HomeMy WebLinkAboutSEP2017-00064 SHX2017-00061 Replace Boathouse - SEP Determinations - 11/15/2017 oN.STAlF MASON COUNTY
Department of Community Services
o r
S u Planning Division
N } n 615 W Alder St, Shelton, WA 98584
of �,oY (360)427-9670
1864
DETERMINATION OF NONSIGNIFICANCE
(WAC 197-11-340)
SEP2017-00064
Description of Proposal: REMOVE AND REPLACE ONE STORY WOOD FRAMED
BOATHOUSE WHICH IS SITTING OVER THE WATER: SAME
FOOTPRINT, NO EXPANSION(SEE BLD2017-00743)
Proponent: RICK ANDERSON
Location of Proposal: 13300 NE NORTH SHORE RD BELFAIR
Parcel Number: 322275200022
Legal Description: MADRONA MORNINGSIDE BCH TRS #2 TR 22-23 & T.L. EX
Directions to Site: 6[/L / 8hfl HORE RD TO SITE ADDRESS
BOATHOUSE IS ON THE WATER SIDE
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.
Please contact Kell Rowen at ext. 365 with any questions. This DNS is issued under WAC
197-11-340(2). 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 Dept. of Community
Development, 615 W Alder St, Shelton WA 98584 by 11/29/2017. Appeal of this determination
must be filed within a 14-day period following this final determination date, per Mason County
Code Chapter 15.11 Appeals.
Authorized Local Government Official Date
SEP 2- ii -OQj(&-
INC
LIST
SEP ENVIRONMENTAL CHECK RECEIVED
A. Background ihpJ NOV 1 5 2017
e
1- Name of proposed project,if applicable:(ii 615 W. Alder Street
Anderson Unheated Bonus Space Replacement
2. Name of applicant: hel
Rick Anderson
3. Address and phone number of applicant and contact person: hel
Rick Anderson
17001 138th ave E
Puyallup,WA 98374
360-872-1099
Dartagnan Merrill Jesfield Construction
P O Box 1590
Allyn,WA 98524
360-649-3669
4. Date checklist prepared: hel J
7130!2017
5. Agency requesting checklist:Itiii1
Mason County
6. Proposed timing or schedule(including phasing,if applicable): theipi
July 15"'—September 15"'
7. Do you have any plans for future additions,expansion, or further activity related to or
connected with this proposal? If yes,explain. h&pj
None
8. List any environmental information you know about that has been prepared, or will be
prepared,directly related to this proposal.jjJ
Jarpa,mason county building permit,and HPA will all be prepared.Lead agency is mason county
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.ffjpet
None
SEPA Environmental checklist(WAC 197-11-960) July 2016 Page I of 11
10. List any government approvals or permits that will be needed for your proposal, if known.
hel
HPA from WDFW
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.) help;
Unheated bonus space will be demolished piece meal and hauled off site.
Remove all concrete piling.
Install 9 32"x 32"concrete footings buried 36"into existing beach grade.Tops of footings will be 18"
below beach grade.
Mount 9 heavily reinforced 12"diameter concrete piling onto new footings
All concrete to beam/girder saddles to be stainless steel with through bolt connections.
Replace deck with fisheries code mesh grating.
Construct new unheated bonus space onto new supports in same footprint as existing.
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. heft,
Address and directions:
Head northwest on WA-300 W toward NE Old Clifton Rd
0 2 mi
Turn left to stay on WA-300 W
33m
m:
Continue onto NE North Shore Rd
3.7 ml
Address 13300 NE North Shore Rd on left,parking on right.
Parcel #:32227-52-00022
Township/Range/Section/quarter Section: 22/3/27/SW
MADRONA MORNINGSIDE BCH TRS #2 TR 22-23 &T.L. EX W 1/2 23 S OF R/W
B. ENVIRONMENTAL ELEMENTS LhPIp1
1. Earth el
a. General description of the site: hel
(circle one): W,rolling,hilly,steep slopes, mountainous,other
b. What is the steepest slope on the site(approximate percent slope)?ihi :
SEPA Environmental checklist(WAG 197-11-960) July 2016 Page 2 of 11
10%behind area to be worked.No excavation of bank to be necessary'for project.
