HomeMy WebLinkAbout03- SEPA Checklist413 Gybe Ho Road - Robert Brown III Trustee
SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 1 of 17
SEPA ENVIRONMENTAL CHECKLIST
Purpose of checklist: Governmental agencies use this checklist to help determine whether the environmental impacts of your
proposal are significant. This information is also helpful to determine if available avoidance, minimization
or compensatory mitigation measures will address the probable significant impacts or if an environmental
impact statement will be prepared to further analyze the proposal.
Instructions for applicants:
This environmental checklist asks you to describe some basic information about your proposal. Please
answer each question accurately and carefully, to the best of your knowledge. You may need to consult
with an agency specialist or private consultant for some questions. You may use “not applicable” or
"does not apply" only when you can explain why it does not apply and not when the answer is unknown.
You may also attach or incorporate by reference additional studies reports. Complete and accurate
answers to these questions often avoid delays with the SEPA process as well as later in the decision-
making process.
The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of
time or on different parcels of land. Attach any additional information that will help describe your proposal
or its environmental effects. The agency to which you submit this checklist may ask you to explain your
answers or provide additional information reasonably related to determining if there may be significant
adverse impact.
Instructions for Lead Agencies:
Please adjust the format of this template as needed. Additional information may be necessary to
evaluate the existing environment, all interrelated aspects of the proposal and an analysis of adverse
impacts. The checklist is considered the first but not necessarily the only source of information needed to
make an adequate threshold determination. Once a threshold determination is made, the lead agency is
responsible for the completeness and accuracy of the checklist and other supporting documents.
Use of checklist for nonproject proposals: For nonproject proposals (such as ordinances, regulations, plans and programs), complete the applicable
parts of sections A and B plus the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D). Please
completely answer all questions that apply and note that the words "project," "applicant," and "property or
site" should be read as "proposal," "proponent," and "affected geographic area," respectively. The lead
agency may exclude (for non-projects) questions in Part B - Environmental Elements –that do not
contribute meaningfully to the analysis of the proposal.
A. Background [HELP]
1. Name of proposed project, if applicable:
413 Gybe Ho Road - Robert Brown III Trustee
2. Name of applicant:
DCD RECEIVED 5/12/2022
413 Gybe Ho Road - Robert Brown III Trustee
SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 2 of 17
Robert M. Brown, III Trustee (land owner)
Josiah Brown
Lauren Brown
Sally Ellis (consultant)
3. Address and phone number of applicant and contact person:
Robert M. Brown, III Trustee (land owner)
206 Garden Club Rd.
Nordland, WA 98358
Ph. 360-301-4777
bob@bb-plumbing.com
Josiah and Lauren Brown
206 Garden Club Rd.
Nordland, WA 98358
Ph. 360-301-5024
Brown.josiah.d@gmail.com
Sally Ellis (consultant)
241 Flamingo Road
Port Townsend, WA 98368
Ph. 360-531-3374
salanjake@hotmail.com
Joanne Bartlett, SPWS Professional Biologist
8900 State Highway 3, Suite 201
Bremerton, WA 98312-4982
Ph. 360-674-7186, ext. 1201
joanne@eco-land.com
4. Date checklist prepared:
This form was prepared on 4/20/2022.
The existing parcel remains undeveloped as of 4/20/2022.
There are no plans for driveway development until permits/approvals have been issued.
5. Agency requesting checklist:
WA State Department of Ecology
Jefferson County Department of Community Development
6. Proposed timing or schedule (including phasing, if applicable):
Once driveway permits have been issued, we plan to put in a driveway (during the dry
season) to gain access to our future building site for a single family home. The future
building site for the single family home and septic will be outside of the wetland and
buffer and are not in the scope of this proposal.
7. Do you have any plans for future additions, expansion, or further activity related to or
connected with this proposal? If yes, explain.
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While we do have future hopes to eventually build a single family home, the future build
site is not located in a critical area. This proposal is specifically related to the impact of
putting a driveway through a category III wetland and its associated buffer.
8. List any environmental information you know about that has been prepared, or will be
prepared, directly related to this proposal.
