HomeMy WebLinkAboutMLA15-00075 - FPA15-00002 SEPA Checklist Agency CommentsSEPA ENVIRONMENTAL CHECKLIST
Purpose of checklist.,
Governmental agencies use this checklist to help determine whether the environmental impacts of your
proposal are significant. This information is also helpful to determine 0 available avoidance, minimization
or compensatory mitigation measures will address the probable significant impacts or if an environmental
impact statement will be prepared to further analyze the proposal.
Instructions for applicants:
This environmental checklist asks you to describe some basic information about your proposal. Please
answer each question accurately and carefully, to the best of your knowledge. You may need to consult
with an agency specialist or private consultant for some questions. You may use "not applicable" or
"does not apply" only when you can explain why it does not apply and not when the answer is unknown.
You may also attach or incorporate by reference additional studies reports. Complete and accurate
answers to these questions often avoid delays with the SEPA process as well as later in the decision-
making process.
The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of
time or on different parcels of land. Attach any additional information that will help describe your proposal
or its environmental effects. The agency to which you submit this checklist may ask you to explain your
answers or provide additional information reasonably related to determining if there may be significant
adverse impact.
Instructions for Lead Agencies:
Please adjust the format of this template as needed. Additional information may be necessary to
evaluate the existing environment, all interrelated aspects of the proposal and an analysis of adverse
impacts. The checklist is considered the first but not necessarily the only source of information needed to
make an adequate threshold determination. Once a threshold determination is made, the lead agency is
responsible for the completeness and accuracy of the checklist and other supporting documents.
Use of checklist for nonproject proposals:hf elol
For nonproject proposals (such as ordinances, regulations, plans and programs), complete the applicable
parts of sections A and B plus the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D). Please
completely answer all questions that apply and note that the words "project," "applicant," and "property or
site" should be read as "proposal," "proponent," and "affected geographic area," respectively. The lead
agency may exclude (for non -projects) questions in Part B - Environmental Elements —that do not
contribute meaningfully to the analysis of the proposal.
A. Background hal
1. Name of proposed project, if applicable:hl gig]
• 6 year Forest Practices Application Development Moratorium Release and Stormwater
Management Permit.
2. Name of applicant:hj @ j
• John Holloway
3. Address and phone number of applicant and contact person:hj pM
SEPA Envimmental ch..kiN (WAC 18]11.960) May 2014 Page 1 of 12
• 260 Kala Point Drive Suite #102, Port Townsend, WA, 98368
• 360.259.5856
4. Date checklist prepared: hf elol
• December 3, 2015.
5. Agency requesting checklist:hf elpl
• Jefferson County Department of Community Development.
6. Proposed timing or schedule (including phasing, if applicable):hj ell j
• Stump removal by excavating and grading to level without changing grade of slope of natural
geography to occur in early 2015 upon approval of permits. Followed by single family residential
development to occur in spring of 2015.
7. Do you have any plans for future additions, expansion, or further activity related to or
connected with this proposal? If yes, explain.ht pM
• Single family residential —residence, septic system, future garden and orchard.
8. List any environmental information you know about that has been prepared, or will be
prepared, directly related to this proposal,hf gM
• None required, no critical areas or buffers are located on the property.
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.hf gm
• None
10. List any government approvals or permits that will be needed for your proposal, if known.
hel
• Release of 6 year FPA Development Moratorium
• Stormwater Management Permit
11. Give brief, complete description of your proposal, including the proposed uses and the size
of the project and site. There are several questions later in this checklist that ask you to
describe certain aspects of your proposal. You do not need to repeat those answers on this
page. (Lead agencies may modify this form to include additional specific information on project
description.) lhglo
• Proposal is to release a 6 year Forest Practices Application development moratorium and obtain a
stormwater management permit to convert land to a residential use. The area logged in June of
2015 does not have vegetation growth. Currently, there are stumps from logged trees with woody
debris on bare ground. The proposal is to clear the interior two acres of the parcel of tree stumps
and woody debris, this area will be graded with the slope of the parcel and reseeded with native
vegetation and allow for natural regrowth. The 26 foot perimeter buffer will not be cleared and
graded but will allow for regrowth. Upon approval for this conversion a building application for a
single family residence will be submitted. Single family residence is proposed to be approximately
1400 sq/ft with land use of approximately t/3 acre.
