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Home My WebLink AboutSDP2015-00016 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT UNIFIED DEVELOPMENT CODE TYPE I LAND USE PERMIT SHORELINE SUBSTANTIAL DEVELOPMENT PERMIT EXEMPTION WASHINGTON STATE SHORELINE MANAGEMENT ACT(RCW 90.58) PROPONENT: STATE OF WASHINGTON-NAT RESOUR PO BOX 47014 OLYMPIA WA 98504-7014 DATE ISSUED: September 11, 2015 DATE EXPIRES: September 11, 2017 MLA NUMBER: MLA15-00057 CASE NUMBER:SDP15-00016 PROJECT PLANNER: Joel Peterson PROJECT DESCRIPTION: BRIDGE MAINTENANCE -- SHORELINE EXEMPTION APPROVAL WATERBODY AND/OR ASSOCIATED WETLANDS: SNAHAPISH RIVER PROJECT LOCATION: DNR C-2700 Bridge across the Snahapish River, S5 T25N R11 W. FINDINGS: 1.) The Administrator finds that this application complies with applicable provisions of the Unified Development Code, all other applicable ordinances and regulations, and is consistent with the Jefferson County Comprehensive Plan and Land Use map. 2.) The parcel has been designated as Commercial Forest(CF80) under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 3.) The applicant submitted a Stormwater Calculation Worksheet for the C-2700 Bridge LWD Removal project. The applicant is not proposing to create or add any new impervious surface and is not proposing to cause any land disturbing activities. 4.) The Washington Department of Natural Resources issued a DNR Proprietary Hydraulic Project Approval (HPA) for this activity (LWD Placement/Removal in Type S Water) on August 3, 2015 and is included within Forest Practice permit FPA/N 2613838, dated August 5, 2015. In-field consultation was done 7/28/2015 with DNR, WDFW and Quinault Tribe. 5.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act(SEPA) pursuant to WAC 197-11-800(3), Repair, remodeling and maintenance activities. The project is below OHWM but there will be no in-water work. The project will move woody debris from the upstream side of the bridge to the downstream side of the bridge during the dry season. 6.) The application was reviewed by the Jefferson County Department of Community Development staff on 9-10-2015 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review, the following ESAs were confirmed to be present in the project area: Type S Stream and spotted owl. The Forest Practices Application includes a DNR Proprietary HCP Implementation Checklist for the Northern Spotted Owl, with a wildlife biologist finding that the spotted owl Structural Habitat will not be impacted by the proposed project. 7.) The site plan as submitted with the Relocating Large Woody Debris to Downstream Side of C-2700 Bridge application on August 19, 2015 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated September 10, 2015 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 8.) This approval is for Relocating Large Woody Debris to Downstream Side of C-2700 Bridge only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 9.) The proposal will be located in the Snahapish River flood plain, in an area that is mapped on the Federal Emergency Management Agency Flood Insurance Rate Map (Panel 53006910008) as Zone A. The proposal does not meet the definition of"Development" and thus is not subject to a floodplain development permit. Using the definition of"Development"from the National Flood Insurance Program, this proposal of moving several trees from one side of the bridge to the other, does not constitute "removal of substantial amounts of vegetation, or alteration of natural site characteristics", nor will there be any"dredging, filling, grading, or excavation". The proposal will not create any substantive change to the environment to reasonably apply the definition of"Development". The proposed project will not result in any increase in flood levels during the occurrence of base flood discharges. 10.) The Development Review Division finds that this proposal is consistent with Shoreline Master Program Section 18.25.560(2) Maintenance and Repair, and is consequently exempt from the substantial development permit (SDP) requirements. Exemptions from the substantial development permit requirements do not exempt a proposed development from compliance with the applicable policies and standards of the Shoreline Master Program or other applicable Federal, State, or local permit or license requirements. 11.) NOTICE: This permit does not excuse the proponent from complying with other local, state, and federal ordinances, regulations, or statutes applicable to the proposed development, but consistent with RCW 90.58. Development pursuant to this permit shall be undertaken subject to the applicable policies and performance standards of the Jefferson County Shoreline Management Master Program and the Jefferson County Unified Development Code. If during excavation or development of the site an area of potential archaeological significance is uncovered, all activity in the immediate area shall be halted, and the Administrator shall be notified at once. The Federal Endangered Species Act rules to protect threatened Chinook and Summer-run Chum salmon became effective on January 8, 2001. Bull trout have been listed as threatened since early 2000. Under the ESA, any person may bring lawsuit against any individual or agency that"takes" listed species (defined as causing harm, harassing, or damaging habitat for the listed species). In addition, the National Marine Fisheries Service can levy penalties. Portions of Jefferson County, including marine environments are included as "critical habitat"for listed species. Development of property along any marine shoreline, freshwater shoreline, or floodplains could harm habitat if protective measures are not taken. To minimize the potential to damage habitat, all property owners developing adjacent to marine shoreline, freshwater shoreline, or floodplains are advised to do the following: -All development activities should avoid unstable slopes, wetlands, and forested areas near surface waters - Remove minimal vegetation for site development, especially large trees -Allow trees that have fallen into surface waters to remain there - Infiltrate stormwater from buildings and driveways onsite through drywells rather than discharging directly into surface waters or roadside ditches The Federal Bald and Golden Eagle Protection Act requires landowners within 660 feet(1/8th of a mile) of an eagle nest to consult with the US Fish and Wildlife Service. This Eagle Act prohibits anyone from "taking" bald eagles. This federal law defines the term "take" and describes the possible legal consequences when a"take" occurs. Among other actions, "take" includes a disturbance of bald eagles or their habitat. Under federal law a permit may still be required for activities that impact bald eagles or their habitat. Contact the US Fish and Wildlife Service (http://www.fws.gov/pacific/eagle/) to learn more about how this law affects your project. Any individual, group, or agency can bring suit for a listed species "taking", even if you are in compliance with Jefferson County development codes. The risk of a lawsuit against you can be reduced by consulting with a professional fisheries habitat biologist, and following the recommendations for site development provided by the biologist. For more information, contact the National Marine Fisheries Service in Seattle, or the U.S. Fish and Wildlife Service. CONDITIONS: 1.) The project shall adhere to the Best Management Practices (BMPs)to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 2.) In addition to Jefferson County permit conditions, the project proponent shall comply with all conditions set forth by the Washington Department of Fish and Wildlife, and Department of Natural Resources through Hydraulic Project Approval. 3.) Prior to commencing development activity, the proponent is responsible for informing the US Army Corps of Engineers (COE) in order for COE to determine whether a Department of the Army permit or review is required. Generally, review is required for construction and dredging in or around navigable waters of the US and for work or fill in hydrologically connected wetlands. Contact the US Army Corps of Engineers, Seattle District Regulatory Branch, PO Box 3755, Seattle WA 98124, (206) 764-3495, for more information. 4.) Any soils inadvertantly exposed by the project shall be seeded and strawed. 5.) The proponent shall not cause any"Development" activity in the Flood Zone, as defined by the National Flood Insurance Program. The proponent shall not remove substantial amounts of vegetation nor alter the natural site characteristics; nor shall the proponent allow any part of the project in the FEMA Zone A to cause any dredging, filling, grading, or excavation during the performance of the project. 6.) Work within the jurisdiction of the Shoreline Master Program other than as described above shall receive separate review from this Department. epa ent o Community Development Staff c: epartment of Ecology, Shorelands Office, Rick Mraz Washington State Department of Fish &Wildlife, Washington State Department of Natural Resources, \\tidemark\data\forms\F_SD P_Exemption_U.rpt 9/11/2015 II. I m 1a. C) ri o LL! w .'i O � Fi r O Oo `. CU co cs Ta,N Ao i al MI T'''''. rn Cu .