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Thurston Co NOA 06-21-06~? ~°~! ~ 1 .COUNTY COMMISSIONERS ~'~IURSTON COUNTY S1NCE 1852 Cathy Wolfe District One ~~~/ Q/~°~ Diane Oberquell ~UN District Two 2z 100! Robert N. Macleod District Three DEVELOPMENT SERVICES COMPLETENESS TRANSMITTAL MEMORANDUM Date Submitted ~ ~ PROJECT NAME: /C~ L.L,C Pxo~ECTNa: zo ()G~ IOaSbB FOLDER SEQUENCENO.: C~Io IO~~~-I ~~ RELATED CASES LISTED BYSEQUENCE NO.: CHID IU~~ Ip~ ~~. 0 TC ENVIRONMENTAL HEALTH ~TC ROADS -DEVELOPMENT REVIEW ^ TC ADDRESSING - C. TOEBBE ~. WA DEPT OF FISH & WILDLIFE - ~I~K. McMURRY [ ] M. SCHIRATO ^ WA DEPT OF TRANSP. - D.SEVERSON ^ WA ARMY CORP OF ENGINEERS. WA DEPT OF REVENUE - B. KRUETz ^TC ROADS/RIGHT OF WAY- Ivl. RABALGIA ^TC WATER & WASTE MGMT ^TC FLOOD REVIEW - ~. BUTLER• ~9WA DEPT OF ECOLOGY - [ ]SHORELINE REVIEWENVIRONMENTAL REVIEW ~,WA DEPT OF NATURAL RESOURCES - PACIFIC CASCADE REGION ADJACENT NRISDICTION (LIST) ^ THURSTON CONSERVATION DISTRICT ^ NISQUALLY REACH ^ OTHER ^ HENDERSON INLET ^ OTHER PLEASE SEE REVERSE SIDE FOR LIST OF REPORTS SUBMITTED WITH APPLICATION Pursuant to the. Thurston County Zoning and Subdivision Ordinances, please review the attached. project information and determine if the application is complete. Check the appropriate box on this form and return the form to the case manager. Please respond in the space below oY in an attachment on or before the due date noted below. "No comment" by the due date.will be considered an indication of the application is complete. Department: Signature•_ Complete ^ Incomplete ^ Not Applicable ^ Date• The following information is required prior to considering the application complete: The following are other items needed to review the project: Please return comments to:_ ~-(~1,~ ~1j~~,9~,~ • by S:OOpm on: Thank you! J 2000 Lakeridge Drive SW, Olympia, Washington 98502-6045 (360) 786-5490, TDD (360) 754-2933 • ~. ~ y ~ O~~ y -b y ~ y ~ ~ b b _ ENVIRONMENTAL HEALTH ROADS DEVELOPMENT REV DEPT. OF REVENUE ROADS-RIGHT OF WAY WA FISH AND WILDLIFE WA DEPT OF ECOLOGY ARMY CORP. OF ENGINEERS FLOOD REVIEW HENDERSON/NISQUALLY ADDRESSING OTHER THURSTON COUNTY ~~<. ra,~ THURSTON COUNTY DEVELOPMENT SERVICES 2000 LAKERIDGE DRIVE SW, OLYMPIA, WA 98502 (360) 786-5490 FAX (360) 754-2939 TYPE I OR II* APPLICATION FOREST LAND CONVERSION (CLASS IV GENERAL) _ _ (*Requires a SEPA Checklist) USE REPRODUCIBLE INK (preferably black) LANDOWNER(S): ^ CONTACT PERSON `TIMBER OWNER :OPERATOR ~ CONTACT PERSON 1 . FULL LEGAL NAME AND/OR COMPANY/ DIVISION NAME OF LANDOWNER GeL !? N 1 2. FULL LEGAL NAME ANDlOR COMPANY/ DIVISION NAME OF TIMBER OWNER n4,y_. ~ ,,, JJJ 3. FULL LEGAL NAME AND/OR COMPANYI DIVISION NAME OF OPERATOR ~n. c ~ereL~serw ~P/ r . rat: , r ~ I~a~u ,as G ~ F~ r~ ~ c~ BUSINESS ADDRESS yzoo 6 ~'Af/c SE x'30 / BUSINESS ADDRESS / E~ -~- _ l'E~- BUSINESS ADDRESS ~0 6 ~ djd~ /~ - CITY STATE ZIP LA~1 ~A.9~So3 CITY ~~-,~- STATE ZIP CITY STATE ZIP ~%onwr.GL- r'JA. 9~&-9565 PHONE: ( ) PHONE' - ~~~ - PHONE: ('3L0) ~~Z ^~j''Z7 FAX: ( ) - FAX: ( ) FAX: (3L D) & 32. ^~/n 2~J 4. TYPE OF LEGAL ENTITY ~ CORPORATION [ ]SOLE PROPRIETOR PARTNERSHIP OTHER (speciry): TYPE OF LEGAL ENTITY f ~ CORPORATION (]SOLE PROPRIETOR I PARTNERSHIP OTHER (speciry): TYPE OF LEGAL ENTITY ()} CORPORATION [ ]SOLE PROPRIETOR [[ ]J PARTNERSHIP OTHER (specify): 5. FOREST TAX REPORTING ACCOUNT NUMBER: [ 800 - o ~f9 ^ ~/S~ ] For tax reporting information or tax numbers call 1-800-548-8829. 