HomeMy WebLinkAboutSHX2015-00001 JARPA Repair Roadway - SHX Permit / Conditions - 3/11/2015 � Washington State Olympic Region
VI/ Department of Transportation Environmental&Hydraulic Services
5720 Capitol Blvd
Lynn Peterson Tumwater,WA 98501
Secretary of Transportation P.O. Box 47440
Olympia,WA 98504-7440
T6TY 510 00-833-6388 0 357-RECEIVED
March 20, 2015 www.wsdot.wa.gov MAR 2 4 2015
426 W. CEDAR ST.
Mason County Department of Community Development
Attn: Grace Miller, Planner
Planning Department
P.O. Box 279
Shelton, WA 98584
RE: US 101 /2.2 Miles South of Beacon Point Rd.—Emergency Slope Stabilization
MP 316.45—MP 316.55
Shoreline Substantial Development Permit(Case # SHX 2015-00001)
Dear Ms. Miller:
Enclosed please find a Joint Aquatic Resources Permit Application (JARPA) for the
project referenced above, proposed by the Washington State Department of
Transportation(WSDOT). This project is located on US 101 between Milepost (MP)
316.45 and MP 316.55 in Mason County.
Also enclosed are two checks, one for$255.82 (# 256500H) and another for$1639.18
(# 256501H) issued 03/09/15 for a total of$1895.00 for processing. In addition you will
find copies of the vicinity map and preliminary site plan (4 sheets) of the proposed
project and a Mason County Shoreline Permit Application. You issued an Emergency
Shoreline Substantial Development Permit Exemption (Case # SHX 2015-00001) on
1/16/2015 to allow WSDOT to proceed with repairs.
This project will construct permanent repairs to US 101 near Beacon Point on Hood
Canal. Damage was sustained by a landslide at this location on December 10, 2014
during an extreme weather event.
Temporary emergency repair work included signage and barrier installation to restrict
travel to one lane, erosion control measures and conducting geotechnical investigation.
Permanent repairs will include removal of slide debris, tree removal, construction of a
soldier pile retaining wall and reconstructing the roadway slope and northbound lane and
shoulder.
Mason County Department of Community Development
March 20, 2012
Page 2
Design steps taken to avoid or minimize impacts to the environment include the following:
• No in-water work will occur as part of this project.
• Proper use of Best Management Practices will ensure that no related pollutants,
sediment or debris enter waters of the State.
• Consultation with the National Marine Fisheries Services and United States Fish and
Wildlife Service will ensure that project activities do not jeopardize listed species or
destroy, or adversely affect, designated critical habitat.
• Conservation measures outlined in the Biological Assessments will be included in the
construction contract.
WSDOT is the SEPA lead for this work and has completed a SEPA Determination of Non-
significance(DNS), effective 4/3/15, per WAC 197-11-340(2).
If you have any questions, please contact Scott Boutilier at 360-570-6742 or Dave Evans at
360-570-6738.
Sincerely,
Jeff Sawyer
Environmental & Hydraulic Manager
Olympic Region
JBS:sb:ip
Enclosures: JARPA
Two checks totaling $1895.00
Vicinity Map and Preliminary Site Plan (4 sheets)
Mason County Permit Application
DNS
cc w/enc: Ricky Bhalla, WA-48
Project File
SF03202015 (7162)
SON-SrA;I, MASON COUNTY
P c � DEPARTMENT OF COMMUNITY DEVELOPMENT
�
o A o N Planning Division
o N z 426 W Cedar St, Shelton, WA 98584
7 N Y y (360)427-9670
OJ �O
1864
Exemption from Shoreline Management Act
Case No.: SHX2015-00001 Substantial Development Permit Requirement
The Proposal By: WA ST DEPT OF TRANSPORTATION
DAVID EVANS
P O BOX 47440
OLYMPIA, WA 98504-7440
To undertake the following development:
PROJECT WILL REPAIR THE ROADWAY AND STABILIZE THE SLOPE ON THE CANAL SIDE OF US
HIGHWAY 101 BY BUILDING A RETAINING WALL. WORK CONSISTS OF REMOVAL OF SLIDE
DEBRIS, CONSTRUCTING A RETAINING WALL AND EMBANKMENT AND RECONSTRUCTING
APPROXIMATELY 100 FT OF THE NORTHBOUND LANE.