=, S 3 5 it O)3 W 73 d� Q Cu i d C .5 Q AAA i U a O ce''''lli \ ooO \\`\0 00 I IV \ ~1.111 '• i \' r ' f ,t,,,, ,L, 11/4„, I.„ N z z a N >. 0 N (713 v E d O to co . N d o° +i + 1.f) x al-P in . 3 a) 0 Q N o wiI cu m ;' v i o• 3 o VI" S K U 4.w �U Q L'- I'uI� I— a tiJ G Land Use Permit Review Routing n Re: peel,-Re . 'SG eLle, 4 f qi J / C Project Planner C<'see. / `r/t(/ ' # I Administrator Up-Frerrt Reviewer RTY/` Jlk tilt ti./ ba/buit Return To: �j c c 5l) DEPARTMENT OF COMMUNITY DEVELOPMENT b; '' 621 Sheridan Street,Port Townsend,WA 98368 � Tel:360.379.4450 ( Fax 360379.4451 — — Web:www.m.iefferson.wa.us/communitydevelopmeat J EC E I M E E-mail:dcd(ico.ieffcrson.wa.us v L!- 9Sff I N O.\� PERMIT APPLICATION AUG 1 9 2015 - Steps in the Permit Process: JEFFERSON COUNTY -Review application checklist to ensure all information is completed prior to submitt ng arPiL, MUNITY DEVELOPMENT -Make sure septic has been applied for and water availability has been proven. -Make an appointment to meet with the Permit Technician by calling 360-379-4450. -This is not a standalone application;it must be accompanied by a project specific supplemental application. -Fees will be collected at intake. Additional fees may apply after review and payment is required before permit is issued. For Department Use Only Building Permit# Related Application#5: MLA# Site Information Assessor Tax Parcel Number: 511010000 Site Address and/or Directions to Property: At milepost 176 on Hwy 101 turn onto the Hoh-Clearwater Mainline,drive to milepost 13.2 and turn right on the C-2700 road. Go about 1/4 mile to bridge site. Access(name of street(s)) from which access will be gained: Present use of property: Timber Production Description of Work(include proposed uses): Bridge Maintenance Wastewater-Sewage Disposal This property is served by Port Townsend or Port Ludlow sewer system? YES NO X If not served by sewer identified above,identify type of septic system below: Type of Sewage System Serving Property: N/A Septic Septic Permit#: _ Community Septic Name of System: Case#: Are other residences connected to the septic system? Additions or repairs to sewage system: Is it a complete or partial system installation: Complete Partial Has a reserve drainfield been designated? Yes No Date of Last Operations& Maintenance check: Attach last report to application Describe or attach any drainfield easements,covenants or notices on title,which may impact the property: Permit Application Page 1 of 2 The authorized agent/representative is the primary contact for all project-related questions and correspondence. The County will mail /e-mail requests and information about the application to the authorized agent/representative and will copy(cc)the owner noted below. The authorized agent/representative is responsible for communicating the information to all parties involved with the application. It is the responsibility of the authorized agent/representative and owner to ensure their mailbox accepts County email(i.e., County email is not blocked or sent to"junk mail"). Applicant/Property Owner Information Property Owner: Name: WA Dept.of Natural Resources Address: 411 Tillicum Lane,Forks,WA 98331 Phone#: 360-640-2129 E-mail Address: bill.mehl @dnr.wa.gov X Please contact Authorized Agent/Representative with project info. (select only one). Property Owner Signature: Date: Note: For projects with multiple owners,attach a separate sheet with each owner(s)information and signatures. Applicant: Authorized Agent/Representative (If of-ler than owner) Name: Bill Mehl Address: Same as above Phone#: 360-640-2129 E-mail Address: bill.mehl@ dnr.wa.gov Professional: Is this an Authorized Agent/Representative for this project? NO YES? Engineer Architect Surveyor Contractor Consultant Name: License# Address: Phone#: E-mail Address: - ------- ---- Professional: Is this an Authorized Agent/Representative for this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: License# Address: Phone#: E-mail Address: Professional: Is this an Authorized Agent/Representativefor this project? NO YES Engineer Architect Surveyor Contractor Consultant Name: License# Address: Phone#: E-mail Address: By signing this application form, the owner/agent attests that the information provided herein, and in any attachments, is true and correct to the best of his or her knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in making any issued permit null and void. I further agree to that all activities I intend to undertake or complete associated with this permit will be performed in compliance with all applicable federal,state and county laws and regulations and I agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later inspections. Applicant may request notice of the County's intent to enter upon the property for visits related to this application and subsequent permit issuance. Signature: � �� g& Print Name: Bill Mehl Date: 8-12-2015 Pcrmit;lpplicztiun PaLm 2 of 2 =k ;_. cam ; go�•' Cb DEPARTMENT OF COMMUNITY DEVELOPMENT I =4 �� 621 Sheridan Street,Port Townsend,WA 98368 j i it, ,:,.. Te1:360.379.4450 Fax:360.379.4451 AUG 9 2015 Web:www.co.jefferson.wa.u./community development .mail:dcd r@co.jefferson.wa.us JEFFERSON COUNTY S//1 NG '. DEPT.OF COMMUNITY DEVELOPMENT STORMWATER CALCULATION WORKSHEET mar vnarcr/arruunrnnMe: C-2700 Bridge LWD removal DETERMINING STORM WATER MANAGEMENT REQUIREMENTS:This stormwater calculation worksheet should be completed first to classify the proposal as "small," "medium," or "large." The size determines whether a Stormwater Site Plan is required in conjunction with a stand-alone stormwater management permit application, building permit application,or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan, if required. PARCEL SIZE(I.E., SITE) Size of parcel 125,000 acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet 5,445,000,000 sq/ft Land-disturbing activity is any activity that results in movement of earth,or a change in the existing soil cover(both vegetative and non-vegetative)and/or the existing soil topography. Land disturbing activities include,but are not limited to clearing,grading,filling, excavation,and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species,other than noxious weeds,that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir, western hemlock, western red cedar, alder, big-leaf maple, and vine maple; shrubs such as willow, elderberry, salmonberry,and salal;herbaceous plants such as sword fern,foam flower,and fireweed. LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared,graded,filled, Answer the following two questions related to excavated,and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: Does the project convert V,,acres or more of Construction site for structures sq/ft native vegetation to lawn or landscaped areas? TVf Drainfeld,septic tank,etc. 0 sq/ft Circle: Yes Well, utilities,etc. sq/ft Does the project convert 2%acres or more of native vegetation to pasture? Driveway,parking, roads,etc. sq/ft CI Circle: Yes 4 Lawn, landscaping,etc. sq/ft Other compacted surface,etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance 0 sq/ft Cut 0 Fill 0 (cu/yd) Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof tops,walkways, patios, driveways,parking lots or storage areas,concrete or asphalt paving,gravel roads, packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater. stormwater cal°worksheet-REV.10/20/2014 1 STORM WATER CALULATIONS–IMPERVIOUS SURFACE NEW EXISTING Structures(all roof area) sq/ft Structures(all roof area) 0 sq/ft Sidewalks sq/ft Sidewalks 0 sq/ft Patios sq/ft Patios 0 sq/ft Solid Decks sq/ft Solid Decks 0 sq/ft (without infiltration below) (without infiltration below) Driveway,parking, roads,etc sq/ft Driveway,parking,roads,etc 6,400 sq/ft Other 0 sq/ft Other (Bridge) 1,344 sq/ft Total New 0 sq/ft Total Existing 7,744 sq/ft TOTAL NEW+TOTAL EXISTING* 7,744 sq/ft 'This amount will be used to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v. REDEVELOPMENT Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: •000 Does the site have 35%or more of existing impervious surface? Circle: Yes No ✓ FURTHER INSTRUCTIONS: If the answer is yes,the proposal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements. For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet. Proponents of "medium" projects—those that must meet only Minimum Requirements#1 through#5—and for"large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan, principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual. APPLICANT SIGNATURE By signing the Stormwater Calculation Worksheet,I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. !3& 71/Aze 8-12-2015 (LANDOWNER OR AU ORIZED REPRESENTATIVE SIGNATURE) (DATE) FOR OFFICE USE ONLY SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes_ No stormwater calc worksheet—REV.10/20/2014 I - C jit,e CIL feels eflSw Sally Ellis ,{ From: Joel Peterson 1 k e cckdec( co► T?c.