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Home My WebLink AboutBLD2021-00286 - 12C JARPAORIA-revised 02/2020 Page 1 of 14 AGENCY USE ONLY Date Received: Agency reference #: . Tax Parcel #(s): . . . WASHINGTON STATE Joint Aquatic Resources Permit Application (JARPA) Form 1,2 [help] USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. Part 1 - Project Identification 1. Project Name (A name for your project that you create. Examples: Smith's Dock or Seabrook Lane Development) [help] Globus Piling Repair Part 2 - Applicant The person and/or organization responsible for the project. [help] 2a.Name (Last, First, Middle) Globus, Barbara 2b. Organization (if applicable) 2c.Mailing Address (Street or PO Box) 110 W Ludlow Pt Rd 2d. City, State, Zip Port Ludlow, WA 98365 2e.Phone (1) 2f. Phone (2) 2g. Fax 2h. E-mail ( 360 ) 301-2417 ( ) ( ) beglobus@gmail.com ¹Additional forms may be required for the following permits: U.S. Army Corps of Engineers for application information (206) 764-3495. listed under the Endangered Species Act, you will need to fill out a Specific Project Information Form (SPIF) or prepare a Biological Evaluation. Forms can be found at http://www.nws.usace.army.mil/Missions/CivilWorks/Regulatory/PermitGuidebook/EndangeredSpecies.aspx . e appropriate city or county government to make sure they accept the JARPA. ²To access an online JARPA form wth [help] screens, go to http://www.epermitting.wa.gov/site/alias__resourcecenter/jarpa_jarpa_form/9984/jarpa_form.aspx . For other help, contact the Governor's Office for Regulatory Innovation and Assistance at (800) 917-0043 or help@oria.wa.gov. May 07 2021 ORIA-revised 02/2020 Page 2 of 14 Part 3 - Authorized Agent or Contact Person authorized to represent the applicant about the project. (Note: Authorized agent(s) must sign 11b of this application.) [help] 3a. Name (Last, First, Middle) Rotsten, Jennifer 3b. Organization (if applicable) Sealevel Bulkhead Builders, Inc. 3c. Mailing Address (Street or PO Box) PO Box 375 3d. City, State, Zip Kingston, WA 98346-0375 3e. Phone (1) 3f. Phone (2) 3g. Fax 3h. E-mail ( 360 ) 297-2401 ( 360 ) 710-0899 ( 360 ) 297-2308 Jenny@sealevelbb.com Part 4 - Property Owner(s) Contact information for people or organizations owning the property(ies) where the project will occur. Consider both upland and aquatic ownership because the upland owners may not own the adjacent aquatic land. [help] Same as applicant. (Skip to Part 5.) Repair or maintenance activities on existing rights-of-way easements. (Skip to Part 5.) There are multiple upland property owners. Complete the section below and fill out JARPA Attachment A for each additional property owner. Your project is on Department of Natural Resources (DNR)-managed aquatic lands. If you don't know, contact the DNR at (360) 902-1100 to determine aquatic land ownership. If yes, complete JARPA Attachment E to apply for the Aquatic Use Authorization. 4a.Name (Last, First, Middle) Globus, Barbara 4b. Organization (if applicable) 4c. Mailing Address (Street or PO Box) 110 W Ludlow Pt Rd 4d. City, State, Zip Port Ludlow, WA 98365 4e.Phone (1) 4f. Phone (2) 4g. Fax 4h. E-mail ( 360 ) 301-2401 ( ) ( ) beglobus@gmail.com May 07 2021 ORIA-revised 02/2020 Page 3 of 14 Part 5 - Project Location(s) Identifying information about the property or properties where the project will occur. [help] There are multiple project locations (e.g. linear projects). Complete the section below and use JARPA Attachment B for each additional project location. 5a. Indicate the type of ownership of the property. (Check all that apply.) [help] Private Federal Publicly owned (state, county, city, special districts like schools, ports, etc.) Tribal Department of Natural Resources (DNR) - managed aquatic lands (Complete JARPA Attachment E) 5b.Street Address (Cannot be a PO Box. If there is no address, provide other location information in 5p.) [help] 110 W Ludlow Pt Rd, 5c. City, State, Zip (If the project is not in a city or town, provide the name of the nearest city or town.) [help] Port Ludlow, WA 98365 5d.County [help] Jefferson 5e. Provide the section, township, and range for the project location. [help] ¹/ Section Section Township Range 17 28 N 01 E 5f.Provide the latitude and longitude of the project location. [help] Example: 47.03922 N lat. / -122.89142 long. (Use decimal degrees - NAD 83) 47.917977 / -122.693320 5g.List the tax parcel number(s) for the project location. [help] The local county assessor's office can provide this information. 