Within HOOD CANAL and/or its associated wetlands is exempt from the requirement of substantial development
because the development is categorized under WAC 173-27-040(2) as being category
D-emergencv construction
Please contact Grace Miller at ext 360 if you have any questions.
Issued: 1/16/2015 ""• ��'�7
Expires: 1/16/2017 Authorized Local Government Official
cc: APPLICANT WQFW USACOE WDOE TRIBAL COUNCIL Sfw ILvis<,''T h�.
00001 �x
RECEIVED
JAN 15 2015
US 1011 MP 316.5 Vic. Beacon Point Landslide— Emergency RepaIJ26 W. CEDAR ST.
Level 1 Information
Needed from Project Manager to Complete Environmental Review
Summary (ERS)—Required for Design Concurrence
To begin the environmental documentation process, submit a formal written request
memorandum to EHS Office for environmental &hydraulic services that contains the
following Level One information.
Please answer or provide information for each and every question. Provide as much
detail and accuracy that is available:
1. Name and phone number of Contact Person.
Jeff Young,Design Team Leader,phone(360) 538-8522
Bonnie Jamieson,Designer,phone(360) 538-8510
2. Project Title,WIN and PIN numbers.
US 101 MP 316.5 Beacon Point Landslide—Emergency Repair
Pin and Win: N/A
3. Work Order Number,Group Number,and Control Section.
(Charge codes to be used by EHS Office).
W.O. #: DMC 220/Gr#: 01 /C.S. C22101
4. Is there the potential for any federal funding?
Yes, 86.5%federal funding.
5. Project Type(Pl-Pavements,P2- Structures, etc.)
Emergency slide repair.
6. Project Limits(area within which all work will occur);include mileposts,
Counties, Cities,Township,Range and Section(s).
US 101, MP 316.45 to 316.50 in Mason County,2.57 miles north of Eldon, in
Township 24 North,Range 3 West, Section 12,WM.
7. Give a summary of the project and the scope of work that it entails.
This project will repair the roadway and stabilizing the slope on the canal side of
US 101 by building a retaining wall.. The work consists of removal of slide debris,
constructing a retaining wall and embankment, and reconstructing approximately
1001f of the NB lane.
8. Will the approximate amount of disturbed area equal 1 acre or more? (Include
clearing&grubbing,pavement removal to bare soil, etc.)
COMPLETED JAN 1 2.2015 1
It is assumed the area of disturbed soils will not exceed the area of the slide which
is approximately 8000 SF which equal 0.18 Ac.
9. What is the approximate added impervious area?
(less than 2000 f1 l) (less than 5000 ftO)(greater than 10,000 ftO).
Less than 2000 SF, repairing the roadway will not add any impervious surface.
10. Describe the source of storm water runoff'
a. Are the culverts larger or smaller then 48"?
No culverts will be impacted.
b. Where does it outfall? (include quantities,if known).
N/A
c. Will there be new impervious surface, and will it be treated by this system
or a new system?
The new impervious surface is considered replaced impervious surface.
No stormwater treatment will be incorporated in this project.
11.Provide preliminary description of any work in streams,rivers or water bodies.
None.
12. Provide preliminary description of any work within 300 feet of any water body.
(Include name of water body). Also designate which of this work is within 200
feet of a water body(include name of water body).
All work is within 200 ft of the Hood Canal.
Will there be any temporary or permanent ditch impacts during the project?
(Example: guardrail terminals,culvert extensions/replacements,re-grading ditches,
access roads,widening).
Yes, the roadway will likely be widened to the west,temporarily placing a culvert
in the ditch-line and covering it so the temporary traffic can have the temporary
required 15 ft lane width.
13. Describe the types and amount of vegetation to be removed. Attach the Roadside
Restoration worksheet.
Native scrub brush, such as ferns and salial bush will be removed during clearing
and grubbing.
14.Do you have knowledge of any wetlands in the area? Describe any anticipated
impacts to wetlands from the project.
No, I do not have knowledge of any nearby wetlands.