+ ree r S Sent: Thursday, August 13, 2015 1:30 PM t`1 To: Sally Ellis " o uJ vuQCt 41) Subject: FW: C-2700 Bridge Tree removal PI Attachments: Permit application LWD relocation C-2700 bridge.pdf In (��/(�pccc Hi Sally, I ` , , I I coached this person on a permit application and it's attached. Can you set up a shoreline exemption approval case for it? Thanks! in FE 0 I El M FE, Joel V AUG 1 9 2015 From: Mehl, Bill (DNB) [mailto:Bill.Mehl @dnr.wa.gov] J 4 Sent:Thursday, August 13, 2015 11:35 AM JEFFERSON COUNTY To:Joel Peterson <JPeterson @co.jefferson.wa.us> DEPT OF COMMUNITYDrVFLOPMFNT Subject: C-2700 Bridge Tree removal Dear Joel: Attached is the permit application & stormwater calc worksheet, along with the FPA/HPA application. There is an existing access trail to where the down trees are, an excavator will walk down to the water edge ( above the OHW line) reach out and take the trees out of the water on the upstream side and then from the road, place/throw them on the downstream side of the bridge. (See diagram) Project to be done in the dry, during the hydraulic timing window, (before September 30`h). Any exposed soils will be seeded and strawed. If necessary, silt fence will be put along stream bank to protect water quality, but I'm not really anticipating much soil disturbance by the equipment. Do you need three hard copies of this, or is this electronic file acceptable? Let me know if there is any additional information you need. Bill Mehl Coast Engineer WA Dept. of Natural Resources Coast District. (360) 649-2129 1 FPA/N#: ,::.?6 /,3g3, / WASHINGTON STATE DEPARTTvt!NT Or Received Date: c5_ "J f MEW Natural Resources ___- -- WDFW Concurrence Due Date: WDFW Concurrence Review �-. J ra 'I�d�(/c�a I cation/Notification Completed: Office Ch c list Page I Comments Due Date: �7j — q-15- -f AUG 1 9 Olym 1 Region Decision Due Date: Q y !S _ j FP Forester: „? f.e / JEFFERSON COUNTY Shutdown Zone: U'o”. DEPT.OF COMMUNITY DEVELOPMENT RMAP#: Pt e2!P /400 cZ y r._ —._ FPA/N CLASSIFICATION: [ 111 III I ]IVG [ 1 IVS , ,RMdAP, Exempt:[ ]80/20 1 ]No Forest Roads [ ]Ag [ 1 LLO Landowner Name: 'r>:.i cwt ell t' P` J� C' 7( ' ,•.v ro act Name: i ,+ �,,�(� f WRIA: & - - e i4,.ts(-Gr--4-c-L./- WAU:____490.41.4_4„,"3./d':,r:J WRIA: .` WAU: Legal Description: �5 -//L )Jl Activity Type: Harvest ac Spray ac Stream Crossing(s) fl Road Construction ft Road Abandonment ft Rock Pit ac ? ALTERNATIVE PRESCRIPTIONS [ 1 Alternate Plan k Habitat Conservation Plan i [ ] Ten-Year Forest Management Plan [ ] Landowner Option Plan for Northern Spotted Owl [ ] Columbia River Gorge National Scenic Area [ ] Cooperative Habitat Enhancement Agreement ( ] Watershed Analysis: j �. :_..._ i RESOURCE REVIEW [ 1 Unstable Slopes(Risk:Highway,Water, ) [ j Bull Trout Overlay ] oils Map(Highly Erodible&Very Unstable) [ I HCP Bull Trout Population SLPSTAB [ j Bald Eagle nest or roost within 660 feet ( ] Landslide Hazard Zonation 1 ] Group A or B Water Supply(TRAX code DM or MU) [ 1 Landslide Polygon [ ] Hatchery(TRAX code S)(Name: ) [ ] Rain-on-Snow and Outside Approved WA [ ] Even-Aged Harvest greater than 120 Acres ( ] Hydac Soils [ 1 Ground-based Equipment on Slopes greater than 40% [ ]Wetland[ ]Forested,[ ]A,[ 1B [ ] Road Construction on Slopes greater than 65% [ ] In W MZ of f A,or[ ]B Wetland g IsX In RMZ/ELZ of Type KS,[ ]F,[ ]N water [ ] Saltwater Islands(Name: ) ,_[ ] Water Verification ASSOCIATED NON-SCANNED DOCUMENTS—On file with the FPA/N at the region office. t [ I SEPA Checklist/Documents [ 1 Large Landowner Road Maintenance and Abandonment Plan ASSOCIATED SCANNED DOCUMENTS I I Conversion Option Harvest Plan [ 1 Hardwood Conversion Form [ I FPHP Pl ns&Specifications �^ [ ] Oualifie E rt r.f" I ] W and Mitigation Plan [ I Natural r at on Plan r,0 [ ] Water Protocol Surveys[ ]Modification Form# [ ] Shoreline Penr}it no/ +M rI I [ I Water Classification Worksheet [ ] Marbled Murrelet Form ti s [ ] FPBM Appendix(s) [ ] Watershed hed Anantason(Stream Shade Assessment Worksheet) I ]Small Landowner RMAP Checklist [ ] DFC Printout Analysis Worksheet [ ]CMZ Assessment Form ( 1 Slope p Printout ( ] Sl Stability Informational Form EARR Tax Credit[ ]Yes 0 No ....._.... by ADDITIONAL COMMENTS: l / 14_ Form completed y r-., 0 --I 1 u l cn T 23- CJ MI C T ^ S m V, N n o 3 nr;f o -0 MI \;_ ' \ In is• Vl- r;..) ' Q erj Q n J . \ *3 4,..‘JD Pf o N 3 U1 -5 o o V P P (J CI o 3 • OD ) N �� N AI o Z z F1, \ ,,, 4 , ,, ,„k ..,....... 1, \I II 1 III t 1 NT `\\\oco . 000 + 3 a O S ot7C n 3 P 3 N 3 P -0 Q N F(. a -O 3 3 (0 3 3 y O P f v N S Q 3 m u c < a CI Co Z 5 t �m N p 2l'� ..,.. pI+V m 0 r "7! 5 P m I z - Q CO ai J 3 r H! F-�1� o p 7 ,N � m O Alt)M •-0 rri "3 W 3 �* e 4' Z �. � c i� C�+. =.,i- i:-. _ Nv■.' , L eglon Office Use Only WASHINGTON STATE DEP• ' :NT OF � T ' Natural Res • �.IL es � a INIF�ZI 6 1 3 8 8 J __11 Forest Practices Application/ otif to onsoNcoul ate' SA'5 'jar Western Washingt• DEPT OF COMMUNITY DEVELOPMENT PLEASE USE THE INSTRUCTIONS TO COMPLETE THIS APPLICATION. TYPE OR PRINT IN INK. 1. Landowner,Timber Owner and Operator Legal Name of LANDOWNER Legal Name of TIMBER OWNER 'Legal Name of OPERATOR (if different than Landowner) (if different than Landowner) Department of Natural Resources Mailing Address: Mailing Address: Mailing Address: 411 Tillicum Lane City, State,Zip City, State,Zip City, State,Zip Forks,WA 98331 Phone( 360 ) 374-2820 Phone( ) Phone( ) michelle.helms? dnr.wa.gov Email: Email: Email: 2. Contact Person Contact Person: Phone( 360 ) 640-2129 Bill Mehl Email: bill.mehi((dnr.wa.gav NOTE:You are required to verify Type Np,and Ns water types within 200 feet of your proposed forest practices activities prior to submitting a Forest Practices Application/Notification. Use the Additional Information section, additional pages, the Water Type Classification Worksheet,and/or a Water Type Modification form to explain how you verified water types. See Water Typing Requirements in the instructions. 3. Landownership Information:See instructions a. ©No ❑Yes Are you a small forest landowner per RCW 76.09.450? If Yes, go to b. b. ONo ❑Yes Is your entire proposed harvest area on a single contiguous ownership consisting of one or more parcel 4. If you are harvesting timber,enter the Forest Tax Reporting Account Number of the Timber Owner For tax reporting in€otmation or to receive a tax number, call the Department of Revenue at 1-800-548-8829. 5. Are you substituting prescriptions from an approved state or federal conservation agreement or watershed analysis? ©No QYes Write"HCP°or"Using Prescriptions'in tables that apply.Attach or reference on file prescriptions and/or crosswalks. 5/9/2014 Page 1 of7 Western Washington 2613838 6. What is the legal description of your forest practice? Section Township Range FAY Tax Parcel Number County 5 25N 1I. W Jefferson 7. When are you planning to begin work on the proposed activity? : September 1,2015 8. is the taxpayer eligible for the EARR Tax Credit? ❑No El Yes 9. 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. ❑No © Yes 10. Do you have a DNR approved Road Maintenance and Abandonment Plan(RMAP)? a. ❑No © Yes List the RMAP number: 10029 If no,go to b. b. ❑No ❑Yes is a Checklist RMAP required?(see instructions) 11. Are there potentially unstable slopes or landforms within the boundaries of your forest practices activity area? ©No 0 Yes—attach geotechnical report and"Slope Stability Informational Form.' If applicable, attach the SEPA checklist, HCP or Watershed Analysis prescriptions. 12. Are there potentially unstable slopes or landforms adjacent to your forest practices activity area? © No ❑Yes—complete and attach the"Slope Stability Informational Form.'If applicable, attach geotechnical report, HCP or Watershed Analysis prescriptions. 13. Is this forest practice appticationlnotification: (Answer every question) a. © No ❑Yes Within city limits or inside an urban growth area? (IF YES SEE INSTRUCTIONS FOR ADDITIONAL REQUIRED DOCUMENTS.) b. Q No ❑Yes For road work that is included in an approved Road Maintenance and Abandonment Plan (RMAP)? c. ® No ❑Yes Within a public park? if Yes, include SEPA Environmental Checklist or SEPA Determination -except for harvesting/salvaging less than 5,000 board feet within a developed public park. d. ©No ❑Yes Within 500 feet of a public park?Park name: e. ® No ❑Yes In an approved Conversion Option Harvest Plan(COHP)from the local government?if yes, include a copy.This only applies to proposals within urban growth areas. f. ❑No © Yes Within 200'of the Ordinary High Water Mark(OHWM)or floodway of Type S water? If yes,check with the county or city to determine whether a substantial development permit is required under the local shorelines master plan. 5/912014 Page 2 of 7 Western Washington 26 13038 b. ONE OR MORE of the following apply to me and/or my land(check all that apply): ❑I currently own more than 80 acres of forestiand in Washington. ❑Between June 5,2006 and today's date I have owned more than 80 acres of forestiand in Washington. ❑ Between June 5, 2006 and today's date this parcel has been more than 20 acres of contiguous ownership. Between June 5,2006 and today's date this parcel has been owned by someone that has owned more than 80 forested acres in Washington. 