HomeMy WebLinkAboutvar2006-00007 MORATORIUM RELEASE - VAR Application - 5/2/2006 Mason County
Forest Moratorium Waiver/Release Application
This application is used to waiver a portion of a parcel for development permits or to release the
entire tract from the six year moratorium for development permits. This process was created
under the guidance of RCW 76. .O6O I his application needs to be filled out completely, so
that we have all the information necessary to process the application in an expedient manner.
Are you requesting a Waiver or a Release from the Moratorium?
O Waiver elease
vk
Applicant's Name LL4
Applicant's Address. `"
42 4t IC
Operator's Name: t s ( °
Operator's Address' t -
LA 13
Parcel number of affected Parcel: -1
Parcel size in acres: 4QJ
Identify what type of timber was removed, ie: Douglas Fir, Western Red Cedar, Alder,Maple,
etc;
Was the timber harvest done under an approved forest practice application. tes Li Na;
Was there an enforcement action taken by the Department of Natural Resources
0 Yes O No
Forest Practice Application Number
Forest Practice Application Date of Approval W �
What do you plan to use the affected parcel for:
f
Are there any critical areas on your site?ie: wetlands, streams, creeks, steep slopes, etc..:
0 Yes ❑ No Identify the type critical areals: civ I'-t, ( Ua r 4)
Please list conditions of approvals by DNR for your forest practice application:
(Additional information can be placed below or on additional page)
Were any of the buffer areas effected by the timber harvest? O Yes t To
Identify if you harvested any timber in the critical areas on your site: d Yes ®'7Io
Have you replanted per DNR standards: t 'Yes o No
APPLICATION SIGNATURE
1.) I certify that I am the forest land owner, as that term is defined in RCW 76.09.020 and
WAC 222.16-010, and that am familiar with the requirements of the Forest Practices Act,RCW
76.09 and-the forest practices rules,WAC Title 222. I am specifically familiar with RCW
76.09.060(3)and its effects.
2)I certify and declare under penalty of perjury under the laws of the St of Washington
that the foregoing is true and correct.
Signed thin?'— day of f1 at
(month) ��rrtIi�,fl
(City) (State)
STATE OF WASHINGTON)) SS
- " ' c
COUNTY OF MASON ) , s sEe �•
. rti d
On this ' ` day of P c am, before me,the undersigned, a
Notary Public in and for the State of Was'lifngton, duly commissioned and sworn, personally
appeared 6r c.,r W c ,5 r- to me known to be the individual described in
and who executed within and foregoing instrument, and acknowledged that h-e
signed the same as h.r tis free
and voluntary act and deed, for the uses and purposes therein mentioned.
rtid }
GIVEN under my hand and official seal this o v day of /1 cz
NOTARY in and'for the State
of Washington residing at .3) ) or .
�oz= Co MASON COUNTY Shelton (360) 427-9670
DEPARTMENT OF COMMUNITY DEVELOPMENT Belfair (360) 275-4467
Planning Elma (360) 482-5269
Mason County Bldg.1 411 N.5th
P.G.Box 279 Shelton,WA 98584
1854
NOTICE OF APPLICATION
FOREST PRACTICES SIX-YEAR MORATORIUM RELEASE
December 12,2006
This is a Notice of Application as required by the Mason County Development Code 15,07.010.Notice to
be posted on site and mailed to all property owners of record within 300 feet of subject property.
Applicant Name: Gary Watson
Date of Application: December 5,2006
Date of Finding of
Completeness: December 12,2006
Location of Project: SW'4,SE 1/4,Section 10,Township 19 N,Range 3 W. W.M.
Description of Project: The owner of this property has applied for a release from a six-year
development moratorium on this property,which was incurred as a normal
condition of a Class III Forest Practices Application.The Moratorium was
effective on 6/27105.The procedure for the Release from Moratorium is per
Mason County Ordinance 103-98,sec 11.04,400.The moratorium would other
wise expire on 6/27/11.
Approvals,Actions
and Required Studies: A hearing will be held(currently unscheduled),to consider this request will be
held before the Mason County Hearings Examiner in the Mason County
Commissioners Chambers(411 N 5`h Ave,Shelton).This project is also subject
to SEPA review with final approval by the Director of the Mason County
Department of Community Development.