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. L veil.,
Beach gravel
d. Are there surface indications or history of unstable soils in the immediate vicinity? If so,
describe.IL p1
I he hill on the other side of the road had a large slide around ten years ago.No excavation of the bank
will be necessary for the project.
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.help
Excavation will occur on the beach to create space for new footings and to remove old concrete piling.
f. Could erosion occur as a result of clearing,construction,or use? If so,generally describe.
felol
No.All depressions will be filled before the tide returns each day.
g. About what percent of the site will be covered with impervious surfaces after project
construction(for example,asphalt or buildings)?-hl e!pl
Impervious surface covering beach will be reduced from 92 square feet to 7.1 I square feet.
h. Proposed measures to reduce or control erosion,or other impacts to the earth,if any:
None
2.Air 'hel
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.Lne p
Exhaust from diesel engines and tractors.
b. Are there any off-site sources of emissions or odor that may affect your proposal? If so,
generally describe. [hejl I
No
c. Proposed measures to reduce or control emissions or other impacts to air,if any:jhelpl
Nor
3. Water Lhejp]
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. Lhe!vl
SEPA Environmental checklist(WAG 197-11.960) July 2016 Page 3 of 11
Flood canal is adjacent to the site.
2)Will the project require any work over,in,or adjacent to(within 200 feet)the described
waters? If yes,please describe and attach available plans.fhelp'
Work will occur whilke the tide is out on the beach of hood canal.
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.ihelo
92 square feet of concrete piling will be removed and 7.11 square feet of concrete will
replace it on beach grade.4.5 yards of concrete will be poured for footings and buried
into the beach.
4)Will the proposal require surface water withdrawals or diversions? Give general
description, purpose,and approximate quantities if known. [nei ,
No
5)Does the proposal lie within a 100-year floodplain? If so,note location on the site plan.
[helol
Yes all work is within the 100 year flood plain f3 ' a -
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. Lip.;
No discharge is intended or anticipated
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. L LJ
There is no well oil site.
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.Lej;.
NO WASTE MATERIAL DISCI IARGE ANTICIPATED
c. Water runoff(including stormwater):
SEPA Environmental checklist(WAC 197-11-960) July 2016 Page 4 of 11
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.jhejp]
Will not change
2)Could waste materials enter ground or surface waters? If so,generally describe. nelpl
No
3)Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site?If
so,describe.f .ffjp',
No
d. Proposed measures to reduce or control surface,ground, and runoff water,and drainage
pattern impacts, if any:[help]
None
4. Plants
a. Check the types of vegetation found on the site: `[pJ
_deciduous tree: alder,maple,aspen,other
_x_evergreen tree: fir,cedar,pine,other
_shrubs
grass
__pasture
_crop or grain
_Orchards,vineyards or other permanent crops.
_wet soil plants: cattail, buttercup,bulirush,skunk cabbage,other
water plants: water lily,eelgrass,milfoil,other
_x_other types of vegetation IUD(
b. What kind and amount of vegetation will be removed or altered?fljpJ
no change
c. List threatened and endangered species known to be on or near the site.(nelq
eagles frequent the canal,no disturbance of their habitat is expected.
d. Proposed landscaping,use of native plants,or other measures to preserve or enhance
vegetation on the site, if any: : _
None
e. List all noxious weeds and invasive species known to be on or near the site. nelp
none known
SEPA Environmental checklist(WAC 197-11.960) July 2016 Page 5 of 11
5. Animals !41
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. i'
Examples include:
birds: hawk,heron,eagle,songbirds,other:
mammals: deer,bear,elk,beaver,other: Simi
fish: bass, ii 1:,trout,herring,shellfish,other
b.List any threatened and endangered species known to be on or near the site InE 1C
None known
c. Is the site part of a migration route? If so,explain. hel
No
d. Proposed measures to preserve or enhance wildlife,if any:(nelpl
NONE
e. List any invasive animal species known to be on or near the site. LhelpI
none known
6. Energy and Natural Resources jh :lnl
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.[t (P)
electricity to power hand tools,diesel for equipment.
b. Would your project affect the potential use of solar energy by adjacent properties?