25. If harvesting within 115 feet of a Type S or F water on an exempt 20-acre parcel,complete the table below. Show RMZs and stream segment Identifiers on your Activity Map. (Include stream shade assessment methodology if you are harvesting within 75 feet,or the maximum RMZ,whichever is LESS. If using BM1 to evaluate shade,you may use the°Stream Shade Assessment Worksheet). Are you Stream Segment Maximum RMZ harvesting within Identifier Water Type Segment Length Bankfull Width Width the maximum (letter) (S, F) (feet) (feet) (feet) RMZ? (Y or N) I 26. Are you harvesting within 29 feet of a Type Np water on a 20-acre exempt parcel? 0 No Continue to number 29. ❑Yes See instructions and describe leave tree strategy in number 31.Then continue to number 29. 27. If harvesting within 200 feet of any of Type S or F waters,complete the table below, Include DFC for all inner zone harvests unless you have an HCP prescription.Show RMZs,CMZs,and stream segment identifiers on your Activity Map. (Include stream shade assessment methodology if you are harvesting within 75 feet of S or F waters. If using BM1 to evaluate shade, you may use the'Stream Shade Assessment Worksheet"). Stream RMZ Segment Water Type Site Class Stream Is there a Harvest Total width Width CMZ? Codes DFC Run Identifier (S or F) (I-V) Code(s) of RMZ (letter) (feet) (YIN) (see Number (f�) — instructions) a 28. If harvesting within 50 feet of Type Np water,complete the table(s)below. Show RMZs and stream segment identifiers on your Activity Map. Total Stream Stream- Length of No-Harvest, Stream Total Length of No-Harvest, Segment 50-foot Buffers in Segment Stream Length in 9 50-foot Buffers in Identifier Harvest Unit Harvest Unit identifier Harvest Unit Harvest Unit (letter) (feet) (feet) (letter) (feet) (feet) . 1 5/9/2014 Page 6 of 7 Western Washington 2613338 21. If harvesting or salvaging timber,complete the table below. Show all harvest areas and unit numbers on your Activity Map. For even-aged harvest units also show surrounding stand information on your Activity Map. Harvest Method e (Rubber Tired Skidder, a Harvest Type • Tracked Skidder,Dozer, E a y (Even aged, Shovel,Full Suspension 2 v 0 «o 'o e'o Uneven-aged,Salvage, n Cable.Lead-end Suspension 2 °.i e m e m "E Right-of-Way) .2 Cable, Helicopter,Animal, g 2 03 o. vs Chipper-forwarder,Slash e - m o o m } Bundler) Q x ? x > x 9 S es s 22. Reforestation.Check the appropriate box(es). 0 Planting. Tree Species: ❑ Natural. Include a Natural Regeneration Plan ❑Not required because of one or more of the following: 0 I am converting some or all of this land to non-forest land in the next 3 years or lands are exempted under WAC 222-34-050. ❑Individual dead,dying,down,or wind-thrown trees will be salvaged. ❑Trees are removed under a thinning program reasonably expected to maximize the long-term productivity of commercial timber. ❑ i am leaving at least 100 vigorous, undamaged,and well-distributed saplings or merchantable trees per acre. ❑An average of 190 tree seedlings per acre are established on the harvest area and my harvest will not damage it. ❑ Road right-of-way or rock pit development harvest only. **** if you own MORE than 80 forested acres in Washington,skip to number 27 •*** 23. Are you using the exempt 20-acre parcel riparian management zone(RMZ)rule on type S, F,or Np waters? ❑ No If no,continue to number 27. ❑ Yes If yes,continue to number 24. See instructions for qualifications and information. 24. Choose the answer below that best fits your situation. Show ail RMIZs on your Activity Map. ❑ a. ALL of the following apply to me and my land: (If no, answer b.) Between June 5,2006 and today's date I have always owned less than 80 acres of forestland in Washington. • Between June 5,2006 and today's date this parcel has always been 20 acres or less of contiguous ownership. • Between June 5,2006 and today's date this parcel has always been owned by me or someone else that has owned less than 80 acres of forestland in Washington. 5/912014 Page 5 of 7 Western Washington 2613838 17. If conducting any of the following activities in or over typed water,complete the table below. Some activities will require Identifiers on your Activity map and/or more information in number 31,Additional Information. See instructions. Activity Type S Water Type F Water Type Np Water Type Ns Water Equipment Crossing" Suspending Cables Cable Yarding LWD Placement/Removal X Beaver Darn Removal Felling and Bucking • Other(describe in number 31) *Existing HPAs issued by WDFW will be complied and enforced by WDFW until expiration. Plan details are not required for hydraulic projects permitted with an existing HPA(see instructions). **Fords and equipment crossings on Type S and F Waters may result in an unauthorized incidental take of certain endangered or threatened fish species. For more information,see"Background for the state's Incidental Take Permits for certain endangered and threatened fish species'following number 24 of the FPAIN Instructions_ 18. If constructing or abandoning forest roads complete the table below. Show the road locations and identifiers on your Activity Map. include abandonment plans for temporary roads and abandonment projects. Road Construction Road Abandonment Road Identifier (name,number} Length(feet) Steepest Length(feet) Abandonment Date Side-slope-slope(%) 19. If depositing spoils and/or expanding or developing a rock pit for forestry use,complete the table below. Show locations and identifiers on your Activity Map. Spoil Area identifier Amount of Spoils Rock Pit Identifier Acres of New Rock Acres of Existing (letter,number) Deposited {name,number or it Developed Rock Pit Expanded (cubic yards} letter} p P 20. If operating In or within 200 feet of a wetland,complete the table below. Show the boundaries of each wetland,along with its identifier,and WMZ on your Activity Map. See instructions for information. Wetland Planned Planned Total Wetland How many How many Wetland Type Pl Identifier Activities in (number, (A,B,or Activities in Maximum Area acres are you acres are you letter) Forested) Wetland Width WMZ (acres) draining? filling? ***** If not harvestinct or saivanina timber.skigto number 29 ***** 5/9/2014 Page 4 of 7 Western Washington 261 .1838 g. © No ❑Yes A request for a multi-year permit? If yes, length requested:❑4 years or❑5 years. Not everyone qualifies for a multi-year permit.See instructions for details. h. ®No CJ Yes An Alternate Plan? If yes,include a copy. L ❑No [}X Yes Within 50 miles of saltwater and do you own more than 500 acres of forest land in Washington State? If Yes-include the"Marbled Murrelet Form"or attach/reference HCP prescriptions. j. ©No ❑Yes In or directly adjacent to a potential Channel Migration Zone(CMZ)?If Yes—include the "CMZ Assessment Form."Attach/reference applicable HCP and/or Watershed Analysis prescriptions. ***** if not working in or over typed waters,skip to number 18 ***** Prior to answering number 14-17 in this section please refer to the Forest Practices Application instructions and Forest Practices Board Manual Section 5(BM 5). 14. Are you proposing any of the following projects NOT permitted by current HPAs from WDFW? a. [Q No Q Yes Installing, replacing or repairing a culvert at or below the bankfuil width of Type S or F Water(s)that exceeds a five percent gradient? b. ®No ❑Yes Constructing, replacing,or repairing a bridge at or below the bankfutl width of unconfined streams in Type S or F water(s)? c. © No ❑Yes Placing fill material within the 100-year flood level of unconfined streams in Type S or F water(s)? 15. Have you consulted with DNR and/or WDFW about the proposed hydraulic project(s)in or over Type S or F water? ❑No d Yes. 16. If installing,replacing,removing or maintaining structures in or over any typed water,complete the table below. Type S and F waters require detailed plan information. Provide plan details in number 31 or attach plan to the FPA/N. Provide crossing locations and identifiers on your Activity Map. (A detailed plan with profiles may also be required for more complex hydraulic projects in Type N Waters per WAC 222-24-042(2)). • a 0. 3 O C yy v o yz _ � � a v ,a� o am p ;moo ; me ° c o 7r c ° S0 o ' s m.. a m.a Q U co m a a aTim rz " c. a c - o :: fm � o mac <c mn om ?. C z Cm � G m $ti Ma Qa CZ4QC > E > oam 2 ,, m � to t ° v ., '3 v' u'= x .-. a .-2 a crt .9- a o-iti (yz179.- 0 .. m z Lk • *Existing HPAs issued by WDFW will be complied and enforced by WORN until expiration. Plan details are not required for hydraulic projects permitted with an existing HPA(see instructions). **Fords and equipment crossings on Type S and F Waters may result in an unauthorized incidental take of certain endangered or threatened fish species.For more information,see"Background for the state's Incidental Take Permits for certain endangered and threatened fish species"following number 24 of the FPA/N Instructions. 