Public Comment.
Period: Comments can be directed to the Staff member listed below.
Existing Environmental
Documents: SEPA Checklist
County Staff Contact: Michael MacSems,360-427-9670 ext 571
Date,Time&Place of
Scheduled Public Meeting:TEA(separate Notice of Hearing to follow).
Timeline for Final
Action: Final action shall follow within (the standard) 120 days from date of a Finding
of Completeness(plus stays—clock stops—for preparation and review of any
required studies .
Signed By: ______________________ Date: 1 ?/06
For DNR Region Office Use Only
WASHINGTONSTATE C7EPARTMiENTt1F
Natural Resources FPAIN#:
Forest Practices Application/Notification Region:
Western Washington Received Date:
YOU MUST USE THE INSTRUCTIONS TO COMPLETE THIS APPLICATION.
TYPE OR PRINT IN INK:
1, Landowner,Timber Owner,and Operator information.
Legal Name of LANDOWNER Legal Name of TIMBER OWNER Legal:Name of OPERATOR
.Ger rd*Fsai ees Watsrtyn Gary and Frances Watson The Herbrand Company
1*411 fH A ,g 7`sa
Mailing Address: Mailing Address: Mailing Address:
2.344 1- - }E 23413 45th AVe SE 315 39th AVe SW,#6
City, State,Zi City, State,Zip City,State,Zip
Bothell,WA 98021 Puyallup,WA 98373
.. C 4 `g5'OZ3
Phone (45479 Phone '(425 ) 482-7990 Phone ( 253) 848-7700
Email: Email: Email:
2. Contact person information.
Contact Person Phone (253 ) 381-2235
Dan Miller
Email: dmiller theherbrandcom an .cam
3. Are you a perpetual timber owner?
[x] No. [ ] Yes. Include the Notice Of Moratorium On Non-Forestry Use Qf Land form and written evidence that the
landowner has been notified.
4. If you are harvesting timber,enter the Forest Tax Reporting Account Number of the Timber Owner:
For tax reporting information or to receive a tax number, call the Department of Revenue at 1-800-548-8829.
5. Are you a small forest landowner?'(Optional)
[]Na. [ ] Yes.
6. Are you substituting prescriptions from an approved state or federal conservation agreement or watershed
analysis?
[x] No. [ ] Yes. Only complete those portions of this application that do not have alternative prescriptions and see
instructions for additional requirements.
7. Legal description and county where the forest practices will occur.-
Sub Division(%f) Section Township Range E/W County
SW14 SE114 10 19 3 W Mason County
QQ 46W(05-14-2005) 1 of 4 WESTERN WASHINGTON
8. Answer each question as it applies to your proposed forest practice. Refer to instructions.
a. [x] No. [ ] Yes. Is the activity within city limits or an urban growth area? City name:
b. [x) No. [ ] Yes. Is the activity within a public park?
c. [f c] No. [ ] Yes. Is the activity within 500 feet of a public park? Park name:
d. r'[x] No. [ ] Yes, Is the activity located on lands platted after January 1, 1960?
e. [tc] No. [ ] Yes. Does the activity convert forestland to a use other than growing timber within 3 years?
f. [x] No. [ ] Yes, Is the activity part of an approved Conversion Option Harvest Plan(COHP)? If yes, include a copy
of the approved COHP.
g. [x] No. [ I Yes. Is the activity within 200'of the Ordinary High Water Mark(OHWM)or floodway of Type S water?
If yes, contact the county for a Shorelines Permit or a written exemption and include a copy with
this application.
h. [cj No. [ I Yes. Are you applying for a multi-year permit? If yes,length requested:� -- - (Specify 3, 4, or 5 years.)
%. [x] No. [ ] Yes. Are you including an Alternate Plan? If yes, include a copy of the Alternate Plan.
1. [xl No. [ ] Yes. Do you have a DNR approved Road Maintenance and Abandonment Plan(RMAP)for your haul
routes? If Yes, RMAP#
If No, is a Checklist RMAP required? [X] No. I'] Yes.
k. [tc] No. [ ] Yes. Is the activity within 50 miles of saltwater?AND do you own more than 500 acres of forest land?
If Yes, include a completed Marbled Murrelet Form with your FPA/N.