12. Location of the proposal. Give sufficient information for a person to understand the precise
location of your proposed project, including a street address, if any, and section, township, and
range, if known. If a proposal would occur over a range of area, provide the range or
SEPA EnW..enWl Onkll•t (WAC
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.hl elol
• Parcel Number 701 051 018; Section 5, Township 27 N, Range 1W; no site address at this time,.
located off of Dabob Bay Road.
B. ENVIRONMENTAL ELEMENTShl el
1. Earthhl LIM
a. General description of the site: hel
(circle one): Flat, rolling, hilly, steep slopes, mountainous, other
• Site is relatively Bat on western half of parcel then slopes to the east with approximately a 9%
slope at steepest.
b. What is the steepest slope on the site (approximate percent slope)?ht elpl
• 9%
c. What general types of soils are found on the site (for example, clay, sand, gravel, peat,
muck)? If you know the classification of agricultural soils, specify them and note any
agricultural land of long-term commercial significance and whether the proposal results in
removing any of these soils.hr gLIM
• Soils are approximately half Alderwood Gravelly Sandy loan (AIC) and Sinclair Gravelly Sandy
Loam (SnD). AIC soil is used for permanent pasture of mixed grasses and legumes. Also, small
grains, vegetables, berries and fruit trees are grown in AIC soils. SnD is mainly used for trees,
urban development, and for wildlife habitat and recreation areas.
d. Are there surface indications or history of unstable soils in the immediate vicinity? If so,
describe.hf elol
• Parcel is located outside of landslide area and buffers, however, some of the surrounding area is
mapped as slight landslide hazard area.
e. Describe the purpose, type, total area, and approximate quantities and total affected area of
any filling, excavation, and grading proposed. Indicate source of fill.hl elgl
• Grading with slope, no fill required.
f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe.
hf elp]
• No significant erosion is expected to occur. Land disturbing activities are expected to be
completed quickly and stabilized by mulching or laying of straw and reseeding
g. About what percent of the site will be covered with impervious surfaces after project
construction (for example, asphalt or buildings)?hl elpl
• For current proposal of stump removal and grading with slope no impervious surface. Future
impervious surface of residence expected to be very small percentage of parcel.
h. Proposed measures to reduce or control erosion, or other impacts to the earth, K any:h( elpj
Envlmnm•nW ChM1,11W(WAC 197-11-990) May 2010
• Best management practices for stormwater management. The disturbed slope will be stabilized by
mulching and reseeding.
2. Air JheM
a. What types of emissions to the air would result from the proposal during construction,
operation, and maintenance when the project is completed? If any, generally describe and
give approximate quantities if known.hf elDl
• Burning of slash piles, stumps and woody debris leftover from previous logging under FPA will
create temporary smoke in the air. Emissions from equipment used will be minimal.
b. Are there any off-site sources of emissions or odor that may affect your proposal? If so,
generally describe. hel
• No
c. Proposed measures to reduce or control emissions or other impacts to air, if any:h( elpl
• None
3. Water IWO
a. Surface Water:
1) Is there any surface water body on or in the immediate vicinity of the site (including
year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe
type and provide names. If appropriate, state what stream or river it flows into.hf elpl
• No surface water body is located on site. Closest water body is a non -fish habitat stream located
approximately 200 feet away. Closest fish habitat stream located approximately 300 feet away
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.hf elpl
• No
3) Estimate the amount of fill and dredge material that would be placed in or removed
from surface water or wetlands and indicate the area of the site that would be affected.
