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HomeMy WebLinkAboutWAT Application - 1/13/2021 MASON COUNTY WAT COMMUNITY SERVICES Bu il3g,PIYnMp EmhmmrnrY Hallh CwmunXy HtaNh 415 N 6ib Street, Bldg 8,Shelton WA 98584, Shelton:(360)427-9670 ext 400 4 Belfair. (360)275-4467 ext 400 {• Elma:(360)482-5269 ext 400 FAX(360)427-7787 Application for Determination of Water Adequacy Instructions 1. Complete Part 1. No determination can be made until Part 1 is fully completed. 2. Complete only the portion of Part 2 applying to the type of water connection utilized. 3. Submit completed application,with any required attachments for review. 4. An approved building site plan must accompany this applimbon. Part 1: Applicant/ Parcel Identification Name on Applicant: NORTH MASON RFA Date: 01/13/2021 Mailing Address: PO BOX 277, BELFAIR WA. 98528 Phone: (360)275-6711 Parcel Number: 123291190060, 123291100030 Type of Water System Reason for Application ❑ Public/Community Water System (2 or more f& Building permit connections) ❑ Division of land: ❑ Individual water source(one connection), it of Parcels? SPL ❑ Well ❑ Boundary line adjustment ❑ Spring/surface water ❑ Other(explain) ❑ Other(explain) ® Replacement or Remodel (please indicate name If you have more than one residence connected of water system below if applicable—no to this well, check the Public/Community Water signature required) System box. Part 2: Water Connection Information Complete the section appropriate for the type of water connection being evaluated: Public Water System Name of Water System: Water Facility Inventory(WFI)Number: (write"none"for two-party) ❑ 1 am the manager of this water system.The water system has been approved for services. There are presently connection(s) in use.This will be the connection. ❑ 1 am the manager of this system.This connection will be to upgrade or change the use of an existing connection on this system (i.e.: recreational to full time). Please indicate on the following line the nature of this change: This water system is able and willing to provide water to this (these)connection(s)without exceeding the limbs of the water system or any limits set by state and local regulation. Signature of Water System Manager Date This form may be scanned and available for public view at www.co.mason.wa.us. J96H Forma\DnnEng Water Revised M52018 Jr Individual Water Well ❑ Water well report(attached to application). Depth ft. ❑ Well capacity Test(attached to application) gpm gpd. The well driller often performs well capacity tests at the time the well is constructed. Results from these tests are noted on the water well report. Results from these tests will be accepted. If the water well report cannot be located by the applicant or if the water well report does not have a capacity test, a well capacity test,which provides stabilization of draw-down and recovery data, must be performed li by a licensed contractor. i ❑ Satisfactory bacteriological test(attach to application). Water Resource Inventory Area (WRIA) Development within which WRIA hftp,//Qis.co.mason.wa.us/i)lanning 14_15_16_22_ Water use or limitation recorded................................... N/A_Yes_ Well Drilled ............................................................... Date Individual Spring/Surface Water ❑ WDOE permit(attach to application) ❑ Method of disinfection ❑ I have reason to believe that this water source can provide at least 800 gallons per day;and/or provides water at a rate of 2 gallons per minute based on the following observations. Author of Statement Date Relationship to Applicant Part 3: Mason County Community Services Evaluation (staff use only) Satisfactory Determination: This determination does not address adequacy of the distribution system,guarantee an adequate supply of water indefinitely in the future,or guarantee compliance with all applicable WDOE water resource regulations. Recommended approval indicates requirements of Sanitary Code,Tide 6,Chapter 6.68.040-Determination of Adequacy for Building Permits are satisfied. Additional Growth Management requirements may apply. Chapter 3630A RCW. Unsatisfactory Determination: Applicant's water supply does not appear adequate to meet the needs of its intended use for the following mason(s). Reviewer's Signatures: Environ. Health: Date CSD Director: Date 2 ofz APPLICATION AND AGREEMENT TO CONSTRUCT EXTENSION TO WATER SYSTEM The undersigned,as the Developer herein,hereby makes application to the Commissioners of Belfair Water District No. I,as the District herein,for permission to construct and connect a private extension to the District's existing water system as herein provided and pursuant to Chapter 57.22 RCW. If this application is accepted,the undersigned,in consideration of the mutual promises and covenants herein contained,agrees to the terms and conditions of this Developer Extension Agreement and as follows: 1. Location of Water System Extension. The proposed water system extension(the"extension')will be installed in streets and other approved rights-of--way and/or easements and shall be for the use and benefit of the real property hereinafter described,which real property is owned by the Developer and/or other