9. Are you cutting or removing timber?
[ ] No. [tc] Yes. Complete the table below and identify all timber harvest and salvage activity boundaries on the
Activity Map.
Unit# Harvest Yarding Acres Volume Volume Number of Trees Per Acre Steepest
Type Method (net) to be to be Remaining After Harvest Slope in
Harvested Harvested < 2"dbh >12"dbh Harvest Unit
(mbf) (/o) -. (%)
1 even-aged skidder 5 150mbf 100% 0 0 10%
10. What reforestation method will you use?
[ ] Reforestation is not required.
[X] Planting. Proposed species: Douglas fir ys...
[ ] Natural. Include a Natural Regeneration Plan.
11. Do you qualify for the Forest Excise Tax Credit(Salmon Credit)?
[A No. [ ] Yes.
12. Are you constructing or abandoning roads?
[x] No. [ ] Yes. Complete the table below. Show locations and identify all road activities on the Activity Map.
Type of Activity Total Length Steepest Side Slope Abandonment Date
(feet) (%) (Mo/Yr)
Road Construction
Temporary Road Construction
Road Abandonment
13. Are you developing a spoil area,a new rock pit or expanding an existing rock pit?
[xl No. [.1 Yes. Complete the table below. Show locations Of all spoils areas and rock pits on the Activity Map.
Spoils Area Volume New Rock Pit Area Rock Pit Expansion Area
(cubic yards) (acres) (acres)
QQ-46W(05-14-2005) 2 of 4 WESTERN WASHINGTON
Work In or over typed water may require a Hydraulic Project Approval(HPA)from the Washington Department of Fish and
Wildlife(WDFM. If you have questions concerning the HPA,visit the WDFW website at www.wdfwwa.govlhabltat.htm
14. Are you installing or replacing water-crossings?
[fcI No. [ I Yes. Complete the table below. Show locations and identify all proposed water-crossings on the Activity
Map.
Crossing Crossing Dimensions Crossing Crossing Dimensions
Identifier Type (width x length) Identifier Type (width x length)
15. Mark the following activities that will be done in or over typed water?
Activity in or over. Type S Water Type F Water Type Np Water Type Ns Water
Removing Culverts or Bridges
Equipment Crossing
Ground Skidding
Suspending Cables
Cable Yarding
Falling and Bucking
Other
16. Are you using the exempt 20-acre parcel RMZ rule on type S,F,or Np waters?
[fcI No. [ I Yes. Complete the table below and go to Question 19.
Stream Segment Identifier Water Type Stream Width How close to the bankfull
(feet) width will you harvest?
• Y AF
17. Are you harvesting in the RMZ of Type S or F waters?
cI No. [ I Yes. Complete the table below. Show locations and identify all stream segments on the Activity Map.
See the instructions for RMZ Harvest Codes.
Stream Water Type Site Class Stream Width is there a RMZ Harvest Total Width of
Segment (feet) CMZ? Code RMZ
Identifier (feet)
18. Are you harvesting within 50 feet of Type Np water?
[xi No. ( I Yes. Complete the table below. Show locations and identify all stream segments on the Activity Map.
Stream Segment Total Stream Length of RMZ in Stream Segment Total Stream Length of RMZ in
Identifier Length in Harvest Unit Identifier Length in Harvest Unit
Harvest Unit (feet) Harvest Unit (feet)
(feet) (feet)
QQ-46W(05-14-2005) 3 of 4 WESTERN WASHINGTON
s .
19. Is any activity in a wetland or a Wetland Management Zone(WMZ)?
( j No. ( . Yes. Complete the table below. Show locations and identify all wetlands and WMZs on the Activity Map.
See the instructions for additional information that may be required with your FPAIN.
Wetland Wetland Type Activity Type in Activity Type in Total Wetland Total Area Total Area
Identifier (A, B,or Forested) Wetland WMZ Area (acres) Drained (acres) Filled(acres)
20. Describe how the following are identified on the ground.
• Harvest boundaries:
• Clumped Wildlife Reserve Trees(WRTs)and Clumped Green Recruitment Trees(CRTs): Scattered
• Right-of-way limits and centerlines for road work,culverts and bridges: NA
• Riparian Management Zone(RMZ)boundaries and leave and/or take trees: NA
• Channel Migration Zone(CMZ): NA
• Wetland Management Zone(WMZ)boundaries and leave'and/or take trees: NA
21. Have you reviewed this forest practices activity area to determine whether it may involve historic sites and/or
Native American cultural resources? Read the instructions before answering this question.