If so,generally describe. Ir,ela
No
c. What kinds of energy conservation features are included in the plans of this proposal?
List other proposed measures to reduce or control energy impacts,if any.
none
7. Environmental Health [heliii
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. hel
All efforts will be made to prevent concrete from contact with bare skin.
1) Describe any known or possible contamination at the site from present or past uses.
hel '
SEPA Environmental checklist(WAC 197-11.960) July 2010 Page 6 of 11
None known.
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.Lheol
None known
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.LhePI
None will be used
4) Describe special emergency services that might be required e1
911 if construction related accidents occur
5) Proposed measures to reduce or control environmental health hazards, if any: [fl I_]
None proposed beyond common sense and building safety codes
b. Noise [henjl
1)What types of noise exist in the area which may affect your project(for example:
traffic,equipment,operation,other)?`",='r'
None will affect the project
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. )y j
Noise would occur during standard working hours 7:30—3:30 and would be limited to hand tools and
operation of equipment and concrete trucks.
3) Proposed measures to reduce or control noise impacts,if any: jhel
None proposed.Work only during standard working hours
8. Land and Shoreline Use f I iel j
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. ihel
Vacation unheated bonus space.No impact is forseen.
b. Has the project site been used as working farmlands or working forest lands?If so,describe.
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?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? ine ni
No
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. [help]
SPA Endronmentsl checklist IWAC 197-11-960) July 2016 Page 7 of 11
No
c. Describe any structures on the site.
a small beach unheated bonus space with a deck is the only structure on site
d. Will any structures be demolished? If so,what?1`, '
Old concrete piling supporting unheated bonus space will be removed and replaced.The
undercarriage of the unheated bonus space will be replaced with more substantial beams
e. What is the current zoning classification of the site?[ pj
hel
Yak e 4cct< ( - - )
f. What is the current comprehensive plan designation of the site? hel
Sluxaiine��--tl v t.,
g. If applicable,what is the current shoreline master program designation of the site? iei
urkx�tr CC—V'
h. Has any part of the site been classified as a critical area by the city or county? If so,specify.
No
i. Approximately how many people would reside or work in the completed project?meld
No change
j. Approximately how many people would the completed project displace? ,',
No change
k. Proposed measures to avoid or reduce displacement impacts, if any: Lhelp
NONE POItSEEN
L.Proposed measures to ensure the proposal is compatible with existing and projected land
uses and plans,if any: h( elQJ
none prepared
m. Proposed measures to reduce or control impacts to agricultural and forest lands of long-term
commercial significance,if any: l'oelp;
not applicable
9. Housing hip(
a. Approximately how many units would be provided,if any? Indicate whether high,mid-
dle, or low-income housing. heh 1
no change
S EPA Environmental checklist(WAC 197-11-960) July 2016 Page 8 of 11
b. Approximately how many units,if any,would be eliminated?Indicate whether high.
middle,or low-income housing. hjlpj
no change
c. Proposed measures to reduce or control housing impacts,if any: [i
no change
10. Aesthetics he
a. What is the tallest height of any proposed structure(s), not including antennas;what is
the principal exterior building material(s)proposed?fhelpl
12 feet
b. What views in the immediate vicinity would be altered or obstructed? hel
No views will be impacted
b. Proposed measures to reduce or control aesthetic impacts,if any: h, elpl
None intended
11. Light and Glare
a. What type of light or glare will the proposal produce? What time of day would it mainly
occur?jjptg
no light or glare would be produced
b. Could light or glare from the finished project be a safety hazard or interfere with views? hel
no
c. What existing off-site sources of light or glare may affect your proposal?the o
none
d. Proposed measures to reduce or control light and glare impacts, if any:(h-1 j
none
12. Recreation `eIp
a. What designated and informal recreational opportunities are in the immediate vicinity? h[_e
water rec in hood canal
b. Would the proposed project displace any existing recreational uses? If so,describe. f he'i
no
c. Proposed measures to reduce or control impacts on recreation,including recreation
opportunities to be provided by the project or applicant, if any:
no impact forseen
13. Historic and cultural preservation Loii
SEPA Environmental Checklist(WAC 197-11-960i July 2016 Page 9 of 11
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?If so,
specifically describe.IIItJP1
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. [hem
11O
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.