15. Is geotechnical work(drilling)planned? [This may trigger additional
documentation/permitting tasks such as BA,wetland delineation, etc.]
COMPLETED JAN 12.2015 2
ay
The Geotechnical Office has already perfonned the necessary drilling at the site.
No further drilling is anticipated.
16.Will any structures be removed? (Buildings, etc.)
No.
17.Are there any known or suspected historic structures, areas, archaeological
resources,or traditional cultural places, etc?
No.
18. Will the project potentially disturb any previously undisturbed areas? [Drilling or
excavation in native soils may trigger additional cultural resources/archaeological
review.]
Yes,the area adjacent to the slide will be disturbed to construct access to remove
the slide debris and construct a permanent retaining wall to stabilize the roadway.
19. Are there any known old gas stations,or other locations with suspected hazardous
materials or waste?
No.
20. Are there any parks,wildlife refuges,recreation areas, etc.,that will be impacted?
The slide debris is on property owned by Girl Scouts of Western Washington.
21. Provide information or knowledge of any previous commitments in the project
area.
I have no knowledge of any previous commitments.
22. Provide a vicinity map and any preliminary plans that you have for information.
Attached is the vicinity map and conceptual roadway sections depicting;the
existing condition, excavation and debris removal, and final embankment and
roadway construction. Additional plan sheets are being developed.
23. Provide total cost of project and percentage of Federal contribution.
The project costs has not been yet been determined. The federal funding
contribution is 86.5 percent.
COMPLETED JAN 12.2015 3
T. 24 N., R. 3 W., W.M. WSDOT
OLYMPIC REGION
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ENTERED BY R WILLIAMS Washington State MP 316.45
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USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW.
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•-------------------------------------
Part 1—Project Identification
1. Project Name (A name for your project that you create. Examples: Smith's Dock or Seabrook Lane Development) [help]
US 101, 2.2 Miles South of Beacon Point Rd. — Emergency Slope Stabilization
Part 2—Applicant
The person and/or organization responsible for the project. [ ]
2a. Name (Last, First, Middle)
Sawyer, Jeff B.
2b. Organization (If applicable)
Washington State Department of Transportation
2c. Mailing Address (Street or PO Box)
P.O. Box 47440
2d. City, State, Zip
Olympia, WA , 98504-7440
2e. Phone(1) A Phone(2) 2g. Fax 21h. E-mail
(360) 570-6701 (360) 790-9646 (360)357-2601 sawyerj@wsdot.wa.gov
Part 3—Authorized Agent or Contact
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
, www.nws.usace.armv.milrfvi , Works/RegulatorylPermitGuidebookiE ndancleredSoecies.aspx.
• Not all cities and counties accept the JARPA for their local Shoreline permits.If you need a Shoreline permit,contact the appropriate city or county
government to make sure they accept the JARPA.
2To access an online JARPA form with[help]screens,go to
http://www.epermitbnq.wa.gov , pa larpa form/9984/iarpa form.aspx.
For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or nelpAora.wa.gov.
JARPA Revision 2012.2 Page 1 of 12
Person authorized to represent the applicant about the project. (Note: Authorized agent(s) must sign 11 b of this
application.) [ I
3a. Name (Last, First, Middle)
Dave Evans
3b. Organization (If applicable)
WSDOT
3c. Mailing Address (street or Po Box)
P.O. Box 47440
3d. City, State, Zip
Olympia, WA , 98504-7440
3e. Phone(1) 3f. Phone(2) 3g. Fax 3h. E-mail
(360)570-6738 ( ) ( ) evansd@wsdot.wa.gov
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. [
® Same as applicant. (Skip to Part 5.)
❑ Repair or maintenance activities on existing rights-of-way or easements. (Skip to Part 5.)
❑ There are multiple upland property owners. Complete the section below and fill out JARPA Attachment A for
each additional property owner.
❑ Your project is on Department of Natural Resources (DNR)-managed aquatic lands. If you don't know,
contact the DNR at (360) 902-1100 to determine aquatic land ownership. If yes, complete JARPA Attachment E
to apply for the Aquatic Use Authorization.