1,ci Na I ) Yes.
22. We affirm that the information contained herein is true,and understand that this proposed forest practice is subject
to the Fores ractices Act and Rules as well as alt other federal,state or local regulations. Compliance with the
Forest Ara ces Act and Rules does not ensure compliance with the Endangered Species Actor other federal,
state or al laws.
Sig tur of LANDO Signature of TIMBER OWNER Signature of OPERATO
'""� (If different than landowner) (I ifferent than Lando n
Print Name: çacaee& en Print Name: Gary and Frances Watson ; nt Name: James E Wood
me .4#vitiAlt7`!4h
1At'so� . /i. GS'
Date: '7, Date: :Pte: '
Additional Information. (Optional)
QQ-46W(0544-2005) 4 of 4 WESTERN WASHINGTON
FOREST PRACTICE ACTIVITY MAP
TOWNSHIP 19 NORTH HALF 0, RANGE 3 WEST(WM.) HALF 0, SECTION 10
Application#:
MII
A /
a Puget gouud
I 607 20 + 607
I •
+1107008 +rt0 100
16 005'i Please use the Legend from the FPA instruction or provide a list of symbols used,
Thursday,June 16.2005 3.20:21 PM
NAD 83
Contour Interval:40 Feet
httt .11www3. vac nr.grovfdnran 5lsctviet/com. .ti.osrit an_R,sriman?ServiceName=fins-rsacf.... 6/1 6/2005
MASON COUNTY DEVELOPMENT REGULATIONS May 5.2002
Publication cost is the- responsibility of the applicant. Final permit processing
will nQt occur until advertising, fees have been paid to'the newspaper by the
applicant. The Shelton-Mason County Journal will bill the applicant directly.
I/WE understand that 1/WE must sign and date the attached acknowledgment
indicating and that.i/WE understand that is MY/OUR responsibility. 1/WE
must submit the signed- page as part: of application in order for it to be
considered•as complete.
DATE"
OWNER
APPLIC NT
MASON COUNTY Shelton (360)427-9670
DEPARTMENT OF COMMUNITY DEVELOPMENT Selfair (360) 275-4467
Planning Elma (360) 482-5269
Mason County Bldg.I 411 N.5th
P.O.Box 279 Shelton,WA 98584
Gary Watson t11AS0NN CO.PU44NIMG DEFT.
23413 45th Ave SE
Bothell,WA 98021
May 9,2006
Letter of Incompleteness VAR 2006-00007
Dear Mr.Watson,
This letter is to acknowledge that the Mason County Planning Department has received your
application for a release from a six-year development moratorium for your property in Section 10,
Township 19N.,Range 3W.,W.M.The application is being placed on HOLD due to a
determination of incompleteness for the following reason(s):
'`l) A SEPA Environmental Checklist is required for my review—but is not attached to your
application.I am enclosing one for your use,
'W'2) I need a drawing/map of your property.
LA) I need a copy of the original approved DNR FPA application.If you still have your copy
could you make an extra copy for me?
- ) I need a list of the names and addresses of all property owners within 300 feet of your
property.
t '5) A signed copy of the enclosed acknowledgement of responsibility for the cost of publication
for a public notice. •
V6) A cover letter describing how you meet the five criteria for moratorium release per section
11.04.420.O(enclosed).
Please submit these additional items to my attention when you are ready.If you have any
questions,please call me at ext. 571.Thank you.
Sincerely,
flU
Michael MacSems
FPA Planner
cc:File
MASON CO. ENVIROMENTAL CHECKLIST
A. BACKGROUND
Parcel # _t ( "` —OOO
1. Name of proposed project, if applicable:
2. Name of applicant:
3. Address and phone number of applicant and contact person:
4. Date checklist prepared: i y 2 .—o C
5. Agency requesting checklist:
h '
6. Proposed timing or schedule (including phasing, if applicable):
7. Dyouahave any plans for future expansion, or further activity related to or connected with this
proposal: If yes, explain.
ucr j -Ot V F5 io. I y
,1'yr �.. . A/ , 7, - ae x a rte( iV r l 2Y ,iiøiiW≤
8. List any environmental information you know about that has been prepared, or will be
prepared, directly related to this proposal.