owners for whom the Developer is acting as agent. All such owners have joined in this application and are designated on the signature page hereof as"additional owners."Please enclose a legal description of the real property including the Tax Lot Number;a common address,if applicable;and a Parcel Number: Legal Description: The south 165 feet of the north 646 feet of the west 660 feet of the northeast quarter(NE 1/4)of the northeast quarter(NE 1/4)of section 29,township 23 north,range 1 west,W.M.,in Mason County Washington,excepting therefrom,rightof-way for"Old Navy Yard Highway'on the West. Parcel ff:123291190030 and 123291190060 Address:490 NE Old Belfair Highway,Belfair,WA 2. Description of Extension. The proposed extension will consist of approximately 518' lineal feet of water pipe and appurtenances and shall be installed in accordance with this Agreement and with the Plans and Specifications provided by the District at the cost of the Developer as hereinafter provided,or in accordance with such Plans as Developer's Engineer may prepare in conformity with District specifications and approved by the District. 3. Fees to be paid by the Developer. a. A non-refundable minimum fee of$850.00 plus inspection fee of$2.00 per lineal foot of line proposed to be constructed,as measured by the District,and a$500.00 Plan review fee shall be paid at the time of making application to the District as a minimum fee for District setup. Provided that the minimum lineal footage fee up to 800 lineal feet shall be$1,600.00;for a minimum combined fee of$2,950.00($850.00 plus$1,600.00 plus$500.00). If the proposed extension is for a new subdivision,the final plans will not normally be reviewed or approved by the District's Engineers and the District until the plat has been filed with the Mason County Auditor and approved by all necessary Mason County agencies and departments. b. In the event Developer's own Engineer is to prepare the Plans in accordance with District Specifications,the Developer shall nevertheless pay,at the time of making application to the District,the fee provided fm in 3(a)above as a partial payment of the expenses associated with preparing the Specifications,and review and approval of the Plans by the District Engineer and the District. Should said expenses for review and inspection be in excess of the initial payment paid by the Developer,the difference shall be paid by the Developer to the District before proceeding with construction. BWDI-5 c. Water Service Connection Charges(SCCI. Service Connection Charges shall be paid by owners of such real properly seeking connection to,or increased water service(such as a new service or change in service)from,the District's water system payable prior to the commencement of construction of the extension as follows based on meter size: 1. 5/8x3/4" $ 2,450.00 2. 1" $ 2,755.00 3. 1-1/2" $ 3,060.00 4. 2" $ 3,980.00 it. System Development Charges(SDC1. System Development Charges shall be paid by owners connecting property to an existing water main,unless the owner installed the main,has already paid its pro rate share for such main,or is required to pay a reimbursement charge. These are payable by the Owner/Developer to the District prior to the commencement of the construction of the extension improvements as follows: A non-refundable System Development Fee shall be charged for ALL NEW Main connections to the Belfair Water District#1 system. The System Development Fee shall be used by the District to make improvements to the source,supply and distribution and transmission facilities of the Water System to the benefit of the Districts ratepayers. The System Development Fee shall be as follows: 4" Main Connection $27,030.00 8" Main Connection $30,600.00 10" Main Connection $32,640.00 12" Main Connection $34,680.00 System Development Basic Charge Per Residential Equivalent*$2950.00 The System Development Fee shall be two fiered. The amount of the fee shall be determined in accordance with the location of the new connection.The above System Development Fee shall apply w all new connections in Pressure Zone B(470)as well as all new connections in Pressure Zone I(272). For new connections in Pressure Zone I(272),properties which paid and can be verified as paid an assessment for the original U.L.I.D.that established Belfair Water District#1 shalt receive a credit for the amount paid under the original property assessment from the System Development Fee. 