5/9/2014 Page 3 of 7 Western Washington 2613838 29. How are the following marked on the ground? (Ragging,paint, mad, fence, etc.) Harvest Boundaries: NIA Clumped Wildlife Reserve Trees/Green Recruitment Trees: N/A Right-of-way limits/road centerlines: N/A Stream Crossing Work: See question 31 Riparian Management Zone Boundaries and Leave/Take Trees: NIA Channel Migration Zone: NIA Wetland Management Zone Boundaries and Leave/Take Trees: N/A 30. Are you converting the land to non-forestry use within 3 years of harvest? 0 No ❑Yes If yes,include your SEPA Determination and/or SEPA checklist. 31. Additional Information(attach additional pages if necessary): For hydraulicproiects in or over S or F water(s)see instructions for required plan information. Project is removal of large woody debris(LWD)upstream of DNR C-2700 bridge across the Snahapish River and relocating LWD downstream of bridge. This is to protect existing structure. Project was looked at in the field on 7/28/20i5 with Bill Mehl,DNR, Brett McGinley,DNR,Theresa Powell,WDFW,and Caprice Fasano representing the Quinalt Tribe. Three trees to be bucked off root wads,and put downstream of bridge. Large spruce to be limbed inside the high water mark. Root wads to be left upstream in place. Application pending with Jefferson County for shorelines exemption C-2700 LWD removal. PEJL L,1,,,4QmdAdet. : Ex c4u.4faR, c..r y. t SE 7A.7.JC To dcc-ESs l wA PF5c�5 rife n• WA cis tip f0 okiodc �f"O "T/fRow" Prcces dot^ 5/.tam!-n. dam.. g (.fls 32. We acknowledge the following: • The information on this application/notification is true. • We understand this proposed forest practice is subject to: o The Forest Practices Act and Rules AND o All other federal,state or local regulations. • Compliance with the Forest Practices Act and Rules does not ensure compliance with the Endangered Species Act or other federal, state or local laws. • If we said that we would not convert the land to non-forestry use,the county or city may deny development permits on this parcel for the next 6 years. • The following may result in an unauthorized incidental take of certain endangered or threatened fish species: o Conversion of land to non-forestry use. o Harvesting within the maximum RMZ on a 20-acre exempt parcel that was acquired after June 5,2006. o Equipment Crossings/Fords in or over Type S and F Waters. 111 naJ a of t#1N ER Signature of TIMBER OWNER* Signature of OPERATOR l 9t/j� r� (If different than landowner) (If different than landowner) Print Name: Print Name: Print Name: Date: l t/f i' Date: Date: •NOTE:If you are a'Perpetual Timber Rights Owner,"and are submitting this without the Landowner's Signature,provide written evidence the landowner has been notified. Please make a copy of this FPA/N for your records. If this FPA/N contains a hydraulic project requiring WDFW concurrence review,it will not be available online for public review until after the WDFW concurrence review period. 5/9/2014 Page 7 of 7 Western Washington FOREST PRACTICE ACTIVITY MAP TOWNSHIP 25 NORTH HALF 0, RANGE 11 WEST(W.M)HALF 0,SECTION 2 6 1 38 3 8 Application# /' I '1.-...., F 87r //ti U\U iP) , l `f` 897 11), I F �.L...\ it \ L lif ,N, r^- Ipi I :-.•:.,< ,,,.? , , ./84,2' :, f:41.t4 n--1,rev i> I ...„,.... ., ,,,,,,i ,‘ , , 04..- 1.____.. ...Nili ---- 1 of oic, N. / 0, N 1."- 11000"1"0:*•10:0,0,___, ' 47 H 8'' ' , wvi —ailla / / r \ //,,,se o umisiomM,1ii .,.,,Project Location •.o-0 .•`.... .. y{ .. S o F +878420 ! :f.,„?....„.pow,rirp-a-s�ararrai- ai 'iliatip, ,„ ,--Not.....--,y '+'"!, t r r 8784 j '\- - ,40:10 A 1 4. 40 Please ute the legend faun the PPA Instruction or provide a Vat of symbols used. Date:7/29/2015 Time;12:33.43 PM HAD 83 Contour Interval:40 Feet Forest Practices Application/Notification Addendum DNR Proprietary HCP Implementation Checklist for the Marbled Murrelet,202t 6 1 3 8 3 8 OESF,Straits,South Coast,and Columbia Planning Units Only Refer to the DNR Proprietary HCP implementation Agreement for the Marbled Murrelet,2014. Marbled Murrelet GIS habitat and occupied site delineation is available on the Quick Data Loader and State Uplands Viewing Tool titled"State Lands—Marbled Murrelet--HCP Policy". I. Is the Forest Practices activity located within an occupied marbled murrelet site,OESF Science Team Additional habitat,OESF marbled murrelet Old Forest or reclassified habitat not available for release'? cxYes,if harvest,salvage or new road construction,then proposal is Wconsisteot with the current HCP strategy. Harvest deferment of habitat. Stun Proposed Activity or document in Question#4 the specifics of proposal and Forest Resources Division(FRD) or Services approval if intending to proceed.Other forest practices may be permitted but requires FRD consultation. If FRD approved,continue to Question#2. No,go to Question#2. 2. Is the proposed activity within 0.25 miles of any occupied site(s)or OESF unsurveyed old forest? o Yes,consult with Region biologist/specialist for recommendations and describe in question#4 any buffers or timing restrictions that are applied,but first go to question #3. ® No,proposal is consistent with the current HCP strategy. Go to Question#3. 3. Is the proposed activity within an area of reclassified habitat available and designated for release'? o Yes,go to Question#6 to document the WAU name,total acres allowed to be harvested and the total acres to date of habitat harvested within the WAU after this proposed harvest and proceed with activity. It is the region's responsibility to ensure that the WAU will maintain at least 50%of the total reclassified habitat. LEI No,proceed with activity;go to Question#4 if any documentation is required. All reclassified habitat within the OESF and within SW Washington(SWWA)is harvest deferred without release. Some reclassified habitat within the Straits,Columbia and South Coast Planning Units,but outside of SWWA may be available for harvest if50%of the habitat will remain within the WAU and it is greater than 0.3 miles from an occupied site.Check MM WAU status.SWWA is defined as those portions of the Columbia and South Coast Planning Unit west of Interstate 5 and that portion of the South Coast planning unit south of Highway 8 and south of Hwy.12 between Elma and Aberdeen.WAUs outside ofSWWA and the OESF must maintain at least 50%habitat. Page I of 2 Revised 4111/2014 .--. C 4- 01 o U '0,4 5- ■ 2 "E. 3'c la 2 _ RI E C CU Z C. Ot al t_ d C ‘k01/ al al al Vt E 4-, NVs■ ,?..).0.' ,O. 'NI •`v. I:13 \\I .. . ,..„ .„. i . z V .... z ,.. (,.,. . as Lb rn L 0- q tr) 4-• x cu in , • In 8 t+' - ;1--.to • c • 1 ai )14> IA 6 i".. 0.■ 11 Cr, a) C elfi Nt rn ia, c-6,:II * in ■ ru c) 13 3 Eg 4+ 0 (xi 32-0 :ts z in o 1 L T_ a o cu ' L itt L)Pel P0 I_i■-- ''" ,-C _ > ■ 0/ 9 9 L 9 --. 4. This question or section is for additional information the checklist suggested you provide in previous questions or any additional information you think is relevant to the proposal.Af i,Pu were able to answer the previous questions without a"Stop Proposed Activity"notifia6tiMi 1 3 8 3 then your proposal is consistent with the HCP and may proceed.Otherwise,more documentation is required here. If varying from current HCP guidance,attach consultation agreement from Forest Resources Division and/or IJSFWS and discuss below. See attached letter by FRD documenting approval of project. Page 2 2613838 August 3,2015,2015 TO: Allen Estep;Assistant Manager,HCP&Scientific Consultation Section,Forest Resources Division THROUGH: Drew Rosanbalm;State Lands Assistant Manager,Olympic Region FROM: Scott Horton;Wildlife Biologist,Olympic Region SUBJECT: Removing logjam from the C-2700 bridge within Reclassified murrelet habitat;T25N R11W SS Summary: The C-2700 bridge over the Snahapish River,a Type 1 water,is threatened by three logs that are jammed against its upstream side.Olympic Region engineers worked with WDFW and Tribal(Hoh and Quinault)biologists to develop a plan to relieve the jam and place the logs in-stream below the bridge. However the river bank and bed is within deferred, Reclassified marbled murrelet habitat and the activity needs Forest Resource Division approval.The surrounding stand is also spotted owl Structural habitat. Proposal: Based on agreements at an on-site Forest Practices ID team meeting,DNR proposes to cut the logs and place them in-channel downstream of the bridge using equipment based on the existing road and right-of-way. No terrestrial vegetation will be disturbed during this work.The plan requires the work to be done during the dry season.No logs will be removed from the northern spotted owl Structural Habitat. Conclusions and Management Recommendations:The logs jammed against the bridge are not murrelet habitat.Their removal is necessary to protect the bridge and downstream aquatic and riparian habitat.I conclude the proposal will not impact the quality of the Reclassified habitat or the northern spotted owl Structural Habitat and recommend the project proceed according to the plan noted above. Because the proposed work is outside of occupied sites and unsurveyed old forest habitat I recommend that timing restrictions are not needed. If you concur with this recommendation,please sign below. 