HomeMy WebLinkAboutSEP2016-00043 - SEP Determinations - 6/15/2016 a
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
June 15, 2016
Mr.Michael MacSems
Mason County
Department of Community Development
Planning Division
PO Box 279
Shelton, WA 98584
Dear Mr.MacSems:
Thank you for the opportunity to comment on the mitigated determination of nonsignificance for
the Rutherford-Clearing Project(SEP2016-00043) located in Shelton as proposed by John and
Lesley Rutherford. The Department of Ecology(Ecology)reviewed the environmental checklist
and has the following comment(s):
WATER QUALITY: Chris Montague-Breakwell(360)407-6364
Erosion control measures must be in place prior to any clearing, grading, or construction.
These control measures must be effective to prevent stormwater runoff from carrying soil
and other pollutants into surface water or stormdrains that lead to waters of the state. Sand,
silt, clay particles, and soil will damage aquatic habitat and are considered to be pollutants.
The following construction activities require coverage under the Construction Stormwater
General Permit:
1. Clearing, grading and/or excavation that results in the disturbance of one or more
acres and discharges stormwater to surface waters of the State; and
2. Clearing, grading and/or excavation on sites smaller than one acre that are part of a
larger common plan of development or sale, if the common plan of development or
sale will ultimately disturb one acre or more and discharge stormwater to surface
waters of the State.
a) This includes forest practices(including,but not limited to, class IV conversions)
that are part of a construction activity that will result in the disturbance of one or
more acres, and discharge to surface waters of the State; and
3. Any size construction activity discharging stormwater to waters of the State that
Ecology:
a) Determines to be a significant contributor of pollutants to waters of the State of
Washington.
b) Reasonably expects to cause a violation of any water quality standard.
Mr.Michael MacSems
June 15, 2016
Page 2
If there are known soil/ground water contaminants present on-site, additional information
(including, but not limited to:temporary erosion and sediment control plans; stormwater
pollution prevention plan; list of known contaminants with concentrations and depths found;
a site map depicting the sample location(s);and additional studies/reports regarding
contaminant(s))will be required to be submitted.
You may apply online or obtain an application from Ecology's website at:
http://www.ecy.wa.g_ov/programs/wq/stormwater/construction/-Application. Construction
site operators must apply for a permit at least 60 days prior to discharging stormwater from
construction activities and must submit it on or before the date of the first public notice.
WATER RESOURCES: Vicki Cline(360)407-0278
Any ground water withdrawals in excess of 5,000 gallons per day or for the irrigation of
more than one-half acre of lawn or noncommercial garden, requires a water right permit from
Ecology.
All water wells shall be constructed in accordance with the provisions of Chapter 173-160
WAC by a driller licensed in the State of Washington. Well reports must be submitted to
Ecology within 30 days after completion of a well.
All water wells that may be drilled must be a minimum of 100 feet from any known,
suspected,or potential source of contamination. Wells shall not be located within 1,000 feet
of a solid waste landfill. WAC 173-160-171(1)The proposed water well shall be located
where it is not subject to ponding and is not in the floodway, except as provided in Chapter
86.16 RCW. (2)It shall be protected from a one hundred year flood and from any surface or
subsurface drainage capable of impairing the quality of the ground water supply.
The Growth Management Act(RCW 19.27.097)requires an applicant to submit evidence of
an adequate water supply before a building permit can be issued for any building requiring
potable water.
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
(SM:16-2847)
cc: Vicki Cline, WR
Chris Montague-Breakwell, WQ
John and Lesley Rutherford(Proponents)
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Planning Division
615 W Alder St, Shelton, WA 98584
t (360)427-9670
MITIGATED
DETERMINATION OF NONSIGNIFICANCE
(WAC 197-11-350)
SEP2016-00043
Description of Proposal: This SEPA is associated wit a Class IV General FPA to log approx
.8 of an acre to a new residence. The parcel is overlaid by a large
Class III wetland with a 110' buffer and an additional 15' building
setback. The proposal meets setback requirements and there are
no other environmental issues.