6. SIGNATURE BLOCKS I (we) do hereby affirm and certify, under penalty of perjury, that I am one (or more) of the owners or owners under contract of the described property, and I believe that the following statements and answers are in all respects true and correct on my /~ ~ information and belief as to those matters. D E (S) ~ TIMBER OWNER OPERATOR /s~ acute; Signatur ' ( r ~~-- Signature: `~' "~ - PrinC !~'-1-~4- Print C~~ / Date of Landowner Signature: Date of Timber Owner Signature: Date of Operator Signat re: 6S- 2 S -- ~ .~ ~/ ~G. D ~ 3/ d ~ Signature: Sign ure: f-c:~ L. 1'_ ILLS c-;~. '~/7 1 '~` Signature: -GwL.G > r- ~ _ .~ ._ Print: Print: Print: Date of landowner Signature: Date of Timber Owner Signature: Date of Operator Signature: Signature: !n signing: this application, the landov+rner(s) hereby grants `, the!Thurston County Development Services Department the Pdnt: right tc~ enter the below described )t~catit~rt tt~ inspect the m d k o ' ' plete wor gress, or co posed~ in pr prn Date or Landowner Signature: Page 1 of 6 7. PROJECT DESCRIPTION R~uav.4c. ~.~ .a,oaec m~9Tlti.2c Tjr.~.4~.¢ Gys~ic'~t/ ~isrs o~ .Si Y6° ~.,Q x~m.4TerGN ~ ou,.v~ RASE •' T i+~/~s ~' r~1~•21~65T/~/G ~[ci~rNGx/T- WiGU ~6 G~-T/L/2E~ LOtd ~Oct.y/J /°~ESS~tL~E 2?uif/3 6i2 TIf2~ES ~!C /UAe"'YL. IJ.U/] SNDIJEs~S 8. PROPERTY LOCATION: 9. ACCESS: EAST WEST (Circle One) NORTH SOUTH Name of road or street from which access is or will be gained. . I Side of (road name): -H~~F+wMH So "7 S~ _ 1. EXISTING ACCESS: tom" tI/ATE ~A/VEwAy 7v Between (road name): lSb~ /~v~ SL ,~~~n2/G /~Apr~sr~ FG[owSHi~ ~u.e~/l. and (road name): ~SR. S(> 7 2. PROPOSED ACCESS: OPERTY ADDRESS /5036 .~~ l-~wY 5b`7 _ P R ~ ,/ yELM (~l//Q • 9~Sq~ ROAD HAUL # DIRECTIONS TO SITE: 10. DESCRIPTION OF PROPERTY ASSESSOR PARCEL NUMBER(S) SECTION TWP RANGE (E)(W) ACRES HARVEST UNIT# (See Section 10) .~/725/3ozoo ~S 1'j Af I 11. TIMBER HARVEST Complete all blocks that apply and LABEL EACH TYPE SEPARATELY ON THE SITE MAP. UNIT> (Note on site map) TYPE-0F HARVEST (Even-aged, Uneven-aged Salvage and/or RigMaf Way) TREES PER ACRE REMAINING AFTER HARVEST. METHOD OF HARVEST (Ground Cable, Highlead, Skyline, Shovel, Rubber Tired Skidder, Tracked Skidder, Animal, Helicopter or 8ailoonJ ACRES (per type of harvest) PERCENT OF VOLUME TO BE CUT ESTIMATED. VOLUME TO BE HARVESTED (inMBF) B1lEN -labb O RuggER naee Src~nObe. T,w~6„ PhD v ~ ~ ~ 9~ J`o 12. ROAD Complete all blocks that apply and LABEL EACH TYPE SEPARATELY ON THE SITE MAP. TYPE OF ACTIVITY TOTALtENGTH `..TOTAL LENGTH OF STEEPEST SIDE IN`FEET ENDHAUL/OVERHAUL SLOPE ROAD ' (no5idecasl) CROSSES CONSTRUCTION (in percent). Show All Locations OnsMap [ ]NEW ROAD CONSTRUCTION [ J EXISTING ROAD RECONSTRUCTION ~ EXISTING ROAD MAINTENANCE qpp ~( ~O ROAD ABANDONMENT Provide a Detailed Plan Page 2 of 6 '_i~. F THURSTON COUNTY „~ ,r,: THURSTON COUNTY DEVELOPMENT SERVICES ENVIRONMENTAL CHECKLIST "USE BLACK Ile1K ONLY" 1: Applicant: ~= ~ ~ f/Lt- Address: Lf ZCa ~ ~7J? ~ VE . S~ ~ ~C (. ^-rc-~ ~ ~ L ~ i A ter' ~.5~ ~1' Phone: Cell: E-Mail Address: 2. Point of Contact: Address: Phone: Cell: E-Mail Address: Phone: Cell: E-Mail Address: 4. Property Address or location: 5. Quarter/Quarter Section/Township/Range: ps ~`ir,s .v f X^~ r ~~ W= ~ ~ ~. `>• ~~-fz g+ ~ ~ ?v ~ ~~~ ~~ c~~~. ~~--~ ~S i•~: •-1 5^ I<4 Etc .