[help]
Appropriate agencies will be contacted if historical artifacts are discovered
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. jr1 ip
none proposed
14. Transportation L : 1
a.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. L h_,!p]
North shore road and Mason transit services the area with dial a ride.
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?Ihe!pl
mason transit services the area with dial a ride.
c. How many additional parking spaces would the completed project or non-project proposal
have? How many would the project or proposal eliminate? fhelpl
no change
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).jhelol
NO
e. Will the project or proposal use(or occur in the immediate vicinity of)water,rail,or air
transportation? If so,generally describe.Leif;
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
SEPA Environmental checklist(1AC 197-11-960) July 2016 Page 10 of 11
be trucks(such as commercial and nonpassenger vehicles).What data or transportation
models were used to make these estimates? p]
4 trips with workmens trucks
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. [n€ o
no
h. Proposed measures to reduce or control transportation impacts, if any: hel
none
15. Public Services cho''
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. l'nelc;
no
b. Proposed measures to reduce or control direct impacts on public services, if any.[n
none
16. Utilities el
a. Circle utilities currently available at the site' [help'
eleptncty,natural gas,water,refuse service telephone,sanitary sewer,septic system.
other
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.[helFi
electricity will be used from the unheated bonus space.
C. Signature 10;,j
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 de cision.
Signature:
Name of signee
Position and Agency/Organizationc,-
Date Submitted: (Irrl c(7``7
SEPA Environmental checklist(WAC 197-11-960) July 2016 Page 11 of 11
PEON.sTAr MASON COUNTY
Department of Community Services
o n o Planning Division
o N z 615 W Alder St, Shelton, WA 98584
N (360)427-9670
OJ �O
1864
Exemption from Shoreline Management Act
Case No.: SHX2017-00061 Substantial Development Permit Requirement
The Proposal By: JESFIELD CONSTRUCTION
P.O. BOX 1590
ALLYN, WA 98524
Parcel Number: 322275200022
Site Address: 13300 NE NORTH SHORE RD BELFAIR
To undertake the following development:
REMOVE AND REPLACE ONE STORY WOOD FRAMED BOATHOUSE WHICH IS SITTING OVER
THE WATER, SAME FOOTPRINT, NO EXPANSION (SEE BLD2017-00743)
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:
B-normal maintenance
Please contact Kell Rowen at ext 365 if you have any questions.
Issued:11/15/2017 Authorized Local Government Official
SHX2017-00061 November 15, 201
--------------------------------------
AGENCY USE ONLY
® Date received: ((( � K'
WASHINGTON STATE ofEngneers e
SnNe Ps�ici �
Joint Aquatic Resources Permit Agency reference#:S t4).WI? C{0�
Application (JARPA) Form1'2 Tax Parcel#(s):
USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. 2_ i C C2�Z
i r
ECEtVEc
PLANNINCG NOV 1 52017
Part 1—Project Identification W, Alder Street
1.Project Name(A name for your project that you create.Examples:Smiths Dock or Seabrook Lane Development) hel
Anderson Cabin Repair
Part 2—Applicant
The person and/or organization responsible for the project. he]
2a.Name(Last,First,Middle)
Rick Anderson
2b.Organization(if applicable)
2c.Mailing Address(Street or PO Box)
17001 1381"ave E
2d.City,State,Zip
Puyallup,WA 98374
2e.Phone(1) 2f.Phone(2) 2g.Fax 2h. E-mail
360-872-1099 rickhds@gmail.com
'Additional forms may be required for the following permits:
• If your project may qualify for Department of the Army authorization through a Regional General Permit(RGP),contact the U.S.Army Corps of
Engineers for application information(206)764-3495.
• if your project might affect species listed under the Endangered Species Act,you will need to fill out a Specific Project Information Form(SPIF)or
prepare a Biological Evaluation. Forms can be found at
http://wvvw.nws usacearmy mil/Missions/CivilWorks/Regulatory/PermitGuideboQk/EndangeredSI)ecies.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
ham:/lwww epermitting wa goy/site/alias resourcecenter/iarpa larpa form/9984Jiiarpa form.aspx.
