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MEP2021-00015 JARPA - MEP Permit / Conditions - 7/14/2021
Mason County Planning Division of Community Development 615 W. Alder St. Bldg.8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us F 1-00015 MASON ENVIRONMENTAL PERMIT DESCRIPTION: REMOVE SLIT, REMOVE CONCRETE ISSUED: 07/14/2021 @SOUTH END, TO RELEASE WATER & SILT BUILD UP ESS: 140 NE MAKELA RD BELFAIR EXPIRES: 01/10/2022 PARCEL: 123202100020 APPLICANT: JOHNSON GARY M &COLLEEN M OWNER: JOHNSON GARY M&COLLEEN M PO BOX 518 PO BOX 518 BELFAIR,WA 98528 BELFAIR, WA98528 1.360.275.4274 CONDITIONS * Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent waters. Silt fencing must be installed and maintained until vegetation has become established or what is the best practice as determined by the Department of Fish &Wildlife. " The proponent shall obtain all necessary Federal and State permits prior to the commencement of any work. * Comply with all requirements that may be placed on the project by the Department of Fish and Wildlife I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of Laws and Ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of ny other state/local law regulating construction or the performance of construction. Issued By: Ac �� Contractor or Authorized Age t: Date: Printed by:Scott Ruedy on:07/14/2021 10:20 AM Page 1 of 1 I d M I 1 7 � f WASHINGTON STATE ofEngineeers Date receive 'iUL 08 2021 S-dw Dishid I I Joint Aquatic Resources Permit I 1 AgencBt'gr e Application (DARPA) Form��2 h[ elpl PZ_U o1.101 USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. ' _I 1 Tax Parcel#(s): la�j2o • - 0002.0 ------------------------------------- Part 1—Project Identification 1. Project Name (A name for your project that you create. Examples:Smith's Dock or Seabrook Lane Development) hf elal :To rJ C ACE14 Part 2—Applicant The person and/or organization responsible for the project. h( eM 2a. Name (Last, First, Middle) n —7 a�500 &P-r- ► "l . 2b. Organization(If applicable) 2c. Mailing Address (Street or PO Box) 2d. City, State, Zip F/A+1'A tju,4- q8s 28 2e. Phone(1) 2f. Phone(2) 2g. Fax 2h. E-mail 3&Q 2-T5--` Z7 m a n ©oz3 Wrn 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/EndancleredSpecies.asi) • 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:/twww.ei)ermitting.wa.gov/site/alias resourcecenter/ian:)a iarpa form/9984/iarpa form asox. For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or helpAoria.wa.gov. ORIA-16-011 Page 1 of 14 Part 3—Authorized Agent or Contact Person authorized to represent the applicant about the project. (Note: Authorized agent(s) must sign 11 b of this application.) Lnei 3a. Name (Last, First, Middle) 3b. Organization (if applicable) 3c. Mailing Address (Street or Po Box) S! 3d. City, State, Zip 13rt-14?7,,2 A- . ct,�528 3e. Phone(1) 3f. Phone(2) 3g. Fax 3h. E-mail &o -215_Ifz7� OC7 tVI'h5n CO 01 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. tg!PJ 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. 0 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) 4f. Phone(2) 4g. Fax 4h. E-mail ORIA-16-011 Page 2 of 14 Part 5—Project Location(s) Identifying information about the property or properties where the project will occur. h ❑ 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.) hf elpl _ 25 Private ❑ Federal ❑ Publicly owned (state,county, city, special districts like schools, ports,etc.) ❑ Tribal ❑ Department of Natural Resources (DNR)—managed aquatic lands (Complete JARPA Attachment E) 5b. Street Address (Cannot be a PO Box. If there is no address, provide other location information in 5p.) h[ ela] 5c. City, State, Zip (If the project is not in a city or town, provide the name of the nearest city or town.) hf elpl 5d. County n[ ejl 900 5e. Provide the section, township, and range for the project location. h[ ell '/4 Section Section Township Range 5f. Provide the Latitude and longitude of the project location. hel • Example:47.03922 N lat./-122.89142 W long. (Use decimal degrees-NAD 83) 5g. List the tax parcel number(s)for the project location. [tpipi • The local county assessor's office can provide this information. 