~ ~ tc , ~` 6. Tax Parcel #: c~ /~ ~5 ! ~ Q 2lj CG 7. Total Acres:• ~ ~~~J 8. Permit Type: i,~r ->2A~.i~t;~ C_~r~if'~/r~~'~~./' 9. Zoning: 1~~ ./~ 10. Shoreline Environment: 11.. Water Body: i/ 12. Brief Description of the Proposal and Project Name: i~~~1~ ~~~C Gas.. ~~~'.~'C',~c~/r~-/,~EG~ `1`a % . c~,~' ~ffi s. ~~~Z * * * * OFFICIAL UJJSE:ONLGY * *G* * Folder Sequence # ~%(Sr "~(~a ~~"o X Project # : ~D n d ~ lQ Related Cases: ~ - S" ~~ X-~ Date Received: ~ /" d~ By; ~°' . r * * * * OFFICIAL USE ONLY 3. Owner: ~ Fa-rv~ c:- ~5 ~ ~ Address: -2- THURSTON COUNTY DEVELOPMENT SERVICES THURSroN courlTY ENVIRONMENTAL CHECKLIST SINCE I53: Purpose of Checklist . The State Environmental Policy Act (SEPA), Chapter 43.21 C RCW, requires all governmental agencies to consider the environmental impacts of a proposal before making decisions. An Environmental Impact Statement (EIS) must be prepared for all proposals with ' probable significant adverse impacts on the quality of the environment. The purpose of this checklist is to provide information to help you and the agency identify impacts from your proposal (and to reduce or avoid impacts from the proposal, if it can be done) and to help the agency decide whether an EIS is required. Instructions for Applicants - USEBLACK INK ONLY This Environmental Checklist asks you to describe some basic information about your proposal. Governmental agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of an EIS. Answer the questions briefly, with the most precise information known, or give the best description you can. Please do not write in.the area that is specified for "agency use only." You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you should be able to answer the questions from your own observations or project plans without the need to hire experts. If you really do not know the answer, or if a question does not apply to your proposal, write "do not know" or "does not apply." Complete answers to .the questions now may avoid unnecessary delays later. Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions if you can. If you have problems, the governmental agencies can assist you. A site plan must accompany the Environmental Checklist. It should be clearly legible, scaled accurately and include information regarding boundary. lines of subject and adjacent properties; roads, existing and proposed; existing buildings; wells and drainfields, if any; geographical features (such as steep slopes, low areas, seasonal or year-round drainages and shorelines) and details of the project. Please submit one copy of the site plan 11" x 17" or smaller. 