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,
Lo
10. List any government approvals or permits that will be needed for your proposal, if known.
11. Give a 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.)
• iLc a c• c
Imo .
12. What is the 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.
B. ENVIRONMENTAL ELEMENTS:
1, EARTH: S
a. General description of the site (circle one): Flat, rolling hilly, steep slopes, mountainous, other
b. •What is the steepest slope on the site (approximate percent slope)?
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 prime farmland.
,61Jc , ��/C j _LA j.
d. • Are there surface indications or history of unstable soils in the immediate vicinity: If so,
describe.
Mason County Environmental Checklist Page 2
e. Describe the purpose, type, and approximate quantities of any filling or grading proposed.
Indicate source of fill.
Nr
f. Could erosion occur as a result of clearing, construction, or use: If so, generally describe.
0
g. About what percent of the site will be covered with impervious surfaces after project
,,constructions (for example, asphalt or buildings)?
h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any:
�t3i`k�i• M1 `
2. AIR:
a. What types of emissions to the air would result from the proposal (i.e. dust, automobile, odors,
industrial wood smoke) during construction and.When the project is completed? If any,
generally describe and give approximate quantities, if known.
b. Are there any off-site sources of emissions or odor that may affect your proposal? if so,
generally describe.
Mason County Environmental Checklist Page 3
c. Proposed measures to reduce or control emissions or other impacts to air, if any:
3 WATER:
a. Surface:
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.
%5 ç2Ap 4m 5 1,,)A,-tog-4L Zf bq o4 -r- A .A s o vi Ct
C- - r t t - 1,.J, - 4` c , rT` t - t t 'i '
01 AT' 4rAs VF Qs r- oil Osf t4CA
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.
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 sourceof fill material.
4) Will the proposal require surface water withdrawals or diversions? Give general
description, purpose, and approximate quantities if known.
Mason County Environmental Checklist Page 4
5) Does the proposal lie within a 100-year floodplain? If so, note location on the-site plan.
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.
tj #-
b.- Ground:
1) Will ground water be withdrawn, or will water be discharged to ground water? Give
general description, purpose, and approximate quantities, if known.
: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.
c. Water runoff(including storm water):
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 flow
into other waters? If so, describe.
2) Could waste materials enter ground or surface waters: If so, generally describe.
0
Mason County Environmental Checklist Page 5
d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any:
4. PLANTS:
a. Check or circle types eficeed:mo,'
ation found on the site:
deciduous tree: aple, aspen, the .F¢-)i'T -RZe V-S
evergreen tree: pine, other
' shrubs
grass
pasture
crop or grain
wet soil plants: cattail; buttercup, bullrush, skunk cabbage, other
water plants: water lily, eelgrass, milfoil, other
other types of vegetation a
b, What kind and amount of vegetation will be removed or altered?
c. List threatened or endangered species known to be on or near the site.
d. Proposed landscaping, use of native plants, or other measures to preserve or enhance
vegetation on the site, if any:
Mason County Environmental Checklist Page 6
5. ANIMALS
a. Circle any birds and animals which have been observed on or near the site or are known to be
on or near the site:
Birds: haw heron, eagle, songbird other
Mammals: dee bear, elk, beaver, o er
Fish: bass, salmon, trout, herring, shellfish, other
b. List any threatened or endangered species known to be on or near the site.
C. Is the site-part of a migration route? If so, explain.,
d. Proposed measures to preserve or enhance wildlife, if any:
6. -ENERGY AND,NATURAL RESOURCES:
a. What kinds of energy,(electric, natural gas, oil,wood stove, solar) will be used to meet the
completed project's energy needs? Describe whether it will be used for heating,
manufacturing, etc.
b. Would your project affect the,potential use of solar energy by adjacent properties: If so,
generally describe.
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:
Mason County Environmental Checklist Page 7
7. ENVIRONMENTAL HEALTH: -
a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire
and explosion, spill, or hazardous waste, that could occur as a result of this proposal? If so,
describe.