Joanne Bartlett, SPWS Professional Biologist of Ecological Land Services, Inc. prepared
a “Wetland Delineation Report” dated April 18, 2021 and a “Wetland Mitigation Plan”
dated March 17, 2022.
We were provided with an “Approved Jurisdictional Determination Form” by the U.S.
Army Corps of Engineers on August 11, 2021, stating that the wetland is not a
jurisdictional water of the U.S.
9. Do you know whether applications are pending for governmental approvals of other
proposals directly affecting the property covered by your proposal? If yes, explain.
No other proposals are pending.
We do have a pending septic system permit with Jefferson County. That permit is
pending approved access to the property.
10. List any government approvals or permits that will be needed for your proposal, if known.
We will need an administrative order from WA Department of Ecology (Rebecca
Rothwell).
We will need a “Reasonable Economic Use Variance” from Jefferson County DCD.
11. Give brief, complete description of your proposal, including the proposed uses and the size
of the project and site. There are several questions later in this checklist that ask you to
describe certain aspects of your proposal. You do not need to repeat those answers on this
page. (Lead agencies may modify this form to include additional specific information on project
description.)
We would like to build a gravel driveway off Gybe Ho Road to gain access to our 5-acre
parcel. This proposed driveway would cross a category III wetland on the East side of
the property, as well as its associated 110-foot buffer.
Total area of proposed disturbed wetland: 285 square feet
Total area of proposed disturbed buffer: 3,106 square feet
The location of the proposed driveway has been determined by a professional biologist
(Joanne Bartlett, SPWS) to be the least impactful to the critical areas on the property. A
site visit was conducted with the WA Dept of Ecology (Rebecca Rothwell) and Jefferson
County DCD on July 14, 2021, who also agreed that the proposed driveway site was the
least impactful overall. It was ultimately concluded this is the only feasible point of
access.
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The driveway will allow access to the future single-family residence on this undeveloped
parcel. This single family home is proposed outside of the critical areas and their
buffers.
12. Location of the proposal. Give sufficient information for a person to understand the precise
location of your proposed project, including a street address, if any, and section, township, and
range, if known. If a proposal would occur over a range of area, provide the range or
boundaries of the site(s). Provide a legal description, site plan, vicinity map, and topographic
map, if reasonably available. While you should submit any plans required by the agency, you
are not required to duplicate maps or detailed plans submitted with any permit applications
related to this checklist.
413 Gybe Ho Road, Nordland, WA 98358
Tax Parcel # 921092007
Section 9
Township 29N
Range 1E
Proposed driveway on East end of parcel.
B. Environmental Elements [HELP]
1. Earth [help]
a. General description of the site:
(circle one): Flat, rolling, hilly, steep slopes, mountainous, other _____________ b. What is the steepest slope on the site (approximate percent slope)?
2-4% slope.
c. What general types of soils are found on the site (for example, clay, sand, gravel, peat,
muck)? If you know the classification of agricultural soils, specify them and note any
agricultural land of long-term commercial significance and whether the proposal results in
removing any of these soils.
Whidbey gravelly sand loam. For more information, please refer to pages 3-5 of the
“Wetland Delineation Report” dated April 18, 2021.
d. Are there surface indications or history of unstable soils in the immediate vicinity? If so,
describe.
No.
e. Describe the purpose, type, total area, and approximate quantities and total affected area of
any filling, excavation, and grading proposed. Indicate source of fill.
We would like to build a gravel driveway off Gybe Ho Road to gain access to our 5-acre
parcel. This proposed driveway would cross a category III wetland on the East side of
the property, as well as its associated 110-foot buffer.
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SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 5 of 17
Total area of proposed disturbed wetland: 285 square feet
Total area of proposed disturbed buffer: 3,106 square feet
Source of fill: Road base to consist of screened pit run from local quarries, comprised of
silts, sands and gravels.
Amount: Approximately 600 cubic yards of gravel for driveway crossing the wetland.
Amount: Approximately 900 cubic yards of gravel for driveway crossing the buffer.
f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe.
No.
g. About what percent of the site will be covered with impervious surfaces after project
construction (for example, asphalt or buildings)?
