ❑ Ns
9h. Will this project be designed to meet the Washington Department of Ecology's most current stormwater
manual? hei
• If no, provide the name of the manual your project is designed to meet.
❑ Yes ® No
Name of manual: Not applicable.
9i. If you know what the property was used for in the past, describe below. hel
Harvest of shellfish.
9j. Has a cultural resource (archaeological) survey been performed on the project area? hei
• If yes,attach it to your JARPA package.
❑ Yes ® No Pending per Northwest Archaeological Associates, Inc.
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. hei
Please refer to the no-effect letter included with this application.
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. hf eid
Osprey and great blue heron. Both species nest on the transmission towers in North Bay. No work is proposed on the
towers,but near them. The proposed project start date is generally past the time period both species would typically fledge.
JARPA 2009 Page 10 of 13
Part 10—Identify the Permits You Are Applying For
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 of Regulatory Assistance at (800) 917-0043 or helper-ora.wa.gov.
10a. Compliance with the State Environmental Policy Act (SEPA). (check all that apply.) hei
• 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 (lead agency). The expected decision date is
❑ I am applying for a Fish Habitat Enhancement Exemption. (check the box below in 10b.)
• Submit the Fish Habitat Enhancement Project form with this application. The form can be found at
http://www.epermitting.wa.gov/Portals/ JarpaResourceCenter/images/default/fishenhancement.doc
® This project is exempt (choose type of exemption below).
® Categorical Exemption. Under what section of the SEPA administrative code (WAC) is it exempt?
SEPA exempt per WAC 197-11-800: "(17) Information collection and research. Basic data collection, research,resource
evaluation, RFPs, and the conceptual planning of proposals shall be exempt. These may be strictly for information-
gathering, or as part of a study leading to a proposal that has not yet been approved, adopted or funded; this exemption does
not include any agency action that commits the agency to proceed with such a proposal."
❑ Other:
❑ SEPA is pre-empted by federal law. (help)
10b. Indicate the permits you are applying for. (check all that apply.) Del
LOCAL GOVERNMENT
Local Government Shoreline permits:
❑ Substantial Development ❑ Conditional Use ❑ Variance
® Shoreline Exemption Type (explain): "Site Exploration and Investigation Activity"per WAC 173-27-040.
(m) Site exploration and investigation activities that are prerequisite to preparation of an application for development
authorization under this chapter, if.
(j)The activity does not interfere with the normal public use of the surface waters;
(ji)The activity will have no significant adverse impact on the environment including but not limited to fish, wildlife,
fish or wildlife habitat, water quality, and aesthetic values;
(111)The activity does not involve the installation of any structure, and upon completion of the activity the vegetation and
land configuration of the site are restored to conditions existing before the activity;
(iv) A private entity seeking development authorization under this section first posts a performance bond or provides
other evidence of financial responsibility to the local jurisdiction to ensure that the site is restored to preexisting conditions;
and
(v)The activity is not subject to the permit requirements of RCW 90.58.550.
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
JARPA 2009 Page 11 of 13
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)
DARPA 2009 Page 12 of 13
Part 11—Authorizing Signatures
Signatures required before submitting the JARPA package.
1la. Applicant Signature (required)
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 authori a tl?e 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 enteripq t[�e property where the project is located to inspect the project site or any work
related to the project. (initial)
Applicant Date
11 b. Authorized Agent Signature :.p]
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 Date
11 c. Property Owner Signature (if not applicant)
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 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 2009 Page 13 of 13
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