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 a significant adverse impact. Use of Checklist for Nonproject Proposals Nonproject proposals are those which are not tied to a specific site, such as adoption of plans, policies, or ordinances. Complete this checklist for nonproject proposals, even though questions may be answered "does riot apply." In addition, complete the Supplemental Sheet for Nonproject Actions (Part D). For nonproject actions, the references in the checklist to the words "project," "applicant," and "property or site" should read as "proposal," "proposer," and "affected geographic area," respectively. Fees: Thurston County Development Services -Minor Administrative Permits Refer to Fee Schedule Thurston County Development Services -Major Hearing Examiner Permits Refer to Fee Schedule STAFF ONLY . Environmental Checklist Submittal Requirements Check all Front Page Entries Check Signature and Date. for Completion Include any environmental reports required. (Wetland report, etc.) Fees, Paid Site Plan: Submit one copy of site plan 11" x 17" or smaller. Plan must be clearly legible and contain pertinent information. 2000 Lakeriiige Dr. SW; Olympia, WA 98502: Phone: (360) 786-5490; TDD (360) 754-2933 Rc ~dse:f '(iiih ,,:> ..,` THURSTON COUNTY <~.~ ~a,: To be Completed by Applicant THURSTON COUNTY DEVELOPMENT SERVICES ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (check-one): Flat. =J Roiling Hilly Steep Slopes Mountainous Other b. What is the steepest slope on the site (approximate percent 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 prime farmland. d. Are there surface indicators or history of unstable soils in the immediate vicinity? If so, describe. /G~C"/li~ e. Describe the purpose, type, and approximate quantities of any filling or grading proposed. Indicate source of fill. f. Could erosion occur as a result of cleaiing, constn-ction, or use? If so, generally describe. /1/G;~ ~i ~ ~~~T ~'~~lG~/~11t~~ ~i~s Evaluation for Aeency Use Onlv -4- Thurston County Development Services Environmental Checklist 13. Did you attend a presubmission conference for this project? Yes ~o ~` If yes, when? ~f/~,~ /~l~,e~ ~Pn~ ~= ~.~3a~ ~~~ 14. Estimated Project Completion Date: ~~ cc S~ ~ ~~ ~ 15. List of all Permits, Licenses or Government Approvals Required for the Proposal (federal, state and local--including rezones): ~.~f~~~ ~~~f~~ ~ i ~~6~z "~t~ G~i~~ 16. Do you have any plans for future additions, expansion or furthei activity related to or connected with this proposal? If yes, explain: G~iY:~~ ~ ~~~~~x.~-vim `-T~~f?~t~~. ~1~1~' ~'~ ~~ ~~~~ 17. Do you know of any.plans by others which may affect the property covered by your proposal? If yes, explain: ~~ I8. Proposed timing or schedule (including phasing, if applicable): 19. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. /L9.~= ~~C=~.; ~./ -3- Thurston County Development Services Environmental Elements To be Completed by Apalicant g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: -, J -rte` °~ ~I/itr/r~i~"' i~~~'~'~7/~~- ~1~~1 !mss ~~~~ c~~~-tea ~~-.~~ ~~.~~~,~~ r~"~~,~ 2. Air a. ,What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities if known. ~~i41r ~ ~~ b. Are there any off-site sources of emissions or odor that may affect your proposal? If so; generally describe. /L~62C-- f. ~"LGt1/ t~-- c. Proposed measures to reduce or control emissions or other impacts to air, if any: /~f ,4'T dam' Ti~E' ~i_~'r / J~'! N v1. c<i ~ C~~~ ni ~'~~ ~~ ~~ ~ ~ 3. Water a. Surface (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. /J~ C Evaluation for A~ency Use Only =5- Thurston County Development Services Environmental Elements I Evaluation for To be Com leted by A licant