4a. Name (Last, First, Middle)
N/A
4b. Organization (If applicable)
N/A
4c. Mailing Address (street or Po Box)
N/A
4d. City, State, Zip
N/A
4e. Phone(1) 4f. Phone(2) 4g. Fax 4h. E-mail
N/A ( ) ( )
Part 5—Project Location(s)
Identifying information about the property or properties where the project will occur. nel
JARPA Revision 2012.2 Page 2 of 12
❑ 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.) L,=, ]
❑ 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.) belpj
US Highway 101, Mile Post (MP) 316.5
5c. City, State, Zip(If the project is not in a city or town, provide the name of the nearest city or town.) [''r q]
Lilliwaup, WA 98555
5d. County
Mason
5e. Provide the section, township, and range for the project location. [ .. ]
% Section Section Township Range
NW 12 24 North 3 West
5f. Provide the latitude and longitude of the project location.
• Example: 47.03922 N lat./-122.89142 W long. (Use decimal degrees- NAD 83)
47.584075 N Latitude / -123.004855 W Longtitude
5g. List the tax parcel number(s)for the project location. [ ]
• The local county assessor's office can provide this information.
N/A- US 101 is a transportation corridor.
5h. Contact information for all adjoining property owners. (If you need more space, use JARPA Attachment C.) h[_ell ]
Name Mailing Address Tax Parcel # (if known)
Totem Girl Scout Council PO Box 900961
....-.--............................—............-._-.........----....... ......
(Robinswold Girl Scout Camp) Seattle WA 98109-9561 32412-00-63000
JARPA Revision 2012.2 Page 3 of 12
5i. List all wetlands on or adjacent to the project location. hei ]
None
5j. List all waterbodies (other than wetlands) on or adjacent to the project location. ei ]
Hood Canal is 100 to 120 feet east of the project area.
5k. Is any part of the project area within a 100-year floodplain? hei ]
❑ Yes ® No ❑ Don't know
51. Briefly describe the vegetation and habitat conditions on the property. [help]
Woody vegetation consists of western hemlock, western red cedar, and big leaf maple. Dominant shrubs
are elderberry, Indian plum, and salmonberry. Herbaceous vegetation consists of sword fern, grasses
and native forbs.
5m. Describehow
o w the
e property is currently used.
US 101 is current) used as a transportation corridor for commercial and private motor vehicles.
Y P
5n. Describe how the adjacent properties are currently used. [hek]
Adjacent properties are currently used for recreation (camping, hiking, fishing and hunting).
5o. Describe the structures (above and below ground) on the property, including their purpose(s) and current
condition.
N/A— There are no structures within the project limits.
5p. Provide driving directions from the closest highway to the project location, and attach a map. hei
Drive north from the city of Shelton WA, through Potlatch, Hoodsport, to the town of Lilliwaup on US
101. The project is located approx. 10 miles north of Lilliwaup WA. At MP 316.5.
Part 6—Project Description
6a. Briefly summarize the overall project. You can provide more detail in 6b.
The project will repair the US 101 roadway and stabilize the slope on the Hood Canal side of the roadway
by building a retaining wall. The work consists of removal of slide debris, constructing a retaining wall
(soldier pile wall) 18.5 feet east of the existing US 101 centerline, with a length of 225 feet and
reconstructing 1,000 LF of northbound US 101.
The wall will be constructed of steel piling placed on approximately 6 foot centers into the existing soils
by drilling a 24 to 30 inch diameter shaft. Piling shafts will be approx. 80 - 85 feet deep. Wood lagging
will be installed between the steel piles to provide the wall face. Excavation will be required at the face
wall to a daylight point downslope to achieve the installation of the wood lagging at the final bottom of
the wall profile. Temporary widening of US 101 in the southbound lane will be required to accommodate
a one lane alternating signalized detour.
I
JARPA Revision 2012.2 Page 4 of 12
6b.
Describe the purpose of the project and why you want or need to perform it. [help]
The purpose of this project is to repair the US 101 northbound lane. The slope located east of US 101 at
MP 316.5 has failed due to significant rain events causing the slide. In order to repair US 101 the slope
needs to be re-enforced by building a retaining wall.
