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HomeMy WebLinkAboutBLD2003-00520UDC CONSISTENCY REVIEW Project Planner: K RUSSELL Master#ML.A03-00474 Review Type Project Description BLD03-00520 I PLACE BRIDGE OVER STREAM IN DRIVEWAY Primary: ALAN IGLITZIN 1608 NE RAVENNA BLVD SEATTLE WA 981052534 Site Address: 7360 CENTER RD QUILCENE WA, 98376 PETER BAHLS REP 3407 EDDY ST PORT TOWNSEND WA 98368 Project Location: Parcel number 801 171006, in Section 17, Township 28, Range 01 West, WM, located at 7360 Center Rd, Quilcene, WA 98376 Parcel Number: 801171006 S-T-R: 17-28N-01W TotalAcreag( 23 Legal Description S17 T28 R1W TAX 5 SUBJ TO EASE Land Use: 1100 Flood District: Fire District: 2 Planning Area: 9A Flood Map (FIRM) Panel No: 5300690440B School 49 Zoning: COMP PLAN DESIGNATION: COMMUNITY PLAN: UGA: MPR: WATER SUPPLY UTILITY: Service Area PUD: [ ] Plot plan states "property line" [ ] Assesor'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 Shoreline De ' at' n:Y O Stream T N� Fish & Wil r . ES NO Wetlands: YES NO Rare Plants:YES NO Seismic: YES NO Landslide: YES NO Flood: YES NO _ Erosion: YES 140 Aquifer Recharge Area:YES NO SIPZ: none At Risk High Risk Coasw Stormwater site plan submitted: Yes No [ ] Forest Lands: YES NO Adjoining Forest Lands: _ Commercial/ Rural/ Inholding _ [ ] Mineral Lands: YES NO _ [ ] Stormwater: New Impervious Surface_ _Land Disturbing Activity _ ESA's Stormwater Req's: BMPs Small PESCP Large PESCP \Engineering [ ] Notice Provisions/Disclosure: Airport YES NO MRL YES NO -Forest Lands YES NO [ ] Landscaping Required: Yes No [ ] Parking Spaces Required NO 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 on ly [ ] Total Building (s) Size: RVC: 20,000 SF CC: 5,000 SF NC: 7,500 SF GC: 10,000 SF All others: su4ect to septic & water cons trairtslNone spedhed [ ] Setbacks: Front: Left Side: Right Side: Rear: Shoreline Setback: LSHA Setback: [ ] Road Classification: Road Approach: EXISTING NOT REQ'D RAP [ ] SEPA Required: YES EXEMPT f 1 Flood Certificate: \ Existing Case(s) & Condition(s): Violations: Yes No Recorded Date of Subdivision: Plat Conditions: Lots/Require Declaration of Restrictive Covenant Site Visit conducted YES NO EW <5yrs=P1 at YES NO, submitted: [ ] 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 No parcel tags found for parcel Over 5yrs=UDC 'on 'tions on plat or Old Ordinance YES NO f Associated CASES status issued finaled description BLD90-00381 BLD96-00435 SEP72-00106 SEP90-00671 MLA03-00474 BLD03-00520 F 06/04/1990 remodle F 07/17/1996 07/22/1996 portable hot water tank N 10/05/1972 FILED WITH SEP90-671 F 06/20/1991 SEP72-106 NOW FILED HERE. P PLACE BRIDGE OVER STREAM IN DRIVEWAY USR96-00030 A 09/01/1996 0474 BUILDING PERMIT APPLICATION ML y e: Revview iew Type: i pe: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00520 Received Date: 8/15/2003 SITE ADDRESS: 7360 CENTER RD QUILCENE, 98376 OWNER: ALAN IGLITZIN PHONE: (360)379-6146 1608 NE RAVENNA BLVD SEATTLE WA 981052534 SUBDIVISION: Block: Lot: PARCEL NUMBER: 801171006 Section: 17 Township: 28 N Range: 01 W CONTRACTOR: PHONE: REPRESENTATIVE: PETER BAHLS 3407 EDDY ST PORT TOWNSEND WA 98368 PROJECT DESCRIPTI011' PLACE BRIDGE OVER STREAM IN DRIVEWAY TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION 10,000.00 MAIN: CODE EDITION: 1997 ADD'L: OCCUPANCY: HEAT BASE: OCCUPANCY: UNHEATED: CONST TYPE: OTHER: CONST TYPE: GARAGE: DECK: SEWAGE DISPOSAL: PHONE: PHONE: (360)379-0135 HEAT TYPE: HEAT TYPE: # OF STORIES: SHORELINE: SETBACK: BANK HEIGHT: WATER SYSTEM. PARCEL TAGS: YES BEDROOMS: BATHROOMS: STORMWATER: YES_ Exist: Exist: Wetland Prop: Prop: Seismic Total: Total: Flood Way Routing Date: ?ho O3F&W Shoreline Forest: Commercial NO NO AREA Erosion Streams Floodplain Landslide _Aquifer Ru ral Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $181.25 MJA 08/15/03 58379 Plan Check $117.81 MJA 08/15/03 58379 State Building Code $4.50 MJA 08/15/03 58379 Total: $303.56 CASES, FINDING, CONDITIONS, PERMISSIONS FOR Parcel 801171006 Printed: August 22, 2003 Cases Name BLD90-00381 IGLITZIN Application Received: 06/04/1990 Permit Issued/Case closed: 06/04/1990 remodle No findings, conditions, or permissions found. BLD96-00435 IGLITZIN Application Received: 07/17/1996 Permit Issued/Case closed: 07/17/1996 portable hot water tanF No findings, conditions, or permissions found. SEP72-00106 IGLITZIN Application Received: 10/05/1972 Permit Issued/Case closed: FILED WITH SEP90-977— No findings, conditions, or permissions found. SEP90-00671 IGLITZIN Application Received: 06/13/1990 Permit Issued/Case closed: SEP72-106 NOW FILED_rR_F__ No findings, conditions, or permissions found. BLD03-00520 MLA03-00474 IGLITZIN Application Received: 08/15/2003 Permit Issued/Case closed: PLACE BRIDGE OV5R—STREWIN DRIVEWAY No findings, conditions, or permissions found. USR96-00030 IGLITZEN Application Received: 10/29/1996 Permit Issued/Case closed: 09/01/1996 No findings, conditions, or permissions found. Review Type Status F Case Finaled: F Case Finaled: 07/22/1996 N Case Finaled: 10/05/1972 F Case Finaled: 06/20/1991 I Case Finaled: Case Finaled: Planner P K RUSSELL A 1 of 1 Parcel Print Parcel Number: 801171006 Owner Mailing Address: ALAN IGLITZIN 1608 NE RAVENNA BLVD SEATTLE WA 981052534 Site Address: 7360 CENTER RD CHIMACUM 98325 Section: 17 School District: Chimacum (49) Qtr Section: NE1/4 Fire Dist: Quilcene (2) Township: 28N Tax Status: Taxable Range: 1W Tax Code: 221 Mapped 23.44 Planning area: South Toandos Acreage: Peninsula,Coyle Area (9) Sub Division: Land Use Code: 1100 - HOUSES (single units, non -farm) Property Description: S17 T28 R1W TAX 5 SUB] TO EASE Page 1 of 1 http://www.co.jefferson.wa.uslassessors/parcellparcelprint.asp?PARCEL_NO=8011710O6 08/21/2003 Map"Output' Page 1 of 2 http://gisserverlservleticom.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0&Form=True&Enc... 08/21 /2003 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street Port Townsend, WA 98368 Al Scalf, Director August 22, 2003 ALAN IGLITZIN 1608 NE RAVENNA BLVD SEATTLE WA 981052534 RE: CASE #: MLA03-00474 LOCATION: Parcel number 801 171 006, in Section 17, Township 28, Range 01 West, WM, located at 7360 Center Rd, Quilcene, WA 98376 Dear ALAN IGLITZIN: Jefferson County Department of Community Development staff have received the application materials for the above project proposal and have assigned your case to: Kevin Russell (360) 385-9406 E-mail: krussell@co.jefferson.wa.us Fax: (360) 379-4473 Please direct all questions to Kevin Russell and refer to MLA03-00474. If you need to speak with Kevin Russell in person, please call to schedule an appointment in order to ensure availability. Currently, planners have an average of 50 cases each. Review times vary depending on the type of application and how complete the application is upon submittal. For more information, please visit the Jefferson County Department of Community Development web page at www.co.iefferson.wa.us/commdevelopment/. Thank you. Sincerely, O- )�VA Department of Community Development Staff c: File PETER BAHLS 3407 EDDY ST PORT TOWNSEND WA98368 Building Permits/ Inspections Development Review Division Long Range Planning (360) 379-4450 FAX: (360) 379-4451 xa -� XE x -h x —1 -- -- -IC3 _ w C3- c--j r+- x a) c3 a) o — -C3 -3 -s CL CD m c3 CD -- CD cC CD CD r-t- o CD E -5 •- o = r\:) CD C-3 ry -s C o 0 cn -, o cn o ry H Op o G7 0 o lO 0 0 E U3 o cm C ) i--F- �, r+ C cn —I cn m u r C Z7 — CD w co H C" aC --j CD cm --A r CD rV cn —I C--) x H —I r17 CZ z C=) Cx) f� rn av m 3> 3:> rn m z rrn o • c.0 r� ry 0 c3 r m C Z3 Q C� C) C CZ co CD CD 0 o ----I -� � 1 Z7 -D � G rn C D C-D CY x} cry c I CQ Cm Q r-F- cn o H C C-D z CA r-h CZ 730 m -3 C7 CD r 4- — ca- cn rn m w — CD -� o -�-. cn - • - - c-D © o 0 H OD Q H C-D '1 -n z ca- r1] -n A--) Q C o H o �7 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT UNIFIED DEVELOPMENT CODE TYPE I LAND USE PERMIT APPLICANT: ALAN IGLITZIN 1608 NE RAVENNA BLVD SEATTLE WA 981052534 DATE ISSUED: DATE EXPIRES: MLA NUMBER: MLA03-00474 PROJECT PLANNER: K RUSSELL PROJECT DESCRIPTION: PLACE BRIDGE OVER STREAM IN DRIVEWAY PROJECT LOCATION: Parcel number 801 171 006, in Section 17, Township 28, Range 01 West, WM, located at 7360 Center Rd, Quilcene, WA 98376 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 application was reviewed by the Jefferson County Department of Community Development staff on 9/03/03 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 and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: Type III Stream and Stormwater. 