HomeMy WebLinkAboutSHX2019-00004 3 Floats, Piling - SHX Permit / Conditions - 2/15/2019 MASON COUNTY COMMUNITY SERVICES Permit No: O &O U p
PERMIT ASSISTANCE CENTER: rA.G S'Gq��t.Wr -� S•
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL ?r
615 W.Alder Street,Shelton,WA 98584 �' i D ^�^�� �
Phone Shelton:(360)427-9670 ext 352•Fax:(36o)4 L 1 N G K ( '
BeNair.(360)2754467•Phone Elma:(360)482-5269 V P A
BUILDING PERMIT APPLICATION AUG
PROPERTY OWNER DINFORMATION: CONTRACTOR INFORMATIOPB
Ll/e'-X- NA : b7G NAME: )5 u•Al*r tl get
MAILING ADDRESS: %G61 /em-�H4v�N MAILING ADDRESS: % OW
CITY: -It
STA :_ ZIP:9a'�!! CITY: STATE: ZIPQFV
PHONE#I. ap(�cSS��D%��J PHONE:
PHONE#2: EMAIL:
EMAIL: L_f- i f A'IA/1, C!0)AA L&I REG# EXP.
PRIMARY CONTACT: OWNER❑ CONTRAC O OTHER❑
NAME S EMAIL
MAILING ADDRESS
DRESS /2,C9 E�.,A^ST 17 I, CITY 'Ts4-z!) Ah STATE 043 , ZIP �
PHONE 9J —3SI —6-y _ CELL_A44/E—
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) %��3��{v I l r 9 o ZONING AyA ct—/ do-5) /A
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT
SITE ADDRESS )6:� C (�i rj' CITY -yA/"
DIRECTIONS TO SITE ADDRESSf�- i� q I f
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check an that apph):
SALTWATERA LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIRK OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg.Etc.)
IS USE: PRIMARY❑ SEASONALK NUMBER OF BEDROOMS NA— NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(whole Bldg)❑ YES(Part[s]of Bldg)❑ NOX
DESCRIBE WORK RP—D FA L 1� l�il�NG
FOOTAGE: (proposed)
I ST FLOOR ND FLOOR sq.ft. 3 1 sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED STORAGE sq.ft. OTHER sq.ft.
GARAGE q. . Attached❑ Detached❑ C Detached❑
INFORMATION: *4 COPIES OF THE REQUIRED*
MAKE MOD LENGTH
WIDTH OOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ Ifyes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO'% EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by
signature below.I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have
obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal
representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This permiUapplication becomes null&void if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT T1
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
MASON COUKfY COMMUMny SERVICES Ber t Via `
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PROOF OF COMTINUATIM I W;L day@ PERMIET t$BY ME49S OF I. TION. RiACTM?Y Of TmS
PERMIT APPWC SO S OF WILL CAUSE T14E APPUCATi TG 6E i1tASC2lt
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FltEItARSti.AL ��
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UNDERHILL RESIDENTIAL PIER
422 E CRONQUIST RD
ALLYN, WA 98524
CALCULATIONS
PREPARED FOR
MARINE FLOATS
1208 EAST D STREET
TACOMA, WA 98421
G. L Ill
WASxI�`
� y r
35799
02, TURAL
�S'SIONAL
07/31/19
PREPARED BY
Sitts & Hill Engineers, Inc.
4815 Center Street
Tacoma, WA 98409
July 31, 2019
S & H Job Number: 18,469
SITTS&HILL ENGINEERS, INC. DESIGNED JMLS DATE 7/15/2019 JOB 18,469
TACOMA,WASHINGTON (253)474-9449 CHECKED CJT DATE 7/16/2019
PROJECT UNDERHILL RESIDENTIAL PIER PAGE 1
CALCULATION INDEX
BASIS 2
GEOMETRY 3
DESIGN LOADS 4- 5
LATERAL DESIGN 6- 9
APPENDICES
11 x 17 DRAWING
SITTS&HILL ENGINEERS, INC. DESIGNED JMLS DATE 7/15/2019 JOB 18,469
TACOMA,WASHINGTON (253)474-9449 CHECKED CJT DATE 7/16/2019
PROJECT UNDERHILL RESIDENTIAL PIER PAGE 2
BASIS FOR DESIGN
BUILDING CODE: 2015 Edition of the International Building Code
SCOPE OF WORK: Replace(3)existing float piles
LATERAL LOAD CRITERIA: Wind Speed= 110 mph,Exposure: D.
Seismic Site Class: D.
Seismic Design Category: D.
STRUCTURAL STEEL: Bolts AS TM A307 unless otherwise noted
Piles ASTM A53 Grade B 35 ksi
All Other Structural Steel Shapes ASTM A36 36 ksi
WOOD: Joists 2x4 HF#2
2x6 and larger HF#2
Beams 4" width or less HF#2
Greater than 4"width DF#2
Ledger 4"width or less HF#2
SITTS & HILL ENGINEERS, INC.
TACOMA, WASHINGTON (253)474-9449 JOB: 18,469
DESIGNED: JMLS DATE: 07/15/2019 3
PROJECT: UNDERHILL RESIDENTIAL PIER CHECKED: CJT DATE: 07/16/2019
PIER GEOMETRY:
EXISTING DOCK, RAMP AND PILES TO REMAIN.
REPLACE EXISTING
WOOD PILES WITH
STEEL PILES.
o
` IlRni MIP y.
EXISTING FLOAT
°^ TO REMAIN.
4
PLAN-P6t RAMP AND FLOAT
NV
/1dr1M YdW
a r[
r s a+rnc eun caw.m sm..
9 EYA71gi-P6t RW NO PWAT
arm
SITTS & HILL ENGINEERS, INC.
TACOMA, WASHINGTON (253)474-9449 JOB: 18.469
DESIGNED: JMLS DATE: 07/15/2019 4
PROJECT: UNDERHILL RESIDENTIAL PIER CHECKED: CJT DATE: 07/16/2019
Wind Lateral Force(s):
Wind Load
Terrain Exposure Comt:ints
Table 26.9-1 I
Expos tra` a a,fit) A a b e P{tlt) £ $®MW
1 7.0 1200 117 0.84 1/4-0 0.45 0.30 320 113.0 iU
-- C—- 9.5 900 114.5 100 1/6.5 0.65 0.20 500 115.0- -1�- —-
It 11.5 M) 1/1].5 1-07 IN-0 0.80 0.15 6.4( 118.0 � 7
xz,—=minimum height used to ensure that the equivalent height 2 is greater of 0.6h or z,u.
For buildings with h<_z_.Z shall be taken as zz,;
Z9:=700 a:=11.5 Per ASCE 7-10 Table 26.9-1
7
`�
K,:=2.01• 15.75 K,=1.039 Per ASCE 7-10 Table 29.3-1
K,t:=1.0 Per ASCE 7-10 26.8
Kd:=0.85 Per ASCE 7-10 Table 26.6-1
G:=0.85 Per ASCE 7-10 26.9
B:=42 ft Length of pier
V:=110 mph
q,:=0.00256•K,•K,t•Kd•V2 •psf=27.357 psf
SITTS & HILL ENGINEERS, INC.
TACOMA, WASHINGTON (253)474-9449 JOB: 18.469
DESIGNED: JMLS DATE: 07/15/2019 5
PROJECT: UNDERHILL RESIDENTIAL PIER CHECKED: CJT DATE: 07/16/2019
Wind at float
B:=20 ft Length of dock
s:=10 ft height of craft
B
=2
s
Cf:=1.40 Per ASCE 7-10 Table 29.4-1 (interpolation)
Af._s. 30 ft + 3 2ft .4 ft•0.75=198 ft'
Ffloatl:=0.5•gz•G•Cf•Af•0.6=1.934 kip
Wind at end of float
B:=20 ft Length of dock
s:=10 ft height of craft
B
=2
s
C f:=1.40 Per ASCE 7-10 Table 29.4-1 (interpolation)
s•30 ft
Af:= =150 ft'
2
F'float2:=q'z,G•C f•A f•0.6=2929.9 Of Per pile, allowable
SITTS & HILL ENGINEERS, INC.
TACOMA, WASHINGTON (253)474-9449 JOB: 18,469
DESIGNED: JMLS DATE: 07/15/2019 6
PROJECT: UNDERHILL RESIDENTIAL PIER CHECKED: CJT DATE: 07/16/2019
PILE AT FLOAT - EMBEDMENT ANALYSIS:
The pile shall be analyzed as a non-constrained embedded pole foundation in accordance
with Section 1807.3.2.1 of the International Building Code
P:=Ffloat1=1933.734 lbf (Lateral Load at Top of Single Pier Pile)
b:=10.8 in (Diameter of Pier Pile)
hl:=12.75 ft (Distance From Ground Surface to Point of Load Application)
h:=(h1+5 ft) (Distance from Fixity to Point of Load Application)
Sl:=100 sf (Allowable Lateral Bearing Pressure)
t
__.
'v d:=15 ft (Guess a Value of"d")
v
LA
d— 1 . 2.34•P l+ 1+ 4.36•h
2 d•b 2.34•P
N Si. (IBC Equation 18-1)
l0� 3 S1 •3b
KD:=Find(d)
Vf
D=17.754 ft
Use an Embedment Depth of 18'-0" Minimum
SITTS & HILL ENGINEERS, INC.