Indicate the source of fill material.hj>e>M
• None
4) Will the proposal require surface water withdrawals or diversions? Give general
description, purpose, and approximate quantities if known.hf e
• No
5) Does the proposal lie within a 100 -year floodplain? If so, note location on the site plan.
hel
• No
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.hf e
• No
SEPA EnAmnaienial ckeckliM (WAG 187-11Afi0) May 2014 Page 4 Of 12
b. Ground Water:
1) Will groundwater be withdrawn from a well for drinking water or other purposes? If so,
give a general description of the well, proposed uses and approximate quantities
withdrawn from the well. Will water be discharged to groundwater? Give general
description, purpose, and approximate quantities if known.hf elol
• No
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.hj e
• Once the single family residence is build domestic sewage for one residence to be
occupied by three people as a 3 bedroom system.
c. Water runoff (including stormwater):
1) Describe the source of runoff (including storm water) and method of collection
and disposal, rf any (include quantities, if known). Where will this water flow?
Will this water flow into other waters? If so, describe.hr elm
Stormwater fully dispersed and no flow into other water sources.
2) Could waste materials enter ground or surface waters? If so, generally describe.hr elPl
• No
3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If
so, describe.[hejpj
• No
d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage
pattern impacts, if any:hj elp]
• Use best management practices for stormwater control. Stablize soils and slope by
mulching and reseeding of native vegetation, install silt fence for temporary control.
Permanent stormwater management through full dispersion using BMPT5.30.
4. PlantsjLft!pj
a. Check the types of vegetation found on the site:hj elpj
X deciduous tree: alder, maple, aspen, other
X evergreen tree: fir, ceedar,ig_ne, other
X shrubs
Xrg ass
pasture
_crop or grain
Environmental chacklbt MAC 19741.660) May 2014
_ Orchards, vineyards or other permanent crops.
wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other
_water plants: water lily, eelgrass, milfoil, other
X other types of vegetation - Thistles
b. What kind and amount of vegetation will be removed or altered?hr elpl
Area proposed to be cleared and graded as previously logged with no replanting or areas of
established vegetation beyond occasional thistle. Proposal will not clear of living vegetation,
replanting of native vegetation will occur.
c. List threatened and endangered species known to be on or near the site.hl elDl
. None
d. Proposed landscaping, use of native plants, or other measures to preserve or enhance
vegetation on the site, if any:hf elpl
. Seed with native vegetation and allow for re -growth.
e. List all noxious weeds and invasive species known to be on or near the site.hr elpl
. Thistle
5. Animals hel
a. List any birds and other animals which have been observed on or near the site or are known
to be on or near the site.hf elpl
Examples include:
birds: hawk, heron, eagle, songbirds, other: Osprey
mammals: deer, bear, elk, beaver, other:
fish: bass, salmon, trout, herring, shellfish, other
b. List any threatened and endangered species known to be on or near the site.hf elol
. None known of.
c. Is the site part of a migration route? If so, explain. hel
. Not this is known of.
d. Proposed measures to preserve or enhance wildlife, if any:[he!PJ
. Allow for regrowth.
e. List any invasive animal species known to be on or near the site.hr elpl
. None known of.
6. Energy and Natural ResourceshI elDl
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.hj elp]
. Fuel/Diesel for equipment/machinery for work performed.
SEPA Envimnmental cM kllst (WAC 197-11.960) May 2014 Page 6 Of 12
. Once residence is built electric for basic home use and wood stove for heating.
b. Would your project affect the potential use of solar energy by adjacent properties?
If so, generally describe. 1heM
. No
c. What kinds of energy conservation features are included in the plans of this proposal?
List other proposed measures to reduce or control energy impacts, if any:hf elol
. None
7. Environmental Healthhj ell j
a. Are there any environmental health hazards, including exposure to toxic chemicals, risk
of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal?
If so, describe. hel
1) Describe any known or possible contamination at the site from present or past uses.
Item
None
2) Describe existing hazardous chemicals/conditions that might affect project development
and design. This includes underground hazardous liquid and gas transmission pipelines
located within the project area and in the vicinity.hj elol
None
3) Describe any toxic or hazardous chemicals that might be stored, used, or produced
during the project's development or construction, or at any time during the operating
life of the project.hf elol
None
4) Describe special emergency services that might be required.hj elp]
. None expected.