3.) The applicant is proposing to replace an existing culvert with a proposed bridge. Sections 6.6 and 6.7 of the Jefferson County Unified Development Code requires that your proposal a Small Project Stormwater provisions. 4.) The Washington Department of Fish and Wildlife issued Hydraulic Project Approval (HPA) for this activity on August 14, 2003 under Log Number ST-F7182-01. The HPA expires on October 31, 2004. 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). 6.) The site plan as submitted with the building application on August 15, 2003 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 9/03/03 shall be resubmittec for review and approval by Jefferson County Department of Community Development. 7.) This approval is for a culvert removal and bridge construction 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. 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.) Prior to commencing development activity, proponent is responsible for informing the Washington Department of Fish and Wildlife (WDFW) in order for WDFW to determine whether this action is subject to the Washington State Hydraulic Code (Chapter 220-10 WAC). Hydraulic Project Approval (HPA) is required for all hydraulic projects, which are defined as construction or performance of other work that will use, divert, obstruct, or change the natural flow or bed of any of the salt or fresh waters of the state. 3.) 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 through Hydraulic Project Approval. 4.) 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. 1 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. 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. Development pursuant to this permit shall be undertaken subject to the applicable development and performance standards of 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. All areas in Jefferson County are included as "critical habitat' for a 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: - Set back buildings, utilities and roads as far as possible from surface waters (streams, rivers, lakes, marine waters), or at least 150 feet from the edge of the water - 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 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 at (206)526-6613, or the U.S. Fish and Wildlife Service at (503) 231-6121. APPEALS: Pursuant to RCW 36.70C, the applicant or any aggrieved party may appeal this final decision to Jefferson County Superior Court within twenty-one (21) calendar days of the date of issuance of this land use decision. For more information p6—lated to judical appeals see UDC Section 8.5.2. UDC Administrator LICENSE DETAIL INFORMATION Form Page 1 of I STATE OF WASHINGTON DEPARTMENT OF LABOR AND INDUSTRIES Specialty Compliance Services Division P. O. Box 44000 Olympia, WA 98504-4000 THE RESULT OF YOUR INQUIRY FOR LICENSE NUMBER SELECTED IS: LICENSE DETAIL INFORMATION Current Filter: None Registration# or License PILCHE*044RQ Name PILCHUCK EXCAVATING Address 2111 S LK ROESIGER Address City SNOHOMISH State WA Zip 98290 Phone Number 3605689466 Effective Date 12/18/1996 Expiration Date 12/27/2003 Registration Status ACTIVE Type CONSTRUCTION CONTRACTOR Entity INDIVIDUAL Specialty Code GENERAL Other Specialties UNUSED UBI Number 601757339 * * *VIEW CROSS REFERENCE FILE FOR THIS LICENSE* * * * * *VIEW PRINCIPAL OWNER(S) FOR THIS LICENSE* * * * * *VIEW CONTRACTOR BOND/SAVINGS INFORMATION * * * * * *CHECK INQUIRY FOR SUMMONS AND COMPLAINTS* * * * * * VIEW CONTRACTOR INSURANCE INFORMATION * * * New inquiry by CITY, NAME, PRINCIPAL OWNER NAME, LICENSE, UBI NUMBER, check the L&I Contractor Industrial Insurance Premium Status or return to the L&I Construction Compliance Home Page https:Hwws2.wa.gov/lni/bbip/TF2Form.asp?License=PILCHE*044RQ 09/03/2003 BOND/SAVINGS INFORMATION Page 1 of I BOND/SAVINGS INFORMATION FOR LICENSE SELECTED When information is presented in both BOND and SAVINGS, to determine which information is most currrent, ompare EFFECTIVE DATE at BOND information with EFFECTIVE DATE at SAVINGS information. Most recent EFFECTIVE DATE is the most current information pertaining to BOND or SAVINGS listed for the License selected for inquiry. BOND INFORMATION: BOND BOND EFFECTIVE EXPIRATION CANCELLATION IMPAIRED LICENSE COMPANY 11 NUMBER DATE DATE DATE DATE MOUNT OLD PILCHE*044RQ REPUBLIC YLI232922 12/18/2001 UNTIL CANCELLED SURETY CO OLD PILCHE*044RQ REPUBLIC YLI232922 12/18/1997 UNTIL CANCELLED SURETY CO ASSIGNMENT OF SA VINGS ACCOUNT INFORMATION: 12000 6000 LICENSE BANK NAME k CCOUNT ID EFFECTIVE DATE I RELEASE DATE IMPAIRED FLAG IMPAIRED DATE AMOUNT THERE ARE NO RECORDS THAT MATCH YOUR SELECTION INQUIRY. https://wws2.wa.gov/lni/bbip/ACTP4.asp?License=PILCHE*044RQ 09/03/2003 HYDRAULIC PROJECT APPROVAL State of Washington D o/ RCW 77.55.100 - appeal pursuant to Chapter 34.05 RCW Department of Fish and Wildlife Region 6 Office Fj�aad 48 Devonshire Road KDLX RECEIVED Montesano, Washington 98563-9618 DATE OF ISSUE: August 14, 2003 AUG 2 2 2003 LOG NUMBER: ST-177182-01 PERMITTEE Northwest Watershed Institute ATTENTION: Peter Bahls 3407 Eddy Street Port Townsend, WA 98368 (360) 379-0135 Fax: (360) 379-0648 AUTHORIZED AGENT OR CONTRACTOR Not Applicable PROJECT DESCRIPTION: Replacement of existing undersized culverts with new 3-foot diameter culverts and stream channel restoration to improve fish passage and stream function. DATABASE PROJECT DESCRIPTION: Water Crossing Structure, Culvert, Trash Rack No, <50-feet, Replace, Permanent, Fixed, Freshwater, On Bed, Manmade, Steel. Water Crossing Structure, Culvert, Trash Rack No, <50-feet, New, Permanent, Fixed, Freshwater, On Bed, Manmade, Steel. Habitat, Refuge Areas, Pool, in channel, New, Permanent, Moveable, Freshwater, On Bed, Natural, Earth, Gravel PROJECT LOCATION: 7670 Center Road, Quilcene, WA. (Lat. N 47.91640, Long. W 122.82593). # WRIA WATER BODY TRIBUTARY TO 1/4 SEC. SEC. TOWNSHIP RANGE COUNTY 1 17.0129 Unnamed Stream Tarboo Creek SE 17 28 North 01 West Jefferson NOTE: This Hydraulic Project Approval pertains only to the provisions of the Washington State Fisheries and Wildlife Codes. It is the permittee's responsibility to apply for and obtain any additional authorization from other public agencies (local, state and/or federal) that maybe necessary for this project. PROVISIONS 1. TIMING LIMITATIONS: The project may begin Immediately and shall be completed by October 31, 2004, provided: a. Work below the ordinary high water line shall only occur between July 15" and October 31" of calendar years 2003 and 2004. 2. NOTIFICATION REQUIREMENT: The permittee or contractor shall notify WDFW Enforcement Officer Henry (126) by mail at the above address or by FAX at (360) 902-2155 at least three working days prior to the start of construction activities. Notification shall include the permittee's name, project location, starting date for work, and the control number for this Hydraulic Project Approval. 