4ft l Z 3 Zo- Z I - 0002-o 5h. Contact information for all adjoining property owners. (If you need more space, use JARPA Attachment C.) hf elpl Name Mailing Address Tax Parcel #(if known) ORIA-16-011 Page 3 of 14 5i. List all wetlands on or adjacent to the project location. n( eM �J©NE 5j. List all waterbodies (other than wetlands) on or adjacent to the project location. [tLei NoNJ _ 5k. Is any part of the project area within a 100-year floodplain? tLg] ❑ Yes )LNo _❑ Don't know 51. Briefly describe the vegetation and habitat conditions on the property. hei D E6 D V 0G'-S -r12;i6 S, P/NCI rr it 21 EPA-rz ¢ Mxz , 4t50 SOME M� t ESwN ��. s, eRy �oU�� ��s� �- w ES sow J)ajp /4R r-,4, r 5 r,1 (1,60 GU 1 r#-,XU 657b5 10AIIEC 5m. Describe how the property is currently used. h[ eM RCS1 bE"riAL , W- 14 VE 666 PpCv 4, NFw 3 49D0 y2 �'N �,�,4-ss. 1-6 x9 a x 5n. Describe how the adjacent properties are currently used. ►,f em e tFpA-i2 -rceEES )q 6 v7-S o P r"99) A I NS I' 5o. Describe the structures (above and below ground) on the property, including their purpose(s) and current condition. nr el 30xba 1{ou 2V x 40 "J � AS O L 6 Zq,x Zt� 4g- g, s CJ�C- 5p. Provide driving directions from the closest highway to the project location, and attach a map. nr eM 00 13E1 42W2 I+ywA-y 1 �g m ' N, e7Z7 8E(,�A/A 40 - MAk- ESA- )D. ORIA-16-011 Page 4 of 14 Part 6-Project Description 6a. Briefly summarize the overall project. You can provide more detail in 6b. hel 0 y r—/}-P-S r LLB D A)' fly S r LT 62 0 P-N- Ups L�lt►vl tA2 F GvEcDs 4 L L ® IJE4 CN?/Rc /4PEA 61A&�NQ7- JAJA I'T,- Mo ✓E CON E TC= 6b. Describe the purpose of the project and why you want or need to perform it. hel T6 D I C C°REi�,-/1 BE0 4- LLs ?'D � AR-A G d�V�LED S✓oEGvA- L Y -rO/f i/ -rh AgCp- ,4'� W ( I 96�toPE 5C-'kRVP1Vb11� twoVN W 1{cN ✓T. DQ!E S 007- /O 'FK IkARiA)E 616 Lb4.�ST 6c. Indicate the project category. (Check all that apply) h[ elp_] ❑ 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 9 Bank Stabilization ❑ Dam/Weir ❑ Floating Home (upland) ❑ Boat House ❑ Dike/ Levee/Jetty ❑ Geotechnical Survey ❑ Road ❑ Boat Launch ❑ Ditch ❑ Land Clearing ❑ Scientific Measurement Device ❑ Boat Lift ❑ Dock/Pier ❑ Marina/Moorage ❑ Stairs ❑ Bridge 9 Dredging ❑ Mining ❑ Stormwater facility ❑ Bulkhead ❑ Fence ❑ Outfall Structure ❑ Swimming Pool ❑ Buoy ❑ Ferry Terminal ❑ Piling/Dolphin ❑ Utility Line C4Channel Modification *Fishway ❑ Raft ❑ Other: ORIA-16-011 Page 5 of 14 6e. Describe how you plan to construct each project element checked in 6d. Include specific construction methods and equipment to be used. [tpjpJ • Identify where each element will occur in relation to the nearest waterbody. • Indicate which activities are within the 100-year floodplain. 1 6 n'i G 0 :l t o W©R Ic w rt f g����r 60"Or i a- CANpt.>_ IOU X I--xCAV,�Tm D(��To fZ T6 Art-HAS D o N C 0� �a 6f. What are the anticipated start and end dates for project construction? (MonthNear) of elpl • 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:© 0 ZOZ( End Date: Z6 Z 1 ❑ See JARPA Attachment D 6g. Fair market value of the project, including materials, labor, machine rentals, etc. hr eM � G uEsS1N9 " *?� -� S.Ovo 6h. Will any portion of the project receive federal funding? MPJ • If yes, list each agency providing funds. ❑ Yes ANo ❑ 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 7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. hel ❑ Not applicable 7b. Will the project impact wetlands? hei ❑ Yes ❑ No ❑ Don't know 7c.Will the project impact wetland buffers? hei ❑ Yes ❑ No ❑ Don't know ORIA-16-011 Page 6 of 14 140 NE Makela Rd-Google Maps Google Maps 140 ICE Makela Rd! Z m 0 c L NE Nristiano WOY O ZI- oc�� PI+ •140 NE Makela Rd Belfair.WA 98528 v p. • =4i S s Nr MAO,Rd � pL O'bl 8�fa`ti S � Ndt Rd m \ O \ 6 \ I A \ I Puget SoundE Go gle Q Map data©2021 200 t' ' L-I'ttpS://Www google comrfnapslplace7140-fMEE•Makela+Rd,+Belfair,+WA+9852a/@47 4730392..122.8354938,177/data=13wfilkWl4m5l:3m4!lsOx5491cabe48c5e441:Oxfa66c3ba425a3be518m2!3d47 471 1/2 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? Lbp!pj -• If-Yes,—submit-the wetland-ratir�g�fo-rrri�s-a�tl-fg>-ire��iitti th�JaRPA p�ckaye —-- ❑ Yes ❑ No ❑ Don't know 7f. Have you prepared a mitigation plan to compensate for any adverse impacts to wetlands? nel • If Yes, submit the plan with the JARPA package and answer 7g. • If No,or Not applicable,explain below why a mitigation plan should not be required. ❑ Yes ❑ No ❑ Don't know 7g. Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was used to design the plan. hel 71h. 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. LtLeM Activity (fill, Wetland Wetland Impact Duration Proposed Wetland drain, excavate, Name' type and area (sq. of impact' mitigation mitigation area flood, etc.) rating ft. or type' (sq.ft. or category2 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. 'Indicate the days,months or years the wetland will be measurably impacted by the activity.Enter"permanent"if applicable. "Creation C ,Re-establishment/Rehabilitation R,Enhancement E,Preservation P,Mitigation Bank/In-lieu fee B Page number(s)for similar information in the mitigation plan, if available: ORIA-16-011 Page 7 of 14 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. hf eio 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. hLelpl 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[M ❑ 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. heI ❑ Not applicable . ? woN 'r -T-mloc-c+ 4Ny feA M#r2'INc �D�c,� isrt- 8b. Will your project impact a waterbody or the area around a waterbody? b@_!pJ ❑ Yes [A No ORIA-16-011 Page 8 of 14 8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland waterbodies? h[ eM • If Yes,submit the plan with the JARPA package and answer 8d. • If No,or Not applicable,explain below why a mitigation plan should not be required. ❑ Yes ❑ No ® Don't know 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. h( esI J Be. Summarize impact(s)to each waterbody in the table below. hel Activity (clear, Waterbody Impact Duration Amount of material Area (sq.ft. or dredge, fill, pile name' location of impact' (cubic yards) to be linear ft.) of drive, etc.) placed in or removed waterbody from waterbody directly affected —ro11Ns101j 14-rCA6EIt Z-3 3"GvIC 4; HX&V, 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. 