For other help.contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or hel oria.wa.gov.
ORIA-16-011 Page 1 of 14
Part 3—Authorized Agent or Contact
Person authorized to represent the applicant about the project. (Note:Authorized agent(s)must sign 11b of this
application.) h. LI
3a.Name(Last,First,Middle)
Merrill, Dartagnan,Charles
3b.Organization (if applicable)
hJesfield Construction
3c.Mailing Address(Street or P0 Box)
P.O Box 1590
3d.City,State,Zip
Allyn,WA,98524
3e.Phone(1) 3f.Phone(2) 3g.Fax 3h.E-mail
360-275-6684 360-649-3669 Merr4914@pacificu.edu
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.
Name(Last,First,Middle)
I --- —
4b.Organization(It applicable)
4c.Mailing Address(Street or Po Box)
4d.City,State,Zip
4e.Phone(1) 4f.Phone(2) 4g.Fax 4h.E-mail
ORIA-16-011 Page 2 or 14
Part 5-Project Location(s)
Identifying information about the property or properties where the project will occur. [c,]
❑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.) Ii ) ]
® Private
❑ Federal
O Publicly owned(state,county,city,special districts like schools,ports,etc.)
❑Tribal
O 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.) [help]
13300 North shore road
5c.City,State,Zip(If the project is not in a city or town,provide the name of the nearest city or town.) (hp]
Belfair,WA,98528
5d.County hel
Mason
5e.Provide the section,township,and range for the project location. el
1/4 Section Section Township Range
51. Provide the latitude and longitude of the project location. [ •zc]
• Example:47.03922 N tat./-122.89142W long.(Use decimal degrees-NAD 83)
47.362150 N/ -122.046703W
5g.List the tax parcel number(s)for the project location. hel
• The local county assessor's office can provide this information.
32227-52-00022
5h.Contact information for all adjoining property owners.(If you need more space,use JARPA Attachment C.) (heiol
Name Mailing Address Tax Parcel#(if known)
GANGNES, ILA P
2418 NW 56TH ST APT 310
SEATTLE WA, 98103 32227-52-00020
CULBERTSON,JOLENE 18490 13TH AVE NE
Poulsbo,WA 98370-8796 32227-52-00024
ORIA-16-011 Page 30114
Si.List all wetlands on or adjacent to the project location.[help]
N/A
5j.List all waterbodies(other than wetlands)on or adjacent to the project location.[help]
Hood Canal
5k.Is any part of the project area within a 100-year floodplain? [help]
® Yes ❑ No ❑ Don't know
51.Briefly describe the vegetation and habitat conditions on the property- [help}]
Work site has no vegetation that will be impacted. Ivy grows along the bank along with doug fir trees.
Sm.Describe how the property is currently used. [teip]
Unheated bonus space used for water recreation and summer vacation.
5n. Describe how the adjacent properties are currently used. [
Adjacent properties are single family residences.
5o. Describe the structures(above and below ground)on the property, including their purpose(s)and current
condition. [help],
The structure is an unheated bonus space 1w 400 square feet in area resting on top of concrete piling.The
bulkhead protects a sidewalk and stairs that access the unheated bonus space from the highway.
5p.Provide driving directions from the closest highway to the project location, and attach a map. [hea]
ORIA-16-011
Page 4 of 14
From Belfair
Washington
Head northwest on WA-300 W toward NE Old Clifton Rd
02rn!
Turn left to stay on WA-300 W
3.3 m
Continue onto NE North Shore Rd
97 m
Address I3.3i0 0 :NE North Shur€ Rd on left,parking on right.
Part 6—Project Description
6a. Briefly summarize the overall project.You can provide more detail in 6b. hel
Unheated bonus space will be piece meal demolished and removed from site.
Remove all concrete piling.
Install 9 3'x 3 concrete footings buried 18"into existing beach grade. Bottoms of concrete footings will be 36"
below beach grade.