969400021 5h.Contact information for all adjoining property owners. (If you need more space, use JARPA Attachment C.) [help] Name Mailing Address Tax Parcel # (if known) Phillip Otness 135 W Ludlow Pt Rd 969400022 Port Ludlow, WA 98365 Jab Inc 100 W Ludlow Pt Rd 969400020 Port Ludlow, WA 98365 May 07 2021 ORIA-revised 02/2020 Page 4 of 14 5i. List all wetlands on or adjacent to the project location. [help] N/A 5j. List all waterbodies (other than wetlands) on or adjacent to the project location. [help] Ludlow Bay 5k. Is any part of the project area within a 100-year floodplain? [help] Yes No Don't know 5l. Briefly describe the vegetation and habitat conditions on the property. [help] Lawn and shrubs within yard. 5m.Describe how the property is currently used. [help] SFR 5n.Describe how the adjacent properties are currently used. [help] SFR 5o.Describe the structures (above and below ground) on the property, including their purpose(s) and current condition. [help] Owners home and garage, existing dock 5p.Provide driving directions from the closest highway to the project location, and attach a map. [help] Heading on Paradise Bay Road, turn onto South Bay Lane, turn left onto Ludlow Pt Rd, End at site. May 07 2021 ORIA-revised 02/2020 Page 5 of 14 Part 6 - Project Description 6a.Briefly summarize the overall project. You can provide more detail in 6b. [help] Repair to the existing dock will include removing the 2x12 wooden planks that are currently around the existing piling. The piling will then have two halve of HDPE plastic pipe around them, which will be anchored together with stainless steel fasteners and filling each with concrete. All work will be done from upland with the subject property providing all access for equipment, materials and laborers. 6b. Describe the purpose of the project and why you want or need to perform it. [help] Pilings along the overwater dock to the floating dock are in need of repair. All work will be done above the concrete pads. These pads will remain. All work will be done by hand at low tides. No increased footprint of the pilings. 6c.Indicate the project category. (Check all that apply.) [help] Commercial Residential Institutional Transportation Recreational Maintenance Environmental Enhancement 6d. Indicate the major elements of your project. (Check all that apply.) [help] Aquaculture Culvert Float Retaining Wall Bank Stabilization Dam / Weir Floating Home (upland) Boat House Dike / Levee / Jetty Geotechnical Survey Road Boat Launch Ditch Land Clearing Scientific Boat Lift Dock / Pier Marina / Moorage Measurement Device Bridge Dredging Mining Stairs Bulkhead Fence Outfall Structure Stormwater Facility Buoy Ferry Terminal Piling / Dolphin Swimming Pool Channel Modification Fishway Raft Utility Line Other: May 07 2021 ORIA-revised 02/2020 Page 6 of 14 6e.Describe how you plan to construct each project element checked in 6d. Include specific construction methods and equipment to be used. [help] Identify where each element will occur in relation to the nearest waterbody. Indicate which activities are within the 100-year floodplain. Only hand tools will be used. No equipment will be needed. Work will be done at low tides. 6f. What are the anticipated start and end dates for project construction? (Month/Year) [help] If the project will be constructed in phases or stages, use JARPA Attachment D to list the start and end dates of each phase or stage. Start Date: 05/24/2021 . End Date: 06/24/2021 . See JARPA Attachment D 6g. Fair market value of the project, including materials, labor, machine rentals, etc. [help] 25,0000.00 6h. Will any portion of the project receive federal funding? [help] If yes, list each agency providing funds. Yes No Don't know Part 7 - Wetlands: Impacts and Mitigation Check here if there are wetlands or wetland buffers on or adjacent to the project area. (If there are none, skip to Part 8) [help] 7a.Describe how the project has been designed to avoid and minimize adverse impacts to wetlands. [help] Not applicable 7b. Will the project impact wetlands? [help] Yes No Don't know May 07 2021 ORIA-revised 02/2020 Page 7 of 14 7c. Will the project impact wetland buffers? [help] Yes No Don't know 7d. Has a wetland delineation report been prepared? [help] submit the report, including data sheets, with the JARPA package. Yes No 7e.Have the wetlands been rated using the Western Washington or Eastern Washington Wetland Rating System? [help] submit the wetland rating forms and figures with the JARPA package. Yes No Don't know 7f. Have you prepared a mitigation plan to compensate for any adverse impacts to wetlands? [help] submit the plan with the JARPA package and answer 7g. explain below why a mitigation plan should not be required. Yes No Not applicable 7g. Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was used to design the plan. [help] 7h. Use the table below to list the type and rating of each wetland impacted, the extent and duration of the impact, and the type and amount of mitigation proposed. Or if you are submitting a mitigation plan with a similar table, you can state (below) where we can find this information in the plan. [help] Activity (fill, drain, excavate, flood, etc.) Wetland Name¹ Wetland type and rating category² Impact area (sq. ft. or Acres) Duration of Impact³ Proposed mitigation type Wetland mitigation area (sq. ft. or acres) ¹ The name should be consistent with other project documents, such as a wetland delineation report. ²Ecology wetland category based on current Western Washington or Eastern Washington Wetland Rating System. Provide the wetland rating forms with the JARPA package. ³ Creation (C), Re-establishment/Rehabilitation (R), Enhancement (E), Preservation (P), Mitigation Bank/In-lieu fee (B) Page number(s) for similar information in the mitigation plan, if available: . May 07 2021 ORIA-revised 02/2020 Page 8 of 14 7i. For all filling activities identified in 7h, describe the source and nature of the fill material, the amount in cubic yards that will be used, and how and where it will be placed into the wetland. [help] 7j. For all excavating activities identified in 7h, describe the excavation method, type and amount of material in cubic yards you will remove, and where the material will be disposed. [help] Part 8 - Waterbodies (other than wetlands): Impacts and Mitigation -wetland waterbodies. (See Part 7 for information related to wetlands.) [help] Check here if there are waterbodies on or adjacent to the project area. (If there are none, skip to Part 9.) 8a.Describe how the project is designed to avoid and minimize adverse impacts to the aquatic environment. [help] Not applicable 8b. Will your project impact a waterbody or the area around a waterbody? [help] Yes No May 07 2021 ORIA-revised 02/2020 Page 9 of 14 8c.non-wetland waterbodies? [help] submit the plan with the JARPA package and answer 8d. explain below why a mitigation plan should not be required. Yes No Not applicable The footprint of the pilings will not be altered. The footing will remain. The proposed work is to re-encase the pilings by removing the rotting wood and replace with HDPE. 8d. Summarize what the mitigation plan is meant to accomplish. Describe how a watershed approach was used to design the plan.[help] If you already completed 7g you do not need to restate your answer here. [help] N/A 8e.Summarize impact(s) to each waterbody in the table below. [help] Activity (clear, dredge, fill, pile drive, etc.) Waterbody name¹ Impact location² Duration of impact³ Amount of material (cubic yards) to be placed in or removed from waterbody Area (sq. ft. or linear ft.) of waterbody directly affected HDPE sleeve with concrete Ludlow Bay In Permanent +/-5 cy 6 sf ¹her documents provided. ²Indicate whether the impact will occur in or adjacent to the waterbody. If adjacent, provide the distance between the impact and the waterbody and indicate whether the impact will occur within the 100-year flood plain. ³Indicate the days, months or years the waterbody will be measurably impacted by the work. 8f.For all activities identified in 8e, describe the source and nature of the fill material, amount (in cubic yards) you will use, and how and where it will be placed into the waterbody. [help] The sleeve will be placed where existing boards are now and then filled with concrete, +/-5cy total. Total of 6 May 07 2021 ORIA-revised 02/2020 Page 10 of 14 8g. For all excavating or dredging activities identified in 8e, describe the method for excavating or dredging, type and amount of material you will remove, and where the material will be disposed. [help] N/A Part 9 - Additional Information Any additional information you can provide helps the reviewer(s) understand your project. Complete as much of this section as you can. It is ok if you cannot answer a question. 