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. h( eip] No Fr "- -rzD f3c ORIA-16-011 Page 9 of 14 8g. For all excavating or dredging activities identified in 8e, describe the method for excavating or dredging, type and amount of material you will remove, and where the material will be disposed. hr elpl Exd A ✓4 T-0 lzi-, B>jckHot, tV1'DE X H164 xto0 ' LoK6 S.r`.-r j-W&DS /Our r-tj 142EPr 8 4ck 1,N PAP&zTy Ole `b f3Y t3loa03 r Sr 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. [LeI Agency Name Contact Name Phone Most Recent Date of Contact 6)o ro6,5`r 60,4po1J ZO- 3iov I 'ZT Su ZOZO HOOP(Em SA L�Mok) (EE ' NNA 6005=,5Z1- 31 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? hr 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/r)rograms/Wq/303d/. O Yes No 9c. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? h[ eM • Go to http://cfpub.epa.gov/surf/locate/index.cfm to help identify the HUC. I 4© 1 eo /o I UN JOrJ R f VC-IL bt)A-rC-z 5 Reb 9d. What Water Resource Inventory Area Number(WRIA#) is the project in? [t2ipi • Go to http://wwww.ecv.wa.gov/water/wria/index.html to find the WRIA#. J ORIA-16-011 Page 10 of 14 9e.Will the in-water construction work comply with the State of Washington water quality standards for turbidity? heel • Go to hftp://www.ecy.wa.qov/programs/wq/swqs/criteda.htmI for the standards. ❑ Yes ❑ No ❑ Not applicable 9f. If the project is within the jurisdiction of the Shoreline Management Act, what is the local shoreline --- environment-designation?—h-e�i • If you don't know,contact the local planning department. • For more information, go to: htt ://www.ec .wa. ov/ ro rams/sea/sma/laws rules/173-26/211 designations.html. ❑ Urban ❑ Natural ❑ Aquatic ❑ Conservancy Other: 0 r 9g.What is the Washington Department of Natural Resources Water Type? hf eM • Go to hfti)://www.dnr.wa.gov/forest-practices-water-typing for the Forest Practices Water Typing System. ❑ Shoreline j<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? LheI • If No, provide the name of the manual your project is designed to meet. Yes ❑ No Name of manual: 9i. Does the project site have known contaminated sediment? hll • If Yes, please describe below. ❑ Yes tt No 9j. If you know what the property was used for in the past, describe below. hl eM 9k. Has a cultural resource (archaeological) survey been performed on the project area? heI • If Yes, attach it to your JARPA package. ❑ Yes C�-No ORIA-16-011 Page 11 of 14 91. Name each species listed under the federal Endangered Species Act that occurs in the vicinity of the project area or might be affected by the proposed work. neI 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. Lbgjpj ORIA-16-011 Page 12 of 14 Part 10—SEPA Compliance and Permits Use the resources and checklist below to identify the permits you are applying for. • Online Project Questionnaire at http://apps.oria.wa.gov/opas/. • Governor's Office for Regulatory Innovation and Assistance at(800) 917-0043 or help(aa)oria.wa.gov. • For a list of addresses to send your JARPA to, click on agency addresses for completed JARPA. 10a. Compliance with the State Environmental Policy Act (SEPA). (Check all that apply.) of elal • For more information about SEPA, go to www.ecy.wa.gov/programs/sea/sepa/e-review.html. ❑ 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 yob.)[Delpj ❑ This project is exempt (choose type of exemption below). ❑ Categorical Exemption. Under what section of the SEPA administrative code (WAC) is it exempt? ❑ Other: ❑ SEPA is pre-empted by federal law. 10b. Indicate the permits you are applying for. (Check all that apply.) hf elpl LOCAL GOVERNMENT Local Government Shoreline permits: ❑ Substantial Development ❑ Conditional Use ❑ Variance ❑ Shoreline Exemption Type (explain): Other City/County permits: ❑ Floodplain Development Permit ❑ Critical Areas Ordinance STATE GOVERNMENT Washington Department of Fish and Wildlife: ❑ Hydraulic Project Approval (HPA) ❑ Fish Habitat Enhancement Exemption—Attach Exemption Form Washington Department of Natural Resources: ` ❑ Aquatic Use Authorization Complete JARPA Attachment E and submit a check for$25 payable to the Washington Department of