4-17(<t-- cL . gh fry Al a.Estep_ Date Assistant Qivision-Manager -&-eientifrcfonsuItation Section Forest Resources Division 1 26 3838 Forest Practices Application/Notification Addendum DNR Proprietary HCP Implementation Checklist for the Northern Spotted Owl,2008(all HCP planning units& OESF) Refer to the DNR Proprietary HCP Implementation Agreement for the NSO.2008. 1. Is the Forest Practice activity within a NRF Management Area? flYes, Go to#2. ElNo, Go to#6. 2. Is the Forest Practice activity within a designated 500-acre Nest Patch? ❑Yes, No timber harvest allowed,harvest deferment of Nest Patches,refer to Substitution Agreement, Section 1.A. End Checklist. Maintenance of existing roads is permitted. Describe road maintenance activity in Question#13. QNo, Go to#3. 3. Is the Forest Practice activity within 0.7 miles of a spotted owl nest site(status 1 or 2)? DYes, Apply timing restrictions;refer to Substitution Agreement,Section I. Go to#4. QNo, Go to#4. 4. Is the SOMU where the Forest Practice activity is located, above the threshold of NRF habitat? ❑Yes, Proceed with the activity,ensuring that habitat within the SOMU will not fall below the target amount. Please describe in Question#13;if the activity will be harvesting habitat or non-habitat, whether it is an enhancement activity or even- age harvest and how many acres or percentage of NRF habitat will remain within the SOMU after harvest. Go to#13. QNo, . Go to#5. 5. Is the Forest Practice activity within suitable submature habitat or better or"next best"? Oyes, Ensure NRF habitat remains after completion of the harvest activity or that the activity will not increase the length of time for the target amount to reach a suitable habitat condition. Please describe in Question#13,type of activity,how habitat will be maintained or next best stands enhanced and what the final stand condition will be. Go to#13. QNo, Ensure that target amount of habitat within the SOMU will not take longer to achieve after activity. Please describe in Question#13 how management activity will maintain and/or achieve the NRF target amount. Go to#13. 6. Is the Forest Practice activity within a Dispersal or DFC Management Area? ❑Yes, Go to#7. ►ONo, Go to#10. 7. Is the Forest Practice activity within 0.7 miles of a spotted owl nest site(status 1 or 2)? ❑Yes, Apply timing restrictions; refer to Substitution Agreement, Section L Go to#8. ONO, Go to#8. 8. Is the SOMU where the Forest Practice activity is located,above the threshold of dispersal habitat? QYes, Proceed with the activity,ensuring that habitat within the SOMU will not fall below the target amount. Please describe in Question#13; if the activity will be harvesting habitat or non-habitat, whether it is an enhancement activity or even- age harvest and how many acres or percentage of dispersal habitat will remain within the SOMU after harvest. Go to#13. Page 1 of 2 2613838 ONo, Go to#9. 9. Is the Forest Practice activity within suitable dispersal habitat or better or"next best"? DYes, Ensure dispersal habitat remains after completion of the harvest activity or that the activity will not increase the length of time for the target amount to reach a suitable habitat condition. Please describe in Question#1.3,type of activity,how habitat will be maintained or next best stands enhanced and what the final stand condition will be. Go to#13, ❑No, Ensure that target amount of habitat within the SOMU will not take longer to achieve after activity. Please describe in Question#13 how management activity will maintain and/or achieve the dispersal target amount. Go to#13. 10.Is the Forest Practice activity located within the OESF? ZYes, Go to#11. ONo, Go to#12.. 11.Landscape planning has been initiated,but has it been completed? Dyes, Proceed with the activity,ensuring that all commitments of the Landscape Plan are fulfilled. Please describe in Question#13; if the activity will be harvesting habitat or non-habitat,whether it is an enhancement activity or even-age harvest and how many acres or percentage of suitable habitat will remain within the SOMU after harvest. Go to#12. EiNo, Proceed with the activity,ensuring that the total amount of habitat harvested since HCP implementation will not exceed the allowable amount as described within the substitution agreement,Section II. Please describe in Question#13; if the activity will be harvesting habitat or non-habitat,whether it is an enhancement activity or even-age harvest and how many acres or percentage of suitable habitat will remain within the SOMU after harvest. Go to#12. 12.Is the Forest Practice activity located within a Status 1 or 2 spotted owl management circle based on the WDFW database? OYes, Apply harvest timing restrictions to activities within the best 70-acre core around the site center; refer to Substitution Agreement,Section III. Include location of best 70-acre core on Forest Practices Map. Go to#13. NNo, Go to#13. 13. Provide any additional information or details requested from previous questions on the following lines. If no additional information is required,simply state"not applicable"below. Otherwise,include the SOMU name(s)when necessary if activity is within NRF or dispersal management areas or OESF and how habitat will be maintained or enhanced,etc. If varying from standard HCP guidance,attach concurrence/variance approval from Land Management Division and/or Federal Services and discuss below. End checklist. See memo from Allen Estep. Page 2 of 2 2613838 Forest Practices Application/Notification Addendum DNR Proprietary HCP,WAC Replacement Summary for Aquatic Resources,2008 OESF Planning Unit Please refer to the DNR Proprietary HCP Substitution Agreement for Aquatic Resources within the OESF Planning Unit,2008. Please check all HCP prescriptions and/or activities, which are relevant to this proposal and describe the management prescriptions and final stand composition at the end of this checklist. NOTE: When assessing hydrologic maturity for each sub-basin inside the rain-on- snow zone,DNR staff will use the most updated data layer delineating Watershed Administrative Units as designated by Forest Practices. ❑ Assessing Hydrologic Maturity in the Rain-On-Snow(ROS)Zone(Refer to item A in the Substitution Agreement). If the activity lies within the ROS zone and subbasin will be managed for ROS, fill out the following table. If within ROS zone, but subbasin will not be managed for ROS,describe why in additional information section below. t.SUB-BASIN NAME 2.TOTAL 3.HYDRO 4.CURRENT 5.ACRES OF 6 SUPRLUS ROS ACRES MATURE DNR SUB- HYDRO (+)OR (DNR) TARGET BASIN ACRES MATURE DEFICIT(-) WITHIN ACRES(2!3 IN HYDRO FOREST TO ACRES SUB-BASIN of Column 2) MATURE BE AFTER FOREST IN REMOVED ACTIVITY ROS ❑ Leave trees in forested wetlands.(Refer to item B in the Substitution Agreement). If this activity will include timber harvest within forested wetlands a minimum basal area of 120 square feet per acre must be maintained. 0 Wetland Management Zones. (Refer to item C in the Substitution Agreement). Describe the site index and WMZ width. If harvesting within the WMZ,describe the remaining stand characteristics within the WMZ. Forested Wetlands within Type A or B Wetlands. (Refer to items D in the Substitution Agreement). If this activity will include timber harvest within forested wetlands a minimum basal area of 120 square feet per acre must be maintained. l ❑ Riparian Management Zones for Type 1,2 and 3 Waters (Refer to item E and Appendix I and 2 in the Substitution Agreement). Describe the interior core and exterior buffer (wind buffer)widths. CI Riparian Management Zones for Type 4 and 5 Waters(Refer to item F and Appendix 1 and 2 in the Substitution Agreement). Describe the interior core and exterior buffer(wind buffer)widths for Type 4 streams. Describe any special protection for Type 5 waters, Page 1 of 2 2613838 [] Shade Requirements to maintain water temperature (Refer to item G in the Substitution Agreement)State whether this activity is located within an area with an approved watershed analysis or a 12-step riparian assessment has been conducted. 