5) Proposed measures to reduce or control environmental health hazards, if any:hl elpl
. None
b. Noisehj ell
1) What types of noise exist in the area which may affect your project (for example:
traffic, equipment, operation, other)?hj ell j
None
2) What types and levels of noise would be created by or associated with the project on a
short-term or a long-term basis (for example: traffic, construction, operation, other)? Indi-
cate what hours noise would come from the site.hf elol
. Short-term construction, Saturday and Sunday during daylight hours.
3) Proposed measures to reduce or control noise impacts, if any: hj ell j
. None
c0eckllat (YAC 197-11.990) May 2014 Page 7 Of 12
8. Land and Shoreline Use 1h§M
a. What is the current use of the site and adjacent properties? Will the proposal affect current
land uses on nearby or adjacent properties? If so, describe.hf e1o1
• Site is currently vacant land. Surround properties are mainly residential uses and some
commercial forest use.
b. Has the project site been used as working farmlands or working forest lands? If so, describe.
How much agricultural or forest land of long-term commercial significance will be converted to
other uses as a result of the proposal, if any? If resource lands have not been designated,
how many acres in farmland or forest land tax status will be converted to nonfarm or
nonforest use? 1LpjpJ
• The project site has not bee used for farmlands. The site was used as forest lands being
logged in June of 2015. The entire three acre parcel is already zoned as rural residential
1:5 converting land to residential use will not have significant impact.
1) Will the proposal affect or be affected by surrounding working farm or forest land normal
business operations, such as oversize equipment access, the application of pesticides,
tilling, and harvesting? If so, how:hI elol
• No
c. Describe any structures on the site.hf LIM
. None
d. Will any structures be demolished? If so, what?hf elol
. No
e. What is the current zoning classification of the site?hf 2IPI
• Rural Residential 1:5
f. What is the current comprehensive plan designation of the site?hf elpl
. Residential
g. If applicable, what is the current shoreline master program designation of the site? jtpm
• Not within shoreline jurisdiction
h. Has any part of the site been classified as a critical area by the city or county? If so, specify.
hj �]
• No
i. Approximately how many people would reside or work in the completed project?hl 2IPI
• 3 people would live in single family residence.
j. Approximately how many people would the completed project displace?hl Q
• None
k. Proposed measures to avoid or reduce displacement impacts, if any:hj ejl j
SEPA Environmental ckeckliat (WAC 191-1"60) May 2014 Page 8 of 12
• None needed, no displacement will occur.
I. Proposed measures to ensure the proposal is compatible with existing and projected land
uses and plans, if any:hf elpl
. Project will comply with Jefferson County Code
m. Proposed measures to ensure the proposal is compatible with nearby agricultural and forest
lands of long-term commercial significance, if any:hl elpl
e None
9. Housinghf elpi
a. Approximately how many units would be provided, if any? Indicate whether high, mid-
dle, or low-income housing.hf elpl
• Would allow for one single family residence of any income to be built.
b. Approximately how many units, if any, would be eliminated? Indicate whether high,
middle, or low-income housing.hf elol
e None
c. Proposed measures to reduce or control housing impacts, if any:hj e
. None
10. Aesthetics 1he1M
a. What is the tallest height of any proposed structure(s), not including antennas; what is
the principal exterior building material(s) proposed?hj p -M
• No structures will be built with this immediate project. Approval of release will allow
residence to be built. Estimate residence height to be 14 feet being build out of concrete
fiber board.
b. What views in the immediate vicinity would be altered or obstructed?hj elp]
e None
b. Proposed measures to reduce or control aesthetic impacts, if any: fhel
. None
11. Light and Glare hel
a. What type of light or glare will the proposal produce? What time of day would it mainly
occuRhj elpj
• None
b. Could light or glare from the finished project be a safety hazard or interfere with views?hf pm
. No
c. What existing off-site sources of light or glare may affect your proposal?hj e
• None
SEPAEnvlronmeMl Ck kliat(9AC 10]-01-900) May 2014 Page 9 of 12
d. Proposed measures to reduce or control light and glare impacts, if any:hf elol
• None
12. Recreationhf elpl
a. What designated and informal recreational opportunities are in the immediate vicinity?hl @M
• None
b. Would the proposed project displace any existing recreational uses? If so, describe.hj elo]
• No
c. Proposed measures to reduce or control impacts on recreation, including recreation
opportunities to be provided by the project or applicant, if any:hf gM
• None
13. Historic and cultural preservation 1hel
a. Are there any buildings, structures, or sites, located on or near the site that are over 45 years
old listed in or eligible for listing in national, state, or local preservation registers located on or
near the site? If so, specifically describe.hf elol
• No
b. Are there any landmarks, features, or other evidence of Indian or historic use or occupation?