Proponent: JOHN & LESLEY RUTHERFORD
Site Address (If Assigned): ............ SHELTON
Directions to Site: Parcel is located on the east side of SE Lynch Rd, near Mile Post
8.
Parcel Number: 220294290013
Legal Description: LOT 3 OF SP #3045 PTN OF NW SE E OF R/W S 10/115
Lead Agency: Mason County
The Lead Agency for this proposal has determined that it does not have a probable significant adverse
impact on the environment. An Environmental Impact Statement (EIS) is not required under RCW
43.21 C.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.
MITIGATED MEASURES ARE ATTACHED.
Please contact Michael MacSems at ext. ext 571 or mms@co.mason.wa.us with any questions. This
DNS is issued under WAC 197-11-350. 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 Community Services
Department, 615 W Alder St, Shelton WA 98584 by 6/15/2016. Appeal of this determination must be
filed within a 14-day enod following this final determination date, per Mason County Code Chapter 15.11
Appeals.
Authorized Local Government Official Date
SEP2016-00043 Page 1 of 2
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Planning Division
615 W Alder St, Shelton, WA 98584
P10I
(360)427-9670
MITIGATED
DETERMINATION OF NONSIGNIFICANCE
(WAC 197-11-350)
SEP2016-00043
CONDITIONS OF THIS DETERMINATION
1) ARCHAEOLOGICAL RESOURCES
Archaeological or historical resources, such as ruins, sites, buildings, artifacts, fossils, or
other objects of antiquity that may have significance from an historical or scientific
standpoint, which may be encountered by the developer/contractor, shall not be further
disturbed. If the developer/contractor encounters any such artifacts, he/she shall
immediately stop work and notify Mason County and the Washington State Department of
Archaeology and Historic Preservation. Failure to do so may result in civil penalties.
2) WETLAND BUFFER/SETBACK
Logging unit shall be setback 125' from Class 3 wetland as depicted on short plat 3045, per
the Mason County Resource Land s and Critical Areas Ord.
3) STORM WATER & EROSION CONTROL
Escape of silty water or mud from this property shall be considered a violation of County
and State storm water management regulations, and could subject the applicant(s) to civil
fines or penalties. This project is represented as disturbing less than one-acre of ground
and creating less than 5,000 sq ft of new impervious surfaces. The contractor shall comply
with the 2005 WSDOE Stormwater Manual compliant best management checklist written
by lain Rutherford.
4) SLASH ABATEMENT
This Forest Practice Application indicates that forest debris resulting from the proposed
logging operation may create an extreme fire hazard under RCW 76.04.600 and WAC
332-24-650. An extreme fire hazard could be created if one or more of the conditions found
in WAC 332-24-650 is located within 100 feet of the running surface of a public road; or is
within 500 of an existing structure and/or designated public use area, which is not owned
by the owner of the fire hazard area.
The land owner is fully liable in the event of fire, if he or she fails to appropriately abate the
hazard. Extreme fire hazards shall be abated by removing the forest debris, or by other
means approved by the Washington State Department of Natural Resources (DNR).
SEP2016-00043 Page 2 of 2
SEPA Environmental Checklist Mason County Permit Center Use:
SEP . o/ - W
❑ Single Family DNS: $385
Date Rcvd:
Q Other DNS: 0 to 9.99 acres: $630
10 to 20 acres: $755 RECEIVED
Over 20 acres: $945
❑ DS/EIS: $2,525+70 Per hr MAY 13 2016
6115 W. Aldr7r Str t
Purpose of checklist:
Governmental agencies use this checklist to help determine whether the environmental impacts of 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 a p'i
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 neededto
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.
A. BACKGROUND
1. Name of proposed project, if applicable
2. Name of applicant
John & Lesley Rutherford
3. Address and phone number of applicant and contact person.-
C/O 214 N Diamond St, Centralia, WA 98531 -360.359.5088
Contact Person: lain Rutherford (360.359.5088)
SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted):2014 Page 1 of 11
4. Date checklist prepared: Le1p]
5/9/16
5. Agency requesting checklist: LheM
Mason Co.