TACOMA, WASHINGTON (253)474-9449 JOB: 18,469
DESIGNED: JMLS DATE: 07/15/2019 7
PROJECT: UNDERHILL RESIDENTIAL PIER CHECKED: CJT DATE: 07/16/2019
STEEL PILE ANALYSIS: PILE AT FLOAT
THE DESIGN NOMINAL FLEXURAL STRENGTH, Mn/ Q, SHALL BE THE LOWER VALUE OBTAINED
ACCORDING TO THE LIMIT STATES OF YIELDING (PLASTIC MOMENT) AND LOCAL BUCKLING
M.ent:_Ffloat,•h Mrnonze.t=411.885 kip•in The moment at pile base
Z:=36.9 in The plastic section modulus
35 ksi•Z
Mn:= Mn=773.353 kip•in The limiting state of yielding
1.67
Check:=if(A/lnwnaent<Mn,"Adequate","N.G.") Check="Adequate"
Do D :=10.8 in Outside Diameter
t:=0.340 in Design wall thickness
D°•D. =31.765 Width thickness ratio
t
0.07.29000 ksi
AP:= —58 Limiting width thickness ratios
35 ksi Com act( p ) per AISC Table B4.1
0.31.29000 ksi
A•,:_ =256.857 Limiting width thickness ratios
35 ksi (Noncompact) per AISC Table B4.1
Check:=if(DO,D, <AP,"Compact",if D O•D• >.\,,,"Slender","Noncompact"
Since the cross section falls under Compact
Check="Compact" Sections,The limiting State of Flange Local
Buckling Does not Apply.
Therefore use (2) 10" Standard Weight Steel Pile
SITTS & HILL ENGINEERS, INC.
TACOMA, WASHINGTON (253)474-9449 JOB: 18.469
DESIGNED: JMLS DATE: 07/15/2019 8
PROJECT: UNDERHILL RESIDENTIAL PIER CHECKED: CJT DATE: 07/16/2019
PILE AT END OF FLOAT - EMBEDMENT ANALYSIS:
The pile shall be analyzed as a non-constrained embedded pole foundation in accordance
with Section 1807.3.2.1 of the International Building Code
P:=Ffj�.U=2929.9 lbf (Lateral Load at Top of Single Pier Pile)
b:=10.6 in (Diameter of Pier Pile)
hl:=15.75 ft (Distance From Ground Surface to Point of Load Application)
h:=(h1+5 ft) (Distance from Fixity to Point of Load Application)
Sl:=100 sf (Allowable Lateral Bearing Pressure)
t
N
d:=15 ft (Guess a Value of"d")
v
d— 1 • 2.34•P 1+ C2.:3
N2 S1• d•b (IBC Equation 18-1)
3Ul 00
fD:=Find(d)
L
D=21.785 ft
Use an Embedment Depth of 22'-0" Minimum
SITTS & HILL ENGINEERS, INC.
TACOMA, WASHINGTON (253)474-9449 JOB: 18.469
DESIGNED: JMLS DATE: 07/15/2019 9
PROJECT: UNDERHILL RESIDENTIAL PIER CHECKED: CJT DATE: 07/16/2019
STEEL PILE ANALYSIS: PILE AT END OF FLOAT
THE DESIGN NOMINAL FLEXURAL STRENGTH, Mn/ Q, SHALL BE THE LOWER VALUE OBTAINED
ACCORDING TO THE LIMIT STATES OF YIELDING (PLASTIC MOMENT)AND LOCAL BUCKLING
M..t:=Ffi.t2•h M,,�,nt=729.545 kip•in The moment at pile base
Z:=36.9 in The plastic section modulus
Mn _ 35 ksi•Z M =773.353 kip in The limiting state of yielding
� 1.67 " p� � g Y� g
Check:=if(M-nt<Mn,"Adequate","N.G.") Check="Adequate"
D°.D.:=10.8 in Outside Diameter
t:=0.340 in Design wall thickness
D°'D' =31.765 Width thickness ratio
t
0.07.29000 ksi
A:_ 35
Limiting width thickness ratios
35 ksi (Compact) per AISC Table B4.1
0.31.29000 ksi
x,.:_ =256.857 Limiting width thickness ratios
35 ksi (Noncompact) per AISC Table B4.1
Check:=if(DO,D* <AP,"Compact",if D O'D' >A,.,"Slender","Noncompact"
Since the cross section falls under Compact
Check="Compact" Sections,The limiting State of Flange Local
Buckling Does not Apply.
Therefore use (1) 10" Standard Weight Steel Pile
APPENDIX A
11 x 17 DRAWINGS
SITTS & HILL ENGINEERS, INC.
a
GENERAL STRUCTURAL NOTES
SCOPE OF WORK:
REPLACE(3)EXISTING WOOD PILES AT FLOAT WITH(3)STEEL PILES.
BULOW CITE:
2015 EDITION OF THE INTERNATIONAL BUILDING CODE „SEE GENERAL STRUCTURAL NOTESLOAD -
. KITH MARINE FLOATS DRAWINGS PRIOR TO START OF CONSTRUCTION; RESOLVE ANY
WIND LOAD= 110 MPH BASIC WIND SPEED,EXPOSURE D INEER. fan
SEISMIC DESIGN CATEGORY D GS MAY NOT BE SHOWN ON THE FRAMING PLANS. FOR EXACT SIZE,NUMBER,AND $
A GS.SEE MARINE FLOATS,MECHANICAL,ELECTRICAL AND PLUMBING DRAWINGS. FOR bb
STEEL PIPE�' EE TYPICAL STRUCTURAL DETAILS,VERIFY ALL SIZES,WEIGHTS AND LOCATIONS OF
ALL STEEL PILING SHALL CONFORM TO ASTM A53 GRADE B(Fy=35 KSI)PIPE WITH PLAIN ENDS. q[TH MECHANICAL ENGINEER AND MECHANICAL CONTRACTOR THROUGH MARINE
PILE DIAMETER SHALL NOT VARY MORE THAN 17(+J-)FROM THE SPECIFIED DIAMETER.INCLUDING zO REMAIN UNCHANGED. a'
OUTSIDE DAMETER AT WELDS. THE WEIGHT OF THE PILE SHALL BE NOT MORE THAN 15%HEAVIER N4
57.UGHTER THAN SPECIFIED PER ASTM A53. PILE NOMINAL WAIL THICKNESS AT ANY POINT SHALL HE UNCHANGED..
BE LESS THAN 12.5%UNDER SPECIFIED WALL THICKNESS. PILE SHALL BE REASONABLY STRAIGHT. F1
SURFACE IMPERFECTION SHALL NOT EXCEED A DEPTH GREATER THAN 25%OF THE NOMINAL WALL �1 UNCHANGED.
THICKNESS. PILE COATING SYSTEM SHALL NOT BE DAMAGED UPON DELIVERY AND UNLOADING. REP
M
OF DEFECTS BY WELDING IS STRUCTURALLY ACCEPTABLE WHEN THE DEPTH M NOT MORE THAN 33%DIPILES WITH 10"NOMINAL STANDARD WEIGHT GALVANIZED STEEL PILES PER CSN
THE NOMINAL WALL THICKNESS. HAMMER TO A MINIMUM EMBEDMENT DEPTH OF 22'-0*OR UNTIL REFUSAL.. _
STRUCTURAL STEEL• o 0 0
ALL STRUCTURAL STEEL SHALL BE ASTM A36(Fy=36 KSI). ALL DOLTS SHALL BE ASTM A307,
UNLESS NOTED OTHERWISE. ALL CONSTRICTION PER LATEST AISC HANDBOOK ALL EXPANSION AND
EPDXY BOLTS TO HAVE I.C.C.RATING FOR MATERIAL INTO WHICH INSTALLATION TAKES PLACE. ALL yL 8
BOLTS,ANCHOR BOLTS,EXPANSION BOLTS.ETC..SHALL BE INSTALLED WITH STEEL WASHERS AT FACE
WOOD OR AT SLOTTED HOLES IN STEEL SECTIONS. ALL WELDING SHALL BE PERFORMED BY WELDERS
HOLDING VALID CERTIFICATES AND HAVING CURRENT EXPERIENCE IN THE 7PE OF WELD SHOWN ON TH
DRAWINGS OR NOTES. CERTIFICATES SHALL BE THOSE ISSUED BY AN ACCEPTED TESTING AGENCY. AL
WELDING DONE BY E70 SERIES LOW HYDROGEN RODS UNLESS NOTED OTHERWISE. ALL WELDING PER w x
LATEST AMERICAN WELDING SOCIETY STANDARDS. THESE DRAWINGS DO NO"DISTINGUISH BETWEEN SHC •J o� Ma g
AND FIELD WELDS:THE CONTRACTOR MAY SHOP WELD OR FIELD WELD AT THEIR DISCRETION. SHOP
WELDS AND FIELD WELDS SHALL BE SHOWN ON THE SHOP DRAWINGS SUBMITTED FOR REVIEW.