'For the Purpose of determining the total System Development,the basis for the charge shall be a 5/8"x3/4"meter equivalent. The following System Development charges shall apply,based on meter size: 5/8x3/4" Meter $2,950.00 I„ Meter $7,040.00 1-1/2" Meter $13,770.00 BWDI-6 2" Meter $21,825.00 f. The expense of preparing or approving plans and specifications requiring special detail work by the District Engineer,such as for pump stations and pressure reducing stations,shall be paid by the Developer to the District,on demand,on the basis of the cost of time and materials plus 15 percent for District administration and overhead. g. If for any reason the district would be required to participate in staking the minimum fee for such staking shall be$500.00. The additional staking fee will be$2.00 per lineal foot of line and the minimum fee shall be$500.00 which would cover the fast 250' lineal feet. The cost per foot for staking,as stated herein,is for horizontal layout only. Additional trips to thejob site as may be required due to lack of site control,planning or the phasing of field work or as requested by the Developer shall be subject to an additional fee of$75.00/hr.per employee,per trip. Unless an emergency situation demands immediate attention,the District will make every effort to inform the Developer or their agent in charge before charging the additional fee. A minimum of 48 hours' notice shall be given the District prior to work commencing on site,and any work involving the water system and requiring the District Inspector on site to witness the work. h. If additional inspections are required due to changes and situations beyond the control of the District,or after hours overtime inspections must occur that were not discussed and planned or the amount of inspections required exceed the collected inspection fees of$2.00/lineal ft. assessed the applicant shall pay to the District the sum of$480.00 for each inspector day,,based on the rate of$60.00 per hour for those working hours between 7:30 a.m. and 4:00 p.m.,Monday through Friday. An inspector day shall be each day or a part thereof during which an inspector shall be reasonably required to be present at the site to provide proper inspection and testing of the work;provided,that the minimum fee for an inspector day shall be$240.00 based on a minimum rate of four hours. Inspection time incurred before 7:30 a.m. or after 4:00 p.m.,or at any time on Saturdays and Sundays,shall be paid for by the applicant at the rate of$80.00 per hour. The District will make every effort to inform the Developer or their agent in charge before charging the additional fee. The District may stop the work until agreement is made on the additional fee or an alternate arrangement is reached that would not require an additional fee. Any assessment of additional fees will be presented prior to work commencing and discussed as well as provided in written format before proceeding and charges accruing. L The foregoing fees are not intended to include allowance for any unusual costs incurred by the District on account of property surveys,changes in design,necessary construction engineering, permits,environmental work,easement work,comment preparation,project coordination,errors, or omissions by the Developer,his contractor or agents,unusual negotiations,legal expenses incurred beyond the expense of normal review of documents,and/or any other project related costs. The District will bill the Developer for any such unusual costs,fees,and expenses,and the same shall be paid promptly and in full by the Developer to the District. j. If the District is required to review any land use application or other review outside of the proposed water system to be developed,a non-refundable fee of$500.00 shall be paid at the time of making application to the District if the Development is a subdivision,short plat,or other land use development application to Mason County. The fee shall be paid for the District's and its consultants'preliminary review of such land use or other application. k. The Developer shall pay all reimbursement charges owing as a condition of final acceptance of the extension improvement. Reimbursement charges shall be owing for. BWDI-7 1. Any existing reimbursement agreement with the District applicable to Developer's extension/real property;or 2. Any reimbursement agreement in force and effect applicable to Developer's extension/real property at the time of the District's final acceptance of Developer's extension. 4. Preparation of Plans by Developer's Engineer. The Developer may have its own engineer prepare the Design and Plans for the extension according to District Standards and Specifications or have the District Engineer prepare the Design and Plans and reimburse the District for the cost thereof according to this Agreement. If the Developer elects to have its own engineer prepare the Design and Plans,then the following requirements shall apply: a. Developer's Engineer shall prepare and submit to the District Engineer a preliminary design and Plan for review by the District. The District shall have the right to require changes in the preliminary design and Plan as may be deemed necessary. All Designs and Plans prepared by Developer's Engineer shall be prepared in accordance with the District's Detail Standards and Specifications for Design. b. Developer's Engineer shall prepare a Draft Plan and submit two(2)copies of the this Plan to the District. The District and the District contracted Engineer shall then review copies of the draft plan. District shall have the right to require such changes to the draft Plan w may be deemed necessary. c. Upon completion of all required changes to the draft plan,if any are required: The Developers Engineer will submit(3)three copies of the amended plan to the District for Final review. If the review finds the amended plan to be in accordance with the Districts requested changes and amendments to the draft