AQency Use Only (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. ~~~ (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. ~G~L (4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. ~G (5) Does the proposal lie within a 100-year flood plain? If so, note location on the site plan. ~~ (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. ~~ b. Ground (1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, purpose, and approximately quantities if known. ~~~ -6- Thurston County Development Services Environmental Elements To be Completed by Aaplicant (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. ~~17r/ c. Water Run-off (including, stonnwater) (1) Describe the source of runoff (including stonnwater) and method of collection and disposal, if any (include quantities, in known). Where will this water flow? Will this water flow into other waters? If so, describe. ~Al ~ J~lyJs !G'~i~~ !~/~L ~Ct'~ ~~G=.2asS. ~~L~- t' ~~~ ~ ~~~K !t'7 ~6 Jam: ~ C9l C, (2) . Could waste-materials enter ground or-surface waters? , If so, generally describe ~~ (3) Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: ~B ~~ 4. Plants a. Check the types of vegetation found on the site: Deciduous tree: der maple aspen. other Evergreen tree: fir ~ cedar pine other ~~1 Lc+~ Shrubs Grass Pasture Crop or grain Wet soil plants: cattail buttercup bulrush skunk cabbage other Water plants: water lily eelgrass milfoil other. Other types of vegetation Evaluation for Agency Use Onlv -7- Thurston County Development Services Environmental Elements Evaluation for To be Comuleted by Aunlicant Aaencv Use Only b. What-kind acid amount of vegetation will be removed or altered? c. List threatened or endangered species known to be on or near the site. l~(P~ ~ ~~©t~ °L/ d. .Proposed landscaping, use of native plants, or other measures to preserve or enhance v,,eegetation on the site, if any: /~~ - . 5. Animals a. Check any birds and animals which hav e been observed on or near the site or are known to be on or near the site: Birds: awk,~ heron, other: eagle;./ on bird Mammals e~ bear, elk, beaver, other: Fish: bass, salmon, trout, herring, . shellfish, other: b. List any threatened or endangered species known to be on or near the site. ~~~ c. Is the site part of a migration route? If so, explain. ~~ d. Propo~se/d measures to preserve or enhance wildlife, if any: 'fbl9 E' -8- Thurston County Development Services Environmental Elements Evaluation for To be Completed by Applicant Agency Use Only 6. Energy and Natural Resources 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. ~~ ~7 ~ b. Would your project affect the potential use of solar. energy by adjacent properties? If so, generally describe. 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 ~~6~~ 7. Environmental Health a. Are there are any environmental health hazards, includirig 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. ~E~ E (1) Describe special emergency services that might be required. ~p/J~ (2) Proposed measures to reduce or control environmental health hazards, if any: ~~~~ -9- Thurston County Development Services Environmental Elements To be Completed by Applicant b. ~ Noise (1) What types of noise exist in the area which may affect your project (for example: traffic; equipment, operation; other)? ~~ ~ ~ (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)? Indicate what hours noise would come from the site. _ / (3) Proposed measures to reduce or control noise impacts, if any: ~~~~m~~ ivffzG4. ~l%~'~?