3. NOTIFICATION REQUIREMENT: The Area Habitat Biologist listed below shall be contacted at least 3 working days prior to start of work, and again within seven days of completion of work to arrange for compliance inspection. Page 1 of 5 HYDRAULIC PROJECT APPROVAL state of Washington moo/ RCW 77.55.100 - appeal pursuant to Chapter 34.05 RCW Department of Fish and Wildlife Flsgaad Region 6 Office 48 Devonshire Road MIX Montesano, Washington 98563-9618 DATE OF ISSUE: August 14, 2003 LOG NUMBER: ST-F7182-01 4. Work shall be accomplished per plans and specifications entitled, Tarboo Watershed Early Action Fish Passage Project - Sjolund Culvert Replacement, dated August 7, 2003, and submitted to the Washington Department of Fish and Wildlife, except as modified by this Hydraulic Project Approval. These plans reflect design criteria per Chapter 220-110 WAC. These plans reflect mitigation procedures to significantly reduce or eliminate impacts to fish resources. A copy of these plans shall be available on site during construction. Permanent Culvert Installation Provisions: 5. The culvert shall be installed and maintained to ensure unimpeded fish passage. 6. The culvert shall be placed on a flat gradient with the bottom of the culvert placed below the level of the streambed a minimum of 20 percent of the culvert diameter for a round culvert The 20 percent placement below the streambed shall be measured at the culvert outlet. 7. The culvert width at the streambed shall be equal to or greater than the average width of the streambed. 8. The culverts shall be installed to maintain structural integrity to the 100-year peak flow with consideration of the debris likely to be encountered. 9. Fill associated with the culvert installation shall be protected from erosion to the 100-year peak flow. 10. The culverts shall be installed and maintained to avoid inlet scouring and to prevent erosion of stream banks downstream of the project. 11. The culverts shall be installed in the dry or in isolation from the stream flow by the installation of a bypass flume or culvert, or by pumping the stream flow around the work area. 12. The culverts shall not exceed 20 feet in total length. 13. The culverts shall consist of a single barrel. 14. Disturbance of the streambed and banks shall be limited to that necessary to place the culvert and any required channel modification associated with it. Affected streambed and bank areas outside the culvert and associated fill shall be restored to preproject configuration following installation of the culvert. Within one year of project completion, the banks shall be revegetated with native or other approved woody species. Vegetative cuttings shall be planted at a maximum interval of three feet (on center) and maintained as necessary for three years to ensure 80 percent survival. 15. Approach material shall be structurally stable and be composed of material that, if eroded into the stream, shall not be detrimental to fish life. Culvert Removal Provision: Page 2 of 5 laiiikll HYDRAULIC PROJECT APPROVAL State of Washington Do a/ RCW 77.55.100 - appeal pursuant to Chapter 34.05 RCW Department of Fish and Wildlife Region 6 Office F%SHOW 48 Devonshire Road VDIN Montesano, Washington 98563-9618 DATE OF ISSUE: August 14, 2003 LOG NUMBER: ST-177182-01 16. The existing culverts shall be removed in the dry or isolated from the stream by a temporary bypass. Equipment Provisions: 17. Equipment used for this project shall operate stationed on existing driveways. 18. Equipment used for this project may operate below the ordinary high water line, provided the drive mechanisms (wheels, tracks, tires, etc.) shall not enter or operate below the ordinary high water line. 19. Equipment used for this project shall be free of external petroleum -based products while working around the stream. Equipment shall be checked daily for leaks and any necessary repairs shall be completed prior to commencing work activities along the stream. Water Quality Provisions: 20. If at any time, as a result of project activities, fish are observed in distress, a fish kill occurs, or water quality problems develop (including equipment leaks or spills), operations shall cease and the Washington Department of Fish and Wildlife at (360) 895-3965 and Washington Department of Ecology at (425) 649-7229 shall be contacted immediately. Work shall not resume until further approval is given by the Washington Department of Fish and Wildlife. 21. Erosion control methods shall be used to prevent silt -laden water from entering the stream. These may include, but are not limited to, straw bales, filter fabric, temporary sediment ponds, check dams of pea gravel -filled burlap bags or other material, and/or immediate mulching of exposed areas. 22. All waste material such as construction debris, silt, excess dirt or overburden resulting from this project shall be deposited above the limits of flood water in an approved upland disposal site. 23. If high flow conditions that may cause siltation are encountered during this project, work shall stop until the flow subsides. 24. Extreme care shall be taken to ensure that no petroleum products, hydraulic fluid, fresh cement, sediments, sediment - laden water, chemicals, or any other toxic or deleterious materials are allowed to enter or leach into the stream. SEPA: Exempt, no other non-exempt permits APPLICATION ACCEPTED: August 14, 2003 ENFORCEMENT OFFICER: Henry(126) [P 1 ] Jeff Davis (360) 895-3965 ��� for Director Area Habitat Biologist WDFW cc: Richard and Sue Sjolund, P.O. Box 1244, Hadlock, WA 98339 Ted Labbe, Port Gamble S'Klallam Tribe Kevin Russell, Jefferson County Dept. Of Community Development Page 3 of 5 HYDRAULIC PROJECT APPROVAL State of Washington bep moo/ RCW 77.55.100 - appeal pursuant to Chapter 34.05 RCW Department of Fish and Wildlife Region 6 Office FJSHOW 48 Devonshire Road WOLN Montesano, Washington 98563-9618 DATE OF ISSUE: August 14, 2003 LOG NUMBER: ST-F7182-01 GENERAL PROVISIONS This Hydraulic Project Approval (HPA) pertains only to the provisions of the Fisheries Code (RCW 77.55 - formerly RCW 75.20). Additional authorization from other public agencies may be necessary for this project. This HPA shall be available on the job site at all times and all its provisions followed by the permittee and operator(s) performing the work. This HPA does not authorize trespass. The person(s) to whom this HPA is issued may be held liable for any loss or damage to fish life or fish habitat which results from failure to comply with the provisions of this HPA. Failure to comply with the provisions of this Hydraulic Project Approval could result in a civil penalty of up to one hundred dollars per day or a gross misdemeanor charge, possibly punishable by fine and/or imprisonment. All HPAs issued pursuant to RCW 77.55.100 or 77.55.200 are subject to additional restrictions, conditions or revocation if the Department of Fish and Wildlife determines that new biological or physical information indicates the need for such action. The permittee has the right pursuant to Chapter 34.04 RCW to appeal such decisions. All HPAs issued pursuant to RCW 77.55.110 may be modified by the Department of Fish and Wildlife due to changed conditions after consultation with the permittee: PROVIDED HOWEVER, that such modifications shall be subject to appeal to the Hydraulic Appeals Board established in RCW 77.55.170. APPEALS - GENERAL INFORMATION IF YOU WISH TO APPEAL A DENIAL OF OR CONDITIONS PROVIDED IN A HYDRAULIC PROJECT APPROVAL, THERE ARE INFORMAL AND FORMAL APPEAL PROCESSES AVAILABLE. A. INFORMAL APPEALS (WAC 220-110-340) OF DEPARTMENT ACTIONS TAKEN PURSUANT TO RCW 77.55.100, 77.55.110, 77.55.140, 77.55.190, 77.55.200, and 77.55.290: A person who is aggrieved or adversely affected by the following Department actions may request an informal review of: (A) The denial or issuance of a HPA, or the conditions or provisions made part of a HPA; or (B) An order imposing civil penalties. It is recommended that an aggrieved party contact the Area Habitat Biologist and discuss the concerns. Most problems are resolved at this level, but if not, you may elevate your concerns to his/her supervisor. A request for an INFORMAL REVIEW shall be in WRITING to the Department of Fish and Wildlife, 600 Capitol Way North, Olympia, Washington 98501-1091 and shall be RECEIVED by the Department within 30-days of the denial or issuance of a HPA or receipt of an order imposing civil penalties. The 30-day time requirement may be stayed by the Department if negotiations are occurring between the aggrieved party and the Area Habitat Biologist and/or his/her supervisor. The Habitat Protection Services Division Manager or his/her designee shall conduct a review and recommend a decision to the Director or its designee. If you are not satisfied with the results of this informal appeal, a formal appeal may be filed. Page 4 of 5 f HYDRAULIC PROJECT APPROVAL State of Washington a/ RCW 77.55.100 - appeal pursuant to Chapter 34.05 RCW Department of Fish and Wildlife Region 6 Office FISH and 48 Devonshire Road WIN Montesano, Washington 98563-9618 DATE OF ISSUE: August 14, 2003 LOG NUMBER: ST-F7182-01 B. FORMAL APPEALS (WAC 220-110-350) OF DEPARTMENT ACTIONS TAKEN PURSUANT TO RCW 77.55.100 OR 77.55.140: A person who is aggrieved or adversely affected by the following Department actions may request an formal review of: (A) The denial or issuance of a HPA, or the conditions or provisions made part of a HPA; (B) An order imposing civil penalties; or (C) Any other "agency action" for which an adjudicative proceeding is required under the Administrative Procedure Act, Chapter 34.05 RCW. A request for a FORMAL APPEAL shall be in WRITING to the Department of Fish and Wildlife, 600 Capitol Way North, Olympia, Washington 98501-1091, shall be plainly labeled as "REQUEST FOR FORMAL APPEAL" and shall be RECEIVED DURING OFFICE HOURS by the Department within 30-days of the Department action that is being challenged. The time period for requesting a formal appeal is suspended during consideration of a timely informal appeal. If there has been an informal appeal, the deadline for requesting a formal appeal shall be within 30- days of the date of the Department's written decision in response to the informal appeal. C. FORMAL APPEALS OF DEPARTMENT ACTIONS TAKEN PURSUANT TO RCW 77.55.110, 77.55.200, 77.55.230, or 77.55.290: A person who is aggrieved or adversely affected by the denial or issuance of a HPA, or the conditions or provisions made part of a HPA may request a formal appeal. The request for FORMAL APPEAL shall be in WRITING to the Hydraulic Appeals Board per WAC 259-04 at Environmental Hearings Office, 4224 Sixth Avenue SE, Building Two - Rowe Six, Lacey, Washington 98504; telephone 360/459-6327. D. FORMAL APPEALS OF DEPARTMENT ACTIONS TAKEN PURSUANT TO CHAPTER 393, LAWS OF 2003: A person who is aggrieved or adversely affected by the denial or issuance of a HPA, or the conditions or provisions made part of a HPA may request a formal appeal. The FORMAL APPEAL shall be in accordance with the provisions of Chapter 393. The request for FORMAL APPEAL shall be in WRITING to the Environmental and Land Use Hearings Board. E. FAILURE TO APPEAL WITHIN THE REQUIRED TIME PERIODS RESULTS IN FORFEITURE OF ALL APPEAL RIGHTS. IF THERE IS NO TIMELY REQUEST FOR AN APPEAL, THE DEPARTMENT ACTION SHALL BE FINAL AND UNAPPEALABLE. Page 5 of 5 oN oo� JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street Port Townsend, WA 98368 Al Scalf, Director MEMORANDUM TO: Interested Parties FROM: Al Scalf, UDC Administrator RE: SEPA Determinations for MLA03-00473/474 DATE: 9/02/03 Two (2) proposals have been submitted by the Northwest Watershed Institute to replace existing culverts with new bridges to allow fish passage enhancement.. The proposals will be funded by the United States Department of Interior/ Fish and Wildlife Service. Engineering has been submitted for two of the bridges and building permits are required by Jefferson County. The Administrator has reviewed the proposals finds them exempt from the State Environmental Policy Act (SEPA) review pursuant to WAC 197-11- 800(3). /�3 Al calf, UDC AdAaniAtratorl Building Permits/ Inspections (360) 379-4450 Development Review Division Long Range Planning FAX: (360) 379-4451 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 800/831-2678 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment Master Land Use Permit Application Form PROPERTY INFORMATION Tax Parcel Number: ®� 1❑ 0 [fl FQ1 0❑ Subdivision Name: na Lot Number: na Property Size: 54 (acres/square feet) Existing Use of Property: reSid, music festival Site Address and/or Directions to Property: North Side of Centu Road, S. of Hwy 104 1 /2 mile APPLICANTS, OWNER INFORMATION Applicant (if applicable): Northwest Watershed Institute Telephone: 3407 Eddy St Address: 3407 Eddy St City: Port Towns State: WA Zip Code: 98368 Email Address 7 %�hG✓wS �' Applicant's Signature: Property Owner(s) of Record: Alan IglitZen Telephone: 360-379-6146 Address: 100 Keesling Rd City: Quilcene State: WA Zip Code: 98376 Email Address I acknowledge that the applicant above is applying for a building permit on my property. Owner's Signature: I hereby si Hate P ahls,NWl to act as my agent in matters relating to this application for permit(s). 8-15-03 ( OPERTY OWNER SIGN T (DATE) :: 5="IPTION OF PnOPOSED US, OR ACTN!TY (Inc!uda sCparate sheets as necessary) Replacement of private driveway culvert crossing of Tarboo Creek with a wood bridge. Please see JARPA application for Olympic Music Festival Bridge project for engineered design and specifications. [THIS SECTION FOR OFFICE USE ONLY] Refer to the specific sections of the UDC referenced below for more information and further requirements. An asterisk (*) indicates that a supplemental application or questionnaire may be required. Type I Permits Refer to: ❑ Septic Permit/Evaluation of Existing System (EES) UDC Section 6.4.1 and Chapter 8.15 JCC ❑ Building/Demolition Permit UDC Section 3.2.1 and Table 3-1 ❑ Allowed "Yes" Use Consistency Analysis UDC Section 3.2.1 and Table 3-1 ❑ Home Business Table 3-1 and UDC Section 4.20 ❑ Stormwater Management * UDC Section 6.7 ❑ Road Access* UDC Section 6.8 ❑ Boundary Line Adjustment* UDC Section 7.2 ❑ Minor PRRD Amendments UDC Section 3.6.13.15 ❑ Sign Permit* UDC Section 6.15 ❑ Site Plan Approval Advance Determination (SPAAD) UDC Section 8.7 ❑ Shoreline Master Program Exemption/Permit Revisions UDC Section 5 ❑ Temporary Use (based on use may be Type II or Type III)* UDC Sections 4.38 and 4.39 (OVER) MASTER LAND USE PERMIT. DOC REV. 02/25/2002 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 15 2, 3 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 800/831-2678 • 360/379-4451 Fax ��FC] iv ,� , � � , ,��;•+,,, www.co.jefferson.wa.us/commdevelopment Master Land Use Permit Application Checklist This packet contains materials to help you make application for permits and approvals under the Unified Development Code. The list below details those documents that constitute a complete application. Yes No N/A ® ❑ M Pre -Application Conference held. If the project application is made for a Type II or Type III permit or a Type I application proposing impervious surfaces of ten thousand (10,000) square feet or more and/or non -single family structures of five thousand (5,000) square feet or more a conference. is required. Otherwise, this does not apply. ® ❑ A completed Master Land Use Permit Application Form (attached) This application must be signed by the property owner(s) and the agent, if an authorized agent is