Natural Resources. Do not send cash. Washington Department of Ecology: ❑ Section 401 Water Quality Certification FEDERAL GOVERNMENT United States Department of the Army permits (U.S. Army Corps of Engineers): ❑ Section 404 (discharges into waters of the U.S.) ❑ Section 10 (work in navigable waters) United States Coast Guard permits: ❑ General Bridge Act Permit ❑ Private Aids to Navigation (for non-bridge projects) ORIA-16-011 Page 13 of 14 Part 11—Authorizing Signatures Signatures are required before submitting the JARPA package. The JARPA package includes the JARPA form, project plans, photos, etc. heI 11 a. Applicant Signature (required) hf eM 1 cerfify fhaf to the test of-my knowledge and belief,fhe i-nTormation provlidedin this app-itcatlon-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 auth a 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 t at I have the authority to grant access to the property. I also give my consent to the permitting agencies ent g th roperty where the project is located to inspect the project site or any work related to the project. (initial) 6A-R-4 M - ::3-©NrV SUIJ A Applicant Name p icant Sig ture Date 11 b. Authorized Agent Signature he�]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 all necessary permits have been issued. ��tisa� M 0 7-0 7- 7oZ l Authorized Ag nt Printed me horized Ag nt Signatu Date 11 c. Property Owner Signature (if not applicant) h[ e�71 Not required if project is on existing rights-of-way or easements (provide copy of easement with JARPA). I consent to the permitting agencies entering the property where the project is located to inspect the project site or any work. These inspections shall occur at reasonable times and, if practical, with prior notice to the landowner. D 7-D7-7071 Property Own&Printed Name --'Property Ow er Signatur Date 18 U.S.0§1001 provides that:Whoever, in any manner within the jurisdiction of any department or agency of the United States knowingly falsifies,conceals,or covers up by any trick,scheme,or device a material fact or makes any false, fictitious, or fraudulent statements or representations or makes or uses any false writing or document knowing same to contain any false,fictitious,or fraudulent statement or entry,shall be fined not more than$10,000 or imprisoned not more than 5 years or both. If you require this document in another format, contact the Governor's Office for Regulatory Innovation and Assistance(ORIA)at(800) 917-0043. People with hearing loss can call 711 for Washington Relay Service. People with a speech disability can call(877)833- 6341. ORIA publication number: ORIA-16-011 rev.07/2017 ORIA-16-011 Page 14 of 14 Application for Streamlined Processing of FISH HABITAT ENHANCEMENT PROJECTS Addition to the Joint Aquatic Resources Permit Application (JARPA) Page l Under RCW 77.55.181 you may qualify for a streamlined permit process with no local government fees if your project is designed to enhance fish habitat. If your project meets the requirements below,you are entitled to the streamlined Hydraulic Project Approval (HPA)process,exemption from the State Environmental Policy Act(SEPA),and exemption from all local government permits and fees. To apply for the exemption process,you must provide,on the same day,a complete application package to:the Department of Fish and Wildlife(WDFW)and all applicable local government planning and permitting departments. Local governments have 15 days to provide comments to WDFW to aid it in deciding whether your project qualifies(see below for details). To QUALIFYfor the fish habitat enhancement exemption you must check at least one each from A and B and provide a letter of approval from one of'the agencies listed in B. /t is highly recommended you discuss your proposal with the local Habitat Biologist prior to submitting your application. A)My project(check all that apply): ® Removes a human-made or caused fish passage barrier. ® Restores an eroded or unstable stream bank using bioengineering techniques. ® Places woody debris or other in-stream structures that benefit naturally reproducing fish stocks. ❑ Restores native kelp or eelgrass beds,or native oysters. B)My project is approved by(check all that apply): ® WDFW's Salmon Enhancement,or Volunteer Cooperative Fish and Wildlife Enhancement Programs. ❑ The sponsor of a watershed restoration plan as provided in chapter 89.08RCW. ❑ WDFW,as a department-sponsored fish enhancement or restoration project. ❑ Conservation District,as a Conservation District-sponsored fish habitat enhancement or restoration project. ❑ A formal grant program established by the legislature or the Department of Fish and Wildlife for fish habitat enhancement or restoration. ❑ The Washington State Department of Transportation's environmental retrofit program as a stand-alone fish passage barrier correction project. ❑ A local,state,or federally