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Home My WebLink AboutStampedLog Item 3 SDP AppSON � ,,� DEPARTMENT" OF COMMUNI'T'Y DEVELOPMEN'f W621 Sheridan Street, Nnt"Townsend, W_\ 48363 -- „� 'Tel:361i.3?9.44�'S0 I Kts:360.377.4431 L cb; ivwxy&i ' • •rNtrn_ t_^ n.' rsr r t nti rle. �5 ! N Go oVer► Jit. PERMIT APPLICATION AP -1- Steps in the Permit Process: �{1 -Review application checklist to ensure all information is completed prior to submitting application4uyv?), -Make sure septic has been applied for and water availability has been proven. �[+� -Make an appointment to meet with the Permit Technician by calling 360-379-4450. -This is not a standalone application; it must be accompanied by a project specific supplemental application. -Fees will be collected at intake. Additional fees may apply after review and payment is required before permit is issued. For Department Use Only Related Application #s: Site Information Assessor Tax Parcel Number: 602282004 Building Permit # MLA # Site Address and/or Di recti Ons to Property: Three miles west of Highway 101 on Dosewallips Road in 13dnnon, WA. Access (name of street(s)) from which access will be gained: Dosewallips Road Present use of property: Hydroelectric plant - tourism, public recreation Description of Work (include proposed uses): The project proposes to move the outfall of the hydroelectric facility from the base of the falls closerto the turbine house. We of the properly W] not change. Wastewater - Sewage Disposal This property is served by Port Townsend or Port Ludlow sewer system? YES NO If not served by sewer identified above, identify type of Type of Sewage System Serving Property: Septic Septic Permit #: Community Septic Name of System: Are other residences connected to the septic system? Additions or repairs to sewage system: Is it a complete or partial system installation: Has a reserve drainfield been designated? system below: Complete Partial Yes No Case #: Date of Last Operations & Maintenance check: -_Attach last report to application Describe or attach any drainfield easements, covenants or notices on title, which may impact the property: Uie Gt�'� ��AiB CS I The authorized agent/representative is the primary contact far all project -related questions and correspondence. The County will mail / e-mail requests and information about the application to the authorized agent/representative and will copy (cc) the owner noted below. The authorized agent/representative is responsible for communicating the information to all parties involved with the application. It is the responsibility of the authorized agent/representative and owner to ensure their mailbox accepts County email (i.e,, County email is not blocked or seat to "junk mail"). Applicant/Property Owner Information Property Owner: Name: Rocky Brook H droelectric;Attn: Wayne Herr Address: PO Box 215, Brinnon, WA 98320 Phone #: 360 302-0658 E-mail Address: hemvayne@yahoo.com Vor Please contact Authorized Agent/Representative with project info. (select only one). Property Owner Signature: Note: For Name: Address: Phone #: with multiple owners, attach a separate sheet with each owner(s) information and Authorized Agent/Representative (It other than owner) Ecological Land Services; Laura Westervelt 1157 3rd Avenue, Suite 220A, Longview, WA 98632 (360) 578-1371 E-mail Address Professional: Is this an Authorized Engineer Name: Address: Phone M Professional: Engineer Name: Address: Phone #: Professional: Engineer Name: Address: Phone #: Architect Date: lauraw@eco-land.com }gent/Representative forthis project? Surveyor Contractor License # E-mail Address: Is this an Authorized Agent/Rel Architect Surveyor Is this an Authorized e Architect Surveyor rrtative for this project? Y Contractor License # E-mail Address: ntative for this project? Contractor License # E-mail Address: NO YES Consultant NO YES Consultant NO YES Consultant By signing this application form, the owner/agent attests that the information provided herein, and in any attachments, is true and correct to the best of his or her knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in making any issued permit null and void. I further agree to that all activities I intend to undertake or complete associated with this permit will be performed in compliance with all applicable federal, state and county laws and regulations and I agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later inspections, Applicant may request notice of the County's intent to enter upon the property for visits related to this application and subsequent permit issuance. Signature: Print Name:_ _DI C.L e, K Ei'�1/✓ Date: 06'7`" U N -�� MLA # DEPARTMENT OF COMMUNITY DEVELOPMENT 021 Sheridan Street, P(>,- r0w,,send, \v_1 95366 Iti: 360.3941 Web: wm. zJi i I ail: &1160_ i SHORELINE DEVELOPM] A completed application form is a requirement of submittal. Include" Application Type (select one): 1) 2) Statement of Exemption - See Examples on back side of application Case # as that do not a ^Variance* Substantial Development* Conditional Use (administrative)* I