~ G~2~ R-~ 7' 8. Land and Shoreline Use a. What is the current use of the site and adjacent properties? C s~ L Cf>~ 1~~zm b. Has the site been used for agriculture? If. §o, describe. /lfG c. Describe any structures on the site. /~/~ /.~IlJ~?C1~%./~r~~ //~,~•Qi~ • c ~ pT~~.~(~E~~ Grp/~ ~-- d. Will any structures be demolished? If so, what? ~~f~ e. What i/s~the current zoning classification of the site? Evaluation for Aaency Use Only - 1~ - Thurston County - Development Services -~--Environmental Elements To be Completed by Annlicant f. What is the current comprehensive plan designation of the site? g. . If ap/plJicable, what is the current Shoreline Master Program designation of the site? /"/ ' ' - h. Has any part of the site been classified an "environmentally sensitive" area? If so, specify. J , /" F~ , i. Approximately how many people would reside or work in the completed project? j. Approximately how many people would the completed project displace? k. Proposed measures to avoid. or reduce displacement impacts, if any? - 1. Proposed measures to ensure the proposal incompatible with existing and projected land uses and plans, if any: ~ `7 ice' ~ s r ,~.~v i~,~-~ ~ ~ ~ ~G,~~,~ ~, ~.~s ~~2~3 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high-, mirddle-, or low-income housing. ~/ Evaluation for Agencv Use Onlv -11- Thurston County Development Services Environmental Elements Evaluation for To be Completed by Applicant Aeency Use Only b.. Approximately how many units, if any, would be eliminated? Indicate whether high-, middle, orlow-income housing. ~~~ c. Proposed measures to reduce or control housing impacts, if any: 10. Aesthetics a. What is the tallest height of any proposed structure(s), not including antennas; what is the pe~r//incipal exterior building material(s) proposed? 4'v`~ b. What views in the immediate vicinity would be altered or obstructed? ®'/ '" , c. Proposed~m/easures to reduce or control aesthetic impacts, if any: /d/ . " 11. Light and Glare a. What type of light or glare will the proposal produce? What time of day would it ' mainly occur? . -~{~ ~ ~j-c . b. Could light or glare from the finished project be a safety hazard or interfere with views? ' ~~ -12- Thurston County Development Services Environmental Elements Evaluation for To be Completed by Applicant AAency Use Onlv c. What existing off-site sources of light or glare may affect your proposal? d. Proposed measures to reduce or control light and glare impacts, if any: i~~~ 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? ~ ~1~r~ ~~ ~~~rf ~~ ~ ~ ~ /~u, ~ s~~ 17. Would the proposed project displace any existing recreational uses? if so, describe.. /v Z' c. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: ' ~~ 13. Historic and Cultural Preservation a. Are there any places or objects listed on, or proposed for, national, state, or local preAse/rvation registers known to be on or next to the site? If so, generally describe. b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. -13- Thurston County Development Services Environmental Elements To be Completed by Applicant c. Proposed measures to reduce or control impacts, if any ~b ~ 14. Transportation a.. Identify public streets and highways serving the site, and describe proposed access to the existing street system.'