approved fish barrier removal grant program designed to assist local governments in implementing stand-alone fish passage barrier corrections. ❑ A city or county for a stand-alone fish passage barrier correction project funded by the city or county. To APPLYfor the Exemption,submit a complete application package consisting of the following documents to the local government Page 1 of 1 sending ix M C Place a check in each of the following boxes when you have collected each of these required application materials: This addition to the JARPA. A completed JARPA(use the most recent version of DARPA). ® Project Plan drawings(no larger than 11 x 17 format). Letter of approval of your specific project from one of the agencies listed in B,above. A copy of,or link to an online version of,the watershed restoration plan,if submitting an approved watershed restoration project I am send#W my applica ' n to the following local government planning department: xV=120xx On: p 7 z t (Date) Continued on back of page 4 Application for Streamlined Processing of FISH HABITAT ENHANCEMENT PROJECTS Addition to the Joint Aquatic Resources Permit Application (JARPA) Page 2 PLEASE NOTE: In addition to applying for this streamlined processing,you need to apply for all other applicable Federal and State permits identified in the JARPA. If WDFW determines that your project meets the fish habitat enhancement exemption criteria,SEPA and all local government permits and fees are waived.WDFW will process your HPA within 45 days of receiving your complete application. If significant concerns are raised during the 15-day comment period regarding adverse impacts from your project that cannot be addressed through HPA conditions,WDFW may determine that the project does not qualify for the exemption process.If WDFW makes that decision,you may re-apply to WDFW,the applicable local government,and any other applicable permitting agency for approval under the full permitting process.If WDFW determines that your project does NOT qualify for the exemption,or if your application is incomplete,you an e local government planning department will be notified. Applicant Name: Gary Johnson Page 1 of 1 oZ � ' Z LZZ <I� - Id 8 T d 34 "9sNc4o� Y�I J ----- 30 JI- Q 57�1�vZ1 Stijo� �` 2 Na (�vo1Nn Smarr tl Mandy Harlow _-- Es@cutiv@ Dir@ctor -- p;360,275,3575 @act, 123 #:360,275,0648 Mil m@ndy@pnwsalmonc@nt@r,org -1. PA Box 2160 1 R@Ifair,WA 98528 -- - - - www,pnwsalmon€@nt@r,org ampnins tha Wnn"tlan Wwaan land,@@adla,and 3alman thmugh ra3taMOM,000#0,and r water, July 16,2021 Oary Johnson 140 NE M@k@I@ Road Rol#air,WA 98528 Door Mr,Johnson, I as@d to sponsor th@ following crook mstoration fiho Hood Canal salmon �nhancom@nt group is p @ p � prof@€t to b@€onductod by you, Johnson Creek Restoration Project—This prof@ct will r@stor@ a str@am on th@ Johnson prop@rty by conv@rtinR an old pond back Into a 4=to=S=foot str@am,Th@ currant pond outlet is blo€k@d with a Poot con€r@t@ borri@r. No to upstr@am logging activiti@s ov@r tho lost 5 y@ars th@ pond has Nod with s@dim@nt.As it is now this pond is a barri@r for salmon,Th@ l@ndown@r is proposing to cl@@r th@ s@dim@nt from th@ pond with an @scavator,r@mov@ th@ concr@t@ barri@r,and r@=slop@ th@ angl@s of th@ bank in ord@r to r@stor@ th@ original str@am formation. Logs and rocks will b@ OHM to st@bilis@ th@ r@stor@d str@@mbanks,Th@ landown@r will also plant nativ@ plants along th@ banks and within th@ old pond's footprint.Th@ r@stor@d stroom which is a tributary to th@ Union Riv@r will bo @c€@ssibl@ to salmon on€@ again, W@ Fool that this proj@ct is @str@m@ly worthwhil@ and fits within our mission to r@stor@ and prof@ct wild salmon runs In th@ Hood Conal W@t@rsh@d. Sin€@r@ly, Mendy Harlow €s@cutiv@ Director HCSE6 APPS Aoaatk Protect)sn ftn%ft t"5yrtem APPS r My Dashboard Application Inspection eService My Account flelle,Gary 6 Help x Logout a 11@911H7pFlR 3 WIPdF@ >.F1§R Ehhahceiner. WRf@ Panel Not Mommumviet(APP Its:22782) A10INN88 To fill n all Appl¢ation Forms please fill out the form below. denotes a required field that must-filled:,.,i FlSP When rwigatinil lrono one pale to anotber within the appbcotlat Please use'Next'and'Previous'controls provided M the application only.Do NOT use browser, (a.g Internet Explorer,Chorine.atc.)'9adk'and'Forwaid'buttons, GNWW billorrnation M you encounter a blank page.please dick'Exit'button and re-enter dris application >Iq(@RfWirm tf@Fmom Aff3efimeM ' 'o upload or mail in all ,equired documentations I am applying for aPre-application. Vfflmk 1M You would reousst tttp prtr 1plil prW"g T To validate all required data 't•You need to find out jt ER f1PA pEFR!