Mount 9 heavily reinforced 12"diameter concrete piling onto new footings to support new cabin.
All concrete to beam/girder saddles to be stainless steel with through bolt connections.
Replace deck with fisheries code mesh grating.
6b. Describe the purpose of the project and why you want or need to perform it. [help)
Unheated bonus space on site sits below storm tide elevation. Extreme tides wash up against the flooring of the
cabin. Existing concrete supports holding cabin up off of the beach are severely deteriorated and in need of
replacement. Project will raise the elevation of the unheated bonus space 1'and maintain the same footprint as
existing.
6c. Indicate the project category. (Check all that apply) ["
Commercial ® Residential ❑ Institutional ❑ Transportation recreational
' .Maintenance ❑ Environmental Enhancement
6d. Indicate the major elements of your project.(Check all that apply) [help)
❑Aquaculture ❑Culvert ❑ Float ❑ Retaining Wall
❑ Bank Stabilization ❑ Dam/Weir ❑ Floating Home (upland)
' Z Boat House ❑ Dike/Levee/Jetty ❑ Geotechnical Survey ❑ Road
❑ Boat Launch El Ditch El Land Clearing 0 Scientific
Measurement Device
El Boat Lift ❑ Dock/Pier El Marina/Moorage El Stairs
❑ Bridge ❑ Dredging ❑ Mining El Stormwater facility
❑ Bulkhead El Fence ❑ Outfall Structure El Swimming Pool
El Buoy O Ferry Terminal ® Piling/Dolphin
❑ Utility Line
❑Channel Modification ❑ Fishway ❑ Raft
ORIA-16-011 Page 5 of 14
0 Other: Replacing unheated bonus space
6e. Describe how you plan to construct each project element checked in 6d. Include specific construction
methods and equipment to be used. [jp]
• Identify where each element will occur in relation to the nearest waterbody.
• Indicate which activities are within the 100-year floodplain.
All activity will occur adjacent to hood canal within the 100 year floodplain. Existing unheated bonus space will
be demolished piece meal and hauled off site. Existing concrete piling will be excavated by machine and lifted
out by boom truck. New footings and piling will be poured with high strength heavily reinforced concrete and
epoxy coated rebar. Saddles for beams and girder will be wet set into piling. New unheated bonus space to be
constructed on new piling in same footprint as the existing structure. Final elevation of new unheated bonus
space will be 1 foot higher than existing.
6f.What are the anticipated start and end dates for project construction?(Month/Year) [t-_clfl
• 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:August 15th End Date:September 15th ❑ See JARPA Attachment D
L. Fair market value of the project,including materials, labor,machine rentals,etc. f, :;•)
i $103,166
6h.Will any portion of the project receive federal funding? [fie i
• If yes,list each agency providing funds.
C Yes [K No ❑ Don't know
Part 7—Wetlands: Impacts and Mitigation
C Check here if there are wetlands or wetland buffers on or adjacent to the project area.
(If there are none, skip to Part 8.)[!c]
7a.Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. [hel
❑ Not applicable
ORIA-16-011
Page 6 of 14
7b.Will the project impact wetlands? [ p]
El Yes ❑ No El Don't know
7c.Will the project impact wetland buffers? [n p]
El Yes El No ❑ Don't know
7d.Hasa 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? [help]
• If Yes,submit the wetland rating forms and figures with the JARPA package.
❑Yes El No ❑ Don't know
7f.Have you prepared a mitigation plan to compensate for any adverse impacts to wetlands? [help]
• 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.
El Yes ❑ No ❑ Don't know
7g.Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was
used to design the plan. [,eip]
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 impact3 mitigation mitigation area
flood,etc.) rating ft.or type4 (sq.ft.or
category2 Acres) acres)
ORIA-16-011 Page 7 of 14
If no official name for the wetland exists,create a unique name(such as Wetland 1"), The name should be consistent with other project documents,such
as a wetland delineation report.
2 Ecology wetland category based on current Western Washington or Eastern Washington Wetland Rating System.Provide the wetland rating forms with
the JARPA package.
'Indicate the days,months or years the wetland will be measurably impacted by the activity.Enter"permanent"if applicable.