1} Describe special emergency services that might be required.
2) Proposed measures to reduce or control environmental health hazards, if any:
b. Noise.
1) What types of noise exist in the area which may affect your project (for example: traffic,
equipment, operation, other)?
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)?
Indicate what hour's noise would come from the site.
3) Proposed measures to reduce or control noise impacts, if any:
8. LAND AND SHORELINE USE:
a. What is the current use of the site and adjacent properties?
Mason County Environmental Checklist Page 8
b. Has the site been used for agriculture? If so, describe.
b
C. Describe any structures on the site.
d. Will any structures be demolished? If so, what?
tt� cy G pS' <R
e. What is the current zoning classification of the site?
f. What is the current comprehensive plan designation of the site?
g. If applicable,what is the current Shoreline Master Program designation of the site?
h. ' Has any part of the sita been classified as an "environmentally sensitive" area? If so,µspecify.
I. Approximately how many people would reside or work in the completed project?
t3( *tA \co )
j. Approximately how many people would the completed project displace?
k. Proposed measures to avoid or reduce displacement impacts, if any:.
Masan County Environmental Checklist Page 9
1. Proposed measures to ensure the proposal is,compatible with,existing and projected land uses
and plans, if any:
.9. HOUSING:
a. Approximately how many units would be provided, if.any? Indicate whether'high, middle, or
low-income housing.
b. Approximately how many units, if any, would be eliminated?- Indicate Whether high, middle, or
low-income housing.
c. Proposed measures to reduce or control housing impacts, if any:
10. AESTHETICS:
a. What is the tallest height of any proposed structure(s), not including antennas;what is the
principal exterior building material(s) proposed?
44 s14 , ,
b. What views in the immediate vicinity would be altered or obstructed?
c. Proposed measures to reduce or control aesthetic impacts, if any:
MasonCounty Environmental Checklist Page 10
11. LIGHT AND CLARE
a. What type of light or glare will the proposal produce? What time of day would it mainly occur?
b. Could light or glare from the finished project be a safety hazard or interfere with views?
c. What existing of site sources of light or glare may affect your proposal:
d. Proposed measures to-reduce or control light and glare impacts, if any:
12. RECREATION:
a. What designated and informal recreational opportunities are in the immediate vicinity?
-b. Would the proposed project displace any existing recreational uses? If so, describe.
z. Proposed measures to reduce or control impacts on recreation, including recreation
opportunities to be provided by the project or applicant, if any:
Mason County Environmental Checklist Page 11
13. HISTORIC AND CULTURAL PRESERVATION:
a. Are there any places or objects listed on, or proposed for, national, state, or local preservation
registers known to be on or next to the site? If so, generallytdescribe.
b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural
importance known to be on or next to the site.
c. Proposed`measures Co reduce or control impacts, if any:
14. - TRANSPORTATION:
a. Identify public streets and highways serving.the site and describe proposed access to the
existing"street system. Show on site plans, if any.
b. Is site currently served by public transit? If not,what is the approximate distance to the
existing street system? Show on site plans, if any.
c. How many parking spaces would the completed project have? How many would the project
eliminate?
d. Will the proposal require any new roads or streets, or improvements to existing roads or
streets, not including driveways? If so, generally describe (indicate whether public or private).
Mason County Environmental Checklist Page 12
e. Will the project use (or occur in the immediate vicinity of)water, rail, or air transportation? If
so, generally describe.
f.. How many vehicular trips per day would be generated by the completed project: if known,
indicate when peak volumes would occur.
g. Proposed measures to reduce or control transportation impacts, if any:
15. PUBLIC SERVICES:'
a. Wouldthe project result*in an increased need for public service (for example: fire protection,
police protection, health care, schools, other)?
If so, generally describe:
b. Proposed measures to reduce or control direct impacts on public services, if any:
Mason County Environmental Checklist Page 13
16. UTILITIES:
a. Circle utilities currently available at the site: lectricit natural gas, water, refuse service,
elephone sanitary sewer, septic syste 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.
Signature:
The above answers are true and complete to the best of my knowledge. I understand that the
lead agency is relying on them to make its decision.
Signature:
Date submitted:
Mason County Environmental Checklist - Page 14