Conditional Use (discretionary)* Does your proposal require in water work and/or works below ordinary high water mark? Yes No Does your pronncal require 1 ,000 sq/ft or more of impervious surface and/or non -single family structures of 5,000 sq/ft or more? Yes No V * If either of the boxes for 1 or 2 above are checked yes or if the permit type above has an asterisk then a_pre-application conference is re un fired prior to submitting for a shoreline permit. Site Information Assessor Tax Parcel #: 602282004 Name of Body of Water: _t.Rocky Brook Property Owner Name(s): Rocky Brook Hydroelectric Project Description Describe the existing property use and condition: The property is used as a hydroelectric plant. The plant is in a state of disrepair and needs updating. To install a turbine that is efficient the outflow needs to be moved. The new outflow -111 bur cl V I WA"l 1.1 ate ly 22E) feet long an d rep laees e ne that h as fal e n i Me d isrepa IF. Proposed distance from ordinary high water mark to use/development: Describe the proposed work that requires a shoreline permit or permit exemption: A new outfall facility will be constructed between the existing power plant and the stream. Because it is moving locations, it does not qualify for a shoreline exemption and requires a 5 feet By signing this application form, the owner/agent attests that the information provided herein, and in any attachments, is true and correct to tree best of his or her knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in making any Issued permit null and void. Owner Signature:_ 14�2 - —---- _ Date: 0(,7- U.- Print (TPrint Name: r k I C. L c Sally Ellis From: Sally Ellis Sent: Wednesday, November 28, 2018 3:51 PM To: Jodi Adams; Nicole Allen Subject: FW: Rocky Brook Hydroelectric (PRE18-00017) Attachments: 2788.01 SEPA.pdf; permit app signed.pdf; shoreline supplement signed.pdf; 2788.01 JARPA.pdf; 2788.01 Rocky Brook Report 11-28-18.pdf I printed this and will get it enter into the database. Sally L Ellis Jefferson County Community Development Permit Technician Ph: 360-379-4452 From: Laura Westervelt [mailto:lauraw@eco-land.com] Sent: Wednesday, November 28, 2018 1:39 PM To: DCD Front Staff <dcd@co.jefferson.wa.us> Cc: 'Dell Keehn' <dek12@isomedia.com>; herrwayne@yahoo.com Subject: Rocky Brook Hydroelectric (PRE18-00017) Hello, Please find the attached shoreline substantial development permit application on behalf of the Rocky Brook Hydroelectric company. I have included the following items: • SEPA checklist • Permit Application • Shoreline Supplemental Application • JARPA • Shoreline Mitigation Plan We are getting under contract with a geo-engineer currently and expect to have their report before Christmas. My hope is that the review process can begin in tandem with them performing their work, to be finished upon receipt of their findings. There is a check for the fees on the way to your office as well. Please let me know if there is anything else I can provide or clarify. Regards, E '175g a! Land Services Laura H Westervelt I Professional Biologist Port of Bremerton Satellite Office 8900 State Highway 3, Suite 201, Bremerton, WA 98312-4982 P: 360-674-7186 www.eco-land.com Office hours -Mont lauraw « eco-I_and.com r through Thursday. Out of office on Fridays. Notice: This message (including any attachments) contains confidential Information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message, and any disclosure, copying, or distribution of this message, or the taking of any action based upon it, is prohibited. APlease consider the environment before printing this e-mail. Committed to helping people - one square foot, one acre, one watershed at a time.° SON C� DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street, Port Townsend, WA 98368 ►C Tel: 360.379.4450 1 Fax: 360.379.4451 Web: vA Ifetson.wa.us/commiiniiydcy&IoRrnent �S T E-mail: dcd(y)cc%ieFferson.wn.us PERMIT FEES ESTIMATE THIS IS AN ESTIMATE OF BUILDING FEES - FEES SUBJECT TO CHANGE AT TIME OF SUBMITTAL Estimated Cost of Project Building Base Fees SDP TYPE III SEPA Notice of Applications Notice of Hearing Notice board Technology/Scan State Fee Other Fees Shoreline Exemption Zoning New Address Road Approach Tech fee Total Fees Office Use Only Receipt Number: Cash/Check/CC: Date: Initials: Parcel # 602282004 $2,300.00 $920.00 $149.00 $149.00 $10.00 $23.00 $177.55 $3,728.55 Page 1 of 1 Parcel Number 602282004 12/03/2018 Owner Mailing Address: FROCKY BROOK HYDROELECTRIC LIMITED PARTNERSHIP 7829 CENTER BLVD SE SNOQUALMIE998800 65-9096 Site Address: C.- -- I Section: 28 School District: Brinnon (46) - - - - -- - - I Qtr Section: NW1/4 Township: 26N Range: Sewer: Bank: View 2: Zoning 2: Sub Division: Fire District: Brinnon (4) Tax Status: ITaxable Tax Code: 10440 Planning Area: Brinnon (11) Drainage: View 1: I Zoning 1: RR -20 - Rural Residential Zoning 3: ,Appraiser: 4 I Assessor's Land Use Code: 4800 - utilities (Locally Assessed) Assessor's Land Use Code::I- _ _- Property Description: S28 T26 R2W TAX 7 http://gisweb.jeffcowa.us/jcdyn/parcelprint?value=602282004 12/3/2018