~S jhow on site plans, if any. ~C'r j ~ !~.> iii i /~ /.S ~~' ~~ ~~~~ ~-" b. Is site currently served by public transit? If not, what is the approximate distance. to the nearest transit stop? c. How many parking spaces would the completed project have? How many would • the project eliminate? ~~ ~ ~ d. Will the proposal require any new roads or streets, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate whether public or private). ~~' e. Will the project use (or occur in~the immediate vicinity of) water, rail, or air transportation? If so, generally describe. ~~' f: How many vehicular trips per day would be generated by the completed project? If known, indicate when peak volumes would occur. .-~!~~- i Evaluation for AQencv Use Onlv -14- :r Thurston County Development Services Environmental Elements Evaluation for To be Completed by Applicant Agencv Use Only g. Proposed measures to reduce or control transportation impacts, if any: ~~' `~ e 15. Public Services a. Would the project result in an increased need for public services (for example: fire protection, police protection, health care, schools, other)? If so,.generally describe. ~f ~~ e b. Proposed measures. to reduce or control direct impacts on public services, if any. ~~0~ ~ 16. Utilities a. Circle utilities currently available at the site: electricity, natural gas, water, refuse . service, telephone, sanitary sewer, septic system, other. ~~~~ e 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. ~~~z° 17. Signature a. 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. ~r /~~LL Print Name ~ ~.w~ k-5 /11¢~C~ Date Submitted ~ ~z --~''~ Signature: yI',.y;' ~~~,~~ -15- r THURSTON COUNTY - SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS - (Do not use .this sheet for project actions) THURSTON COUNTY ' ~IKE.IF51 Non-project proposals are those which are not tied to a specific site, such as adoption of plans, policies, or ordinances. 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. To be Completed by Applicant 1. How would the proposal be likely to increase discharge to water; emissions to air; production, storage, or release of toxic or hazardous substances; or production of noise? ~~ i~ Proposed measures to avoid or reduce such increases are: ~~~, ~ ~, ~.Q,~ ~~ ~ `~ ~+-~ inks ~~~~N ~ ~=~j55 i ~-5 ~ 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? Proposed measures to protect or conserve energy and natural resources are: Evaluation for AaencV Use Onlv -16- 9 Thurston County Development Services Supplemental Sheet for Non}iroject Action To be Completed by Applicant 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 /s`ites, wetlands, flood plains, or prime farmlands? /v/ 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? ~v/ ' ` 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 mea~su/res to reduce or respond to such demand(s) are: !v 7. Identify, if possible, whether the proposal may conflict with local, state, or federal laws or requirements for the protection of the environment Evaluation for AEencv Use Onlv -17- ~v~sT vN~~ ~~ rst~ C®n NI rte" NAME: FH1, LLC -~~t 42~ 6`b Ave. SFi~ 301 ,~`F Lacey, WA. 98503 DESCRIPTION: Timber Removal " ~ -oo approximately 4 acrs ~ - - _ ~ ,r' ~` _ '' LEGEND: _ ~~ ----- Hatvest,BQfid~ ry-= _.t` xxxx _=Ezisting9+ence` -^ Existing 12otAd ~~l ~~ ~^ J y ~~ . fj f - ~. f _ ~ ? '~' 2 _ ~ p Q~ NORTH i` ~ _°~'~,' `}J' _ ' ~~ ~ _ y Y 1 Bt1$tJ . of N N N rl7 tU Parcel: 21725130200 `z :3 :" ~ ~/ r r. L Z ~ 2 ~ .