plan,the District will mark the plans approved and this becomes the Final plan set,one copy of the approved plans will be returned to the Developers Engineer for their use. d. The General manager will present the Developers Extension Agreement to the District's Board of Commissioners with the final Plan for approval at the next available regularly scheduled Board meeting. The District Board of Commissioners shall have the right to approve,reject,or require changes to the Developers Extension Agreement and the final Plan as may be deemed necessary in its sole discretion. e. Upon approval of the final Plan by the District Board of Commissioners,the District shall then indicate approval of the Developers Extension Agreement and the Plan on the original documents submitted and shall become the property of the District in accordance with Paragraph WS-6 of this agreement. f. Upon receipt of the Final Plan drawings,and acceptance by the District Board of Commissioners, the District will secure such permits and approvals for the Final Plan as may be necessary. Should changes to the Plan be required to receive such permits and approvals, Developer's Engineer shall make all changes as required at the Developer's sole cost and expense. g. After receiving such permits and approvals of the Final Plans as may be necessary,the District will then complete the Developer Extension checklist form which estimates the cost of construction for the extension and fee calculations for purposes of the fees to be paid by the Developer,and the bonds to be posted by the Developer,all in accordance with this Agreement. The District will prepare and submit to the Developer invoices for all costs owing. Such invoices shall be paid in full by the Developer to the District before construction of the worklextension improvement commences. BWDI-8 h. The Developer will schedule a pre-construction meeting with the District and all entities involved prior to the work commencing on the extension project,to set up schedules and timelines for the work progression as well as address any concerns that may arise from said meeting. Any agreed upon changes to the Final Plans will be noted and changes made by the Developers Engineer and amended plans sent to the District and all involved with notations made for any such changes. 5. Performance Guarantee. The Developer shall furnish to the District prior to the preconstruction conference a performance guarantee of a type and in a form as determined by the District,in its sole discretion,in an amount equal to the Engineer of Record for the projects estimated cost of the extension or contractor bid price. The performance guarantee shall require completion of all work within a period of two years;(24)months from the date of the Agreement with the District in accordance with the Agreement,the Plans and Specifications and other requirements of the District. The District will require a payment bond of a type and in a form as determined by the District and as is standard practice for special purpose districts within Washington State requiring the payment by the Developer of all persons furnishing labor and materials is connection with the work performed under the Agreement and shall hold the District harmless from any claims therefrom. All payment bond required by the District shall be provided to the District prior to the preconstruction conference or immediately following commencement of work as a condition of the District granting final acceptance of the work referenced herein. No third person or party shall have any rights under any performance or payment guaraatee the District may require from the Developer and such are provided entirely for the benefit of the District and the Developer and their successors in interest. 6. Final Acceptance-Conditions Precedent. Compliance with all terms and conditions of this Agreement,the Plans and Specifications prepared hereunder,and other District requirements shall be a condition precedent to the District's obligation to accept the bill of sale and easements to the extension improvements and to the District's Agreement to maintain and operate the extension improvements and to provide water service to the real property that is described in this Agreement. The District shall not be required to allow any connection to the District water system of any portion of the real property described in this Agreement if there are any fees or costs unpaid to the District under this Agreement or here are other fees or charges owing the District by the Developer pursuant to other District requirements. The District shall not be obligated to provide water service to the property described in this Agreement if construction by third parties of facilities to be conveyed to the District has not been completed and title accepted by the District if such third-party facilities are necessary to provide water service to the property described in this Agreement. The District will accept title to the extension improvements at such time as all work on the extension improvements has been completed,any damage to said extension improvements which may exist has been repaired,and the District has made final inspection and given