6c. Indicate the project category. (Check all that apply) [help]
❑ Commercial ❑ Residential ❑ Institutional ® Transportation ❑ Recreational
❑ Maintenance ❑ Environmental Enhancement
6d. Indicate the major elements of your project. (Check all that apply) [r,..,,.]
❑ Aquaculture ❑ Culvert ❑ Float ® Retaining Wall
❑ 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 ❑ Dredging ❑ Mining
El Stormwater facility
❑ Bulkhead ❑ Fence ❑ Outfall Structure
❑ Swimming Pool
❑ Buoy ❑ Ferry Terminal ❑ Piling/Dolphin
❑ Utility Line
❑ Channel Modification ❑ Fishway ❑ Raft
❑ Other:
6e. Describe how you plan to construct each project element checked in 6d. Include specific construction
methods and equipment to be used. Lei ]
• Identify where each element will occur in relation to'the nearest waterbody.
• Indicate which activities are within the 100-year floodplain.
This project has no activities within a 100 year floodplain.
Temporary emergency repair work already in place consists of signage and barrier installation to restrict
travel to one lane, erosion control measures and conducting a geotechnical investigation.
A culvert will be temporarily placed in the ditch line for 400 feet on the west side of US 101 to allow for
widening the southbound lane to the required 15 foot lane width.
Initial repair work will remove slide debris from the existing slope which will be accessed from the
bottom of the slope utilizing an existing dirt road which is owned by the Robbinswold Girl Scout Camp.
A short additional road may be constructed off of this dirt road to access the slide area in order to
construct the retaining wall and /or new slope protection.
The damaged asphalt will then be removed from the US 101 northbound lane, WSDOT approved fill and
j gravel for compaction will be replaced and new asphalt applied.
JARPA Revision 2012.2 Page 5 of 12
6f. What are the anticipated start and end dates for project construction? (Month/Year) [I : ]
• 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: Summer 2015 End date: Fall 2015 ❑ See JARPA Attachment D
6g. Fair market value of the project, including materials, labor, machine rentals, etc. [h 2]
$ 1,500,000
6h. Will any portion of the project receive federal funding? [ ]
• If yes, list each agency providing funds.
® Yes ❑ No ❑ Don't know FHWA
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.) Lei ]
7a. Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. [hey]
® Not applicable
7b. Will the project impact wetlands? hel
❑ Yes ® No ❑ Don't know
7c. Will the project impact wetland buffers? [help]
❑ Yes ® No ❑ Don't know
7d. Has a wetland delineation report been prepared? help]
• 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? [hel
• If Yes, submit the wetland rating forms and figures with the JARPA package.
❑ Yes ® No ❑ Don't know
7f. Have you prepared a mitigation plan to compensate for any adverse impacts to wetlands? [hLei
• 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.
JARPA Revision 2012.2 Page 6 of 12
❑ Yes ❑ No ® Not applicable
7g. Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was
used to design the plan. help]
N/A
7h. Use the table below to list the type and rating of each wetland impacted, the extent and duration of the
impact, and the type and amount of mitigation proposed. Or if you are submitting a mitigation plan with a
similar table, you can state (below) where we can find this information in the plan. [ ;]
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)
N/A
If no official name for the wetland exists,create a unique name(such as"Wetland 1"). The name should be consistent with other project documents,such
as a wetland delineation report.
2 Ecology wetland category based on current Western Washington or Eastern Washington Wetland Rating System. Provide the wetland
rating forms with the JARPA package.
3Indicate the days,months or years the wetland will be measurably impacted by the activity. Enter"permanent"if applicable.
°Creation(C), Re-establishment/Rehabilitation(R), Enhancement(E), Preservation(P), Mitigation Bank/In-lieu fee(B)
Page number(s) for similar information in the mitigation plan, if available:
7i. For all filling activities identified in 7h, describe the source and nature of the fill material, the amount in cubic
yards that will be used, and how and where it will be placed into the wetland.
N/A
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. Lei ]
N/A
Part 8—Waterbodies (other than wetlands): Impacts and Mitigation
In Part 8, "waterbodies" refers to non-wetland waterbodies. (See Part 7 for information related to wetlands.) [helgi
® 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.