~ Z tv k x di n, e., e~., r., ~.. rv N ty .~ - .~C _ . ----- f -~-- -----._ _ _... __..~ _ _ . _ ._ _ ~. ~X f$TfN ~ - 1 B o ~° S ~~~° ~' Y4 n - TtaBtnz~a ~aF.sj: Cinar ~ Y~rds4a'~'~y 50 ~ ~~~ t 05th Ave ~ ~ ,q,~ k:, ~ .. f2afifaa'M Ct Se ~ ~~ ~ i~ ae11r x_~~ _ ]Irnso.=z1 ~htch $t-.$E i~ 9f1t4th A_va Se ,;; ~''~ ~5~ o~~ ., 9~a~r r' S THURSTON GEODATA CENTER ~ SUMMARY TABLE _ _- - ~L FHI LLC ~~ ~ i ~`~ - MAILING ADDRESS: ~;~ r ~~ ~- L ~ ~ i ~~ ~ ~ ~i~ ~~ 9200 6TH AVE SE # 301 _ -. it F_~ _ f~ i~ ~, Y i; Q LACEY, WA 98503 'k - 'F ~ ~'~ '`~ ~,- - 'i ~ SITE ADDRESS _ _ ~ _ F y i~_ ,~~ ~~ _ -. '. 15036 SE 507 HWY ~ ~ ~ ~f ~~ _ ~' ~~ ~ '~~ ~ _ ~ YELM, WA 98597 ., ~'I -~.~ ~ ~ ~ ~ ~~ ;:(~ -. ~ t -{I PARCEL#: 21725130200 ~. cl .. - ' ~ ~ ~ ~ ~ ~~ j~ -- ' - ~~ ~ - SECTION: 525171E ~';' .. _ '/ ii C~~ i i n+ ;zl ' ~ ~ A _ I _ _ ~ ~ ~ ~~LY ~^ 1 ~t~° U ~~ ~-~ '~~ _ ~~ .• CONTAMINATION SITE: NO .~--; Y'-° 1 ~ _ - \a ~ I ~ HISTORIC SITE: NO i. ~~ L (yyy~~~''' ~ ~ ~~ ~'~;'. ~ r'v, ? j- FEMA 100YR FLOOD ZONE: NO ~~ ' ! 4 ~A ., ~' ~ ~ / ~~ ~ ~, FEMA PANEL: 365 ~> i~ r ~cfq L" 4 ': f ~.~ ~ ~.' ZONING: RR1~5 ~~~, ~ ~~~~ ~ 1' ~ _ _ .~~~~ WETLAND: NO __ r __ Q.t 1.~~~^~/,7{ - " ~~ •..~ ` ~.,~ ~~~~.- ~ r 1 ~~;; WETLAND BUFFER: YES I -~I 7" ~ ~~~~ ~'I ` HAZARDOUS SLOPES: YES ~' .._ _ I. I \a _<• , _ _ i ~ ~ ~ r ~ ~ ~ ~ON~ ,. C~ `~~ ~~ '~ _ ~ ~ WELLHEAD PROTECTION: NO ~- Q VJ ~ ~ Y~ \ ~~~y ~ ,~ ~~ r ~ DNR RARE PLANTS : NO i ' - ~ ~~`ti ~ Yt ~~ WATER SERVICE AREA: NONE - M B FER: STREA OF NO _. ~ i _.. _ / _. '~ ____ v' ~~ ~. .. ~-- ,_ c _ ,'~~. , 1 SHORELINE BUFFER: NO i ~uil ._..i 4 -~ ,_. .~ I I ~~~ - _ f t `. i r, _ _~ r'. i_: REEN VE BA I f G CO S N. NO I ~- ~~~~ ~~ w`~ ~ ~t~ ~. _ "i ~ _ I _ ~~ SALMON CREEK BASIN: NO 1 j ~ ~ ~ „F ~ 11 -.~ ~ I ~~ FLOOD OF 1996: NO rt 6 - I F ~ i 7nrrimin ~ + _ HGW HAZARD : NO (LIMITED GROUNDWATER: NONE i -- ~i OAK STANDS: YE - ~ ~ `' '-' ~-~) DEV REV INSPECTOR: NONE ~ "fir RGE ~~ i ~ ~ ! ~ ~~- ~ - ~-' WEED CONTAINMENT: NO ORIJ ." l i _ ~ L ff I ` - i . ~ ~ BUILDING INSPECTOR: GREG _ __. L.. }l`U ;_~f l ~i ~ - v HYDRIC SOILS: NO ' ~ ~ _I ~ "' ~ ~ ~ CAROLYN LANDSLIDE: NO -~}. _ - ., __ - _ __ ~-- "" - '°' ~~~ NITRATES: NO o. i - ~-~~_,. !` . ~ _ ~ MINERAL LANDS SUPPER: NO LTF SOOFT BUFFER: NO i LTA SOOFT BUFFER: NO ~I - ~ 9 - PRIORITY SPECIES: NO ' SHORELINE MASTER PLAN: NONE Q SURSDICTION: YELMUGA i = SCHOOL DISTRICT: NA ' (n FIRE DISTRICT: YELM i ___._____.. _ , _.; __ -- -- -, ~ / _ _.'' ., PLANNING ZONE: 9 -' ... ... ;F' , 5T ...LN -V~{~ ,. ~ ~ '~ ~- Z ~~ ~ TE[UR.STON COUNTY .. ~' ~~~ ~ ~ ~ ,,,,,,,,,,~ > ~ _ Not [o Scale ~- ~ .. ~ ... o Mon Jun 12 14:25:07 2006 ' " ' ~ ~ '- ~~ ,,... '' ", All Locations are Approximate. Therefore, this map is to be used as . '~ _. .. "" ~ . ~. '- - an illustration only. All data represented may change without notice! _-,,:;__ -mil ~