Creation(C),Re-establishmenVRehabilitation(R).Enhancement(E).Preservation(P).Mitigation ank/tn-lieu fee(B)
Page number(s)for similar information in the mitigation plan,if available:
71. 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. [.,
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. [h; ]
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.) [help]
L� 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.
hel-]
❑ Not applicable
In the course of the project concrete rubble and debris will be removed from the beach to offset any unintended
harmful impact that work will cause to the environment.Total square footage of covered beach by impervious
surfaces will go down significantly by the end of the project.
8b.Will your project impact a waterbody or the area around a waterbody? [help]
❑ Yes N No
ORIA-16-01 t
Page 8 of 14
8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non-wetland
waterbodies?[_c
• If Yes,submit the plan with the JARPA package and answer 8d.
• If No,or Not applicable,explain below why a mitigation plan should not be required.
❑ Yes ® No ❑ Don't know
8d.Summarize what the mitigation plan is meant to accomplish Describe how a watershed approach was used
to design the plan.
• If you already completed 7g you do not need to restate your answer here. [r:-!
8e.Summarize impact(s)to each waterbody in the table below. [help]
Activity(clear, Waterbody Impact Duration Amount of material Area(sq.ft.or
dredge,fill, pile name' location2 of impact3 (cubic yards)to be linear ft.)of
drive, etc.) placed in or removed waterbody
from waterbody directly affected
New concrete Below cabin
4.5 cubic yards of 7.11 square feet of
Hood canal Permanent concrete in footings, 1.8 beach will be
piling on beach ards in columns. covered
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. net
Old deteriorated concrete footings cast in 55 gallon drums will be removed and replaced with 36"x 36"x 18"
footings buried into the beach with 12"diameter columns poured on top to support the unheated bonus space.
Area of impervious surface on the beach will change from 92 square feet to 7.11 square feet.
ORIA-16-011 Page got 14
8g.For all excavating or dredging activities identified in 8e, describe the method for excavating or dredging,
type and amount of material you will remove, and where the material will be disposed. [ p]
Excavation will be done with a small backhoe. Concrete rubble will be removed and disposed of offsite.
Part 9—Additional Information
Any additional information you can provide helps the reviewer(s) understand your project. Complete as much of
this section as you can. It is ok if you cannot answer a question.
9a.If you have already worked with any government agencies on this project,list them below. [hel
Agency Name Contact Name Phone Most Recent
Date of Contact
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? (z_t ]
• If Yes,list the parameter(s)below
• If you don't know,use Washington Department of Ecology's Water Quality Assessment tools at
hffp:/Jwww_ecy.wa.00v/programs/w 303d1.
❑ Yes lNo
9c.What U.S.Geological Survey Hydrological Unit Code(HUC)is the project in? [help]
• Go to 1t :/lcfoub.eoa.uovlsurf/Iocatefindex.cfm to help identify the HUC.
17110019
9d.What Water Resource Inventory Area Number(WRIA#)is the project in? he j
• Go to htm//www.ecv.wa.00v/wateriwna/inaex html to find the WRIA#.
Kennedy-Goldsborough '6A4-s-t1,..IF
ORIA-16-011 Page 10 of 14
9e.Will the in-water construction work comply v,;un the State of Washington water quality standards for turbidity?
• Go to htto://www.ecy.Ap aoy/pro rams/wglsw�c s.,,.-_n3 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? [2J
• If you don't know,contact the local planning department.
• For more information,go to:httpi/www.ec-y.wa gov/programs/sea/sma/iaws rules/173-26211 desgnations.html.
-®-drbaw ❑ Natural ❑Aquatic ❑Conservancy -f1 Other. tea;
9g.What is the Washington Department of Natural Resources Water Type? hel
• Go to htfp/!www.dnr.wa.govlforesi-practices-water-tvpina for the Forest Practices Water Typing System.
Z Shoreline ❑ Fish ❑ Non-Fish Perennial O Non-Fish Seasonal
9h.Will this project be designed to meet the Washington Department of Ecology's most current stormwater
manual? ( ,,.-1
• If No,provide the name of the manual your project is designed to meet.