designated. ❑ The applicable fee, as set forth in the Jefferson County Fee Ordinance (see attached). ® n A Site Plan. All site plans shall be drawn with a straight edge and features shall be to scale. For Residential Applications - A site plan printed on 11"x17" (or smaller) paper with a graphic scale of 1"=50' for parcels over one acre in area and 1"=25' for parcels under one acre showing the following. ❑ North arrow ❑ Title block with the project name and address, drawing title, tax parcel number, and the name/address/phone of the person preparing the drawing. ❑ All property boundaries, total parcel acreage or square footage dimensions, and the land use on adjoining parcels ❑ Building footprint and square footage for all proposed and existing structures [for Site Plan Approval Advance Determination (SPAAD) applications show buildable area rather building footprint] ❑ Environmentally sensitive areas such as ravines, seasonal creeks, bodies of water, wetlands, steep slopes, etc. ❑ On -site septic system location or sewer lines (existing or proposed) ❑ Well location or water lines ❑ Impervious surfaces such as driveways or patios ❑ Setback distances from property boundaries to structures, distance between structures, and distance from structures to environmentally sensitive areas such as wetlands, shorelines, steep banks, etc. ❑ Location of any easements and encumbrances such as utility or access easements ❑ Method and location of stormwater disposal facilitates such as drainage swales, tightlines, dry wells, curtain drains, etc. ❑ For applications on marine or river shorelines show ordinary high water mark, top of banks and height of banks For Commercial Industrial Multifamily and Small-scale Recreational and Tourist Uses as listed in Table 3-1 - A site plan prepared by a licensed civil engineer, architect, or landscape architect containing the following information in addition to the general information required above (in these instances, site plans may be printed on larger paper). ❑ All existing and proposed development or use areas. ❑ Existing structures and significant features on the subject property and on adjacent properties. ❑ Property lines, adjoining streets, and immediately adjoining properties and their ownership. ❑ The layout of an internal vehicular and pedestrian circulation system, including location and dimensions of existing and proposed improvements on public rights -of -way such as roads, sidewalks, and curbs. ❑ Corner grades and existing contours of topography at five-foot contour intervals. ❑ Existing and proposed grades and volume and disposition of excavated material, if applicable ❑ Natural drainage direction and storm drainage facilities and improvements. ❑ Locations of all existing and proposed utility connections ❑ Parking spaces and driveways. ❑ Proposed landscaping. ® ❑❑ W A State Environmental Policy Act (SEPA) checklist (unless project is SEPA exempt) © Evidence of available and adequate water supply, if applicable, as required by the Jefferson County Department of Health and the Coordinated Water System Plan. ® Evidence of sewer availability, septic approval, or septic suitability, if applicable, as required by the Jefferson County Department of Health for wastewater disposal. © Supplemental application sheets, if applicable. MASTER LAND USE PERMIT. DOC REV. 02/25/2002 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 800/831-2678 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment Master Land Use Permit Application Form JEFFERVOCN CCu'I i Y i PROPERTY INFORMATION Tax Parcel Number: ® 0❑ 1❑ 7❑ 0 0❑ 0❑ Subdivision Name: na Lot Number: na Property Size: 54 (acres/square feet) Existing Use of Property: resid, music festival Site Address and/or Directions to Property: North side of Center Road, S. of Hwy 104 1/2 mile APPLICANT & OWNER (INFORMATION Applicant (if applicable): Northwest Watershed Institute Telephone: 3407 Eddy St Address: 3407 Eddy St City: Port Towns State: WA Zip Code: 98368 Email Address !i %,h�✓�✓S�4P Applicant's Signature: Property Owner(s) of Record: Alan Iglitzen Telephone: 360-379-6146 Address: 100 Keesling Rd City: QUllcene State: WA Zip Code: 98376 Email Address I acknowledge that the applicant above is applying for a building permit on my property. Owner's Signature: I hereby designate Peter Bahls,NWI to act as my agent in matters relating to this application for permit(s). 8-15-03 (PROPERTY OWNER SIGNATURE) (DATE) DESCRIPTION OF PROPOSED USE OR ACTIVITY (Include separate sheets as necessary) Replacement of private driveway culvert crossing of Tarboo Creek with a wood bridge. Please see JARPA application for Olympic Music Festival Bridge project for engineered design and specifications. [THIS SECTION FOR OFFICE USE ONLY] Refer to the specific sections of the UDC referenced below for more information and further requirements. An asterisk (*) indicates that a supplemental application or questionnaire may be required. Type I Permits Septic Perm it/Eva Iuation of Existing System (EES) Building/Demolition Permit Allowed "Yes" Use Consistency Analysis ❑ Home Business ❑ Stormwater Management ❑ Road Access* ❑ Boundary Line Adjustment* ❑ Minor PRRD Amendments ❑ Sign Permit* ❑ Site Plan Approval Advance Determination (SPAAD) ❑ Shoreline Master Program Exemption/Permit Revisions ❑ Temporary Use (based on use may be Type II or Type I Refer to: UDC Section 6.4.1 and Chapter 8.15 JCC UDC Section 3.2.1 and Table 3-1 UDC Section 3.2.1 and Table 3-1 Table 3-1 and UDC Section 4.20 UDC Section 6.7 UDC Section 6.8 UDC Section 7.2 UDC Section 3.6.13.15 UDC Section 6.15 UDC Section 8.7 UDC Section 5 UDC Sections 4.38 and 4.39 MASTER LAND USE PERMIT. DOC REV. 02/25/2002 Type II Permits ❑ Discretionary "D" or Unnamed Use Classification ❑ Cottage Industry ❑ Short Plat, Preliminary and Final* ❑ Binding Site Plan* ❑ Conditional (Administrative) "C(a)" Use ❑ Conditional (Discretionary) "C(d)" Use ❑ Variance, Minor* ❑ Wireless Telecommunication ❑ Shoreline Substantial Development (Primary Use) ❑ Forest Practices Act/Release of Six -Year Moratorium for Single - Family Residence ❑ Appeal Type III Permits ❑ Conditional "C" Use ❑ Long Plat, Preliminary* ❑ Planned Rural Residential Development Preliminary Approval (PRRD) and Major Amendments* ❑ Plat Vacation/Alteration ❑ Variance, Major* ❑ Reasonable Economic Use Variance* ❑ Wireless Telecommunication ❑ Shoreline Management Substantial Development, Secondary Use* ❑ Shoreline Management Conditional Use* ❑ Shoreline Management Variance* ❑ Appeal Type IV Permits ❑ Long Plat, Final ❑ PRRD, Final Type V Permits ❑ Special Use (Essential Public Facilities) ❑ Jefferson County Comprehensive Plan/UDC/Land Use District Map Amendment* ❑ Jefferson County Shoreline Master Program Amendment* ❑ Appeal of SEPA Refer to: UDC Sections 3.2.1, 3.2.2 and Table 3-1 UDC Section 7.3 and Table 3-1 UDC Section 7.3 UDC Section 7.5 UDC Table 3-1 and Section 8.8 UDC Table 3-1 and Section 8.8 (Discretionary Permit Review Process Determined by Administrator) UDC Section 8.9 Ordinance 06-0712-99 (UDC Appendix C) UDC Section 5 UDC Section 4.16.5(c) UDC Section 8.4.2 SEPA 8.10.12(b) UDC Section 8.8 UDC Section 7.4 UDC Section 3.6.13 (must be in conjunction with an underlying land division application) UDC Section 7.1.3(d) UDC Section 8.9 UDC Section 3.6.4(h) Ordinance 06-0712-99 UDC Appendix C UDC Section 5 UDC Section 5 UDC Section 5 UDC Section 8.4.3 SEPA 8.10.12 (c) UDC Section 7.4 UDC Section 3.6.13 UDC Section 3.3.5 UDC Section 9 UDC Section 5 JEFFEG iu Vi I UDC Section 8.10.12(d) Other Local, State or Federal Permits ❑ Please identify any other local, state or federal permits required for this proposal, if known: ACKNOWLEDGEMENTS [PLEASE NOTE THAT TWO SIGNATURES ARE REQUIRED] By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all liabilities, judgments, court costs, reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further 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. This right of entry shall expire when the County (through the Administrator or the Administrator's resentatives) concludes the application has complied with all applicable laws and regulations. Access and right of entry to the applicant' pr per shall eques d and shall occur only during regular business hours. (PROPERTY ANNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential "take" of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act' or "ESA." Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual, group or agency can file a lawsuit on behalf of an endangered species regarding your action(s) even if you are in compliance with the Jefferson County development code The Applicant acknowledges that he, she or it holds individual and non -transferable responsibility for adhering to and complying with the ESA. The App4f$nt has re ,pd)this di§laimer and signs and dates it below. (PROPERTY&NER OR AUTHORIZED REPRESENTATIVE SIGNATURE) i- 3' (DATE) MASTER LAND USE PERMIT. DOC REV. 02/25/2002 AGENCY USE ONLY Agency Reference #: Date Received: Circulated by: (local govt. or agency) JOINT AQUATIC RESOURCES PERMIT APPLICATION FORM kJARPA - - (for use in Washington State) aPLEASE TYPE OR PRINT IN BLACK INK TARBOO WATERSHED EARLY ACTION FISH PASSAGE PROJECT'y OLYMPIC MUSIC FESTIVAL BRIDGE 1 Z H l" ...:.._.... '-I r�.-.t"ITYDCn ❑ Application for a Fish Habitat Enhancement Project per requirements of RCW 77.55.290. Ydb host -submit a copy of this completed JARPA application form and the (Fish Habitat Enhancement JARPA Addition) to your local Government Planning Department and Washington Department of Fish & Wildlife Area Habitat Biologist on the same day. NOTE: LOCAL GOVERNMENTS — You must submit any comments on these projects to WDFW within 15 working days. Based on the instructions provided, I am sending copies of this application to the following: (check all that apply) ❑ Local Government for shoreline: ❑ Substantial Development ❑ Conditional Use ❑ Variance ❑ Exemption ❑ Revision ❑ Floodplain Management ❑ Critical Areas Ordinance ® Washington Department of Fish and Wildlife for HPA (Submit 3 copies to WDFW Region) ❑ Washington Department of Ecology for 401 Water Quality Certification (to Regional Office -Federal Permit Unit) ❑ Washington Department of Natural Resources for Aquatic Resources Use Authorization Notification ❑ Corps of Engineers for: ❑ Section 404 ❑ Section 10 permit ❑ Coast Guard for General Bridge Act Permit ❑ For Department of Transportation projects only: This project will be designed to meet conditions of the most current Ecology/Department of Transportation Water Quality Implementing Agreement SECTION A - Use for all permits covered by this application. Be sure to ALSO complete Section C (Signature Block) for all permit applications. 1. APPLICANT Northwest Watershed -Institute MAILING ADDRESS 3407 Eddy Street, Port Townsend, WA 98368 WORK PHONE E-MAIL ADDRESS HOME PHONE FAX # 360-379-0135 peter@nwwatershed.org 360-379-0648 if an agent is acting for the applicant during the permit process, complete #2. Be sure agent signs Section C (Signature Block) for all permit applications 2- AUTHORIZED AGENT MAILING ADDRESS WORK PHONE E-MAIL ADDRESS HOME PHONE FAX # 3. RELATIONSHIP OF APPLICANT TO PROPERTY: ❑ OWNER ❑ PURCHASER ❑ LESSEE ® OTHER: applicant is non-profit org. doing salmon restoration project for landowner 4. NAME, ADDRESS, AND PHONE NUMBER OF PROPERTY OWNER(S), IF OTHER THAN APPLICANT: Alan Iglitzen, 1608 Ravenna Blvd, Seattle, WA 98105 206-527-6622 or 360-379-6146 (Chris, manager) 5. LOCATION (STREET ADDRESS, INCLUDING CITY, COUNTY AND ZIP CODE, WHERE PROPOSED ACTIVITY EXISTS OR WILL OCCUR) 100 Keesling Road, Quilcene, WA 98376 LOCAL GOVERNMENT WITH JURISDICTION (CITY OR COUNTY) Jefferson County WATERBODY YOU ARE WORKING IN TRIBUTARY OF WRIA # Unnamed tributaries Tarboo Creek 17. 0129 (mainstem Tarboo) IS THIS WATERBODY ON THE 303(d) LIST? YES ❑ NO IF YES, WHAT PARAMETERS)?_Stream temperature on mainstem and East Fork http://www.ecv.wa.goy/programs/Wg/links/impaired wtrs.html WEBSITE FOR 303d LIST '/. SECTION SECTION TOWNSHIP RANGE GOVERNMENT LOT SHORELINE DESIGNATION NW1/4 16 28N 1W na na ITUDE: ZONING DESIGNATION E31L22.2455 u al residential DNR STREAM TYPE, IF KNOWN Type 3 JARPA, Revised 7/02 Contact the State of Washington Office of Regulatory Assistance for latest version, 360/407-7037 or 800/917-0043 1 6. DESCRIBE THE CURRENT USE OF THE PROPERTY, AND STRUCTURES EXISTING ON THE PROPERTY. HAVE YOU COMPLETED ANY PORTION OF THE PROPOSED ACTIVITY ON THIS PROPERTY? ❑ YES ® NO FOR ANY PORTION OF THE PROPOSED ACTIVITY ALREADY COMPLETED ON THIS PROPERTY, INDICATE MONTH AND YEAR OF COMPLETION. The property is grounds of the Olympic Music Festival with historic farm, fields and forest IS THE PROPERTY AGRICULTURAL LAND? ® YES ❑ NO ARE YOU A USDA PROGRAM PARTICIPANT? ❑ YES ® NO 7a. DESCRIBE THE PROPOSED WORK THAT NEEDS AQUATIC PERMITS: COMPLETE PLANS AND SPECIFICATIONS SHOULD BE PROVIDED FOR ALL WORK WATERWARD OF THE ORDINARY HIGH WATER MARK OR LINE, INCLUDING TYPES OF EQUIPMENT TO BE USED. IF APPLYING FOR A SHORELINE PERMIT, DESCRIBE ALL WORK WITHIN AND BEYOND 200 FEET OF THE ORDINARY HIGH WATER MARK. IF YOU HAVE PROVIDED ATTACHED MATERIALS TO DESCRIBE YOUR PROJECT, YOU STILL MUST SUMMARIZE THE PROPOSED WORK HERE. ATTACH A SEPARATE SHEET IF ADDITIONAL SPACE IS NEEDED. Please see attached site map, engineered plans and specifications. The existing driveway to the Olympic Music Festival includes a culverted stream crossing that will be removed and replaced with a bridge. A total of six habitat logs approx. 30' long and 8" minimum diameter will be placed upstream and downstream of the crossing to enhance the structure of the stream. Existing riprap along the north bank downstream of the culvert will be removed and some will be relocated for use in protecting the bridge abutments, but outside of the channel width. The previously rip -rapped bank will be sloped, covered with erosion protection matting, with planting to follow in the winter of 2003-2004. All riprap will be landward of the ordinary high water channel width under the bridge. Spawning gravel will be added under the bridge. PREPARATION OF DRAWINGS: SEE SAMPLE DRAWINGS AND GUIDANCE FOR COMPLETING THE DRAWINGS. ONE SET OF ORIGINAL OR GOOD QUALITY REPRODUCIBLE DRAWINGS MUST BE ATTACHED. NOTE: APPLICANTS ARE ENCOURAGED TO SUBMIT PHOTOGRAPHS OF THE PROJECT SITE, BUT THESE DO NOT SUBSTITUTE FOR DRAWINGS. THE CORPS OF ENGINEERS AND COAST GUARD REQUIRE DRAWINGS ON 8-112 X 11 INCH SHEETS. LARGER DRAWINGS MAYBE REQUIRED BY OTHER AGENCIES. 7b. DESCRIBE THE PURPOSE OF THE PROPOSED WORK AND WHY YOU WANT OR NEED TO PERFORM IT AT THE SITE. PLEASE EXPLAIN ANY SPECIFIC NEEDS THAT HAVE INFLUENCED THE DESIGN. The purpose of the project is to restore fish passage for coho salmon, steelhead, and searun cutthroat trout to approximately 4 miles of upstream tributaries of Tarboo Creek. The existing culvert crossing is a fish passage velocity and low flow barrier due to the excessive slope of the culvert. The culvert crossing will be replaced with a historic design, non -treated log bridge. 