6. Proposed timing or schedule (including phasing, if applicable): hC eM
6/1/16—2 days
7. Do you have any plans for future additions, expansion, or further activity related to or connected with
this proposal? If yes, explain. kL i
Flcti Cs,ls
No
8. List any environmental information you know about that has been prepared, or will be prepared,
directly related to this proposal. heel �Ve��o�� � Q-,.,
Not applicable p)o #3�.l_ 04 5
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. Ll,em ��� 6?e Y -^�
No
10. List any government approvals or permits that will be needed for your proposal, if known. LhP4o
FPA
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.) hl ei i
Clear approximately 0.8 acre of brush/lightly wooded area of parcel#22029-42-90013 for construction of
single-family home and living area.
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 are not required to
duplicate maps or detailed plans submitted with any permit applications related to this checklist. IhLeM
The property is located near milepost 8 of SE Lynch Road, Shelton,WA 98584.
Subdivision#3045, Section 29, Township 20 North, Range 2 West,W. Mason County,WA
SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted):2014 Page 2 of 11
B. ENVIRONMENTAL ELEMENTS hp,'!
1. Earth
a. General description of the site L ;al
one): Flat rolling, hilly steep slopes; mountainous; other.
b. What is the steepest slope on the site (approximate percent slope)? h( eld
Unknown
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. f eM
Soil types are Alderwood gravelly sandy loam and Indianola loamy sand. Soil will not be removed from
the site.
d. Are there surface indications or history of unstable soils in the immediate vicinity? If so,
describe
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. i
Construction of single-family home, approx. 2256 sq ft—excavation of foundation and access driveway—
fill for driveway will be imported rock product.
f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. hf eV
No
5,6 rkr;.�Jo, T3 N( P.s
g. About what percent of the site will be covered with impervious surfaces after project
construction (for example, asphalt or buildings)?
Approximately 15%
h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: n�eipt
Landscaping, planting of new flora.
12 - Y6 I,�- S.k-v vl,.w4 e�.
2. Air
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. rhelpt
None
b. Are there any off-site sources of emissions or odor that may affect your proposal? If so,
generally describe. . .�_r:
No
c. Proposed measures to reduce or control emissions or other impacts to air, if any
None
SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted):2014 Page 3 of 11
3. Water
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.
Wetland area to the east of the property.
2) Will the project require any work over, in, or adjacent to (within 200 feet) thedescribed
waters? If yes, please describe and attach available plans.
It will be within 200 feet of the wetland area, but outside the existing buffer zone.
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.
None
4) Will the proposal require surface water withdrawals or diversions? Give general description,
purpose, and approximate quantities if known.
No
5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan.
No
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.
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 withdrawn from
the well. Will water be discharged to groundwater? Give general description, purpose, and
approximate quantities if known.
Yes, well to be drilled for use by single-family home with normal use
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.
Household waste, one septic system —2 x 1,200 gallon tanks and 267 If of drain field pipe
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.
Unknown 54CVA, W-4e- S�ne�i,Jp� vt�f
SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted):2014 Page 4 of 11
2) Could waste materials enter ground or surface waters? If so, generally describe. hel
No
3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If so,
describe.
No
d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage pattern
impacts, if any:
None
4. Plants hf e
a. Check the types of vegetation found on the site:theipa
X deciduous tree: alder, maple, aspen, other
X evergreen tree: fir, cedar, pine, other
X shrubs
grass
pasture
crop or grain
orchards, vineyards or other permanent crops
X wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other
water plants: water lily, eelgrass, milfoil, other
X other types of vegetation
b. What kind and amount of vegetation will be removed or altered? h[ elpl
Mixed brush and trees will be cleared and removed to build home and living area.
II
c. List threatened and endangered species known to be on or near the site. IMP]
None
d. Proposed landscaping, use of native plants, or other measures to preserve or enhance
vegetation on the site, if any: hj_M
Landscaping will include grass, small trees, shrubs and other plants
e. List all noxious weeds and invasive species known to be on or near the site.