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SCALE N T.S. sto
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18,469
MASON COUNTY DEPARTMENT OF COMMUNITY SERVICES
DETERMINATION OF NONSIGNIFICANCE
SEP2019-00004
Description of This SEPA is associated with the repair and
Proposal: replacement of three (3) pilings associated with an
existing floating dock.
Proponent: Tom Underhill
Location of Proposal: 422 Cronquist Rd., Allyn, WA.
Parcel Number: 122324091190
Legal Description: Sec 32, Twp. 22N., Rng 1W., W.M.
The Lead Agency for this proposal has determined that it does not have a probably significant adverse
impact on the environment. An Environmental Impact Statement (EIS) is not required under RCW
43.21C.030(2)(c). This decision was made after review of a completed Environmental Checklist and other
information on file with the Lead Agency.This information is available to the public upon request.
Please contact Ron Buckholt at ext. 287, or rbuckholt@co.mason.wa.us with any questions. This
DNS is issued under WAC 197-11-340(2).The Lead Agency will not act on this proposal for 14 days
from the date shown below, when the determination is final. Comments must be submitted to
Dept.of Community Development,615 W Alder St,Shelton WA 98584 by 3/1/2019.Appeal of this
determination must be filed within a 14-day period following this final determination date, per
Mason County Code Chapter 15.11 Appeals.
Date: 2 15 2019 c
Ron Buckholt Senior Planner
Conditions:
1. Proponent shall obtain all necessary state and federal permits prior to the
commencement of any work.
r
RECEIVED
DEC 2 0 2018
SEPA ENVIRONMENTAL CHECKLIST 615 W. Alder Street
Purpose of checklist:
Governmental agencies use this checklist to help determine whether the environmental impacts o your
proposal are significant. This information is also helpful to determine if available avoidance, minimization
or compensatory mitigation measures will address the probable significant impacts or if an environmental
impact statement will be prepared to further analyze the proposal.
Instructions for applicants:
This environmental checklist asks you to describe some basic information about your proposal. Please
answer each question accurately and carefully, to the best of your knowledge. You may need to consult
with an agency specialist or private consultant for some questions. You may use "not applicable" or
"does not apply" only when you can explain why it does not apply and not when the answer is unknown.
You may also attach or incorporate by reference additional studies reports. Complete and accurate
answers to these questions often avoid delays with the SEPA process as well as later in the decision-
making process.
The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of
time or on different parcels of land. Attach any additional information that will help describe your proposal
or its environmental effects. The agency to which you submit this checklist may ask you to explain your
answers or provide additional information reasonably related to determining if there may be significant
adverse impact.
Instructions for Lead Agencies:
Please adjust the format of this template as needed. Additional information may be necessary to
evaluate the existing environment, all interrelated aspects of the proposal and an analysis of adverse
impacts. The checklist is considered the first but not necessarily the only source of information needed to
make an adequate threshold determination. Once a threshold determination is made, the lead agency is
responsible for the completeness and accuracy of the checklist and other supporting documents.
Use of checklist for nonproject proposals: h� eipl
For nonproject proposals (such as ordinances, regulations, plans and programs), complete the applicable
parts of sections A and B plus the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D). Please
completely answer all questions that apply and note that the words "project," "applicant," and "property or
site" should be read as "proposal," "proponent," and "affected geographic area," respectively. The lead
agency may exclude (for non-projects)questions in Part B - Environmental Elements —that do not
contribute meaningfully to the analysis of the proposal.
A. Background hf f lM
1. Name of proposed project, if applicable: hf elpl
Tom Underhill Piling Replacement
2. Name of applicant: hf elpl
Tom Underhill
3. Address and phone number of applicant and contact person: thel
Applicant: 16014 1201h Ave NE Bothell, WA 98011 - (206)550-0168
SEPA Environmental checklist(WAC 197-11-960) May 2014 Page 1 of 11
Agent: Marine Floats/Lorrie Chase, 1208 East D St. Tacoma, WA 98421 253-383-2740
4. Date checklist prepared: thel
12/17/18
5. Agency requesting checklist: h
Mason County
6. Proposed timing or schedule (including phasing, if applicable): h1
December 2018-February 2020
7. Do you have any plans for future additions, expansion, or further activity related to or
connected with this proposal? If yes, explain. h( elpl
NO
8. List any environmental information you know about that has been prepared, or will be
prepared, directly related to this proposal. [he
JARPA and SEPA Checklist
9. Do you know whether applications are pending for governmental approvals of other
proposals directly affecting the property covered by your proposal? If yes, explain. tb.e
No
10. List any government approvals or permits that will be needed for your proposal, if known.
ftglpi
Planning and Building, WDFW, Ecology,DNR and Corps
11. Give brief, complete description of your proposal, including the proposed uses and the size
of the project and site. There are several questions later in this checklist that ask you to
describe certain aspects of your proposal. You do not need to repeat those answers on this
page. (Lead agencies may modify this form to include additional specific information on project
description.) hf e
Remove (3) existing failing creosote treated timber pilings. The piling(s) will be removed using direct
pull methods unless physically impossible. Direct pull method will incorporate BMPs at all times. Barge
will not be permitted to ground. Work surface on barge shall include a containment basin for the pilings
and any sediments or debris. A floating surface boom will be installed to capture any debris or oil
sheen. Pilings will not be shaken or scraped during the removal process, and will be taken from the site
in a work barge to be properly disposed of at an upland disposal site.
Install (3) 10" galvanized float piling(s). The new piling(s) will be barged to site and driven using an
impact hammer utilizing a bubble curtain and wooden block cushion for sound attenuation (Longmuir
and Lively 2001).
12. Location of the proposal. Give sufficient information for a person to understand the precise
location of your proposed project, including a street address, if any, and section, township, and
range, if known. If a proposal would occur over a range of area, provide the range or
boundaries of the site(s). Provide a legal description, site plan, vicinity map, and topographic
map, if reasonably available. While you should submit any plans required by the agency, you
SEPA Environmental checklist(WAC 197-11-960) May 2014 Page 2 of 11
are not required to duplicate maps or detailed plans submitted with any permit applications
related to this checklist. thel
Take WA-16 W toward Bremerton; Take the Burnham Dr NW exit; At the traffic circle, take the 4th exit
onto Burnham Dr NW; At the traffic circle, take the 1st exit and stay on Burnham Dr NW;Turn right to stay
on Burnham Dr NW;Turn left onto Purdy Dr NW;Turn left onto WA-302W;Turn right to stay on WA-302W;
Continue straight onto E North Bay Rd;Merge onto WA-3 S; Continue on E Grapeview Loop Rd. Drive to
Cronquist Rd; Turn left onto E Grapeview Loop Rd.;Turn left onto Cronquist Rd.
B. ENVIRONMENTAL ELEMENTS hf elpl
1. Earth [hel
a. General description of the site: Lhel
(circle one): Flat, rolling, hilly, steep slopes, mountainous, other:
b. What is the steepest slope on the site (approximate percent slope)? hf elpl
5%
c. What general types of soils are found on the site (for example, clay, sand, gravel, peat,
muck)? If you know the classification of agricultural soils, specify them and note any
agricultural land of long-term commercial significance and whether the proposal results in
removing any of these soils. Jhel
Glacial till, sand, mud
d. Are there surface indications or history of unstable soils in the immediate vicinity? If so,
describe. thel
No
e. Describe the purpose, type, total area, and approximate quantities and total affected area of
any filling, excavation, and grading proposed. Indicate source of fill. h� e
N/A
f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe.
heI
No, building dock in water
g. About what percent of the site will be covered with impervious surfaces after project
construction (for example, asphalt or buildings)? hf elpl
Same as before;replacing piling only in water
h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: hI elpl
N/A
2. Air ftjel
a. What types of emissions to the air would result from the proposal during construction,
operation, and maintenance when the project is completed? If any, generally describe and
give approximate quantities if known. h( elpl
Temporary emissions from boat exhaust
b. Are there any off-site sources of emissions or odor that may affect your proposal? If so,
generally describe. hel
SEPA Environmental checklist(WAC 197-11-960) May 2014 Page 3 of 11
No
c. Proposed measures to reduce or control emissions or other impacts to air, if any: thel
N/A
3. Water [hel
a. Surface Water:
1) Is there any surface water body on or in the immediate vicinity of the site (including
year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe
type and provide names. If appropriate, state what stream or river it flows into. h[ e
Case Inlet
2)Will the project require any work over, in, or adjacent to (within 200 feet)the described
waters? If yes, please describe and attach available plans. thel
Yes, see submitted plans with application
Replace (3) existing failing creosote float pilings with (3) 10" galvanized steel float piling(s).
Construction sequence of the piling replacements will be:
1. Remove (3) existing failing creosote treated timber pilings. The piling(s) will be removed using
direct pull methods unless physically impossible. Direct pull method will incorporate BMPs at all
times. Barge will not be permitted to ground. Work surface on barge shall include a containment
basin for the pilings and any sediments or debris. A floating surface boom will be installed to
capture any debris or oil sheen. Pilings will not be shaken or scraped during the removal
process, and will be taken from the site in a work barge to be properly disposed of at an upland
disposal site.
2. Install (3) 10" galvanized float piling(s). The new piling(s)will be barged to site and driven using
an impact hammer utilizing a bubble curtain and wooden block cushion for sound attenuation
(Longmuir and Lively 2001).