7c. DESCRIBE THE POTENTIAL IMPACTS TO CHARACTERISTIC USES OF THE WATER BODY. THESE USES MAY INCLUDE FISH AND AQUATIC LIFE, WATER QUALITY, WATER SUPPLY, RECREATION, and AESTHETICS. IDENTIFY PROPOSED ACTIONS TO AVOID, MINIMIZE, AND MITIGATE DETRIMENTAL IMPACTS, AND PROVIDE PROPER PROTECTION OF FISH AND AQUATIC LIFE. IDENTIFY WHICH GUIDANCE DOCUMENTS YOU HAVE USED. ATTACH A SEPARATE SHEET IF ADDITIONAL SPACE IS NEEDED. The project should enhance the fish passage, as well as proper stream functioning and downstream movement of wood and gravel due to the 24+ wide opening under the bridge. The potential for sediment delivery to the stream during and after construction will be minimized by implementing the following best management practices — All in -water work will be conducted during an in -stream work window of May 1 to October 31, and in the dry. Stream flow at this site during thisproposed construction period tends to bea trickle or even dry. Prior to construction, the stream will be diverted around the construction site using a temporary coffer dam of gravel filled bags placed upstream of the construction area, with a bypass pipe. Downstream of the road, a second temporary coffer dam will be built to trap muddy seepage water in the construction area. This seepage water will be pumped to an upland location for infiltration. Temporary fish screens will be installed across the stream upstream and downstream of the coffer dams to prevent fish access and possible injury in the construction area or bypass pipes. Dewatering of the construction area will occur in stages as needed to minimize the number of fish trapped in the construction area. However, no fish were electro-fish sampled in this area during March, 2003 and none were seen in July 2003. Water will be transferred to the diversion pipe in increments, without installing the downstream coffer dam or downstream fish net to allow fish to migrate downstream as flow drops. Then, the downstream coffer dam and fish screen will be installed. Fish may remain stranded in puddles. Immediately upon installation of the downstream coffer dam and fish screen, a seine net and hand nets will be used as necessary to trap fish and immediately move them safely outside of the construction area. After construction, disturbed soils will be seeded with sterile wheat completely covered with straw. Excess earth that was excavated for the larger bridge span will be hauled offsite to a designated stable, upland location. The previously rip -rapped bank will be sloped, covered with erosion protection matting, with planting to follow in the winter of 2003-2004.There will be no fill outside of the existing road prism. 7d. FOR IN WATER CONSTRUCTION WORK, WILL YOUR PROJECT BE IN COMPLIANCE WITH THE STATE OF WASHINGTON WATER QUALITY STANDARDS FOR TURBIDITY WAC 173201A-110? ® YES ❑ NO (SEE USEFUL DEFINITIONS AND INSTRUCTIONS) 8. WILL THE PROJECT BE CONSTRUCTED IN STAGES? ❑ YES ® NO PROPOSED STARTING DATE: August 11, 2003 ESTIMATED DURATION OF ACTIVITY: until October 31, 2003 9. CHECK IF ANY TEMPORARY OR PERMANENT STRUCTURES WILL BE PLACED: ® WATERWARD OF THE ORDINARY HIGH WATER MARK OR LINE FOR FRESH OR TIDAL WATERS; AND/OR— sandbag dams for diversion (temporary), habitat logs ❑ WATERWARD OF MEAN HIGHER HIGH WATER LINE IN TIDAL WATERS 10. WILL FILL MATERIAL (ROCK, FILL, BULKHEAD, OR OTHER MATERIAL) BE PLACED: ® WATERWARD OF THE ORDINARY HIGH WATERMARK OR LINE FOR FRESH WATERS?— IF YES, VOLUME (CUBIC YARDS) /AREA (ACRES) ❑ WATERWARD OF THE MEAN HIGHER HIGH WATER FOR TIDAL WATERS? IF YES, VOLUME (CUBIC YARDS) AREA (ACRES) JARPA, Revised 7/02 Contact the State of Washington Office of Regulatory Assistance for latest version, 360/407-7037 or 800/917-0043 2 11. WILL MATERIAL BE PLACED IN WETLANDS? ❑ YES ® NO IF YES: A. IMPACTED AREA IN ACRES: B. HAS A DELINEATION BEEN COMPLETED? IF YES, PLEASE SUBMIT WITH APPLICATION. ❑ YES ❑ NO C. HAS A WETLAND REPORT BEEN PREPARED? IF YES, PLEASE SUBMIT WITH APPLICATION. ❑ YES ❑ NO D. TYPE AND COMPOSITION OF FILL MATERIAL (E.G., SAND, ETC.): E. MATERIAL SOURCE: F. LIST ALL SOIL SERIES (TYPE OF SOIL) LOCATED AT THE PROJECT SITE, & INDICATE IF THEY ARE ON THE COUNTY'S LIST OF HYDRIC SOILS. SOILS INFORMATION CAN BE OBTAINED FROM THE NATURAL RESOURCES CONSERVATION SERVICE (NRCS): G. WILL PROPOSED ACTIVITY CAUSE FLOODING OR DRAINING OF WETLANDS? ❑ YES ❑ NO IF YES, IMPACTED AREA IS _ ACRES OFDRAINED WETLANDS. NOTE: If your project will impact greater than % of an acre of wetland, submit a mitigation plan to the Corps and Ecology for approval along with the JARPA form .NOTE., a 401 water quality certillication will be required from Ecology in addition to an approved mitigation plan ff your project impacts wetlands that are: a) greater than X acre in size, or b) tidal wetlands or wetlands adjacent to tidal water. Please submit the JARPA form and mitigation plan to Ecology for an individual 401 certillication if a) orb) applies. 12. STORMWATER COMPLIANCE FOR NATIONWIDE PERMITS ONLY: THIS PROJECT IS (OR WILL BE) DESIGNED TO MEET ECOLOGY'S MOST CURRENT STORMWATER MANUAL, OR AN ECOLOGY APPROVED LOCAL STORMWATER MANUAL ❑ YES ❑ NO IF YES — WHICH MANUAL WILL YOUR PROJECT BE DESIGNED TO MEET If NO —FOR CLEAN WATER ACT SECTION 401 AND 404 PERMITS ONLY— PLEASE SUBMITTO ECOLOGY FOR APPROVAL, ALONG WITH THIS JARPA APPLICATION, DOCUMENTATION THAT DEMONSTRATES THE STORMWATER RUNOFF FROM YOUR PROJECTOR ACTIVITY WILL COMPLY WITH THE WATER QUALITY STANDARDS, WAC 173.201(A) 13. WILL EXCAVATION OR DREDGING BE REQUIRED IN WATER OR WETLANDS? ® YES ONO IF YES: A. VOLUME: 10 (CUBIC YARDS) /AREA .01 (ACRES) - rlprap removal along toe of bald( that extends into Stream channel B. COMPOSITION OF MATERIAL TO BE REMOVED: C. DISPOSAL SITE FOR EXCAVATED MATERIAL: D. METHOD OF DREDGING: 14. HAS THE STATE ENVIRONMENTAL POLICY ACT (SEPA) BEEN COMPLETED? ❑ YES ® NO SEPA LEAD AGENCY: SEPA DECISION: DNS, MONS, EIS, ADOPTION, EXEMPTION DECISION DATE (END OF COMMENT PERIOD): SUBMIT A COPY OF YOUR SEPA DECISION LETTER TO WDFW AS REQUIRED FOR A COMPLETE APPLICATION 15. LIST OTHER APPLICATIONS, APPROVALS, OR CERTIFICATIONS FROM OTHER FEDERAL, STATE OR LOCAL AGENCIES FOR ANY STRUCTURES, CONSTRUCTION, DISCHARGES, OR OTHER ACTIVITIES DESCRIBED IN THE APPLICATION (I.E., PRELIMINARY PLAT APPROVAL, HEALTH DISTRICT APPROVAL, BUILDING PERMIT, SEPA REVIEW, FEDERAL ENERGY REGULATORY COMMISSION LICENSE (FERC), FOREST PRACTICES APPLICATION, ETC.) ALSO INDICATE WHETHER WORK HAS BEEN COMPLETED AND INDICATE ALL EXISTING WORK ON DRAWINGS. NOTE: FOR USE WITH CORPS NATIONWIDE PERMITS, IDENTIFY WHETHER YOUR PROJECT HAS OR WILL NEED AN NPDES PERMIT FOR DISCHARGING WASTEWATER AND/OR STORMWATER. TYPE OF APPROVAL ISSUING AGENCY IDENTIFICATION DATE OF APPLICATION DATE APPROVED COMPLETED? NO. 16. HAS ANY AGENCY DENIED APPROVAL FOR THE ACTIVITY YOU'RE APPLYING FOR OR FOR ANY ACTIVITY DIRECTLY RELATED TO THE ACTIVITY DESCRIBED HEREIN? ❑ YES ® NO IF YES, EXPLAIN: JARPA, Revised 7/02 Contact the State of Washington Office of Regulatory Assistance for latest version, 360/407-7037 or 800/917-0043 - 3 SECTION B - Use for Shoreline and Corps of Enqineers permits only: 17a. TOTAL COST OF PROJECT. THIS MEANS THE FAIR MARKET VALUE OF THE PROJECT, INCLUDING MATERIALS, LABOR, MACHINE RENTALS, ETC. 17b. IF A PROJECT OR ANY PORTION OF A PROJECT RECEIVES FUNDING FROM A FEDERAL AGENCY, THAT AGENCY IS RESPONSIBLE FOR ESA CONSULTATION, PLEASE INDICATE IF YOU ILL RECEIVE FEDERAL FUNDS AND WHAT FEDERAL AGENCY IS PROVIDING THOSE FUNDS. SEE INSTRUCTIONS FOR INFORMATION ON ESA" EDERAL FUNDINIG OYES ONO IF YES, PLEASE LIST THE FEDERAL AGENCY 1B. LOCAL GOVERNMENT WITH JURISDICTION: Jefferson County 19. FOR CORPS, COAST GUARD, AND DNR PERMITS, PROVIDE NAMES, ADDRESSES, AND TELEPHONE NUMBERS OF ADJOINING PROPERTY OWNERS, LESSEES, ETC... PLEASE NOTE: SHORELINE MANAGEMENT COMPLIANCE MAY REQUIRE ADDITIONAL NOTICE — CONSULT YOUR LOCAL GOVERNMENT. NAME ADDRESS PHONE NUMBER SECTION C - This section MUST he cmmnleted fnr anv nermit covered by this annUratinn 0. APPLICATION IS HEREBY MADE FOR A PERMIT OR PERMITS TO AUTHORIZE THE ACTIVITIES DESCRIBED HEREIN. I CERTIFY THAT I AM FAMILIAR WITH THE INFORMATION CONTAINED IN THIS APPLICATION, AND THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF, SUCH INFORMATION IS TRUE, COMPLETE, AND CCURATE. I FURTHER CERTIFY THAT I POSSESS THE AUTHORITY TO UNDERTAKE THE PROPOSED ACTIVITIES. I HEREBY GRANT TO THE AGENCIES TO WHICH HIS APPLICATION IS MADE, THE RIGHT TO ENTER THE ABOVE -DESCRIBED LOCATION TO INSPECT THE PROPOSED, IN -PROGRESS OR COMPLETED WORK. I AGREE TO START RK ONLY ER ALL NECESSARY PERMITS HAVE BEEN RECEIVED. SIGNATURE OF P CAT DATE / / F( SIGNATURE L WNER DATE 1 DATE HEREBY DESIGNATE 0 ACT AS MY AGENT IN MATTERS RELATED TO THIS APPLICATION FOR PERMIT(S). I UNDERSTAND THAT IF A FEDERAL PERMIT IS ISSUED, MUST SIGN THE PERMIT. SIGNATURE OF APPLICANT DATE LANDOWNER (EXCEPT PUB)C ENTITY LA OWNERS, E.G. DNR) )APPLICANT THIS APPLICATION MUST BE SIGN T THE AGENT, IF AN AUTHORIZED AGENT IS DESIGNATED. 