its approval to the extension improvements as having been completed in accordance with this Agreement,the Plans and Specifications and other requirements of the District. Such acceptance by the District shall not relieve the Developer of the obligation to correct defects in labor and/or materials as herein provided and/or the obligations set forth in applicable paragraphs hereof. After acceptance of the extension improvements by the District and the transferring of title to such extension improvements as set forth herein,the Developer shall furnish to the District a cash only maintenance bond which shall continue in force from the date of acceptance of said extension for a period of two years. The bond shall be in a form as contained herein and shall require the Developer to correct the defects in labor BWDI-9 and materials which arise in said system for a period of two years(24 months)from the date of acceptance of the system and transfer of title to the District. The cash maintenance bond shall be in an amount equal to ten(10)percent of the cost of said extension,but not less than two thousand dollars ($2,000.00). Prior to the release of such cash maintenance bond,the Developer shall be required to repair or replace,or otherwise remedy any defects indicated on the Districts inspection punch list to the extension improvements at Developer's sole cost and expense,and to confirm that such improvements are free from defects in labor and materials. Any defects in labor or materials noted by the District on reinspection shall be repaired and corrected before the release of the bond. 7. Procedure for Acceptance. Acceptance of title to the extension improvements will be made by motion of the Board of Commissioners of the District. Prior to such acceptance,an executed Bill of Sale of the extension improvements in a form approved by the District and containing the warranties required by this Agreement shall be executed by the Developer and any additional owners and delivered to the District. S. Warranties of the Developer. The Bill of Sale to be provided by the Developer to the District shall contain the following warranties with the District as beneficiary: a. The Developer is the owner of the extension improvements,the same are free and clear of all encumbrances and the Developer has good right and authority to transfer title thereto to the District and will defend the title of the District against the claims of all third parties claiming to own the same or claiming any interest therein or encumbrance thereon;and b. The extension improvements are in proper working condition,order,and repair,and are adequate and fit for the intended purpose of use as a water system and as an integral part of the water supply and distribution system of the District;and a. For a period of two(2)years from the date of final acceptance of the extension improvements by the District,the extension improvements and all parts thereof shall remain in proper working condition,order and repair;and the Developer shall repair or replace,at its sole cost and expense, any work or material which may prove to be defective during the period of the warranty. In addition,the Developer shall obtain written warranties and guaranties from its contractor and/or suppliers where such warranties or guaranties are specifically required in this Agreement. When corrections of defects occurring within the warranty period are made,the Developer shall further warrant corrected work for one(1)year after acceptance of the corrected work by the District. 9. Affect of Acceptance. Acceptance by District shall cause the extension improvements to be subject to the control,use,and operation of the District and all regulations and conditions of service and service charges as the District determines to be reasonable and proper. 10. Phased Construction. The extension improvements may be constructed in phases with prior Board approval as conditioned and as specifically designated in the Plans and Specifications. Acceptance may also be on a phased basis when all requirements have been met. There will be no conditional acceptance or acceptance for use and operation. it. Correction of Defects Occurring Within Warranty Period. When defects in the extension improvements are discovered within the warranty period, the Developer shall start work to remedy any such defects within seven(7)days of notice by the District and shall BWDI-10 complete such work within a reasonable time. In emergencies,where damages may result from delay and where loss of service may result,corrections may be made by the District upon discovery,in which case the cost thereof shall be home by the Developer. In the event the Developer does not commence and/or accomplish corrections within the time specified,the work may be accomplished by the District at its option,and the cost thereof shall be paid by the Developer. The Developer shall be responsible for any expenses incurred by the District resulting from defects in Developer's work,including actual damages,costs of materials and labor expended by the District in making repairs and the cost of engineering,inspection and supervision by the District or the District Engineer. 