3) Estimate the amount of fill and dredge material that would be placed in or removed
from surface water or wetlands and indicate the area of the site that would be affected.
Indicate the source of fill material. h� elpl
N/A
4)Will the proposal require surface water withdrawals or diversions? Give general
description, purpose, and approximate quantities if known. hf elpl
No
5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan.
hel
Yes -5301150150C Eff: 5/17/1988
6) Does the proposal involve any discharges of waste materials to surface waters? If so,
describe the type of waste and anticipated volume of discharge. the
No
b. Ground Water:
1) Will groundwater be withdrawn from a well for drinking water or other purposes? If so,
give a general description of the well, proposed uses and approximate quantities
SEPA Environmental checklist(WAC 197-11-960) May 2014 Page 4 of 11
withdrawn from the well. Will water be discharged to groundwater? Give general
description, purpose, and approximate quantities if known. hf elpl
No
2) Describe waste material that will be discharged into the ground from septic tanks or
other sources, if any (for example: Domestic sewage; industrial, containing the
following chemicals. . . ; agricultural; etc.). Describe the general size of the system, the
number of such systems, the number of houses to be served (if applicable), or the
number of animals or humans the system(s) are expected to serve. h� elpl
N/A
c. Water runoff(including stormwater):
1) Describe the source of runoff(including storm water) and method of collection
and disposal, if any(include quantities, if known). Where will this water flow?
Will this water flow into other waters? If so, describe. h� e
N/A
2) Could waste materials enter ground or surface waters? If so, generally describe. hI e
No
3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If
so, describe. hf e
No
d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage
pattern impacts, if any: h� elPl
N/A
4. Plants hf eM
a. Check the types of vegetation found on the site: h� e
_X_deciduous tree: alder, maple, aspen, other
_X_evergreen tree: fir, cedar, pine, other
_X_shrubs
X_grass
pasture
crop or grain
Orchards, vineyards or other permanent crops.
wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other
water plants: water lily, eelgrass, milfoil, other
other types of vegetation
b. What kind and amount of vegetation will be removed or altered? hf elpl
No changes proposed
c. List threatened and endangered species known to be on or near the site. JLLeM Unknown
SEPA Environmental checklist(WAC 197-11-960) May 2014 Page 5 of 11
d. Proposed landscaping, use of native plants, or other measures to preserve or enhance
vegetation on the site, if any: tLel
No changes proposed
e. List all noxious weeds and invasive species known to be on or near the site. h� elpl
Unknown
5. Animals [hel
a. List any birds and other animals which have been observed on or near the site or are known
to be on or near the site. h� elPl
Examples include:
birds: hawk, heron, eagle, songbirds, other: Water birds
mammals: deer, bear, elk, beaver, other:
fish: bass, salmon, trout, herring, shellfish, other Surf Smelt
b. List any threatened and endangered species known to be on or near the site. hf elpl
Nearshore Rockfish, Puget Sound Chinook Salmon, Bull Trout, Marbled Murrelet, Pacific
Herring pre-spawner holding area --1,000 ft to the east, Sand Lance
c. Is the site part of a migration route? If so, explain. thel
Unknown
d. Proposed measures to preserve or enhance wildlife, if any: hel
t. Piling are galvanized steel
2. Piling driven with a air driven pile hammer, utilizing a bubble curtain and wood block cushion for
sound attenuation (Longmuir and Lively 2001)
3. Care will be taken to contain all construction debris.
4. "Best Management Practices" will be exercised throughout this project
e. List any invasive animal species known to be on or near the site. hf e
Unknown
6. Energy and Natural Resources hf elpl
a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet
the completed project's energy needs? Describe whether it will be used for heating,
manufacturing, etc. hf elpl
N/A
b. Would your project affect the potential use of solar energy by adjacent properties?
If so, generally describe. hf e No .
c. What kinds of energy conservation features are included in the plans of this proposal?
List other proposed measures to reduce or control energy impacts, if any: hf e
N/A
SEPA Environmental checklist(WAC 197-11-960) May 2014 Page 6 of 11
7. Environmental Health hf e
a. Are there any environmental health hazards, including exposure to toxic chemicals, risk
of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal?
If so, describe. h� e
No
1) Describe any known or possible contamination at the site from present or past uses.
hel
Unknown
2) Describe existing hazardous chemicals/conditions that might affect project development
and design. This includes underground hazardous liquid and gas transmission pipelines
located within the project area and in the vicinity. hf elpl
N/A
3) Describe any toxic or hazardous chemicals that might be stored, used, or produced
during the project's development or construction, or at any time during the operating
life of the project. hel
N/A
4) Describe special emergency services that might be required. hf e
N/A
5) Proposed measures to reduce or control environmental health hazards, if any: h� e
N/A
b. Noise hf elpl
1)What types of noise exist in the area which may affect your project (for example:
traffic, equipment, operation, other)?the
Residential noises
2)What types and levels of noise would be created by or associated with the project on a
short-term or a long-term basis (for example: traffic, construction, operation, other)? Indi-
cate what hours noise would come from the site. hf e
Temporary construction noises during approved work window
3) Proposed measures to reduce or control noise impacts, if any: hf e
Piling driven with a air driven pile hammer, utilizing a
bubble curtain and wood block cushion for sound attenuation
(Longmuir and Lively 2001)
8. Land and Shoreline Use h( e
a. What is the current use of the site and adjacent properties? Will the proposal affect current
land uses on nearby or adjacent properties? If so, describe. the
Houses with attached and detached garages and accessory buildings. No effect on
neighboring parcels.
b. Has the project site been used as working farmlands or working forest lands? If so, describe.
How much agricultural or forest land of long-term commercial significance will be converted to
other uses as a result of the proposal, if any? If resource lands have not been designated,
SEPA Environmental checklist(WAC 197-11-960) May 2014 Page 7 of 11
how many acres in farmland or forest land tax status will be converted to nonfarm or
nonforest use? hf elpl
No
1)Will the proposal affect or be affected by surrounding working farm or forest land normal
business operations, such as oversize equipment access, the application of pesticides,
tilling, and harvesting? If so, how: tbgM
No
c. Describe any structures on the site. hj�el 1
Houses with attached and detached garages and accessory buildings
d. Will any structures be demolished? If so, what? hf elpl
No
e. What is the current zoning classification of the site? hf e
Unknown
f. What is the current comprehensive plan designation of the site? the
Unknown
g. If applicable, what is the current shoreline master program designation of the site? hI e
Residential Aquatic
h. Has any part of the site been classified as a critical area by the city or county? If so, specify.
hf eM Shorelines
i. Approximately how many people would reside or work in the completed project? tLLeM
N/A
j. Approximately how many people would the completed project displace? hf elpl
None
k. Proposed measures to avoid or reduce displacement impacts, if any: hf elpl
N/A
L. Proposed measures to ensure the proposal is compatible with existing and projected land
uses and plans, if any: hf�]
Obtain all necessary permits
m. Proposed measures to ensure the proposal is compatible with nearby agricultural and forest
lands of long-term commercial significance, if any: hj e
N/A
9. Housing hel
a. Approximately how many units would be provided, if any? Indicate whether high, mid-
dle, or low-income housing. hf e
N/A
SEPA Environmental checklist(WAC 197-11-960) May 2014 Page 8 of 11
b. Approximately how many units, if any, would be eliminated? Indicate whether high,
middle, or low-income housing. jhel
N/A
c. Proposed measures to reduce or control housing impacts, if any: hel
N/A
10. Aesthetics hI elpl
a. What is the tallest height of any proposed structure(s), not including antennas; what is
the principal exterior building material(s) proposed? h� e
N/A
b. What views in the immediate vicinity would be altered or obstructed? hf e
N/A
b. Proposed measures to reduce or control aesthetic impacts, if any: the
N/A
11. Light and Glare h( elpl
a. What type of light or glare will the proposal produce? What time of day would it mainly
occur? hf elpl
None
b. Could light or glare from the finished project be a safety hazard or interfere with views? hI elpl
No
c. What existing off-site sources of light or glare may affect your proposal? hI elpl
N/A
d. Proposed measures to reduce or control light and glare impacts, if any: hf elpl
N/A
12. Recreation hf elpl
a. What designated and informal recreational opportunities are in the immediate vicinity? h� elpl
N/A
b. Would the proposed project displace any existing recreational uses? If so, describe. hI jp]
N/A
c. Proposed measures to reduce or control impacts on recreation, including recreation
opportunities to be provided by the project or applicant, if any: hf elpl N/A
13. Historic and cultural preservation thel
a. Are there any buildings, structures, or sites, located on or near the site that are over 45 years
old listed in or eligible for listing in national, state, or local preservation registers located on or
near the site? If so, specifically describe. hel
SEPA Environmental checklist(WAC 197-11-960) May 2014 Page 9 of 11
No
b. Are there any landmarks, features, or other evidence of Indian or historic use or occupation?