18 U.S.0 §1001 provides that Whoever, in any manner within the jurisdiction of any department or agency of the United States knowingly falsifies, conceals, or covers up by any trick, scheme, or device a material fact or makes any false, fictitious, or fraudulent statements or representations or makes or uses any false writing or document knowing same to contain any false, fictitious, or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than 5 years or both. COMPLETED BY LOCAL OFFICIAL A. Nature of the existing shoreline. (Describe type of shoreline, such as marine, stream, lake, lagoon, marsh, bog, swamp, flood plain, floodway, delta; type of beach, such as accretion, erosion, high bank, low bank, or dike; material such as sand, gravel, mud, clay, rock, riprap; and extent and type of bulkheading, if any) B. In the event that any of the proposed buildings or structures will exceed a height of thirty-five feet above the average grade level, indicate the approximate location of and number of residential units, existing and potential, that will have an obstructed view: C. If the application involves a conditional use or variance, set forth in full that portion of the master program which provides that the proposed use may be a conditional use, or, in the case of a variance, from which the variance is being sought: These Agencies are Equal Opportunity and Affirmative Action employers. For special accommodation needs, please contact the appropriate agency in the instructions. JARPA, Revised 7/02 Contact the State of Washington Office of Regulatory Assistance for latest version, 360/407-7037 or 800/917-0043 4 191 7 F! �- 1 P' i + q r F-,m,...•r ate, - � r �x � J � v 1a ° *� , t e y 51 300 § 1r it c sc Fesivat"" dge , ,r UPI 1 ;�- V i l �l x 1, -4 6. 5 71 ZR Name: CENTER Location: 047' 55.1635' N 122° 49.1632' W Date: 8/9/2003 Caption: TARBOO EARLY ACTION FISH PASSAGE - NORTH MAP Scale: 1 inch equals 1000 feet coovriaht (C) 1 IN REPLY REFER TO: United States Department of the Interior FISH AND WILDLIFE SERVICE 911 NE. 11 th Avenue Portland, Oregon 97232-4181 t A�;u MAY 2 g gFERSON COUNTY DCD Peter Bahls, Executive Director Northwest Watershed Institute 2215 SE 55' Avenue Portland, Oregon 97215 Dear Mr. Bahls: Congratulations, your Tarboo Watershed Early Action Fish Passage Project for $143,510 has been selected for funding under the Private Stewardship Grant Program. This was the first year of this program and there was a tremendous response for requests for funding. In the Pacific Region alone, we received nearly 100 proposals totaling almost $11 million. Of these we were able to fund 25 proposals totaling $2.8 million. You will be contacted by your local Fish and Wildlife Service Office for project planning and implementation. Enclosed is a list of our local field offices and the contact persons for the Private Stewardship Grant Program. Your, local contact person will need to ensure that all environmental compliance requirements, including Endangered Species .Act section 7 consultation, National Environmental Policy Act, and National Historic Preservation Act, are met. You will also need to work with your local contact person to develop a contract package that will satisfy the Service's Contracting and General Services (CGS) requirements. For project approval through CGS, the Field Office will be required to provide CGS with (1) originals of the agreement - two sets, one for you and one for regional office CGS files; (2) any attachments referenced in the agreement - i.e. budget, scope of work, etc.; (3) an executed acquisition request for each agreement; and (4) a completed Application for Federal Assistance (which you have already included with the original application submitted under the request for proposals). In addition, all Federal funds are required to be paid electronically. In order to receive electronic payment, you must register with the Central Contractors Registration at www.ccr.gov. Good luck with project implementation and thank you for your interest in conserving imperiled species. Sincerely, / / r Regional Director Enclosure v C' JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax http://www.co.jefferson.wa.us/commdevelopment/ ,', 1 C" n Stormwater Management Permit Supplemental Application (Stand -Alone or Integrated) MLA # PROJECT/APPLICANT NAME: b�� `L �/r t G Nw/ Applications for clearing and grading, land -disturbing activities, and building permits or other land use approvals that require a stormwater management permit shall include the following information. This information may also be provided on other diagrams, plans, studies, or attachments submitted with the project application. If so, please indicate such on this permit application. The Administrator may waive specific submittal requirements de ned to e un ecessary f r review of th a lication. 1. Source of fill material and deposition of excess material.— � 0�0 s w�Gr lG-c-ea0 .� fig. s dY� c.� . J r� 2. Physical c aracteristics of fill material: 3. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. bleewl 2K1G �. 4. Proposed surfacing material. 5. Proposed method(s) of drainage and erosion control.f- G c-, 6. Methods for restoration of the site. _.C—A 7. Demonstrate that instream flow of water will remain unobstructed. k� ✓°a-�( d-�-ri C arm 8. Demonstrate that erosion and sedimentation from outflow channels will be minimized by vegetation or other means, and demonstrate that pond runoff will be controlled to protect adjacent property damage. 'IF �_' / 1 h By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. I al certify that this application is being made with the full knowledge and consent of all owners of the affected property. (LANDOWNER OR AUTHORIZED krPRESENTATIVE SIGNATURE) (DATE) STORMWATER MGMT PERMIT.DOC REV. 12/23/2002 1°�, JEFFERSON COUNTY "�' DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax http://www.co.jefferson.wa.us/commdevelopment/ Stormwater Calculation Sheet JEFFEIiJ V IV C V j 1 DGD MLA # PROJECT/APPLICANT NAME: / `, 5-, C This stormwater calculation sheet should accompany stand-alone stormwater management permit applications, building permit applications, and other land use approval applications that involve stormwater review. NEW Structures (all roof area) Driveway Sidewalks Patios Solid Decks Other Total New STORMWATER CALULATIONS sq/ft sq/ft sq/ft sq/ft sq/ft - IMPERVIOUS SURFACE EXISTING Structures (all roof area) Driveway Sidewalks Patios Solid Decks sq/ft Other sq/ft Total Existing / TOTAL NEW + TOTAL EXISTING* (' sq/ft *This amount will be used to check total lot coverage sq/ft sq/ft sq/ft sq/ft sq/ft sq/ft sq/ft Please also indicate the amount of land -disturbing activity, in addition to the creation of impervious surface, that will take place: LAND DISTURBING ACTIVITY Drainfield area cleared sq/ft Well, Structures, Utilities, etc. sq/ft Driveway (0O0 sq/ft Other ` sq/ft Total Land Disturbance � sq/ft STORMWATER MGMT PERMIT.DOC REV. 12/23/2002