9a.If you have already worked with any government agencies on this project, list them below. [help] Agency Name Contact Name Phone Most Recent Date of Contact ACOE Jerry Gregory ( ) Jefferson County Brian Benjamin ( ) 5/6/21 via CAM ( ) 9b. Are any of the wetlands or waterbodies identified in Part 7 or Part 8 of this JARPA on the Washington [help] list the parameter(s) below. http://www.ecy.wa.gov/programs/wq/303d/. Yes No 9c.What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? [help] Go to http://cfpub.epa.gov/surf/locate/index.cfm to help identify the HUC. 17110019 9d. What Water Resource Inventory Area Number (WRIA #) is the project in? [help] Go to http://www.ecy.wa.gov/services/gis/maps/wria/wria.htm to find the WRIA #. 17 May 07 2021 ORIA-revised 02/2020 Page 11 of 14 9e. Will the in-water construction work comply with the State of Washington water quality standards for turbidity?[help] Go to http://www.ecy.wa.gov/programs/wq/swqs/criteria.html for the standards. Yes No Not Applicable 9f.If the project is within the jurisdiction of the Shoreline Management Act, what is the local shoreline environment designation? [help] If you For more information, go to: http://www.ecy.wa.gov/programs/sea/sma/laws_rules/173-26/211_designations.html. Rural Urban Natural Aquatic Conservancy Other: 9g. What is the Washington Department of Natural Resources Water Type? [help] Go to http://www.dnr.wa.gov/BusinessPermits/Topics/ForestPracticesApplications/Pages/fp_watertyping.aspx for the Forest Practices Water Typing System. Shoreline Fish Non-Fish Perennial Non-Fish Seasonal 9h. manual? [help] , provide the name of the manual your project is designed to meet. Yes No Name of manual: 9i. Does the project site have known contaminated sediment? [help] Yes No 9j. If you know what the property was used for in the past, describe below. [help] SFR 9k.Has a cultural resource (archaeological) survey been performed on the project area? [help] attach it to your JARPA package. Yes No May 07 2021 ORIA-revised 02/2020 Page 12 of 14 9l. Name each species listed under the federal Endangered Species Act that occurs in the vicinity of the project area or might be affected by the proposed work. [help] Marbeld murrelet, spotted owl, chinook salmon, steelhead, killer whale, humpback whale, gray wolf 9m. ty Habitats and Species List that might be affected by the proposed work. [help] Habitat: Puget Sound Nearshore Species: Pacific Lamprey, River Lamprey,White Sturgeon,Pacific Herring,Longfin Smelt,Surfsmelt,Bull Trout/ Dolly Varden,Chinook Salmon,Chum Salmon,Coastal Res./ Searun Cutthroat,Coho,Pink Salmon,Rainbow Trout/ Steelhead/ Inland Redband Trout,Pacific Cod,Pacific Hake,Walleye Pollock,Black Rockfish,Bocaccio Rockfish Brown Rockfish,Copper Rockfish,Greenstriped Rockfish,Quillback Rockfish,Redstripe Rockfish,Tiger Rockfish Yellowtail Rockfish,Lingcod,Pacific Sand Lance,English Sole,Rock Sole,Western Toad,Pacific Pond Turtle, Common Loon,Common Murre,Marbled Murrelet,Tufted Puffin,Western grebe,W WA nonbreeding concentrations of: Loons, Grebes, Cormorants, Fulmar, Shearwaters, Storm-petrels, Alcids W WA breeding concentrations of: Cormorants, Storm-petrels, Terns, Alcids, Great Blue Heron,Brant,Cavity- Bufflehead, Hooded Merganser,Western Washington nonbreeding concentrations of: Barrow's Goldeneye, Common Goldeneye, Bufflehead,Harlequin Duck,Trumpeter Swan,Waterfowl Concentrations ,Bald Eagle Peregrine Falcon,Mountain Quail,Sooty Grouse,"W WA nonbreeding concentrations of:Charadriidae, Scolopacidae, Phalaropodidae "Band-tailed Pigeon Yellow- Purple Martin,Dall's Porpoise,Humpback Whale,Gray Whale,Sperm Whale,Harbor Seal,Orca (Killer Whale) Pacific Harbor Porpoise,California Sea Lion,Steller (Northern) Sea Lion,Roosting Concentrations of: Big-brown -eared Bat,Keen's Long- Columbian Black-tailed Deer,Pinto (Northern) Abalone,Geoduck ,Butter Clam,Native Littleneck Clam Manila Clam,Olympia Oyster,Pacific Oyster,Dungeness Crab,Pandalid shrimp (Pandalidae),Puget Blue Part 10 - SEPA Compliance and Permits Use the resources and checklist below to identify the permits you are applying for. Online Project Questionnaire at http://apps.oria.wa.gov/opas/. -0043 or help@oria.wa.gov. For a list of addresses to send your JARPA to, click on agency addresses for completed JARPA. 