This may include human burials or old cemeteries. Are there any material evidence, artifacts,
or areas of cultural importance on or near the site? Please list any professional studies
conducted at the site to identify such resources. hf e
No
c. Describe the methods used to assess the potential impacts to cultural and historic resources
on or near the project site. Examples include consultation with tribes and the department of
archeology and historic preservation, archaeological surveys, historic maps, GIS data, etc.
hl�l
N/A
d. Proposed measures to avoid, minimize, or compensate for loss, changes to, and disturbance
to resources. Please include plans for the above and any permits that may be required. hI e
N/A
14. Transportation hI elpl
a. Identify public streets and highways serving the site or affected geographic area and
describe proposed access to the existing street system. Show on site plans, if any. hf e
E Grapeview Loop Rd. and Cronquist Rd.
b. Is the site or affected geographic area currently served by public transit? If so, generally
describe. If not, what is the approximate distance to the nearest transit stop? hI e
Unknown
c. How many additional parking spaces would the completed project or non-project proposal
have? How many would the project or proposal eliminate? hI e
N/A
d. Will the proposal require any new or improvements to existing roads, streets, pedestrian,
bicycle or state transportation facilities, not including driveways? If so, generally describe
(indicate whether public or private). Jhel
No
e. Will the project or proposal use (or occur in the immediate vicinity of) water, rail, or air
transportation? If so, generally describe. thel
In the water, it's a piling replacement
f. How many vehicular trips per day would be generated by the completed project or proposal?
If known, indicate when peak volumes would occur and what percentage of the volume would
be trucks (such as commercial and nonpassenger vehicles). What data or transportation
models were used to make these estimates? [he
N/A
SEPA Environmental checklist(WAC 197-11-960) May 2014 Page 10 of 11
g. Will the proposal interfere with, affect or be affected by the movement of agricultural and
forest products on roads or streets in the area? If so, generally describe. hel
N/A
h. Proposed measures to reduce or control transportation impacts, if any: hel
N/A
15. Public Services hel
a. Would the project result in an increased need for public services (for example: fire protection,
police protection, public transit, health care, schools, other)? If so, generally describe. h( e
N/A
b. Proposed measures to reduce or control direct impacts on public services, if any. h� e
N/A
16. Utilities Lhel
a. Circle utilities currently available at the site: hf elpl
electricity, natural gas, water, refuse service, telephone, sanitary sewer, septic system,
other
b. Describe the utilities that are proposed for the project, the utility providing the service,
and the general construction activities on the site or in the immediate vicinity which might
be needed. h[ elpl
None
C. Signature hf elpl
The above answers are true and complete to the best of my knowledge. I understand that the
lead agency is relying on them to make its decision.
Signature:
Name of signee Z
Position and Agency/Organization
Date Submitted:
SEPA Environmental checklist(WAC 197-11-960) May 2014 Page 11 of 11
��E STAT£pF
yP, y�2
O
HZ ttir �
STATE OF WASHINGTON
DEPARTMENT OF ECOLOGY
PO Box 47775 •Olympia, Washington 98504-7775 •(360)407-6300
711 for Washington Relay Service •Persons with a speech disability can call 877-833-6341
March 1,2019
Ron Buckholt,Planner
Mason County
Department of Community Services
Planning Division
PO Box 279
Shelton, WA 98584
Dear Ron Buckholt:
Thank you for the opportunity to comment on the determination of nonsignificance for the
Underhill Piling Replacement Project(SEP2019-00004)located at 422 Cronquist Road in Allyn
as proposed by Tom Underhill. The Department of Ecology(Ecology)reviewed the
environmental checklist and has the following comment(s):
SOLID WASTE MANAGEMENT: Derek Rockett(360)407-6287
The applicant proposes to remove a structure(s)that contain treated wood. Please refer to
Ecology's publication "Focus on Treated Wood Exclusion," available at:
https:Hfortress.wa.gov/ec�/publications/publications/0304038.pdf, for suggested best
management practices and disposal requirements for treated wood. All removed debris
resulting from this project must be disposed of at an approved site. Contact the local
jurisdictional health department for proper management of these materials.
Ecology's comments are based upon information provided by the lead agency. As such,they
may not constitute an exhaustive list of the various authorizations that must be obtained or legal
requirements that must be fulfilled in order to carry out the proposed action.
If you have any questions or would like to respond to these comments,please contact the
appropriate reviewing staff listed above.
Department of Ecology
Southwest Regional Office
(MLD:201900825)
cc: Derek Rockett, SWM
Tom Underhill(Proponent)
Lorrie Chase, Marine Floats(Contact)
Inspection Line (360)427-7262
totoMASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. 3 426 W. Cedar P.O. Box 279
o Shelton, WA 98584
o MECHANICAL PERMIT BLD2015-00801
OWNER: TOM UNDERHILL RECEIVED: 9/16/2015
CONTRACTOR: PRICE JONES LLC 360.377.6119 LICENSE: PJSHOHE914KL EXP: 5/13/2016 ISSUED: 9/16/2015
SITE ADDRESS: 422 E CRONQUIST RD ALLYN EXPIRES: 3/16/2016
PARCEL NUMBER: 122324091190
LEGAL DESCRIPTION: TR 19 OF GOVT LOT 3 &TAX 1141-A PCL 1 OF BLA#96-51 #630631 PCL 3 OF BLA#01-66
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW DUCTLESS HEAT PUMP ST RT 3, R ON GRAPEVIEW LOOP RD, R ON CRONQUIST RD TO STIE
ADDRESS ON THE RIGHT SIDE SHARED DRIVEWAY WITH 420
General Information Setback Information
Type of Use: SF Insp. Area: Front: Ft. Shoreline: Ft.
Type of Work: MEC Fire Dist.: 5 Rear: Ft. Slope: Ft.
f Valuation: Side 1: Ft.
Side 2: Ft.
Mechanical Fixtures FEES
Type Qty. Type By Date Amount Receipt
Heat Pump 1 Building Special inspection GMM 9/16/2015 $73.00 S120150000(
Mechanical Permit Fee GMM 9/16/2015 $18.20 S120150000(
Mechanical Base Fee GMM 9/16/2015 $28.50 S120150000(
Total $119.70
BLD2015-00801 Please refer to the following pages for conditions of this permit. Page 1 of 4
CASE NOTES FOR
BLD2015-00801
CONDITIONS FOR
BLD2015-00801
1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance
Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-800:647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
X 11
2) ALL FURNACE INSTALLATIONS SHALL MEET THE MINIMUM EFFICIENCIES SET FORTH IN THE CURENT EDITION OF THE WASHINGTON
STATE ENERGY CODE (WSEC). ANY PORTION OF THE MECHANICAL SYSTEM THAT IS ALTERED OR REPLACED SHALL MEET THE MINIMUM
STANDARDS SET FORTH IN THE WSEC AND INTERNATIONAL MECHANICAL CODE.
X
3) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
per.W-,evocation.
X 0
BLD2015-00801 Please refer to the following pages for conditions of this permit. Page 2 of 4
4) Installation of heating equipment in a single-family residence shall meet the requirements of the current IECC/WSEC R403, applicable sections of the
IRC, and IMC.
Heating equipment shall be sized in accordance to ICC/WSEC, Section R403.6. Heating and design load calculations for the purpose of sizing HVAC
systems are required and shall be calculated in accordance with accepted practice, including infiltration and ventilation. Design calculations shall be
available for inspection during inspection.
Referencing IRC M1601.4, all ducts, air handlers, filter boxes, and building cavities shall be sealed. All joints of duct systems and seams shall be made
substantially air tight by means of tapes, mastics, liquid sealants, gasketing or other approved closure systems. Closure systems used with rigid fibrous
glass ducts shall comply with UL181A and shall be marked 181A-P for pressure-sensitive tape, 181A-M for mastic or 181 A-H for heat-sensitive tape.
Closure systems used with flexible air ducts and flexible air connectors shall comply with UL181 B and shall be marked 181 B-FX for pressure-sensitive
tape or 181 B-M for mastic. Duct connections to flanges of air distribution system equipment or sheet metal fittings shall be mechanically fastened.
Mechanical fasteners for use with flexible nonmetallic air ducts shall comply with UL 181 B and shall be marked 181 B-C. Crimp joints for round metal
ducts shall have a contact lap of at least 1-1/2 inches (38 mm) and shall be mechanically fastened by means of at least three sheet-metal screws or
rivets equally spaced around the joint. Closure systems used to seal metal ductwork shall be installed in accordance with the manufacturer's installation
instructions.
Duct tape is NOT permitted as a sealant on any ducts. When ducts are located in unheated spaces the ducts hall be insulated to R-8
DUCT TIGHTNESS TESTING shall be conducted by person(s) trained to perform such testing. A signed affidavit documenting test results in
accordance to IECC/WSEC Section R403.2.2 shall be provided to the Mason County Building Department prior to the final occupancy inspection.
Affidavit forms are available on at the WSU-Energy Program website titles, "Duct Leakage Affidavit" or"Duct Leakage Testing Results (Existing
Construction)." Duct tightness testing is not required if the air handler and all ducts are located within the heated space.
X ')
5) The demolition and disposal of debris must meet the regulations of Mason County and Olympic Region Clean Air Agency (ORCAA).
It is unlawful for any person to cause or allow the demolition (or major renovation) of any structure unless all asbestos containing materials have been
identified and removed from the area to be demolished. Work shall not commence on an asbestos project or demolition project unless the owner or
operator has obtained written approval from ORCCA.2490 B Limited Lane NW, Olympia WA 98502, 360.586.1044/800.422.5623 www.orcaa.org
X
6) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason County ordinances and building regulations.
X
7) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder have prevented action from being taken. No more than one extension may be granted.
X
BLD2015-00801 Please refer to the following pages for conditions of this permit. Page 3 of 4
OWNER/ BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by
signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the
work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The
owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if
construction work is suspended for aperi d of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION 0F48"AYS WILL INVALIDATE THE APPLICATION.
ature Date
��f OWNER - REPRESENTATIVE - CONTRACTOR
Print Name (Circle one to indicate)
BLD2015-00801 Please refer to the following pages for conditions of this permit. Page 4 of 4
(9/16/2015) Genie McFarland - mech permit_packet.pdf.pdf Page 1
° rt MASON COUNTY PERMIT NO.J�' D08o
DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING•PLANNING•FIRE MARSHAL
WWW.cO.MASON.WA.US (360)427-9670 Shelton ext.352
y Mason County Bldg.III,426 West Cedar Street (360)275-4467 Belfair ext.352
r a PO Box 279,Shelton,WA 98584 (360)482-5269 Elma ext.352
PLUMBING &MECHANICAL PERMIT APPLICATION
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: Underhill Tom NAME: Price Jones,LLC.
MAILING ADDRESS: 422 L UronquisFREF— MAILING ADDRESS: 26262 Leyman Ln Ne
CITY: STATE: Wa ZIP: I CITY: Kingston STATE: Wa ZIP: 98346
PHONE- CELL: PHONE: 360-377-6119 CELL:
EMAIL: CO 8 EMAIL: PriceJonesLLCP-gmail.com
L&I REG# PJSHOHE914KL EXP.
PARCEL INFORMATION: r
PARCEL NUMBER(12 DIGIT NUMBER): o� - "7 - I CIO
LEGAL DESCRIPT��IQQN(4BBREVIAT�Q):
SITE ADDRESS: ''tom. — CITY: t �
DIRECTIONS TO SITE ADDRESS:
TYPE OF JOB
NEW ADD ALT REPAIR OTHER USE OF BUILDING
LOCATION OF FIXTURES/UNITS—IST FLOOR 2hDFLOOR BASEMENT GARAGE OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No.of Fixtures Fees Fuel Type:Electric_LPG_Natural Gas—Heat Pump_
Toilets Type of Unit No.of Units Fees
Bathroom Sink Furnace
Bath Tubs Heatpump
Showers Spot Vent Fan
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kitchen Sinks Wood/Gas/Pellet Stove
Dishwasher Kitchen Exhaust Hood
Hosebibs Dryer Vent
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or contractor.I further declare
that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including
any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is
accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This
permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is
suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS WILL ALIDATE THE APPLICATION.
x 7/29/2015
Sign re of Applican Date
X Detrick Jones Owner/Owners Representative/Contractor
Print Name (indicate which one)
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
MASON COUNTY
Department of Community Services
Planning Division
615 W Alder St, Shelton WA 98584
IPI (360)427-9670
Exemption from Shoreline Management Act
Case No: SHX2019-00004 Substantial Development Permit
The Proposal By: Underhill Floating Dock Piling (3) Replacement
16014 120th Ave. N E
Bothell, WA 98011
Parcel Number: 12232-40-91190
Site Address: 422 E. Cronquist Rd., Allyn
To undertake the following development:
Repair and Replace three pilings associated with an existing floating dock
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:
Repair & Replacement
Please contact Ron Buckholt at ext 287 if you have any questions.
Issued:2/15/2019 &*e-�/�
Authorized Local Government Official
2/15/2019
---------------------------------------
AGENCY USE ONLY
..
M i
� Date received:
WASHINGTON STATE of�a TS
Joint Aquatic Resources Permit Agency reference#:
Application (JARPA) Form" Tax Parcel#(s): k!MQ,-LAoCf 19f)
USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. 1
i
1 ,
RECEIVED --
DEC 2 0 2018
Part 1—Project Identification 615 W. Alder Street
1. Project Name (A name for your project that you create. Examples: Smith's Dock or Seabrook Lane Development) hel
Tom Underhill Piling Replacement
Part 2—Applicant
The person and/or organization responsible for the project. [Lelpj
2a. Name (Last, First, Middle)
Underhill, Tom
2b. Organization(If applicable)
2c. Mailing Address (Street or PO Box)
16014 1201h Ave NE
2d. City, State, Zip
Bothell, WA 98011
2e. Phone(1) 2f. Phone(2) 2g. Fax 21h. E-mail
(206)550-0168 ( ) ( ) ftunderhill@gmail.com
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
http://www.nws usace.army.mil/Missions/CivilWorks/Regulatory/PermitGuidebook/EndangeredSpecies asr)x.
• 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.epermifting.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)ora.wa.gov.
JARPA Revision 2012.2 Page 1 of 12
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.) LtLeM
3a. Name (Last, First, Middle)
Chase, Lorrie
3b. Organization (If applicable)
Marine Floats Corporation
3c. Mailing Address (street or Po Box)
1208 E D St
3d. City, State, Zip
Tacoma, WA 98421
3e. Phone(1) X Phone(2) 3g. Fax 3h. E-mail
(253)383-2740 ( ) (253)383-1102 Ichase@marinefloats.com
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. LheM
® 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)
4b. Organization (If applicable)
4c. Mailing Address (Street or Po Box)
4d. City, State, Zip
4e. Phone(1) 0. Phone(2) 4g. Fax 4h. E-mail
JARPA Revision 2012.2 Page 2 of 12
-Project Location(s)
ntifying information about the property or properties where the project will occur. heI
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.) heI
® 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.) heI
422 E Cronquist Rd
5C. city, State, Zip(If the project is not in a city or town, provide the name of the nearest city or town.) heI
Allyn, WA 98524
5d. County heI
Mason County
5e. Provide the section, township, and range for the project location. heI
% Section Section Township Range
32 22N 1 W
5f. Provide the latitude and longitude of the project location. heI
• Example:47.03922 N lat./-122.89142 W long. (Use decimal degrees-NAD 83)
47.352670/-122.825920
5g. List the tax parcel number(s)for the project location. [bpjpj
• The local county assessor's office can provide this information.
122324091190
5h. Contact information for all adjoining property owners. (If you need more space, use JARPA Attachment C.) [held
Name Mailing Address Tax Parcel # (if known)
Raskin, Et Al, Jack and Irene 114 131"Ave NE 122324091020
Bellevue, WA 98005
Fetch, John and Donna 1933 SE 16th Place 122324091032
Renton, WA 98055
51i. List all wetlands on or adjacent to the project location. h( elp]
Unknown
5j. List all waterbodies (other than wetlands) on or adjacent to the project location. heI
Case Inlet, Puget Sound
5k. Is any part of the project area within a 100-year floodplain? heI
JARPA Revision 2012.2 Page 3 of 12
® Yes ❑ No ❑ Don't know 5301150150C Eff: 5/17/1988
51. Briefly describe the vegetation and habitat conditions on the property. hel
Residential grasses, shrubs and trees
5m. Describe how the property is currently used. hel
Residential use
5n. Describe how the adjacent properties are currently used. hf eld
Residential use
5o. Describe the structures (above and below ground) on the property, including their purpose(s) and current
condition. hel
Single family home, detached garage, stairs, and bulkhead most in good condition.
5p. Provide driving directions from the closest highway to the project location, and attach a map. hf elA
Take WA-16 W toward Bremerton
Take the Burnham Dr NW exit
At the traffic circle, take the 4th exit onto Burnham Dr NW
At the traffic circle, take the 1 st exit and stay on Burnham Dr NW
Turn right to stay on Burnham Dr NW
Turn left onto Purdy Dr NW
Turn left onto WA-302W
Turn right to stay on WA-302W
Continue straight onto E North Bay Rd.
Merge onto WA-3 S
Continue on E Grapeview Loop Rd. Drive to Cronquist Rd
Turn left onto E Grapeview Loop Rd.
Turn left onto Cronquist Rd.
Part 6—Project Description
6a. Briefly summarize the overall project. You can provide more detail in 6b. hei
Replace (3) existing failing creosote float pilings with (3) 10" galvanized steel float piling(s).
6b. Describe the purpose of the project and why you want or need to perform it. hf eM
Due to the condition of the pilings; the replacement is needed to ensure human safety when utilizing the dock.
The dock itself is needed for water dependent access, and will create an opportunity for water dependent
activities such as fishing, swimming, boating.
6C. Indicate the project category. (Check all that apply) [he
❑ Commercial ® Residential ❑ Institutional ❑ Transportation ® Recreational
❑ Maintenance ❑ Environmental Enhancement
6d. Indicate the major elements of your project. (Check all that apply) [help]
❑ Aquaculture ❑ Culvert ❑ Float ❑ Retaining Wall
(upland)
JARPA Revision 2012.2 Page 4 of 12
❑ Barik Stabilization ❑ Dam /Weir ❑ Floating Home ❑ Road
❑ Boat House ❑ Dike / Levee /Jetty ❑ Geotechnical Survey ❑ Scientific
❑ Boat Launch ❑ Ditch ❑ Land Clearing Measurement Device
❑ Boat Lift ❑ Dock / Pier ❑ Marina / Moorage ❑ Stairs
❑ Bridge ❑ Dredging ❑ Mining ❑ Stormwater facility
❑ Bulkhead ❑ Fence ❑ Outfall Structure ❑ Swimming Pool
❑ Buoy ❑ Ferry Terminal ® Piling/Dolphin ❑ Utility Line
❑ Channel Modification ❑ Fishway ❑ Raft
❑ Other:
6e. Describe how you plan to construct each project element checked in 6d. Include specific construction
methods and equipment to be used. hel
• Identify where each element will occur in relation to the nearest waterbody.
• Indicate which activities are within the 100-year floodplain.
Replace (3) existing failing creosote float pilings with (3) 10" galvanized steel float piling(s).
Construction sequence of the piling replacements will be:
1. Remove (3) existing failing creosote treated timber pilings. The piling(s) will be removed using direct pull
methods unless physically impossible. Direct pull method will incorporate BMPs at all times. Barge will
not be permitted to ground. Work surface on barge shall include a containment basin for the pilings and
any sediments or debris. A floating surface boom will be installed to capture any debris or oil sheen.
Pilings will not be shaken or scraped during the removal process, and will be taken from the site in a
work barge to be properly disposed of at an upland disposal site.
2. Install (3) 10" galvanized float piling(s). The new piling(s) will be barged to site and driven using an
impact hammer utilizing a bubble curtain and wooden block cushion for sound attenuation (Longmuir and
Lively 2001).
Marine Floats will transport the old pilings offsite to an approved upland disposal site.
6f. What are the anticipated start and end dates for project construction? (Month/Year) hel
• 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: December 2018 End date: Feb 2020 ❑ See JARPA Attachment D
6g. Fair market value of the project, including materials, labor, machine rentals, etc. hf elpl
$26,115.00
6h. Will any portion of the project receive federal funding? hf eio
• 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.) hel
JARPA Revision 2012.2 Page 5 of 12
7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. hei
® Not applicable
7b. Will the project impact wetlands? hel
❑ Yes ® No ❑ Don't know
7c. Will the project impact wetland buffers? [held
❑ Yes ® 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 ® No
7e. Have the wetlands been rated using the Western Washington or Eastern Washington Wetland Rating
System? [help]
• 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? hei
• 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 ® Not applicable -
N/A
7g. Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was
used to design the plan. hei
N/A
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. hei
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
categoryZ 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.
3Indicate 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:
7i. 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. [help]
N/A
JARPA Revision 2012.2 Page 6 of 12
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. hel
N/A
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
❑ 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
1. The overall project complies with all regulatory agencies to minimize environmental impacts;
2. The piling(s) are small and galvanized steel;
3. The piling (s) are driven with a impact pile hammer, utilizing a bubble curtain and wood block cushion for
sound attenuation;
4. The floating pile driver will not ground;
5. Care will be taken to contain all construction debris;
6. Best management practices (BMP's) will be exercised throughout this project;
7. Regulatory in-water work windows will be observed.
81b. Will your project impact a waterbody or the area around a waterbody? hel
® Yes ❑ No
8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland
waterbodies? hf eid
• 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 ❑ Not applicable
No mitigation plan has been completed at this time. Our preference is to receive comments first from the various
agencies in order to comply with their requirements. This results in fewer revisions.
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. hf elpl
NIA
8e. Summarize impact(s) to each waterbody in the table below. hei
Activity (clear, Waterbody Impact Duration of Amount of material Area (sq. ft. or
dredge, fill, pile name' location impact3 (cubic yards) to be linear ft.) of
drive, etc.) placed in or waterbody
removed from directly affected
waterbod
Remove Case Inlet Occurs in Permanent Remove (3) 12" 2.37 sq ft
Creosote Float Water creosote pilin
JARPA Revision 2012.2 Page 7 of 12
Piling
Install Steel Float Case Inlet Occurs in Permanent Install (3) 10" 1.65 sq ft.
Piling Water galvanized steel
pilings
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.
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. hem
N/A
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. hel
N/A
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. nel
Agency Name Contact Name Phone Most Recent
Date of Contact
Mason County ( )
WDFW ( )
USACE ( )
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? hl eM
• 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.gov/programs/wq/303d/.
❑ Yes ® No
9c. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? hem
• Go to http://cfpub.epa.gov/surf/locate/index.cfm to help identify the HUC.
17110019
9d. What Water Resource Inventory Area Number (WRIA#) is the project in? hf eM
• Go to http://www.ecy.wa.gov/services/gis/maps/wria/wria.htm to find the WRIA#.
WRIA #15
9e. Will the in-water construction work comply with the State of Washington water quality standards for
turbidity? [held
• Go to http://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? hl elpl
JARPA Revision 2012.2 Page 8 of 12
9e. Will the in-water construction work comply with the State of Washington water quality standards for
turbidity? hel
• Go to http://www.ecy.wa.gov/programs/wq/swqs/criteria.htm]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.html.
❑ Rural ❑ Urban ❑ Natural ❑ Aquatic ❑ Conservancy ❑ Other Rural Residential
9g. What is the Washington Department of Natural Resources Water Type? h( gm
• Go to http•//www dnr wa qov/BusinessPermitsfTopics/ForestPracticesApplications/Pages/fp watertyping aspx 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? h[ e�]I
• If No, provide the name of the manual your project is designed to meet.
❑ Yes ❑ No X N/A
Name of manual:
9i. Does the project site have known contaminated sediment? hel
• If Yes, please describe below.
❑ Yes ❑ No
9j. If you know what the property was used for in the past, describe below. hf eM
Unknown
91k. Has a cultural resource (archaeological) survey been performed on the project area? hel
• If Yes, attach it to your JARPA package.
❑ Yes ❑ No Should archaeological materials (e.g. bones, shell, stone tools, beads, ceramics, old bottles,
hearths, etc.) or human remains be observed during project activities, all work in the immediate vicinity should stop.
The State Department of Archaeology and Historic Preservation (360-586-3065), the County/City planning office,
the affected Tribe(s) and the county coroner(if applicable) should be contacted immediately in order to help assess
the situation and determine how to preserve the resource(s). Compliance with all applicable laws pertaining to
archaeological resources (RCW 27.53, 27.44 and WAC 25-48) is required. Failure to comply with this requirement
could constitute a Class C Felony
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. h[ elpl
Nearshore Rockfish, Puget Sound Chinook Salmon, Bull Trout, Marbled Murrelet, Pacific Herring pre-spawner
holding area -r1,000 ft to the east, Sand Lance
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. hLeM
Surf Smelt spawning northeast -2,000 ft, Estuarine and Marine Wetland, Estuarine Zone
JARPA Revision 2012.2 Page 9 of 12
❑ A SEPA determination is pending with (lead agency). The expected decision date is
❑ 1 am applying for a Fish Habitat Enhancement Exemption. (Check the box below in 10b.)LeAl
® This project is exempt (choose type of exemption below).
❑ Categorical Exemption. Under what section of the SEPA administrative code (WAC) is it exempt?
WAC 197-11-800 (3) Repair, remodeling and maintenance activities
❑ Other:
❑ SEPA is pre-empted by federal law.
10b. Indicate the permits you are applying for. (Check all that apply.) h[ eIp]
LOCAL GOVERNMENT
Local Government Shoreline permits:
❑ Substantial Development ❑ Conditional Use ❑ Variance
X Shoreline Exemption Type (explain): WAC 173-27-040 2(b) normal maintenance and repair
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 —Attach Exemption Form
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.
❑ 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.)
❑ Project 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
JARPA Revision 2012.2 Page 10 of 12
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 Page 11 of 12
Part 11—Authorizing Signatures
Signatures are required before submitting the JARPA package. The JARPA package includes the JARPA form,
project plans, photos, etc. h[ elp)
11a. Applicant Signature (required) t I
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 au tho 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 ente&' Aproperty where the project is located to inspect the project site or any work
related to the project (initial)
2.
Applicant Printed Name App i Slgn Date
11 b. Authorized Agent Signature hel
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.
/V//
Authorized Agent Printed Name Authorized Agent Signature Date
11c. Property Owner Signature (if not applicant). h[Nd
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.
Property Owner Printed Name Property Owner SignWike 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)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.
ORA Dublication number. ENV-019-09 rev.06-12
JARPA Revision 2012.1 PaM 1 nf I
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1208 East D St-Tacoma-WA 98421-253-383-2740
SCALE: 1"=3of APPROVED BY: DRAWN BY
DATE: 1 2-4-1 8 REVISION#
PROPOSED SITE PLAN
UNDERHILL, TOM DRAWING NUMBER
CASE INLET 2583
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RECEIVEIRCCEI\ iCD
MASON COUNTY DEC 2 0 2018
COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
615 W. Alder Street
615 W.Alder St.—Bldg.8,Shelton,Wa 98584
Phone:(360)427-9670 ext.352♦ Fax:(360)427-7798 PERMIT
SHORELINE PERMIT APPLICATION
SHORELINE PERMITS
CONDITIONAL USE* SUBSTANTIAL DEVELOPMENT
VARIANCE* EXEMPTION
The Washington State Shoreline Management Act (RCW 90.58) requires that substantial developments 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 the total cost or fair market
value exceeds $7,047.00 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 may further describe the proposed development.