3300 square feet of 5-acre property (1.5% of property)
h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any:
Stormwater shall remain dispersed throughout the proposed driveway construction
area. Vegetated surfaces downhill of the proposed driveway corridor shall be
preserved. Bare surfaces including soil stockpiled for greater than seven days shall
promptly be planted with ground cover and grasses. Straw mulch shall be applied to
surfaces not ready for vegetation.
2. Air [help]
a. What types of emissions to the air would result from the proposal during construction,
operation, and maintenance when the project is completed? If any, generally describe and
give approximate quantities if known.
During construction of the driveway, we will be using a excavator/tractor for
approximately 20 hours. This will emit a very limited amount of CO2 only during
construction.
b. Are there any off-site sources of emissions or odor that may affect your proposal? If so,
generally describe.
No.
c. Proposed measures to reduce or control emissions or other impacts to air, if any:
No.
3. Water [help] a. Surface Water: [help]
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1) Is there any surface water body on or in the immediate vicinity of the site (including
year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe
type and provide names. If appropriate, state what stream or river it flows into.
The proposed driveway will cross a category III seasonally flooded wetland (labeled
‘Wetland A’ on diagrams).
2) Will the project require any work over, in, or adjacent to (within 200 feet) the described
waters? If yes, please describe and attach available plans.
The proposed driveway will cross a category III seasonally flooded wetland (labeled
‘Wetland A’ on diagrams) and its associated 110-foot buffer.
3) Estimate the amount of fill and dredge material that would be placed in or removed
from surface water or wetlands and indicate the area of the site that would be affected.
Indicate the source of fill material.
We would like to build a gravel driveway off Gybe Ho Road to gain access to our 5-acre
parcel. This proposed driveway would cross a category III wetland on the East side of
the property, as well as its associated 110-foot buffer.
Total area of proposed disturbed wetland: 285 square feet
Total area of proposed disturbed buffer: 3,106 square feet
Source of fill: Road base to consist of screened pit run from local quarries, comprised of
silts, sands and gravels.
Amount: Approximately 600 cubic yards of gravel for driveway crossing the wetland.
Amount: Approximately 900 cubic yards of gravel for driveway crossing the buffer.
The mitigation plan proposes to excavate 570 square feet of soil material to create
additional wetland on the west side of Wetland A. There is no estimate for volume
because of the small size. The excavation will be supervised by the project biologist to
ensure the appropriate elevation is reached.
4) Will the proposal require surface water withdrawals or diversions? Give general
description, purpose, and approximate quantities if known.
No.
5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan.
No.
6) Does the proposal involve any discharges of waste materials to surface waters? If so,
describe the type of waste and anticipated volume of discharge.
No.
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b. Ground Water: [help]
1) Will groundwater be withdrawn from a well for drinking water or other purposes? If so,
give a general description of the well, proposed uses and approximate quantities
withdrawn from the well. Will water be discharged to groundwater? Give general
description, purpose, and approximate quantities if known.
No.
2) Describe waste material that will be discharged into the ground from septic tanks or
other sources, if any (for example: Domestic sewage; industrial, containing the
following chemicals. . . ; agricultural; etc.). Describe the general size of the system, the
number of such systems, the number of houses to be served (if applicable), or the
number of animals or humans the system(s) are expected to serve.
None.
c. Water runoff (including stormwater):
1) Describe the source of runoff (including storm water) and method of collection
and disposal, if any (include quantities, if known). Where will this water flow?
Will this water flow into other waters? If so, describe.
Water runoff from driveway will be minimal. Proposed 12-inch diameter culverts beneath
the proposed driveway will discharge onto dispersion pads consisting of quarry spalls.
These dispersion pads will be located >90 ft from the parcel's downhill southern
boundary, thus providing ample downhill vegetated flow path in which to attenuate and
treat flowing water.
For additional information, see Stormwater Managent Plan, prepared by Everett
Sorensen, PE (Evergreen Engineering Services) on April 12, 2022.
2) Could waste materials enter ground or surface waters? If so, generally describe.
No.
3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If
so, describe.
No. Driveway through the wetland will include culverts to maintain original drainage
patterns of the wetland (see diagram).