Scotsbroom
5. Animals
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. Examples include: Lelp
birds: hawk, heron, eagle, songbirds, other:
mammals: deer, bear, elk, beaver, other:
fish: bass, salmon, trout, herring, shellfish, other:
SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted):2014 Page 5 of 11
b. List any threatened and endangered species known to be on or near the site. hg elpt
None
c. Is the site part of a migration route? If so, explain.
No
d. Proposed measures to preserve or enhance wildlife, if any
Keeping over 1.25 acres of existing woodland in addition to the approximately 3 acres of wetland area on
the property.
e. List any invasive animal species known to be on or near the site.
None
6. Energy and natural resources
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. ; ;
Electric
b. Would your project affect the potential use of solar energy by adjacent properties?
If so, generally describe.
No
c. What kinds of energy conservation features are included in the plans of this proposal?
List other energy impacts,ro osed measures to reduce or control acts if any:
p p 9Y p _.
Smart home technology, energy-efficient appliances.
7. Environmental health
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 ;
No
1) Describe any known or possible contamination at the site from present or past uses.
None
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.
None
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.
None
4) Describe special emergency services that might be required.
None
5) Proposed measures to reduce or control environmental health hazards, ifany:
None
SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted):2014 Page 6 of 11
b. Noise
1) What types of noise exist in the area which may affect your project (for example:
traffic, equipment, operation, other)? 1 e�
None
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.ghelp]
Short-term construction during regular business hours.
3) Proposed measures to reduce or control noise impacts, if any: fhgm
None
8. Land and shoreline use
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. tneip1
Currently the land is vacant, un-developed. No
b. Has the project site been used as working farmlands or working forest lands? If so, describe.
No
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?
None
If resource lands have not been designated, how many acres in farmland or forest land tax
status will be converted to nonfarm or nonforest use?Lqe�]
Approximately 0.75 acre
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:
No
c. Describe any structures on the site. L e.
None
d. Will any structures be demolished? If so, what? hf elo
Not applicable
e. What is the current zoning classification of the site? hf plat R P S
91 - Undeveloped Land
f. What is the current comprehensive plan designation of the site? hI�1
91 - Undeveloped Land
SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted):2014 Page 7 of 11
g. If applicable, what is the current shoreline master program designation of the site? ftel ]
Not applicable
h. Has any part of the site been classified as a critical area by the city or county? If so, specify.
hf eM l,ve lcti�.
None
i. Approximately how many people would reside or work in the completed project?JLeM
Two
j. Approximately how many people would the completed project displace? hf ell
None
k. Proposed measures to avoid or reduce displacement impacts, if any: help]
Not applicable
L. Proposed measures to ensure the proposal is compatible with existing and projected land
uses and plans, if any: dhelp]
Not applicable
I. Proposed measures to ensure the proposal is compatible with nearby agricultural and forest
lands of long-term commercial significance, if any:
None
9. Housing
a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-
income housing. they.]
One-middle income.
b. Approximately how many units, if any, would be eliminated? Indicate whether high,
middle, or low-income housing. 1heip
None
c. Proposed measures to reduce or control housing impacts, if any: hf M
Not applicable
10. Aesthetics
a. What is the tallest height of any proposed structure(s), not including antennas; what is
the principal exterior building material(s) proposed? hf elgl
Building height is approximately 20' and exterior building materials consist of James Hardie 'Hardi-plank'
siding and lumber trim.
b. What views in the immediate vicinity would be altered or obstructed? [help]
None
c. Proposed measures to reduce or control aesthetic impacts, if any: hf eM
None
SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted):2014 Page 8 of 11
11. Light and glare
a. What type of light or glare will the proposal produce?What time of day would it mainly
occur?
None
b. Could light or glare from the finished project be a safety hazard or interfere with views?
No
c. What existing off-site sources of light or glare may affect your proposal?
None
d. Proposed measures to reduce or control light and glare impacts, if any:
None
12. Recreation
a. What designated and informal recreational opportunities are in the immediate vicinity?
Unknown
b. Would the proposed project displace any existing recreational uses? If so, describe.
No
c. Proposed measures to reduce or control impacts on recreation, including recreation
opportunities to be provided by the project or applicant, if any.