}r is REEBE9(9/yeHF(_+FBJEEI or and documentations J.You want assistance from a blolnBist to tlleFyt};fife#eF.t 91491 WerE 9114!t11N11119 P EAFRRIEtF j1FI9R•YYPRiIY AHBP.gh FI6B!RRkRB4 N91hg ttre ore-application process as a means to retf@FP PA "sm PFAF04�lR9 tltRPk IRFRFE4P yBpr NRAPfg4P,#IRq LO @IE pillf R. (F em,III,9FtA ip Sd�lllltilBR dilIEFIFi§pptipng/alfpraa!i�et for your pntlficL To submit application _ pi�BEt 18ilitlf cation _ Prdt@Pf IV@FR@(A FkIfR@ f@F yAIIF @F@i@6F Ih@f y@d Ef@@f@r€*@MM@4 §Fno'§®tom 9F @@pF@®k WR@®@Y@IN¢FP@Fi(I Johnson Creek fti@€t Tywisl tLIIwN 4 rim 66plvt' QAquatic Plant Control QBank Protection QBarge Landing Q Boat Access Q Buoy Q Channel Chaige/Realignment p D"i sl6h Structure Q Dredging Q Fish Trap or Dlverskm Weir Q Fishways p Fruit Access=beddh`stairs,cable oar,etc ❑OarSaga anti Debris Removal (:)Gravel Extraction Q Habitat Q Logging Q Outfall structure Q Overiheter Structure Q Shoreline Arrik 60-Marine ❑Utility Crossing Q Water Crossing Structure Q Water Surface Control Other ❑Beaver Dam Modification Q Dock MaintenaneWRepair ❑Fish Screen Maintenance or Replacement Mineral Prospeetang Other Thdh Suction ❑Repositioning or Removal of Q Road Maintenance Work Dredging. Large Wood ❑Scientific Instruments ❑Trenchless Conduit(Utility) Q Suction Dredging Crossing Applicant Business Name(if applitable)0- First Name*j Middle Name Last Name Gary M Johnson Address 1 Address 2 140 NE Makela Rd PO Box 518/Mail Address City State/Prdvirice Zip Code(12345 or 12345.1234) country Belfair AA 98528-9024 United Slates Primary Phone No(M5.555.55S5 Ext.) MbbfIt Phont Nd(555-555-5555) Fez(555.545-5555) 3602754274 Email msfan0023@msn com ❑Check here if you have made corrections to your dbnfedt information abbvii and t41sh to apply those changes to your user Orals. ApplieattF 1SlsNbUft! Please select one spplicant account type O Agriculture—Business Q Agriculture-Individual O Agriculture-Irrigation.Drainage.or Other District •�ttns:/Iwww.gevonlinesaas.corf�IV1lA/1�►@�1Nl�t��li�/�R�l�iAsl�p►Rtit/��®�sl/�plil�A�it�M�®miWii�F ��iI���F�n1Ni�rl�r�s�lE9�yp�f=fijN��px(9®�t9�V..r 'I� I 1 0 Commercial or Industrial(non-agriculture) 0 Forestry 0 Government-City 0 Government-County 0 Government—Federal 0 Government-Ports 0 Government-State 0 Government-Tribal 0 Non-Profit Group 0 Single or Multiple Private Individuals Authoriic9A-End 6f 6bn"8d Parsan authartwd to FoprisaM Ina epptmanr mul uil ORILet ti you are as authorised agent applying for an app gt.yBut POMW ititBRR.ai19R fnpst hs inc}uga9 in this saoMoa of the ggiflicati9R•WpFyr fi" not accept applications In which a registered user sHJRiiES 4p BgyliE3119n plfEEhPif E9i14EE iFH9fA18Ei9fl limos not apgpor iR the"016aRi an9*. afthorised agent section,h you are an authorised aQeRl,y99 wol he FepuifeA t9 uplifl9ln 9titiorriellit Eo document the @M*Fm94'!e9filehf ggachment must have applicant's signaturas.To 091rRieaA a FRey 9110110 49c991eR1 click here. No agent will be acting on behalf of the Applicant Business Name(if applicable) First Name Middle Naive Last Name (nary M Johnson Address 1 Address 2 140 NE Makela Rd PO Box 518/Mail Address City State/Province Zip Code(12345 or 12345-1234) Country Belfair WA v 98528-9024 Unftetl Suites v Primary Phone No(55S55S5555 Ext.) Mobile Phone No(555555-5555) Fax(555-555-5555) 3602754274 Email msfan0023@msn.eorn dflt>Fpt inf9F9+lNen/er le 9f 91 l"%"M"14 ii► "Ittis)where the WIN 9aopMF II iJ941 lr!fl91�91Vllef 9F Ffle efFY i3 9P.��LHllillc i1141 p11109109110 Consent or Property Owner attachment and t4pil"#"in AtMFlml9t6 9t IE f1gg11peNRR BF FnaN 9 wpk1N- Check here if Property Owner is the same as Applicant There are multiple property owners.Complete the section below for one of the prbpetty owners and fig out Multiple Owner Attachment to Path additional property owner. Business Name(if applicable) First Name Middle Name Last Name Gary M Johnson Address 1 Address 2 140 NE Makela Rd PO Box 518/Mail Address City statelprovince Zip Code(12345 or 12345-1234) Country Belfair 1NA - 98528-9024 United Stales Primary Phone No(555555.5555 Ext.) Mobile Phone No(555.555-5555) Far(555.555-5555) 3602754274 Email msfan0023@msn com €9pyf1@ht 019@>F44#enfoTech&Consulting In,:!NI i101ot§$Served Terms of Use!Privacy Statement ad r;;aalreg 11fflE A1®=W03 @3.14 BM) h���;IlvNlMvlr,�PMAt1iiR@§�����mIWANVB�V1►l�y�li�l�n�t�i��l�@rtr+i��a®��P-�i�ti�fi/�(�f�tWi�!�!PYna►�i�®f�►Wi�f��as,��(��N�(�=fiiN�����m3�i�,,, t;r / ApB APPS yaaat Prstectian P«nittirig f�ttln 110,HSH .-r RVAJFE kopse, ` 1L�LI My Dashboard Application Inspection eService My Account Hello.Gary 0 Help X Logout « AI!fA[tafl 3 W12f1 PaFipl 3 F!