For additional information, see Stormwater Managent Plan, prepared by Everett
Sorensen, PE (Evergreen Engineering Services) on April 12, 2022.
d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage
pattern impacts, if any:
Water runoff from driveway will be minimal and drainage patterns will not be disturbed.
Proposed 12-inch diameter culverts beneath the proposed driveway will discharge onto
dispersion pads consisting of quarry spalls. These dispersion pads will be located >90
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ft from the parcel's downhill southern boundary, thus providing ample downhill
vegetated flow path in which to attenuate and treat flowing water.
For additional information, see Stormwater Managent Plan, prepared by Everett
Sorensen, PE (Evergreen Engineering Services) on April 12, 2022.
4. Plants [help]
a. Check the types of vegetation found on the site:
__X__deciduous tree: alder, maple, aspen, other
__X__evergreen tree: fir, cedar, pine, other
__X__shrubs
__X__grass
____pasture
____crop or grain
____ Orchards, vineyards or other permanent crops.
__X__ wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other
____water plants: water lily, eelgrass, milfoil, other
____other types of vegetation
b. What kind and amount of vegetation will be removed or altered?
Our proposed driveway will disturb 285 square feet of wetland and 3,106 square feet of
buffer.
The vegetation in the category III wetland includes: red alder (young, less than 3 years
old), salmonberry, Himalayan blackberry, slough sedge, soft rush, lady fern, stinging
nettle, hedge nettle, and water parsley. The proposed driveway would mainly disturb
soft rush.
The vegetation in the buffer includes: red alder (young), salmonberry, ocean spray, red
elderberry, salal, Himalayan blackberry, Oregon grape, sword fern, trailing blackberry,
large-leaf avens, velvet grass, stinging nettle, and bracken fern.
We do not intend to remove any fir or cedar trees in the construction of this driveway.
c. List threatened and endangered species known to be on or near the site.
None.
d. Proposed landscaping, use of native plants, or other measures to preserve or enhance
vegetation on the site, if any:
The mitigation plan proposes to plant deciduous cuttings within the created wetland area
and native trees and shrubs are to be planted within the buffer to compensate for the
wetland and buffer impacts.
e. List all noxious weeds and invasive species known to be on or near the site.
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Himalayan blackberry (although we have spent the last year painstakingly working to
remove this invasive species by hand).
5. Animals [help] a. List any birds and other animals which have been observed on or near the site or are known
to be on or near the site.
Examples include:
birds: hawk, heron, eagle, songbirds, other:
mammals: deer, bear, elk, beaver, other:
fish: bass, salmon, trout, herring, shellfish, other ________
We have observed songbirds, deer, coyote, and squirrels.
b. List any threatened and endangered species known to be on or near the site.
None.
c. Is the site part of a migration route? If so, explain.
No.
d. Proposed measures to preserve or enhance wildlife, if any:
None.
e. List any invasive animal species known to be on or near the site.
None.
6. Energy and Natural Resources [help] a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet
the completed project's energy needs? Describe whether it will be used for heating,
manufacturing, etc.
No energy will be needed long-term. In the short-term, fuel will be needed for
construction equipment.
b. Would your project affect the potential use of solar energy by adjacent properties?
If so, generally describe.
No.
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c. What kinds of energy conservation features are included in the plans of this proposal?
List other proposed measures to reduce or control energy impacts, if any:
None.
7. Environmental Health [help]
a. Are there any environmental health hazards, including exposure to toxic chemicals, risk
of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal?
If so, describe.
1) Describe any known or possible contamination at the site from present or past uses.
None.
2) Describe existing hazardous chemicals/conditions that might affect project development
and design. This includes underground hazardous liquid and gas transmission pipelines
located within the project area and in the vicinity.
None.
3) Describe any toxic or hazardous chemicals that might be stored, used, or produced
during the project's development or construction, or at any time during the operating
life of the project.
None.
4) Describe special emergency services that might be required.
None.
5) Proposed measures to reduce or control environmental health hazards, if any:
Since there are no environmental hazards there is no need to reduce or control
environmental hazards.
b. Noise 1) What types of noise exist in the area which may affect your project (for example:
traffic, equipment, operation, other)?