0 Harvesting or Salvaging within Type 1,2,3 and 4 Riparian Management Zones. (Refer to item H in the Substitution Agreement). If harvesting,describe the general HCP Riparian Forest Restoration Strategy management scenario under which the proposal's riparian stand will be managed. Describe stand treatment including removals,down wood and snag recruitment and type of activities. Describe post-harvest stand;how it meets the management parameters of the general management scenario,what species composition and diameter classes will remain,trees per acre, basal area,and relative density. If salvaging,describe how you will be meeting the RDFC conditions,what you will retain and removals and other salvage/restoration conditions described within the Ecosystem Services Section approved site specific restoration plan(and/or attach plan). Please provide any requested additional information below. If varying from standard HCP guidance,attach concurrence/variance approval from Forest Resources and Conservation Division and/or Federal Services and discuss below(e.g.research). ■ No harvest in riparian zones,onlyLWD removal from upstream side of bridge and re-located to downstream side. Page 2 of 2 UDC CONSISTENCY REVIEW Project Planner: Master#MLA15-00057 Review Type Project Description y� SDP15-00016 I BRIDGE MAINTENANCE �/ SHORELINE EXEMPTION APPROVAL Primary: STATE OF WASHINGTON-NAT RESOUR Site Address: PO BOX 47014 OLYMPIA WA 98504-7014 WA, APL BILL MEHL 411 TILLICUM LANE FORKS WA 98331 Project Location:,_ Parcel Nu 1010000 S-T-R: 1-25N-11W Total Acreage 10,457 Legal Description O 18 T25 R11 W ALL OF SECTIONS Land Use: 9720 Flood District: Fire District: 0 Planning Area: Flood Map(FIRM)Panel No: chool D 20 Zoning: COMP PLAN DESIGNATION: COMMUNITY PLAN: UGA: UGA Trans [ ] Plot plan states "property line" [ ] Assessor's Map (Property lines on submitted plot plan must match the property lines as identified on the Assessor's 1/4 map) [ ] Legal Access to Property YES NO [ ] Parcel Tags or Scanned Documents YES NO [ ] ESA's: Special Reports Nearby YES NO [ ] Designated Ag YES NO [ ] Shoreline Designation: 1Wili NO c'c py) . [ ] Shoreline Slo Stability. S NO r Stream T E NO - s FWHCA: NO Spe,''} eA. ,1 Wetlands: YES c) Rare Plants:YES Seismic: YES CSD Landslide: YES Flood: A r _ ,/ ,401! ' .r+ IL Erosion: YES Aquifer ' - . . ge AreC ES NO _ A ^ U A r , Ar _0 r .. - go, -. SIPZ: At sk High Risk Coastal CMZ: non: High Risk Moderate skDisco�te CMZ Stormwater si :-I an submitted: Ye o 84)9_5. [ ] Forest Lands: NO Adjoining Forest ands: Commercia 1) Rural/ Inholding [ ] Mineral Lands: YES [ ] Agricultural Lands: �yES No) [ ] Archaeology: YES `V� [ ] No Shooting Zone: YES [ ] Stormwater: rieror-Impervious Surface 0 Land Disturbing Activity 03 ESA's Stormwater Req441in Req I-) Min Req#1 thru#5 Min Req#1 thru#10 Engineering [ ] Notice Provisions/Disclosure:Airport YES NO MRL YES NO Forest Lands YES NO [ ] Landscaping Required: Yes No [ ] Parking Spaces Required 2 Other Building Height: 35' UBC Standard [ ] Impervious Surface coverage percentage: Resource Lands&Public: 10% Rural Residential: 25% Rural Industrial: Per UDC Sec 6.7 Rural Commercial: 60% Area of Building Coverage:60%in Rural Industrial Lands only [ ] Total Building(s) Size: N, RVC:20,000 SF CC: 5,000 SF NC:7,500 SF GC: 10,000 SF All others:subject to septic&water constraints/None specified [ ] Setbacks: Front: Left Side: Right Side: Rear: Shoreline Setback: /fir//3 LSHA Setback: [ ] Road Classification: S C -a 706 Road Approach: EXISTING 19Z 'D RAP 43r1 SEPA Required: YES Flood Certificate: [ ] Existing Case(s)&Condition(s): Violations: Yes No [ ] Recorded Date of Subdivision: AFN Over 5yrs=UDC Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance [ ] Lots/Require Declaration of Restrictive Covenant YES NO, submitted: YES NO [ ] UGA No Protest Agreement YES NO, submitted: YES NO [ ] Site Visit conducted YES NO [ ] Require Final Zoning Approval YES NO [ ] ADMIN: Setbacks entered in Permit Plan case N/A YES New Parcel Tags entered in Permit Plan N/A YES Special Reports Scanned N/A YES Title Notes Updated Parcel tags found for parcel 511010000 1.) 6yr Mor. on FPA2608323 application for 3-6-2007. Moratorium expires 9/11/07 Non-Forest Permits 3-6-2013. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 2.) 6yr Mor. on FPA2609689 application approved on 1/21/2009. 1/29/09 Non-Forest Permits Moratorium expires 1/21/2015. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 3.) 6yr Mor. on FPA2609723 application approved on 3/4/2009. 3/5/09 Non-Forest Permits Moratorium expires 3/4/2015. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 4.) 6yr Mor. on FPA2610347 application approved on 2/25/2010. 3/1/10 Non-Forest Permits Moratorium expires 2/25/2016. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 5.) 6yr Mor. on FPA2610422 application approved on 4/8/2010. 4/8/10 Non-Forest Permits Moratorium expires 4/8/2016. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 6.) 6yr Mor. on FPA2610670 application approved on 7/29/2010. 8/2/10 Non-Forest Permits Moratorium expires 7/29/2016. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 7.) 6yr Mor. on FPA2610950 application approved on 3/12/2011. 3/14/11 Non-Forest Permits Moratorium expires 3/12/2017. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 8.) 6yr Mor. on FPA2611280 application approved on 8/7/11. Moratorium 8/8/11 Non-Forest Permits expires 8/7/17. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 9.) 6yr Mor. on FPA2611378 application approved on 8/26/11. Moratorium 8/29/11 Non-Forest Permits expires 8/26/17. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 10.) 6yr Mor. on FPA2611576 application approved on 2/18/2012. 2/21/12 Non-Forest Permits Moratorium expires 2/18/2018. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 11.) 6yr Mor. on FPA2611687 application approved on 4/5/2012. 4/6/12 Non-Forest Permits Moratorium expires 4/5/2018. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 12.) 6yr Mor. on FPA2611881 application approved on 7/29/12. Moratorium 8/1/12 Non-Forest Permits expires 7/29/18. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 13.) 6yr Mor. on FPA2611935 application approved on 9115/12. Moratorium 9/20/12 Non-Forest Permits expires 9/15/18. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 14.) 6yr Mor. on FPA2612203 application approved on 3/23/13. Moratorium 3/18/13 Non-Forest Permits expires 3/23/19. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511019000 15.) 6yr Mor. on FPA2612724 application approved on 1/25/2014 1/27/14 Non-Forest Permits Moratorium expires 1/25/2020. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Parcel tags found for parcel 511010000 16.) 6yr Mor. on FPA2613378 7/30/15 Non-Forest Permits Moratorium Effective: 01/30/2015 Moratorium Expiration: 01/30/2021 JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application." Parcel tags found for parcel 511010000 17.) 6yr Mor. on FPA2613838 application approved on 8/19/2015. 8/21/15 Non-Forest Permits Moratorium expires 8/19/2021. JCC18.20.160(5)(b) "Mandatory six year development moratorium. For six years after the date of the application the county shall deny any and all applications for permits and approvals, including building permits and subdivision approvals, relating to or for non forestry uses of land subject to the application. Associated CASES status issued finaled description 511010000 CAM15-00374 P Tree removal from upstream side of bridge across Snahapish River to protect structure. What application forms and maps need to be sent in? FPA2602947 F 10/6/1999 12/15/1999 Forest practice application. FPA2604392 F 2/9/2002 2/26/2002 Reconstruction of existing road FPA2604459 F 3/23/2002 3/29/2002 New permanent road construction,reconstruction of existing road and maintenance of existing road,even age harvest FPA2604829 F 8/31/2002 9/4/2002 New Permanent Road Construction FPA2606566 F 3/21/2005 75 ft of culvert and road. FPA2607159 F 8/28/2005 No Harvest,culvert replacement. FPA2607690 F 6/1/2006 6/2/2006 20 ft rd construction and 4 stream crossings FPA2607733 F 6/17/2006 6/20/2006 50 ft road construction FPA2609139 C APPLICATION WITHDRAWN 3-11-2008 463 acres of timber harvest and 6595 feet of road construction FPA2609707 P 4 stream crossings and spoils area FPA2610347 F 2/25/2010 3/1/2010 Addendum: Stream corrected to reflect Ns). 70 feet of road construction and 5 stream crossings to replace 5 culverts FPA2610422 F 4/8/2010 4/8/2010 150 feet road construction and 5 culvert replacements FPA2610579 C 6/4/10: application denied due to inadequate pipes sized declared within FPA. Culvert replacements only FPA2610624 D 7/7/2010 2 stream crossings FPA2610670 P 7/29/2010 2 spoils areas: remove culverts and install Fords. FPA2610938 D 2/15/2011 2/8/2011:DNR DENIED application due to incompleteness and water types have not been adequately verified. 14 stream crossings(10 culvert replacements,one removal of gravel from channel,two riprap installations). FPA2610950 F 3/12/2011 3/14/2011 13 stream crossings(10 culvert replacements, 1 culvert installation and 2 riprap additions). FPA2611280 F 8/7/2011 8/8/2011 184-acre timber harvest; 1979 feet of road construction and 4 culvert removals and 2 culvert installations. FPA2611378 F 8/26/2011 8/29/2011 105-acre salvage FPA2611576 F 2/18/2012 2/21/2012 2 culvert replacements. FPA2611687 F 4/5/2012 4/6/2012 Four culvert replacements. FPA2611869 W 7/12/2012 167-acre even aged timber harvest and 2862 feet of road construction. FPA2611881 F 7/29/2012 8/1/2012 167-acre even age/salvage timber harvest and 2862 feet of road construction. FPA2611935 F 9/15/2012 9/20/2012 One culvert replacement. FPA2612183 W One concrete bridge replacement&three culvert replacements (9 foot x 70 foot long, 8.5 foot x 66 foot long,and 3 foot x 74 foot long). FPA2612203 F 3/23/2013 3/18/2013 One culvert replacement and one concrete bridge replacement (50'L x 17.5'W) FPA2612724 F 1/25/2014 1/27/2014 FPA2613838 F 8/19/2015 8/21/2015 C-2700 LWD REMOVAL MLA15-00057 SDP15-00016 P BRIDGE MAINTENANCE SHORELINE EXEMPTION APPROVAL L7 0I"1R 4# i.O P 10l9 1 s Q. y J. r - 'I G .