Not applicable
13. Historic and cultural preservation
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.
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.
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. n[ elpt
Not applicable
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.
Not applicable tti.adl Wal '/(
Galsccve!� Cc-104.
SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted):2014 Page 9 of 11
14. Transportation
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. h�
SE Lynch Road runs adjacent to the north-west of the property, access will be an existing private
driveway from the road.
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? Jhelpi
No, approximately 10 miles
c. How many additional parking spaces would the completed project or non-project proposal have?
How many would the project or proposal eliminate?jheEpj
Not applicable Z-
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). h[ eipl
No
e. Will the project or proposal use (or occur in the immediate vicinity of) water, rail, orair
transportation? If so, generally describe. hI eil
No
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?lhgipl
One regular trip daily small passenger vehicle !U
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.
No
h. Proposed measures to reduce or control transportation impacts, if any: hf eipl
None
15. Public services
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. nI eip1
No
b. Proposed measures to reduce or control direct impacts on public services, if any. ILeip
None
SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted):2014 Page 10 of 11
16. Utilities
a. Circle utilities currently available at the site: Lei ]
electricity, natural gas, water, refuse service, telephone,
sanitary sewer, septic system, other
None currently installed.
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. L�elpl
Proposed utilities are:water(well), septic system,telephone/internet
C. SIGNATURE Ltd
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: 2&�!
Date Signed:
Print Name of Signee: lain Rutherford
If applicable, Position and Agency/Organization: N/A
L
Date Submitted:
SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted):2014 Page 11 of 11
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Conditions Asso ated With 9:31:55AM
Case#: SEP2016-00043
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Permit Condition Status Updated
item# Code Titl Status Changed By Tag Date By
1) 1 ARCHAEOLOGICAL RESOURCES NOT MET 6/16/2016 _ MMS
ARCHAEOLOGICAL RESOURCES
Archaeological or historical resources,such as ruins,sites,buildings,artifacts,fossils,or other objects of
antiquity that may have significance from an historical or scientific standpoint,which may be encountered by
the developer/contractor,shall not be further disturbed. If the developer/contractor encounters any such
artifacts,he/she shall immediately stop work and notify Mason County and the Washington State Department of
Archaeology and Historic Preservation.Failure to do so may result in civil penalties.
2) 1 WETLAND BUFFER/SETBACK NOT MET 5/31/2016 MMS
WETLAND BUFFER/SETBACK
Logging unit shall be setback 125'from Class 3 wetland as depicted on short plat 3045,per the Mason County
Resource Land s and Critical Areas Ord.
3) 1 STORM WATER &EROSION CONTROL NOT MET 5/31/2016 MMS
STORM WATER &EROSION CONTROL
Escape of silty water or mud from this property shall be considered a violation of County and State storm water
management regulations,and could subject the applicant(s)to civil fines or penalties.This project is
represented as disturbing less than one-acre of ground and creating less than 5,000 sq ft of new impervious
surfaces.The contractor shall comply with the 2005 WSDOE Stormwater Manual compliant best management
checklist written by Iain Rutherford.
4) 1 SLASH ABATEMENT NOT MET 5/31/2016 MMS
SLASH ABATEMENT
This Forest Practice Application indicates that forest debris resulting from the proposed logging operation may
create an extreme fire hazard under RCW 76.04.600 and WAC 332-24-650.An extreme fire hazard could be
created if one or more of the conditions found in WAC 332-24-650 is located within 100 feet of the running
surface of a public road;or is within 500 of an existing structure and/or designated public use area,which is not
owned by the owner of the fire hazard area.
The land owner is fully liable in the event of fire,if he or she fails to appropriately abate the hazard.Extreme
fire hazards shall be abated by removing the forest debris,or by other means approved by the Washington State
Department of Natural Resources(DNR).