10a. Compliance with the State Environmental Policy Act (SEPA). (Check all that apply.) [help] For more about SEPA, go to www.ecy.wa.gov/programs/sea/sepa/e-review.html A copy of the SEPA determination or letter of exemption is included with this application. A SEPA determination is pending with Jefferson County (lead agency). The expected decision date is 05/21/2021 . I am applying for a Fish Habitat Enhancement Exemption. (Check the box below in 10b) [help] This project is exempt (choose type of exemption below). Categorical Exemption. Under what section of the SEPA administrative code (WAC) is it exempt? May 07 2021 ORIA-revised 02/2020 Page 13 of 14 . Other: SEPA is pre-empted by federal law. 10b. Indicate the permits you are applying for. (Check all that apply.) [help] LOCAL GOVERNMENT Local Government Shoreline permits: Substantial Development Conditional Use Variance Shoreline Exemption Type (explain): . Other City/County permits: Floodplain Development Permit Critical Areas Ordinance STATE GOVERNMENT Washington Department of Fish and Wildlife: Hydraulic Project Approval (HPA) Fish Habitat Enhancement Exemption - Attach Exemption Form Washington Department of Natural Resources: Aquatic Use Authorization Complete JARPA Attachment E and submit a check for $25 payable to the Washington Department of Natural Resources. Do not send cash. Washington Department of Ecology: Section 401 Water Quality Certification Non-Federally Regulated Waters FEDERAL AND TRIBAL GOVERNMENT United States Department of the Army permits (U.S. Army Corps of Engineers): Section 404 (discharges into waters of the U.S.) Section 10 (work in navigable waters) United States Coast Guard: For projects or bridges over waters of the United States, contact the U.S. Coast Guard at: d13-pf-d13bridges@uscg.mil Bridge Permit Private Aids to Navigation (or other non-bridge projects) United States Environmental Protection Agency: Section 401 Water Quality Certification (discharges into waters of the U.S.) on tribal lands where tribes do not have treatment as a state (TAS) Tribal Permits: (Check with the tribe to see if there are other tribal permits, e.g., Tribal Environmental Protection Act, Shoreline Permits, Hydraulic Project Permits, or other in addition to CWA Section 401 WQC) Section 401 Water Quality Certification (discharges into waters of the U.S.) where the tribe has treatment as a state (TAS). May 07 2021 ORIA-revised 02/2020 Page 14 of 14 Part 11 - Authorizing Signature Signatures are required before submitting the JARPA package. the JARPA package includes the JARPA form, project plans, photos, etc. [help] 11a.Applicant Signature (required) [help] I certify that to the best of my knowledge and belief, the information provided in this application is true, complete, and accurate. I also certify that I have the authority to carry out the proposed activities, and I agree to start work only after I have received all necessary permits. I hereby authorize the agent named in Part 3 of this application to act on my behalf in matters related to this application. (Initial) By initialing here, I state that I have the authority to grant access to the property. I also give my consent to the permitting agencies entering the property where the project is located to inspect the project site or any work related to the project. (Initial) Barbara Globus See attached owner agent agreement Applicant Printed Name Applicant Signature Date I certify that to the best of my knowledge and belief, the information provided in this application is true, complete, and accurate. I also certify that I have the authority to carry out the proposed activities and I agree to start work only after all necessary permits have been issued. Jennifer Rotsten Authorized Agent Printed Name Authorized Agent Signature Date 11c.Property Owner Signature (if not applicant). [help] Not required if project is on existing rights-of-way or easements. I consent to the permitting agencies entering the property where the project is located to inspect the project site or any work. These inspections shall occur at reasonable times and, if practical, with prior notice to the landowner. Barbara Globus Property Owner Printed Name Property Owner Signature Date 18 U.S.C 1001 provides that: Whoever, in any manner within the jurisdiction of any department of agency of the United States knowingly falsifies, conceals, or covers up any trick, scheme, or devise 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. If you require this document in another format, contact the Governor's Office for Regulatory Innovation and Assistance (ORIA) at (800) 917-0043. People with hearing loss can call 711 for Washington Relay Service. People with a speech disability can call (877) 833-6341. ORIA publication number: ENV-019-09 rev. 09/2015 5/7/21 May 07 2021