None. Project is in rural area surrounded by other properties with acreage.
2) What types and levels of noise would be created by or associated with the project on a
short-term or a long-term basis (for example: traffic, construction, operation, other)? Indi-
cate what hours noise would come from the site.
Short-term noise would be created from construction equipment (less than 24 hours).
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3) Proposed measures to reduce or control noise impacts, if any:
None.
8. Land and Shoreline Use [help]
a. What is the current use of the site and adjacent properties? Will the proposal affect current
land uses on nearby or adjacent properties? If so, describe.
The site is currently undeveloped. Adjacent properties are residential. This proposal will
not affect land use of adjacent properties.
b. Has the project site been used as working farmlands or working forest lands? If so, describe.
How much agricultural or forest land of long-term commercial significance will be converted to
other uses as a result of the proposal, if any? If resource lands have not been designated,
how many acres in farmland or forest land tax status will be converted to nonfarm or
nonforest use?
No.
1) Will the proposal affect or be affected by surrounding working farm or forest land normal
business operations, such as oversize equipment access, the application of pesticides,
tilling, and harvesting? If so, how:
No.
c. Describe any structures on the site.
None.
d. Will any structures be demolished? If so, what?
No.
e. What is the current zoning classification of the site?
Undeveloped land.
f. What is the current comprehensive plan designation of the site?
According to Jefferson County Comprenesive Plan page 1-16 our property is zoned as
RR-5 Rural Residential.
g. If applicable, what is the current shoreline master program designation of the site?
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Our property does not lie within 200 feet of a shoreline, so there is no applicable
designation.
h. Has any part of the site been classified as a critical area by the city or county? If so, specify.
Yes. The category III wetland and its associated buffer are considered a critical area.
i. Approximately how many people would reside or work in the completed project?
None.
j. Approximately how many people would the completed project displace?
None.
k. Proposed measures to avoid or reduce displacement impacts, if any:
None.
L. Proposed measures to ensure the proposal is compatible with existing and projected land
uses and plans, if any:
None.
m. Proposed measures to reduce or control impacts to agricultural and forest lands of long-term
commercial significance, if any:
None.
9. Housing [help] a. Approximately how many units would be provided, if any? Indicate whether high, mid-
dle, or low-income housing.
None.
b. Approximately how many units, if any, would be eliminated? Indicate whether high,
middle, or low-income housing.
None.
c. Proposed measures to reduce or control housing impacts, if any:
None.
10. Aesthetics [help]
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a. What is the tallest height of any proposed structure(s), not including antennas; what is
the principal exterior building material(s) proposed?
No proposed structures. Driveway only.
b. What views in the immediate vicinity would be altered or obstructed?
None.
b. Proposed measures to reduce or control aesthetic impacts, if any:
None.
11. Light and Glare [help] a. What type of light or glare will the proposal produce? What time of day would it mainly
occur?
None.
b. Could light or glare from the finished project be a safety hazard or interfere with views?
No.
c. What existing off-site sources of light or glare may affect your proposal?
None.
d. Proposed measures to reduce or control light and glare impacts, if any:
None.
12. Recreation [help]
a. What designated and informal recreational opportunities are in the immediate vicinity?
None.
b. Would the proposed project displace any existing recreational uses? If so, describe.
No.
c. Proposed measures to reduce or control impacts on recreation, including recreation
opportunities to be provided by the project or applicant, if any:
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None.
13. Historic and cultural preservation [help] a. Are there any buildings, structures, or sites, located on or near the site that are over 45 years
old listed in or eligible for listing in national, state, or local preservation registers ? If so,
specifically describe.
No.
b. Are there any landmarks, features, or other evidence of Indian or historic use or occupation?
This may include human burials or old cemeteries. Are there any material evidence, artifacts,
or areas of cultural importance on or near the site? Please list any professional studies
conducted at the site to identify such resources.
No.
c. Describe the methods used to assess the potential impacts to cultural and historic resources
on or near the project site. Examples include consultation with tribes and the department of
archeology and historic preservation, archaeological surveys, historic maps, GIS data, etc.