§N Efl1i9H€tffl2fiE Wizard Panel Fish Em"memiW(APP ID:22782) A006"hill To fill in all Application Forms Please fill cut the form below. denotes a required field that must be filled ouc rm"t:n,1?r,eFp6Al VAwn 1YvM,plh9 ne bun o page to an-14 tald n the+PPfirr.tjwti Please use'Next and'Previo t tr'controls provided in the application only.Do NOT use browser (a.g lrrteenet Explore c Chrome.etc)•Cat*mW'Forwwd'buttons. L*W+Wai VillarRialirr, M you encounter,a blame page•please dick'Exit-button and reenter thn apprr ti Project Information Save Previous Next watenns,; --q ENlaricentieng Detail Project Loc#W Athchlnerit 1_t of 1 kerns _ To upload or mail in all required dccumen+ations U"ar" Site Na":,- A s i f„i:Y St.;te Co.rri9 Larrtct!. F- 1 Johnson Creek 140 NE Makela rd Belfair WA 98528 Mason -47.241949 -122.997925 VaBdeHon To validate all required data N and documentations Submission Ptojict Description To suomrt application Will you operate equipment in water?O Yes O No Type of equipment used large excavator to clear sludge from old pond to be converted into a 4 to 5 foot Creek with Gradual slope from North to South dropping into existing creek bed Summarize the overall project. Original pond is filled with Silt,sludge&sediment for last 5 years from up stream Logging.Would like to dig out Sludge& make a new creek into area with a straight line to south Exit.After material on banks are dry I will plant Native plant& recomended logs that was suggested by Biologist Brittany Gordon Describe how you plan to construct each project element.Include specific construction methods and equipment to be used. •Identify where each element will occur In relation to the nearest waterbody. •Indicate which activities are within the 100•year flood plain. Will take out old Concrete 3 tt barrier at south end Will pull back each bank at a proper angle from DFFL or correct Biologist Suggests Will plants suggested to plant&banks are dried out enough to walk on.Salmon should return once again. Standard A standard HPA is valid for a maximum of 5 years Please propose an end date that does not expired 5 years from your requested start date. Requested Project start Date: 0 810 2/2 0 2 1 Requested Project End Date: 08/31/2021 Will your project be conducted In munipfe phases?Q Yes Q No ®PYflAlil!rrl le=a9[B enfoTech&consulting Inc I311,WiTs Fese--- Terms of Use i Privacy Statement Las)i'WH 0 ilTW 0O Wf) O 94:15 PM hupgj*WW.ggvonliA@Mar..corn/WAnn►QFWtRybli@/FnOuit@/P@F►r WRageslApplieatien/FwmWiz4►tiIA?rtomi�~ift ,���>E?Qt��►Y-Mulff Opok@1Tw ? AlAA APPS Mastic f4eteRiea►ermtetiry S�aln`—�, µn.VU &APPS �'b My Dashboard Application Inspection eService My Account Aerie Cary Y Help X Logout <, MaWA1t+an?"If l'dlliil>rwl cruiar..� WlM Panel PifN INNANSAMINt(APO t©: 22782) Appilimm To fill in all Application Forms Please fill out the form below. denotes a reouired field that must be filled out. rinn Crinanoemant when navil9atin9 hem on,page to—wid r r-till the applfotlon,please use'Next'and'Previorra controls provided in the,pplkatlion Dory Do NOT use browser le-g-krtmv t Explo e.Chrwne.etc)'bade'and'Fm-— balibeea. ueneral uTrvrmateon If you encounter a blank page,please did'Emit'button wall ns-efrter this application rfole InTolhid, Waterbodies •cxn cnnancement Dell we Nbodlsl.�dAfl6i[H3H WbiBHtlbli Ilr1i%"To uii@Itl�illbN -- Atfarfil"fll r , _, .,_.. ,%..r "w8k!fN@AMa"fl!Mf6 l@ R@R�WlFIaRR wRMR39Blbs reouired documentations Describe how the project Is designed to avoid and minimize adverse impacts to the aquatic environment. f lNM annhraM" Validation Tc validate all renuired da+e Will do in August to keep in line with Salmon runs.should be little to no impact on fish a"d documentations Submission To subm-t application will your project Impact a waNrbody or the area around a waterbody? (_)Yes#No Have you prepared a inhigatjdn Olen to compeniatE for the preject's adverse impacts to non-weHand waterbodies? •If yes,submit the mitigation plan In AFiablbf lift 611IM1641 bf Iflfa$0011bahisn.. •If No.or Not applicable,explain below why I thill[Widii#Wh blietlld hot W requlred. C)Yes*No()Not applicable right now no fish can get lhru to upstream.will work in August to get it done as fast to keep from hurting salmon run.By doing this restoration we can get fish once again upstream Describe the source and nature of any fill material,amount fin cubic ynrdcj you will use.and how and where it will he placed into the waterbody. no Fill to be used For all excaysbng or dredging acbvides,describe the melhod for axuvating Or dredging. type and amount of material you will remove,and where the material will be disposed Removing 4 to 5 feet of sludge about 3 ft deep at south end&about t ft at north end.approx length is 50 ft..right now no fish can get thru because of sludge.will be beneficial to remove sludge to restore salmon run ii@PyFIARI 4111" 04P enfoTecn&Consulting Inc Aft FM914 4ser ed Terms of Use!Privacy Statement final d610764-03 03:15 PM I httpsJ/www.govonlinesaas.corn/WAANDFW/PubliclEn&uiteitPerlrlil/PageslAPPlieationlFomlWizaFd/©ynamieEorrnWizard.aspx?query=U/FEdSo9kGfi w... I NOW" APPS AqvatkFrvs*ctWn_Pemftn9 System 4&v , „ � E AgAPPS My Dashboard Application Inspection eService My Account 1 e406,68Py d Help M Logout u APgIfe4@R;�Wlnim b4Rp a FI4R F.nnAneemwit Wizard Panel P16H (INHANONIMSNT(APP 10: 22782) APPIMAtion To fill in all Application