[ .,]
❑ Not applicable
JARPA Revision 2012.2 Page 7 of 12
Highway 101 at MP 316.5 runs parallel to hood canal and is approximately 100 to 120 feet away from the
water body. All work will be within 200 feet of Hood Canal.
On the north end of the project there is a culvert conveying drainage underneath US 101 from the west
to the east. This culvert will be straddled by piling installed for the soldier pile wall. Wood lagging will
be installed over the top of the culvert, but will not impact the culvert.
Best Management Practices will be utilized to control storm water from entering waters of the state.
Methods are approved by the Washington State Department of Ecology and are from the latest version
of the Washington State Department of Transportation's Highway Runoff Manual.
No impacts to adjacent water bodies are anticipated.
81b. Will your project impact a waterbody or the area around a waterbody?
❑ Yes ® No
8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland
waterbodies? [r:, ]
• If Yes,submit the plan with the JARPA package and answer 8d.
• If No, or Not applicable, explain below why a mitigation plan should not be required.
❑ Yes ® No ❑ Not applicable
No mitigation will be required as there will be no impacts to waterbodies.
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. [hej]
N/A
8e. Summarize impact(s) to each waterbody in the table below. h[ ell
Activity (clear, Waterbody Impact Duration Amount of material Area (sq. ft. or
dredge, fill, pile name' location of impact3 (cubic yards) to be linear ft.) of
drive, etc.) placed in or waterbody
removed from directly affected
waterbody
N/A
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.
z 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. hel
N/A
8g. For all excavating or dredging activities identified in 8e, describe the method for excavating or dredging,
type and amount of material you will remove, and where the material will be disposed.
N/A
Part 9—Additional Information
Any additional information you can provide helps the reviewer(s) understand your project. Complete as much of
this section as you can. It is ok if you cannot answer a question.
JARPA Revision 2012.2 Page 8 of 12
9a. If you have already worked with any government agencies on this project, list them below. [hel
Agency Name Contact Name Phone Most Recent
Date of Contact
Mason County Grace Miller ( 360 )426-9670 x 360 Feb. 2015
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? [r,, ]
• If Yes, list the parameter(s)below.
• If you don't know, use Washington Department of Ecology's Water Quality Assessment tools at:
htti)://www.ecy.wa.gov/programs/wq/303d/.
❑ Yes ® No
9c. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? [help]
• Go to http://cfi)ub.epa.gov/surf/locate/index.cfm to help identify the HUC.
17110018
9d. What Water Resource Inventory Area Number (WRIA#) is the project in? [Lei ]
• Go to http://www.ecy.wa.gov/services/gis/maps/wria/wria.htm to find the WRIA#.
16 Skokomish - Dosewallips
9e. Will the in-water construction work comply with the State of Washington water quality standards for
turbidity? h[ elgl
• Go to http://www.ecy.wa.gov/g)rograms/wq/swgs/cntena.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? [help]
• If you don't know, contact the local planning department.
• For more information,go to: http://www.ecy.wa.gov/programs/sea/sma/laws rules/173-26/211 designabons.html
❑ Rural ❑ Urban ❑ Natural ❑ Aquatic ❑ Conservancy ® Other - Residential
9g. What is the Washington Department of Natural Resources Water Type? hel
• Go to http://www.dnr.wa.gov/BusinessPermitsi7opics/ForestPracticesAI)piications/Pages/fp watertvping.aspx for the Forest Practices
Water Typing System.
❑ Shoreline ❑ Fish ❑ Non-Fish Perennial ❑ Non-Fish Seasonal DNR listed as Unknown
9h. Will this project be designed to meet the Washington Department of Ecology's most current stormwater manual?
1- 11
• If No, provide the name of the manual your project is designed to meet.
❑ Yes ® No
Name of manual: WSDOT Highway Runoff Manual M31-16.04 (April 2014)
9i. Does the project site have known contaminated sediment? [ ]
• If Yes, please describe below.
JARPA Revision 2012.2 Page 9 of 12
❑ Yes ® No
9j. If you know what the property was used for in the past, describe below. hel
The property has been and continues to be used as a transportation corridor for public and private vehicles.