Page 1 of 1 CaseConditions..rpt
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May 26, 2016 1:5,948
0 0.05 0.1 0.2 mi
Determined Eligible Derived from Assessor — Register Properties (Lines) i ,� , I I �r
0 0.075 0.15 0.3 km S
` Determined Not Eligible A Heritage Barns Register Properties(Polygons)
Sources: Esri, HERE, DeLortne, Intermap, ncrement P Corp., GEBCO,
USGS,FAO,NPS,NRCAN,GeoBase,IGN,Kadaster NL,Ordnance Survey,
No Determination '*' Register Properties (Points) Q Register Districts
' SEPA Contact List
MASON COUNTY DCD
Sent SEPA to (check all that apply)on
❑ Skokomish Tribal Nation, Nat. Res.Dept. WA Department of Ecology
ATTN: Randy Lumper Environmental Review Section
N 541 Tribal Center Rd., Skokomish Nation, 98584 PO BOX 47703, Olympia, 98504-7703
rlumper@skokomish.org separegister@ecy.wa.gov
❑ Skokomish Tribal Historic Preservation Officer ❑ WA Department of Commerce
ATTN: Kris Miller reviewteam@commerce.wa.gov
80 N Tribal Center Rd, Skokomish Nation,98584
shlanay1@skokomish.org ❑ U.S.Army Corps of Engineers
SEPA Reviewer-Darren Habel
❑ Quinault Indian Nation PO Box C-3755, Seattle, 98124
ATTN: Mark Mobbs darren.habel@usace.army.mil
PO Box 189,Tahola, 98587
mmobbs@quinault.org WA Dept.of Fish and Wildlife
papplications@dfw.wa.govP
�Squaxin Tribal Nation, Natural Res.Dept.
2952 SE Old Olympic HWY Shelton 98584 /WA Dept.of Fish and Wildlife
jdickison@squaxin.us ATTN: Margie Bigelow
emarbet@squaxin.us (Habitat Biologist-S Puget Sound Watershed)
2391 W Deegan Rd., Shelton, 98574
❑ The Confederated Tribe of the Chehalis margaret.bigelow@dfw.wa.gov
ATTN: SEPA Reviewer-Glen Connelly
420 Howanut Rd., Oakville, 98568 ❑ WA Dept.of Fish and Wildlife
ATTN: Joshua Benton
Joshua.Benton@dfw.wa.gov
/connelly@chehalistribe.org
A DNR,South Puget Sound Region
950 Farman Avenue N, Enumclaw, 98022-9282 ❑ WA Dept.of Transportation
southpuget.region@dnr.wa.gov ATTN: Dale Severson
P.O. Box 47440, Olympia 98504-7440
❑ WA DNR,Aquatic Resources OR-SEPA-REVIEW@wsdot.wa.gov
PO BOX 47027, Olympia, 98504-7027
and@dnr.wa.gov ❑ City of Shelton
ATTN:Jason Dose
WA DNR,SEPA Center 525 West Cota St., Shelton 98584
ATTN: External Coordinator jasond@ci.shelton.wa.us
PO BOX 47015, Olympia, 98504-7015
sepacenter@dnr.wa.gov ❑ Port of Shelton
ATTN: Brandon Palmer
Olympic Region Clean Air Agency 21 West Sanderson Way, Shelton 98584
ATTN:Aaron Manley
2940-B Limited Ln. NW, Olympia. 98502
ron.manley@orcaa.org /andonP@portofsheiton.com
ffice of Archaeology&Historic Preservation
ATTN: Lance Wollwage
Mason County Transit P.O. Box 48343, Olympia, 98504-8343
ATTN: Mike Oliver Lance.Wollwage@dahp.wa.gov
PO Box 1880, Shelton, 98584
moliver@masontransit.org ❑ Tacoma Public Utilities-Real Property Service.-
ATTN: Dave Letterman
Mason County PUD#1 3628 S 35th St,Tacoma, 98409-3192
ATTN: Jocelyn Gray dletterm@cityoftacoma.org
N 21971 Hwy 101, Shelton, 98584
ocelyneg@mason-pud1.org ❑ Other:
Mason Cty P.W.ATTN:
❑ School District:
❑ Mason Cty E.H. ATTN:
Agent:
M(FDCNgA9P t %Mgd 8;i%20/2015
Applicant: