HomeMy WebLinkAboutSHX97-00004 JARPA - Rip Rap - SHX Application - 1/22/1997 ` AGENCY USE ONLY
1 Agency Reference #: Date Received:
SE?A Lead Agency:
Other.
— DARPA APPLICATION FORM -
- for use in Washington State -
PLEASE TYPE OR PRINT IN BLUE OR BLACK INK
Based on the preceding checklist, I am sending copies of this application to the following: (cheat all that apply)
® Local Government: for shoreline ❑ Substantial Development ❑ Conditional Use ® Variance
❑ Exemption; or ❑ Floodplain Management ❑ Critical Areas Ordinance
Washington Department of Fish and Wildlife for EPA
Washington Department of Ecology Approval to Allow Temporary Exceedance of water Quality Standards
❑ 401 Water Quality Certification Nationwide Permits
❑ Corps Engineers for Section 404 or Section 10 permit(s)
SECTION A -Use for all permits covered by this application. Be sure to also complete Section C (Signature Block) for
all permit applications. f
1. Applicant �'al�lA- 14�C' W r' i 1 J (y *- Alac ar-ef iA 5eet
Mailing Address H& 101
A
Work Phone: CIA S'1 C) y Home Phone: (3 $?7-q i 2,-3
Fax Number-
If an agent is actin for the cant during the 't complete�42 &3.
ag 8 applicant 8 permit Process
2. Authorized Agent
Mailing Address
Work Phone: ( ) Home Phone: ( )
Fax Number. ( )
3. Designation of Authorized Agent, if applicable:
I hereby designate to act as my agent in matters related to
this application for permit(s). I understand that if a Federal permit is issued, I must sign the permit.
Signature of App cant Date
4. Relationship of applicant to property: Owner ❑ Purchaser ❑ Lessee ❑ Other
S. Name, address, and phone number of property owner(s), if other than applicant:
Application Page 1 of 5
6. Location where proposed activity exists or will occur: Waterbody HOO ►lit 7 --sakqI77ree-
DNR Sb=m Type (if known)
Street Address N 7 o h i akw(kv l01 Tributary of
QO d t,4 r 1, (IM a-so A) VJA- q� 4 S L,egsl Description:
City, County, State, Zip Code Tax Parcel No.: '�)2- 3 31 .2_3 9 0 0 2-4
14 Sf Section Townsh}p Range
7. Describe the current use of the property, and structures existing on the property. If any portion of the proposed activity
is already completed on this property, indicate month and year of completion.
RV Park , 6o,,4' .ou6e used `fir dr� boat' s4vra�e a,Lo(
bona I6LL'u4 �
Is the property agricultural land? 0 Yes No Are you a USDA program participant? 0 Yea EfNo
8. Describe the proposed activity, and the activity's purpose. Include expected water quality and fish impacts, and proposed
actions to reduce the duration and severity of those impacts and provide proper protection for fish life. Complete plans
and specifications should be provided for all work watetward of the Ordinary High Water Mark or Line, including types
of equipment to be used, and for lQ work if applying for a shoreline permit. If additional space is needed, please attach
a separate sheet.
l45 p� t. L,1- ' o-F `flyte l eeember �, lQ4& ;S*rksv , 4ve- boa4koL se
S��-der e o( s''{ru r°c.Q G�Gcwt a 'ram w et`t1�� off= '�c
P�jAered ov` J
*h� roo-C CD-veG� i.vt o✓i � o��avL p4 if, raC�'`Sbe�evt
10Ae re �v►i✓l� `Jor+'ov' � . `�,v�q5 a✓td Pt,1 iK, h"
V
a i'esu) �' O� 4he Cowlb►v►r4` -Ov-L e-C eXe-ess Wecq�-{- �s►►c�,fa'.tra�,�•, avco�
edrewier eroscavx ''rr� y e- �[ood�h� o� 5u�G< L'ree-k- *ka--+ tS
ad aet.`r qo `Fly e bo,+kouse let. Appr6X1 rvta4e1 12-1 s -re e& o-F
7"`�-'r"(
)ow ba&4k washed Wasked Gam �ctn � oL �ero5ioA Will ea -5e SiCt/1RtCQµ� damay-'e—.
Oar Propo5ol i 3 �o repair/replAe-e)-vvyrove iv4459rt�y a-( ` k.k-
Yjoa` kouse builds, t aj4d to bu�1d a Prv+ee4tve— rack (rip)rap) btu
h,ea& CLIC)V1 '+ke �p6r+0"\ o'C eroclirl olrzt-k beet +Lta
'+14re0JeKZA 'tWe buk"Ct V ,
� ' � ou[0( be l'Y►irt;Y►1a-� P r10 equ��rnek'� Wou(al be �w
WoAer �ual� y f ,'! iM act, W ra eel 'Joe „n rOCL), (irk W001d- be,
y4he wo-fer, m ipuwta.( O4' i K (On� *D p P `1
bn4 l f-W r't r *0 3/�5��?� Per f«k w- w li^-Fe r�uCa�rax.
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Preparation of drawings: See Appendix A - sample drawings and checklist for completing the drawings. One set of
original or good quality reproducible drawings Must be attached NOTE: Applicants are encouraged to submit
photographs of the project site, but these do not substitute for drawings. THE CORPS OF ENGMEERS REQUIRFS
DRAWINGS ON 8-1/2 X 11 INCH SHEETS. Luger drawings may be required by other agencies.