• n h '+ ^rvgrfi ,: [r . t r 0',4 t r {+st� .{ r t�.' +?� )i�w�r�'sr`''.`#; fril'r:."ir },,`"l.i.,. /r's..tiJ?:• e i m m $ yl' rix.y4y' r7 r f rrJ r4"ri'R — + .14.v.-4 o. I �� ry°"{M1�r� lI '�fz 11,P1'3ry Y �" ,a- e Y'fi Pa: ' r 'a .,.. 1• Tp11110111111110t.,- - 1 r � • A • • •k ` % f '001 I i r 'v a n � �i � n � i f d V v n 3 0 V ,, '' gNeao c4 ii1 ii ( at ; 2Ea " x ; ± i ° .0 n o r t 4, l i r ! r ; i 'l l w n B m ° 2 : E€ d .. 6 m a • Br 3 I0711ft t111C51®IADP @060 ._]ODD"9w/oD10 d a4 i 1 ` * Jr, n .I 3 31b p' ¢n ` ° vM- r' - y�yy.6 i; a i t. '' a 4 "4-. '.4 , �.. a �i :8 7 "` R r ' �� f r. - ` t ' 0 - f ., $ r r ` t '' . ' � 4r ` r n it f. 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JEFFERSON COUNTY �!• DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street I Port Townsend, WA 98368 360-379-4450 I email: dcd @co.jefferson.wa.us .isf/t N� www.co.jefferson.wa.us/commdevelopment Date Due: BILLING ADDRESS: 9/19/2015 STATE OF WASHINGTON-NAT RESOUR PO BOX 47014 OLYMPIA WA 98504-7014 SMP Exemption Base 546.00 Scanning Fee 19.50 REMIT TO: Total Amount Due: $565.50 Jefferson County DCD 621 Sheridan St. Port Townsend, WA 98368 Please return the above portion with your payment Permit Number: SDP15-00016 SMP Exemption Base 546.00 Scanning Fee 19.50 Total Amount Due: $565.50 Payment is accepted by cash, check, debit or credit card (Visa, Mastercard, Discover, American Express) To pay by credit card, go to www.co.jefferson.wa.us/commdevelopment, and click on the "Online Credit Card & echeck Payments" link on the left side of the page. (questions: call 360-379-4450) Parcel Details Page 1 of 2 „ Jefferson County . .., _ A. Yta r wh, xiea i- t. ho is , le tarn' - E T �, � Name County info Departments Search Parcel Number: [511010000 1 I SEARCH Number: 511010000 Printer Friendly Owner Mailing Address: STATE OF WASHINGTON-NAT RESOUR NALA 1C- ' PO BOX 47014 LJ OLYMPIA WA98504-7014 Site Address: Section: 1 School District: Queets - Clearwater (20) Qtr Section: Fire Dist: None Township: 25N Tax Status: STATE Range: 11W Tax Code: 0502 Planning area: West Jefferson County (12) Sewer: Drainage: Bank: View 1: View 2: Zoning 1: CF-80 - Commercial Forest Zoning 2: Zoning 3: Sub Division: Assessor's Land Use Code: 9720 - DNR Managed Timberlands (except Forest Transfer) Property Description: S1 TO 18 T25 R11W ALL OF SECTIONS Permit Data Tax, A/V, Sales, Photos, and Bldg Data Map Parcel .'lets &Surve s Septic Monitoring Info Pu Jefferson County i ” HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later Windows - Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?value=511010000 8/13/2015 Begin Time: End Time: I DEPARTMENT OF COMMUNITY DEV I Sheridan Street, Port Townsend,WA 98368 Tel:360.379.4450 I Fax:360.3794451 Web:E-mail:dcd @co.jefferson.wa.us i ,i 1' : ��L ' )EFERSOfd COUNf i PT.0f GOA44lL1hl1Y 9E�ELOE�FM Customer Assistance Intake-Foam Help us provide you the information you need by filling out this form. This is a public information form,the contents of this form is available to view by the public. • The first 15 minutes of staff time is free. Office Use Only • After the first 15 minutes, a minimum of one hour will be charged at the rate of $78.00 a hour with additional time over Receipt#: one hour billed in 15 minute increments. Check/CC#: • Please complete form and submit to the address or email Date Paid: above and a staff member will contact you. • Our goal is to respond within 14 calendar days of the request. Received By: Bill Mehl for Wa Dept. of Natural Resources NAME: DATE: .� 3t bill.mehl @dnr.wa.gov EMAIL ADDRESS: 411 Tillicum Lane, Forks, WA 98331 MAILING ADDRESS: 360-640-2129 r 1 TELEPHONE: (HOME) -(CELL) PLEASE NOTE: Information and guidance provided through Customer Assistance is advisory only and is based on information provided by the customer. This is not intended to be an exhaustive review of all potential issues.Any discussion or information provided shall not bind or prohibit the County's future implementation or enforcement of all applicable laws and regulations. No statements or assurances made by County representatives shall in any way relieve the applicant of his or her duty to submit an application consistent with all relevant requirements of County, state and federal codes, laws, regulations, land use plans, and other requirements. -F,iL! Your Signature: Monday, September 29, 2014 Begin Time: End Time: Customer Assistance Intake Form Page 2 of 2 Information Requested - List all questions and any information you need addressed. Attach additional sheets of paper if necessary. Tree removal from upstream side of bridge across Snahapish River to protect structure. Need to know what application forms and maps need to be sent in. Project has been OK'd by W)DFW & Quinalt tribe. FPALHPA application being processed. Property Description 9-DIGIT PARCEL NUMBER(from Property Tax Statement):511010000 PROPERTY ADDRESS: NW1/4 SE1/4 Section 5 T.25N. R11W. 124* 9' 2.175"W 47*41' 50.381" N Office Use Only Joel Peterson From: Joel Peterson Sent: Friday, August 07, 2015 5:04 PM To: 'Mehl, Bill (DNR)' Cc: Sally Ellis Subject: RE: Tree Re-location for bridge maintenance, Snahapish River T25N R11W Sec 5 Hi Bill, Sorry I've been really busy and pulled away from answering your question completely. The Jefferson County permit will be a Shoreline Exemption Approval. Our permit forms are on line at http://www.co.Jefferson.wa.us/commdevelopment/PermitForms.htm. My understanding is that the project is to move trees. Does it also include the bridge maintenance?Are you doing in- water work/is the Army Corps involved? Please include 3 copies of the site plan documents& master permit application form. Please include a Stormwater Calculation Worksheet with any relevant information you can provide for how you will address water quality and sediment transport. Please include any FPA/HPA information you provided to agencies. Fees are $546.00 for the Exemption Approval review and $19.50 for records management fee ($565.50). I think that is it. Thanks. Joel Joel Peterson Associate Planner,Jefferson County Department of Community Development 621 Sheridan Street * Port Townsend, WA 98368 Phone 360-379-4457 * Fax 360-379-4451 j peterson nco.jefferson.wa.us Jefferson County DCD Mission: To preserve and enhance the quality of life in Jefferson County by promoting a vibrant economy, sound communities and a healthy environment. All e-mail sent to this address will be received by the Jefferson County e-mail system and may be subject to Public Disclosure under Chapter 42.56 RCW SAVE PAPER - Please do not print this e-mail unless absolutely necessary From: Mehl, Bill (DNR) [mailto:Bill.Mehl @dnr.wa.govj Sent: Friday, August 07, 2015 2:01 PM To:Joel Peterson <JPeerson @co.jefferson.wa.us> Subject:Tree Re-location for bridge maintenance, Snahapish River T25N R11W Sec 5 Joel i Just a quick follow up on our conversation(s)from last week. Our FPA/HPA application is in and going through review, FPA#2613838, due to be approved on 9/4/2015. As I explained earlier,these trees are a danger to the structural integrity of our bridge, and need to be removed during this year's hydraulic window. Thanks for all your help. Respectfully, Bill Mehl WA Dept. of Natural Resources Coast Engineer 2 411 Tillicum Lane Forks, WA (360)640-2129 Bill.mehl@dnr.wa.gov 2 Haylie Clement From: Sally Ellis Sent: Thursday,July 30, 2015 2:35 PM To: Haylie Clement Subject: FW:Tree removal From upstream side of Snahapish River Bridge Attachments: Customer Assistance Intake Form-writable.pdf Please enter this and then give it to me so I can talk to joel Sally L Ellis Jefferson County Community Development Permit Technician 621 Sheridan St.,Port Townsend,WA 98368 Mon-Thurs 9am -4:30pm,closed from 12-1 Ph: 360-379-4452 Fax: 360-379-4451 sellis @co.jefferson.wa.us http://www.co.jefferson.wa.us From: Mehl, Bill (DNR) [mailto:Bill.Mehl @dnr.wa.gov] Sent:Thursday,July 30,2015 12:19 PM To:Sally Ellis<SEllis @co.jefferson.wa.us> Subject:Tree removal From upstream side of Snahapish River Bridge Dear Sally: Thank you for your help with this project. Our main concern is to remove the trees and protect the structure, this needs to be done before the end of September. On a secondary note,the bridge needs some maintenance done to it,which includes guard rail replacement and rip-rap bank stabilization at the two upstream corners and the East side downstream corner of the bridge. (Rip-rap work to be done above ordinary High Water.) What applications will the maintenance part of the project need,and what would the estimated time line be for a permit? Thanks! Bill Mehl Dept.of Natural Resources, Olympic Region Coast Engineer 2 (360)640-2129 1