Not applicable.
d. Proposed measures to avoid, minimize, or compensate for loss, changes to, and disturbance
to resources. Please include plans for the above and any permits that may be required.
Not applicable.
14. Transportation [help]
a. Identify public streets and highways serving the site or affected geographic area and
describe proposed access to the existing street system. Show on site plans, if any.
There are no public streets. To access the site you turn off Flagler Rd (a state road; SR
116), onto Gybe Ho Road (a private road), and then will acess the site through the
development of this proposed driveway.
b. Is the site or affected geographic area currently served by public transit? If so, generally
describe. If not, what is the approximate distance to the nearest transit stop?
Not applicable.
c. How many additional parking spaces would the completed project or non-project proposal
have? How many would the project or proposal eliminate?
None.
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d. Will the proposal require any new or improvements to existing roads, streets, pedestrian,
bicycle or state transportation facilities, not including driveways? If so, generally describe
(indicate whether public or private).
No.
e. Will the project or proposal use (or occur in the immediate vicinity of) water, rail, or air
transportation? If so, generally describe.
No.
f. How many vehicular trips per day would be generated by the completed project or proposal?
If known, indicate when peak volumes would occur and what percentage of the volume would
be trucks (such as commercial and nonpassenger vehicles). What data or transportation
models were used to make these estimates?
1-2 vehicular trips per day after completion of the driveway to access private residential
property.
g. Will the proposal interfere with, affect or be affected by the movement of agricultural and
forest products on roads or streets in the area? If so, generally describe.
No.
h. Proposed measures to reduce or control transportation impacts, if any:
None.
15. Public Services [help]
a. Would the project result in an increased need for public services (for example: fire protection,
police protection, public transit, health care, schools, other)? If so, generally describe.
No.
b. Proposed measures to reduce or control direct impacts on public services, if any.
None.
16. Utilities [help]
a. Circle utilities currently available at the site:
electricity, natural gas, water, refuse service, telephone, sanitary sewer, septic system,
other ___________
None currently available.
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b. Describe the utilities that are proposed for the project, the utility providing the service,
and the general construction activities on the site or in the immediate vicinity which might
be needed.
None proposed at this time.
C. Signature [HELP]
The above answers are true and complete to the best of my knowledge. I understand that the
lead agency is relying on them to make its decision. Signature: ___________________________________________________
Name of signee _Robert M. Brown, III_________________________________
Position and Agency/Organization __Property owner______________________
Date Submitted: _04/20/2022____________
D. Supplemental sheet for nonproject actions [HELP]
(IT IS NOT NECESSARY to use this sheet for project actions) Because these questions are very general, it may be helpful to read them in conjunction
with the list of the elements of the environment. When answering these questions, be aware of the extent the proposal, or the types of
activities likely to result from the proposal, would affect the item at a greater intensity or
at a faster rate than if the proposal were not implemented. Respond briefly and in
general terms.
1. How would the proposal be likely to increase discharge to water; emissions to air; pro-
duction, storage, or release of toxic or hazardous substances; or production of noise?
Proposed measures to avoid or reduce such increases are:
2. How would the proposal be likely to affect plants, animals, fish, or marine life?
Proposed measures to protect or conserve plants, animals, fish, or marine life are:
3. How would the proposal be likely to deplete energy or natural resources?
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Proposed measures to protect or conserve energy and natural resources are:
4. How would the proposal be likely to use or affect environmentally sensitive areas or
areas designated (or eligible or under study) for governmental protection; such as parks,
wilderness, wild and scenic rivers, threatened or endangered species habitat, historic or
cultural sites, wetlands, floodplains, or prime farmlands?
Proposed measures to protect such resources or to avoid or reduce impacts are:
5. How would the proposal be likely to affect land and shoreline use, including whether it
would allow or encourage land or shoreline uses incompatible with existing plans?
Proposed measures to avoid or reduce shoreline and land use impacts are:
6. How would the proposal be likely to increase demands on transportation or public
services and utilities?
Proposed measures to reduce or respond to such demand(s) are:
7. Identify, if possible, whether the proposal may conflict with local, state, or federal laws or
requirements for the protection of the environment.
DCD RECEIVED 5/12/2022