12. Limitation of Period of Acceptance. The extension improvements shall be completed and accepted within two years of the date of this Agreement. If the extension is not completed and accepted within the two-year period,then this Agreement and all of Developer's rights herein shall terminate and cease. No extension of the time completion of the Agreement shall be allowed for any cause or reason,without the District's Board of Commissioners specific approval, including,but not limited to,adverse weather conditions or other reason beyond the control of Developer. Any extension to this agreement will for a specific time frame as requested by the Developer in writing with the reasons for requesting the extension as well as clearly defining an amount of time in months to complete the work. In the event the Agreement terminates,and no extension is requested or granted,the Developer shall be required to make a new application for extension agreement to the District. Any such new agreement entered into between the District and the Developer pursuant to a new application shall be subject to any new or amended resolutions,policies,and fees which have taken effect since the execution of the terminated agreement. All conditions me subject to change. 13. Warranty of Authority. The Developer and any additional owners warrant that they are the owners of the real property described in this Agreement and have the power and authority to sign and carry out the purposes of this Agreement. The Developer shall also upon request provide a title report and duly authorized and adopted resolution of the Developer's business entity to the District establishing that the parties executing this Agreement are the owners of all the real property to be served by the extension improvements described herein. 14. Rates and Charees. The real property described in this Agreement shall be subject to all rates and charges established by the District,including such increases as may occur from time to time. 15. Subletting and Subcontractina. The Developer is fully responsible for the acts and omissions of its contractors and persons employed, directly or indirectly,by its contractors,as well as the acts and omissions of persons directly or indirectly employed or retained by the Developer. 16. No Assignment Without District Approval. Developer's rights and responsibilities arising out of this Agreement are not assignable or transferable unless District consent is obtained,as conditioned by the District,prior to any proposed assignment. Written documents,an"Assignment and Assumption of Developer Extension Agreement,"as required by the District of any District approved assignment, shall be filed with the District by the Developer at the time of any assignment. BWDI-1 l 17. Technical Details and Specifications. Refer to`Parts Two,Three,Four,and Five for Technical Specifications"for Materials,Constmction, Standard Details Specifications,and Detail Standards for Design completed by Engineers which are attached hereto and made a part of this Agreement. BWDI-12 ACCEPTANCE OF THIS APPLICATION BY THE DISTRICT CONSTITUTES A CONTRACT WITH THE APPLICANT,THE TERMS OF WHICH ARE EACH PARAGRAPH OF THIS AGREEMENT, THE DISTRICT'S MATERIALS,CONSTRUCTION,AND STANDARD DETAILS SPECIFICATIONS SHEETS,THE EXTENSION IMPROVEMENT PLANS AND DESIGN APPROVED BY THE DISTRICT BOARD OF COMMISSIONERS,AND ALL OTHER APPLICABLE DISTRICT REGULATIONS AND WASHINGTON LAW,INCLUDING CHAPTER 57.22 RCW. DEVELOPER, North Mason Recriortal Fire Authority a©corporation, (municipal corp) a❑partnership, a❑joint venture, a❑limited liability company, a❑sole proprietorship. NOTE: I. If the Developer is a corporation,this Agreement must be executed by its duly authorized representative and the Developer hereby warrants same. A Corporate Resolution authorizing the representative to sign the Agreement must be provided. 2. If the Developer is a partnership,at least one of the general partners must sign this Agreement and indicate hisRrer/its capacity as such. A Partnership Resolution authorizing the representative to sign the Agreement most be provided. 3. If the Developer is a limited liability company,this Agreement must be executed by its duly authorized manager. A Resolution of the LLC authorizing the representative to sign the Agreement must be provided. By Beau H (Prim ro/type ans) Its Fire Chief (PrinUtype office/title) STATE OF WASHINGTON ) ) ss. COUNTY OF MASON ) I certify that 1 know or have satisfactory evidence that Beau Bakken is the person who appeared before me,and said person acknowledged that he/she signed this instrument,on oath stated that he/she was authorized to execute the instrument,and acknowledged it as the Fire Chief (title or position)of North Mason Regional Fire Authority to be the free and voluntary act of such corporation for the uses and purposes mentioned in the instrument. Dated t yam,pl ANGIE MCCORMICx Not.ry Public NJ. lc in and for the State of Washington BUG or Washington raiment<z Pues: Commeston a 20115283 MY appointment My Camm.Expbn May 21,2024 BWDI-13 THE FOREGOING APPLICATION of is accepted this day of ,20_ BELFAIR WATER DISTRICT NO. I By President of the Board By Secretary of the Board BWDI-14