D Yes ❑ No
Name of manual:
9i.Does the project site have known contaminated sediment? p--i ]
• If Yes,please describe below.
❑ Yes ® No
9j. If you know what the property was used for in the past,describe below. nel
Vacation unheated bonus space
9k.Has a cultural resource(archaeological)survey been performed on the project area? [- ',j
• If Yes,attach it to your JARPA package.
❑ Yes ® No ---- --- — —�
ORIA-16-011 Page 11 of 14
91.Name each species listed under the federal Endangered Species Act that occurs in the vicinity of the project
area or might be affected by the proposed work. [hp]
None known
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. [nelp]
None+t`tewtr r r l ' ''J. _ t _
���►YtiD
Part 10—SEPA Compliance and Permits
Use the resources and checklist below to identify the permits you are applying for.
• Online Project Questionnaire at http.//apps.oria.wa.gov/opasf.
• Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or helps ona.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.) [neap]
• For more information about SEPA,go to y ww.ecv wa aov prroyrams/sea/seoate-review.htmi.
❑A copy of the SEPA determination or letter of exemption is included with this application.
®A SEPA determination is pending with Mason County (lead agency).The expected
decision date is i 1 0/2017
❑ I am applying for a Fish Habitat Enhancement Exemption. (Check the box below in lob.)[:_]
❑This project is exempt(choose type of exemption below).
El Categorical Exemption. Under what section of the SEPA administrative code(WAC)is it exempt?
El Other:
❑ SEPA is pre-empted by federal law.
ORIA-16-011 Page 12 of 14
1 Ob. Indicate the permits you are applying for. (Check all that apply.) [he)p]
LOCAL GOVERNMENT
Local Government Shoreline permits:
❑ Substantial Development ❑Conditional Use E -❑Variance
® Shoreline Exemption Type(explain):
Other City/County permits:
El Floodplain Development Permit El Critical Areas Ordinance
STATE GOVERNMENT
Washington Department of Fish and Wildlife:
® Hydraulic Project Approval(HPA) ❑ Fish Habitat Enhancement Exemption—Attach Exemption Form
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
❑ Otheck enclosed.Check#
Attacchh-,check made payable to Washington Department of Fish and Wildlife.
❑ 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 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 (U.S.Army p g'
p permits U.S. Corps of Engineers):
❑ Section 404(discharges into waters of the U.S) ❑ Section 10(work in navigable waters)
United States Coast Guard permits:
LI Private Aids to Navigation(for non-bridge projects)
ORIA-16-011 Page 13 of 14
Part 11-Authorizing Signatures
Signatures are required before submitting the JARPA package.The JARPA package includes the JARPA form,
project plans,photos,
11 a.Applicant Signature(required) l i
I certify that to the best of my knowledge and belief,the information provided in this application is true,complete,
and accurate.I also certify that I have the authority to carry out the proposed activities,and I agree to start work
rmiy after I have received all necessary permits.
i hereby authori the agent named in Part 3 of this application to act on my behalf in matters related to this
application._ _(in,t,al)
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 entering ttie property where the project is located to inspect the project site or any work
related to the project. ( (initial) / )
Applicant Prin d Name ---_-- -"----- ---
A plic nt ignature ----"---
Date
11 b.Authorized Agent Signature
I certify that to the best of my knowledge and belief,the information provided in this application is true,complete.
and accurate.I also certify that I have the authority to carry out the proposed activities and I agree to start work
only after all necessary permits have been issued. �y� L
f 1!IIdMtJI
Authorized Agent inted Name Authorized gent Signature Da te
11 c.Property Owner Signature(it not applicant)t _„1
Not required if project is on existing rights-of-way or easements(provide copy of easement with JARPA).
I consent to the permitting agencies entering the property where the project is located to inspect the project site
or any work,These inspections shall occur at reasonable times and,if practical,with prior notice to the
.andowner.
Property Owner Printed Name roperty Owner Signature Date
18 U.S.C§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,r:ontact 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-
i 6341. ORIA ubficafion number: ORIA-16-011 (X92016
ORIA-16-011
Page 14 of 14
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