Application Page 2 of 5
9. Proposed Starting Date: A6A P Farimatod duration of activity: Prior +o 32,5117
Will the project be constructed in stages? ❑ Yes *No
10. Will any structures be placed:
a. waterward of the Ordinary High Water Mark or line for fresh or tidal waters? Yes ❑ No
b. waterward of Mean High Water line in tidal waters? Yes ❑ No
11. Will fill material frock, Sll, bulkhead, pilings or other material) be placed waterward
of Ordinary High-Water Mark or Line for fresh or tidal waters? Yes ❑ No
a. If"yes," in fresh water indicate volume in cubic yards: 2 CC%
b. If"yes," in tidal waters, indicate volume in cubic yards waterward of the line of mean higher high
water:
12. Will material be placed in wetlands? ❑ Yes No If yes, impacted arts: (acres)
If yes:
a. Has a delineation been completed? ❑ Yes ❑ No (If yes, please submit with application.)
b. Type and composition of fill material (e.g., sand, etc.):
c. Material source:
d. list all soil series (type of soil) located at the project site, & indicate if they are on the county's list of hydric soils:
Soils information can be obtained from the Natural Resources Conservation Service (NRCS), formerly Soil
Conservation Service (SCS).
13. Will proposed activity cause flooding or draining of
wetlands? ❑ Yes No If yes, impacted area: (acres)
14. Will excavation or dredging be required in water or wetlands? ❑ Yes No
If yes, volume: (cubic yards)
a Composition of material removed:
b. Disposal site for excavated material:
c. Method of dredging:
15. List other applications, approvals, or certifications from other Federal, state or local agencies for any strucurres,
construction, discharges, or other activities described in the application(i.e., preliminary plat approval, health district
approval, building permit, SEPA review, FERC license, Forest Practices Application, etc.) Also indicate whether work
has been completed and indicate all existing work on drawings.
Date of Date Completed?
Type of Approval Issuing Agency Identification No. Application Approved Yes or No
SInOrP_6ie m&5alk Ci�LAA
iYl�x �rrn��` Maser. &Lt t
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wo r
SEPA Lead Agency: w SEPA Decision Date:
Application Page 3 of 5
16. Has any agency denied approval/or the activity described herein or for any activity directly related to the activity
described herein? 0 Yes X No If Yes, explain:
SECTION B - Use for Shoreline & Corps of Engineers permits only:
17. Total cost of Project. This means the fair market value of the project, including materials, labor, machine rentals, etc.
18. Local government w/jurisdiction:
Shoreline Environment designation: Zoning designation:
19. For corps permits, provide names, addresses, and telephone numbers of adjoining property owners, lessees, etc.,
PLEASE NOTE: Shoreline management compliance may require additional notice— consult your local government.
SECTION C - Complete for any permit covered by this application
20. Application is hereby made for a permit or permits to authorize the activities described herein. I certify that I am
familiar with the information contained in this application, and that to the best of my knowledge and belief, such
information is true, complete, and accurate. I further certify that I possess the authority to undertake the proposed
activities. I hereby grant to the agencies to which this application is made, the right to enter the above-described location
to inspect the proposed or completed work.
Signature of AjAcant or Authorized Agent (REQUIRED) Date
Signature of Landowner (REQUEUD if other thaw applicant) Date
This application must be signed by the applicant. If an authorized agent is to be designated, the applicant must also Sign
at Item #3.
is U.S.0 01001 provides that: Whoever,in any manner within the ymsdictum of any department or agency of the United States knowingly
falsifies, conceals, or covers up by any trick, scheme, or device a material fitet or makes any fate, fictitious, or fraudulent statemems or
repreeentations or makes or uses any false writing or document knowing same to contain any false, fictitious, or fimukderit statement or
entry, shall be fined not more than$10,000 or imprisoned not more than 5 yam or both.
Application Page 4 of 5
DO NOT SEND FEDERAL PROCESSING FEE WITH APPLICATION
TO BE COMPLETED BY LOCAL OFFICIAL
A. Nature of the existing shoreline. (Describe type of shorelinc, such as ,stream, Wce, lagoon, marsh, bog, swamp,flood per,
floodway, deft:;type of beach, such as accretion,arosion,high bank,low bank,or dike;material such as sand.gravel, mud, clay,
rock,riprap;and ezomand type of bulkheading,if any:) .
B. In The event that any of the proposed buildings orstructures will Woeed a Wit:of thirty-five feet above the average grade level,
indicate the approximate location of and number of residential units, existing and pownbal,that will have an obi avcoed view-
C. if the application involves a eoaditiond use or variance,.aw:£o:lh is M that portion of the master program which provides that the
proposed use may be a conditional.use,:vr,.in the case of is variance,from wbwh the variance is being sought:
Mese Agencies are F4ual Opporrwuuy and Affrnuaaw Action employers.
For special accommodation needs, please contact the appropriam age'ftm Appendu A.
Application Page 5 of 5
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CCCfI GAADE G,3C-EIS �3EO
January 22, 1997
Hugo Flores
Shoreline Planner
Mason County Dept. of Community Development
Mr. Flores,
This letter is to follow up my telephone conversation with you on
Tuesday January 21, 1997 regarding the construction of a protective rip-rap
bulkhead along Sund Creek. During the December 26, 1996 storm
approximately 12 to 15 feet of low bank washed away leaving our boat
house facility exposed and vulnerable when/if further erosion occurs.
We are asking for an emergency variance under the emergency status
that this storm created for Mason County. We feel the project needs to be
started ASAP in order to have it completed before further erosion and
damage occurs and prior to the March 15, 1997 date that is required by the
Department of Fish and Wildlife for such work.
Enclosed you will find a copy of proposed plans, JARPA application,
Environmental checklist, HPA and Misc. Building Permit.
We appreciate your time and attention to our concerns.
Sincerely,
i
Cindy and and Margaret Nielsen
Co-owners Rest-a-While RV Park
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