Incomplete applications will be returned.
*Shoreline Variances and Conditional uses require public hearings and have additional pages that shall be
attached to this application.
APPLICANT: �—
ADDRESS: I 6 f / +�.�U E N E
(street) k)ft-
(city) / (state) (zip)
TELEPHONE: aD(,- �.50- d l 6
(home) / (business)
AUTHORIZED REPRESENTATIVE:
ADDRESS: D D e�/q ST D d
-7-A,(!LM P- (street)
(city) 2 2 (state) (zip)
TELEPHONE:
PROPERTY DESCRIPTION:
General location (include property address, water body and associated wetlands-identify the name of the shoreline):
0/577 /U)p
Rev. March 1, 018
Include all parcel numbers: Projects located in open water areas, away from land shall provide latitude/longitude.
OWNERSHIP: Contract
Applicant Owner V Lessee Purchaser (Identify) Other
Owner:
(street) (city) (state) (zip)
DEVELOPMENT DESCRIPTON:
Development proposal (identify and describe the proposed project, including the type of materials to be used, construction
methods, principle dimensions, and other pertinent information):
1A/a ,tz& aa1VAzVz7, r,7::) h 1
_ z
_ 02-ZAPQ
Existing Use (identify current use of property with exist improvements):
w� 2�h ir°2 C)!< f& h L!,�Z &/V_1 9614
Reason for requesting development:
1
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The applicant shall provide, at a minimum, the following information:
a. SITE PLAN - drawn to scale and including:
i. The boundary of the parcel(s)of land upon which the development is proposed;
ii. The ordinary high water mark (OHWM). This may be an approximate location provided, that for
any development where a determination of consistency with the applicable regulations requires a
precise location of the OHWM the mark shall be located precisely and the biological and
hydrological basis for the location as indicated on the plans shall be included in the development
plan. Where the OHWM is neither adjacent to or within the boundary of the project, the plan shall
indicate the distance and direction to the nearest OHWM of a shoreline;
iii. Where appropriate, the proposed land contours using five-foot intervals in water area and ten-foot
intervals on areas landward of OHWM, if development involves grading, cutting, filling, or other
alteration of land contours;
iv. The dimensions and location of existing structures which will be maintained; VIA
V. The dimensions and locations of proposed structures; parking and landscaping;
vi. The location of proposed utilities, such as sewer, septic tanks and drain fields, water, gas and
electricity;
vii. The location, source, composition, and volume of fill material;
viii. The location, composition and volume of any extracted materials, and proposed disposal area;
b. CROSS SECTION, drawn to scale including:
i. The existing ground elevations;
ii. The proposed ground elevations;
Jiii. The location and height of existing structures;
iv. The location and height of proposed structures;
V. The OHWM.
c. VICINITY MAP, including:
i. The location of subject parcel using natural points of reference (roads, state highways, prominent
landmarks, etc.).
ii. If the development involves the removal of any soils by dredging or otherwise, identify the
N/ proposed disposal site on the map. If disposal site is beyond the confines of the vicinity map,
provide another vicinity map showing the precise location of the disposal site and its distance to
nearest city or town.
iii. On the map, or separately, give a brief narrative description of the vicinity of the proposed project
including identification of the adjacent uses, structures and improvements, intensity of
development and physical characteristics. 'S f E—:� R PA
d. ADJACENT LANDOWNERS. Provide names and mailing addresses of all real property owners
within 300 feet of property line boundaries where development is proposed.
ACKOWLEDGEMENT:
I hereby declare, to the best of my knowledge and belief, the forgoing information and all attached information is true and
correct.
(Applicant or Authorized Representative) (date)
..................................................................................................................................................................................................................................................
Publication Cost Agreement
Publication cost is the responsibility of the applicant. Final permit processing will not occur until advertising fees have
been paid to the newspaper by the applicant. The Shelton-Mason County Journal will bill the applicant directly.
I/WE understand that I/WE must sign and date the attached acknowledgment indicating and that I/WE understand that
is MY/OUR responsibility. I/WE must submit the signed page as part of application in order for it to be considered as
complete.
Signature of Property Owner Date Print Name
OR
Signature of Applicant Date Print Name
LIST OF ADJACENT PROPERTY OWNERS' MAILING ADDRESSES
WITHIN 300 FEET OF YOUR PROPERTY BOUNDARIES
FOR PUBLIC HEARING NOTIFICATION
December 3, 2018
Dear Tom,
In order to submit your documents to Mason County and act on your behalf to the process the
necessary Shoreline Substantial Development Exemption Application,JARPA, various
documents, studies and/or reports, the following statement needs to be signed and returned for
submittal to Mason County.
PROPERTY MANAGER/APPLICANT AGREEMENT
The undersigned is the property owner of record of the property identified by the Mason County
Assessor's account number 122324091190 and
located at 422 East Cronquist Rd., Allyn,WA 98524
The undersigned gives(give)cone and approval to Marine Floats Corporation
To act on his/her/their behalf as er/ agent to proceed with a land use application for a
(an) Shoreline Substantial elhi ent xem tion Permit JARPA and associated studies/r orts
on the Fy &efeenc,,1re'
Owner ate
NOTARY:
STATE OF WASHINGTON)
SS
COUNTY OF KING )
On this I a day of Dece -o L before me,the undersigned,a Notary Public
in and for the State of Washington,duly commissioned and sworn,personally appeared
Fra,*c `1` U n ae i 1- I` to me known to be the individual described in and who
executed the foregoing instrument,and acknowledged to me that he/she/they signed and sealed
the said instrument as a free and voluntary act and deed for the uses and purposes therein
mentioned.
Given under my hand and official seal this day of
A j ►► Notary Public in and for the State of Washington
M1ss►o ,,/� F �`� �h
- �o rq�FtA,�9� Residing at 1311 o .�/� I? ) P L
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My commission expires L{ 16 a d
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422 Cronquist Rd
Marine Floats
1208 East D St-Tacoma-WA 98421-253-383-2740
t t APPROVED BY:
SCALE: NTS DRAWN BY
DATE: 12-4-18 REVISION#
PROPRIETARY PROPERTY
MARINE FLOATS CORPORATION
This document is the proprietary property of VICINITY MAP
Marine Floats Corporation and shall not be used in part or whole
for any other project without
THE WRITTEN PERMISSION OF MARINE FLOATS UNDERHILL, TOM DRAWING NUMBER
CORPORATION CASEIN LET 2583
RASKINS, ET AL
424 E CR❑NQUIST RD
ALLYN, WA 98524
122324091020
UNDERHILL, TOM
422 E CR❑NQUIST RD
ALLYN, WA 98524
122324091190 v
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FETCH, J❑HN AND DONNA Oz \
XXX E CR❑NQUIST RD
ALLYN, WA 98524 0
122324091032
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Marine Floats
1208 East D St-Tacoma-WA 98421 -253-383-2740
PROPRIETARY PROPERTY SCALE 1 °=30 APPROVED BY: DRAWN BY
MARINE FLOATS CORPORATION
This document is the proprietary property of DATE: 1 Z-4-1 8 REVISION#
Marine Floats Corporation and shall not be used in part or whole
for any other project without EXISTING SITE PLAN
THE WRITTEN PERMISSION OF MARINE FLOATS
CORPORATION
UNDERHILL, TOM DRAWING NUMBER
CASE INLET 2583
RASKINS, ET AL
424 E CR❑NQUIST RD
ALLYN, WA 98524
122324091020
UNDERHILL, TOM
422 E CR❑NQUIST RD
ALLYN, WA 98524
122324091190 v
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FETCH, J❑HN AND DONNA
XXX E CR❑NQUIST RD
ALLYN, WA 98524 o
122324091032 - \
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i REPLACE (3) CREOSOTE PILING
WITH STEEL PILE (10' - 3/4")
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1208 East D St-Tacoma-WA 98421 -253-383-2740
O A� OR SCALE: 1 "=3 Q' APPROVED BY: DRAWN BY
PROPRIETARY PROPERTY
MARINE FLOATS CORPORATION
This document is the proprietary property of DATE: 2-4- $ REVISION#
Marine Floats Corporation and shall not be used in part or whole
forany other project without PROPOSED SITE PLAN
THE WRITTEN PERMISSION OF MARINE FLOATS
CORPORATION
UNDERHILL, TOM DRAWING NUMBER
CASE INLET 2583
104'
42' 32' 30'
10' 20'
O o
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O O (1J
VEPLACE (3) CREOSOTE PILING
WITH STEEL PILE (10' - 3/4")
Al
Marine Floats
1208 East D St-Tacoma-WA 98421-253-383-2740
� ' :
SCALE: � = 20 APPROVED BY DRAWN BY
DATE: 1 2.4_1 8 REVISION#
PROPRIETARY PROPERTY
MARINE FLOATS CORPORATION
This document is the proprietary property of PROPOSED PILING REPLACEMENT
Marine Floats Corporation and shall not be used in part or whole
for any other project without
THE WRITTEN PERMISSION OF MARINE FLOATS UNDERHILL, TOM DRAWING NUMBER
CORPORATION CASE INLET 2583