9k. Has a cultural resource (archaeological) survey been performed on the project area? hel l
• If Yes, attach it to your JARPA package.
® Yes ❑ No
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. [a )
Federal Endangered Species Act listed:
• Bull Trout (Threatened)
• Streak Horned Lark (Threatened)
• Puget Sound Steelhead (Threatened)
•Yellow Billed Cuckoo (Threatened)
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. [° )
• Hardshell Clam Beds
• Oyster Beds
• Dungeness Crabs
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.ecy.wa.gov/opas/.
• Governor's Office for Regulatory Innovation and Assistance at(800) 917-0043 or help(aDora.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.) [hel
• 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
❑ I am applying for a Fish Habitat Enhancement Exemption. (check the box below in 10b.)[
❑ 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.
JARPA Revision 2012.2 Page 10 of 12
10b. Indicate the permits you are applying for. (Check all that apply.) [help]
LOCAL GOVERNMENT
Local Government Shoreline permits:
® Substantial Development ❑ Conditional Use ❑ Variance
❑ Shoreline Exemption Type (explain): Mason County
Other City/County permits:
❑ Floodplain Development Permit ❑ Critical Areas Ordinance
STATE GOVERNMENT
Washington Department of Fish and Wildlife:
❑ Hydraulic Project Approval (HPA) ❑ Fish Habitat Enhancement Exemption —Attach Exemption Form
Effective July 10, 2012, you must submit a check for $150 to Washington Department of Fish and Wildlife,
unless your project qualifies for an exemption or alternative payment method below. Do not send cash.
Check the appropriate boxes:
❑ $150 check enclosed. Check #
Attach check made payable to Washington Department of Fish and Wildlife.
❑ Charge to billing account under agreement with WDFW. Agreement#
❑ My project is exempt from the application fee. (Check appropriate exemption)
❑ HPA processing is conducted by applicant-funded WDFW staff.
Agreement #
❑ Mineral prospecting and mining.
❑ Project occurs on farm and agricultural land.
(Attach a copy of current land use classification recorded with the county auditor, or other proof of current land use.)
❑ Project is a modification of an existing HPA originally applied for, prior to July 10, 2012.
HPA #
Washington Department of Natural Resources:
❑ Aquatic Use Authorization
Complete JARPA Attachment E and submit a check for$25 payable to the Washington Department of Natural Resources.
Do not send cash.
Washington Department of Ecology:
❑ Section 401 Water Quality Certification
FEDERAL GOVERNMENT
United States Department of the Army permits (U.S. Army Corps of Engineers):
❑ Section 404 (discharges into waters of the U.S.) ❑ Section 10 (work in navigable waters)
United States Coast Guard permits:
❑ Private Aids to Navigation (for non-bridge projects)
JARPA Revision 2012.2 Page 11 of 12
Part 11—Authorizing Signatures
Signatures are required before submitting the JARPA package. The JARPA package includes the JARPA form,
project plans, photos, etc. [held
11 a. Applicant Signature (required) help]
I certify that to the best of my knowledge and belief, the information provided in this application is true, complete,
and accurate. I also certify that I have the authority to carry out the proposed activities, and I agree to start work
only after I have received all necessary permits.
I hereby authorize the agent named in Part 3 of this application to act on my behalf in matters related to this
application. (initial)
By initialing here, I state that I have the authority to grant access to the property. I also give my consent to the
permitting agencies ent the property where the project is located to inspect the project site or an work
r g P Y P J P P J Y
related to the project. (initial)
Applicant Printed Name Applic nt&6nature Date
11 b. Authorized Agent Signature hel
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
=Ofter ll necessary permits have been issued.
Authorized Agent Printed Name Authorized Agent Signature Date
11 c. Property Owner Signature (if not applicant) hei ]
Not required if project is on existing rights-of-way or easements.
I consent to the permitting agencies entering the property where the project is located to inspect the project site
or any work. These inspections shall occur at reasonable times and, if practical, with prior notice to the
landowner.
Property Owner Printed Name Property Owner Signature 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: ENV-019-09 rev. 08/2013
JARPA Revision 2012.2 Page 12 of 12