This may include human burials or old cemeteries. Are there any material evidence, artifacts,
or areas of cultural importance on or near the site? Please list any professional studies
conducted at the site to identify such resources.hf elpl
• No
c. Describe the methods used to assess the potential impacts to cultural and historic resources
on or near the project site. Examples include consultation with tribes and the department of
archeology and historic preservation, archaeological surveys, historic maps, GIS data, etc.
hj eM
• Dataset supplied from the Departmetn of Archeology and Histroic Preservation
d. Proposed measures to avoid, minimize, or compensate for loss, changes to, and disturbance
to resources. Please include plans for the above and any permits that may be required.hl e
• None
14. Transportation hel
a. Identify public streets and highways serving the site or affected geographic area and
describe proposed access to the existing street system. Show on site plans, if any.hf PIDI
• Dabob Road. Access will be off of a County road, Dabob Road, a road approach from the County
will be needed.
b. Is the site or affected geographic area currently served by public transit? If so, generally
describe. If not, what is the approximate distance to the nearest transit stop?hl elol
• Closest transit stop is on Center Road.
SEPA Environmental chnklist PAC 197-11.990) My 2014 Page 10 of 12
c. How many additional parking spaces would the completed project or non -project proposal
have? How many would the project or proposal eliminate?hf elol
None for release, 2 or 3 for residence.
d. Will the proposal require any new or improvements to existing roads, streets, pedestrian,
bicycle or state transportation facilities, not including driveways? If so, generally describe
(indicate whether public or private).hf elpi
No
e. Will the project or proposal use (or occur in the immediate vicinity of) water, rail, or air
transportation? If so, generally describe.hf elpl
No
f. How many vehicular trips per day would be generated by the completed project or proposal?
If known, indicate when peak volumes would occur and what percentage of the volume would
be trucks (such as commercial and nonpassenger vehicles). What data or transportation
models were used to make these estimates?hj elpl
2 trips per a day, approximately 7 am and 6 pm.
g. Will the proposal interfere with, affect or be affected by the movement of agricultural and
forest products on roads or streets in the area? If so, generally describe.hI eIDI
No
h. Proposed measures to reduce or control transportation impacts, if any:hf em
None
15. Public Services lhel
a. Would the project result in an increased need for public services (for example: fire protection,
police protection, public transit, health care, schools, other)? If so, generally describe.hf elol
e No
b. Proposed measures to reduce or control direct impacts on public services, 1 any.hf elol
No
16. Utilitieshj ell l
a. Circle utilities currently available at the site:hI elol
electricity, natural gas, water, refuse service, telephone, sanitary sewer, septic system,
other
e None
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.hI elol
Residential development will need electricity through PUD.
SEPA Environmental caeclaiat(WAC 19)11-900) MayZ14 Page 11 of 12
C. Signaturehf elpl
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. L
Signature: PI a.0 SEPA S PA C h,,, k t tI skJ t _C'Ub/'nInrr-1 �jp&e?At
Name of signee ///
Position and Agency/Organization
Date Submitted:
Thls SFPA c-hecc,, 6-A, applicR2-&Z
responses in a -Ad i-hOn tc) lead agen6 j Gam177,e/t6S,
Lead ager Jer-o Sort, (ouA6 b -e pa; tment of
(,ammur)iLc) Rcwejopment. —reue ,-c Anna.Bausher
ASS%S,L0 tt TlanRcC LI(yv p-.-�Ja��n-e�� 12/10AS
SEPA Envimmental chackliat(WAC 18]11-400) May 2016 Page 12 of 12