Forms Please fill out the form below. denotes a required field that must be filled out. Fish knnang@ff"i When navigating from one page to another within the application,please use'Next'and*Previous'controls provided in the application only.Do NOT use browser(e.g.Internet Explorer,Chrome,etc)'Back'and'Forward'buttons. poilar'tll IRformatiOR If you encounter a blank page,please click'Exit-button and re-enter this application. I'teiact 1►listrindt;�: Wai:anx etea Fish Enhancement Detail FISH HABITAT 111WHANfC€MINT AttB�flfibent My project(check all that apply): To upload or mail in all required documentations Q Removes a human-made or caused fish passage barrier Ytil�itNR Q Restores an eroded or unstable stream bank Using bioengineering techniques. T�vali late an reouired ata D Places woody debris or other in-stream structures that benefit naturally reprodUeing and documentations fish stocks. ❑Restores native kelp or eelgrass beds, or native oysters. SUtNnlealW To submit application My project is approved by(select one). 0 WDFW's Salmon Enhancement,or Volunteer Cooperative Fish and Wildlife Enhancement Programs. O The sponsor of a watershed restoration plan as provided in chapter 89.08RCW O WDFW,as a department-sponsored fish enhancement or restoration project. )A Conservation District, as a Conservation District-sponsored fish habitat enhancement or restoration project. (`j A formal grant program established by the legislature or the Department of Fish and Wildlife for fish habitat enhancement or restoration. (-)The Washington State Department of Transportation's environmental retrofit program as a stand-alone fish passage barrier correction project 0 A local,state,or federally approved fish barrier removal grant program designed to assist local governments in implementing stand-alone fish passage barrier corrections. (-)A city or county for a stand-alone fish passage barrier correction project funded by the city or county. copyiight 919"4094 enfdTech&Consulting Inc.All 090.4 r@§eW@@ Terms of Use'Privacy Statement (fa§t rfipailipO Time:4p14-04-03 0111t ,rttDs:/rwww.govonlinesaas.com/WA/WDFW/Public/EnSuite/PermiUPages/Application/FormWizard/DynamicFormWizard.aspx?queryeU/FEdSp9k0lTw. 111 QI) CD 1 �ro1Nn ScnLvrn O� From: Gordon, Brittany N (DFW) Sent: Monday, July 27, 2020 2:58 PM To: msfan0023@msn.com Cc: Evan Bauder; Dwight, Christopher E (DFW) Subject: permitting for stream restoration Gary, Thanks for the call today to discuss your property at 140 NE Makela Rd. To restore the creek by removing the concrete dam/steps and recreating a stream channel, you will need to apply for a Hydraulic Project Approval (HPA) permit. Unfortunately I forgot to mention (so sorry!) that to qualify as a Fish Habitat Enhancement Project, you would need a sponsor. The Mason Conservation District may be willing to sponsor the project(cc'd). I am also cc'ing Chris Dwight, who works with some NRCS grants that could be a good fit for the project. If you can't get a sponsor, you would just apply for a standard HPA. And then the only difference is you would need County permits, which would hopefully not be too difficult since this is a restoration project. For the HPA application, we will need to see plan drawings (aerial view before and after), a stream cross section, and a stream profile. Here is an example: T Stream Cross Section After 1 Stream profile-After T j Plan View-Before Dian View-After We'll need a list of plants you plan to install along the banks to help with natural bank stabilization. I recommend taking a look at Sound Native Plants' website,they have some great information on what to plant. https://soundnativeplants.com/nursery/species-selection- guide/?doing wp cron=1595886500.3323481082916259765625 Some good options could be native willow stakes, black cottonwood, salmonberry, sword fern, salal, red alder, red cedar, western crabapple. Consider how wet or dry the soil will be when creating your planting plan. For the stream profile, you don't necessarily need to do an elevation survey but try to measure how much higher the upstream stream bed is compared to the downstream stream bed (below the dam) and draw a straight line to connect those two elevations. I highly recommend placing some large logs in the stream, as shown above, as these will help the channel form some natural pools, meter the slower release of sediment downstream, and create hiding spots for fish and amphibians. The HPA application is here: https://www.govonlinesaas.com/WA/WDFW/Public/Client/WA WDFW/Shared/Pages/Main/Login.aspx Evan and Chris, here is Gary's contact info: ' Gary Johnson, Zd 360.275.4274 140 NE Makela Rd, Belfair 123�,. 2t-oZD�° 1 hope this helps to get you started. r23Z�� Best regards, Brittany N. Gordon WDFW Area Habitat Biologist Region 6: Port Orchard Office Mobile: 620-3601 11'ashineton 11,partmcnt cal FISH and I I 1�,D kjFE LO Q C) r � o 0