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WSDOT PavingLIST OF ATTACHED a W c J a d m a�Q W REPORTS AND J '� w o oco w 0 W ROUTINGS w m c Q z o z W W 0' Z O N Z Q Vcl) W � w' Ix > w > o LU '.a H.. O:\admin\TRANSMITTAL MEMORANDUM.doo �'� SCANNED r ..... e� THURSTON COUNTY SINCE 1BSZ Thurston County Permit Assistance Center 2000 Lakeridge Dr. SW, Olympia, WA 98502 (360)786-5490 / (360)754-2939(Fax) . TDD Line (360) 754-2933 Email: permit Cco.thurston.wa.us www.co.thurston.wa.us/peri-nittinQ Creating Solutions for Our Future MASTER APPLICATION STAFF USE ONLY DATE STAMP THURSTON COUNTY RECEIVED "f)V 20114 2014108101 PERM ASSISTANCE CENTpR 14 127681 XL Site Address: Parcel #: Intake by: The Master Application is required for all projects and shall accompany a project -specific supplemental application(s). The Master Application may not be submitted alone. Property Tax Parcel Number(s): N/A Subdivision Name (if applicable): N/A Lot #: Property Address: SR 507, MP 13.64 to MP 36.22 City: Tenino to Roy State: WA Zip Code: Directions to the Property: From Tenino, head east on SR 507, thru Yelm to Nisqually River bridge (county line). Property Access Issues (locked gate, code required, dogs or other animals): ❑X No QYes If yes, Describe: OWNER IS RESPONSIBLE FOR SECURING ANIMALS BEFORE SITE VISIT. DESCRIPTION OF PROJECT PROPOSAL SR 507 / Old Hwy 99 to E. of Water Street — Paving This project is located on SR 507 between MP 13.64 and MP 36.22 in Thurston and Pierce Counties, and SR 702 between MP 0.00 and 0.30 in Pierce County. The project will utilize a mill and fill process to replace the top course of Hot Mix Asphalt to rehabilitate SR 507 and SR 702. Other work will include pavement repair, pre- level and tack coat. This project will also evaluate and upgrade pedestrian crosswalks to meet current ADA compliance. Revised 8-13 Form No. MA001 Thurston County Permit Assistance Center Master Application Page 2 of 2 Type or Print: Additionalproperty owner sheet can be obtained online at www.co.tlznrston.wa.its/perinittii or copy obtained from the Permit Assistant Center. Property Owner(s): WA State Dept. of Transportation Mailing Address: PO Box 47440 City: Olympia State: WA Zip Code: 98504-7440 Phone #: (360) 570-6700 Ext. Fax #: (360) 357-2601 Cell #: E-mail: Signature:* Date: Applicant (if different than owner): Jeff Sawyer / WA State Dept. of Transportation Mailing Address: City: State: Zip Code: Phone #: (360) 570-6701 Ext. Fax #: Cell #: E-mail: sawyeri a wsdot.wa.gov Signature:*. Date: l / 3 Point of Contact: Mailing Address: City: State: Zip Code: Phone #: Ext. Fax #: Cell #: E-mail: Signature:* Date: BILLING INVOICES The base application fee charged at the time of application covers base hours listed on the fee schedule. When the base hours by a Department are used, a monthly billing invoice will be generated for additional hours at the hourly rate listed on the fee schedule. Should review of the project exceed the base hours allotted, billing invoices shall be mailed to: ❑X Owner 0 Applicant ❑ Point of Contact *Application is hereby made for a permit or permits to authorize the activities described herein. I certify that I am familiar with the information contained in the application and that to the best of my knowledge and belief, such information is true, complete, and accurate. I further certify that I possess the authority to undertake the proposed activities. I hereby grant to the agencies to which this application is made or forwarded, the right to enter the above-described location to inspect the proposed, in -progress or completed work. I agree to start work only after all necessary permits/approvals have been received. Revised 8-13 Form No. MA001 SCANNED 0 WASHINGTON STATE USArmy S rps of Engineers Seattle Districtict Joint Aquatic Resources Permit Application (DARPA) Form',2 USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. Part 1—Project Identification --------------------------------------- AGENCY USE ONLY Date received: t t Agency reference W. Tax Parce�°�#($�i:..LUE€ I ' 14 127681 XL i Permit Type: JARPA - Exemption Sub Type: Roads (New or Repair) Work Type: Repair / Maintenance 1. Project Name (A name for your project that you create. Examples: Smith's.Dock or Seabrook Lane Development) SR 507 / Old Hwy 99 to E. of Water Street - Paving Part 2—Applicant The person and/or organization responsible for the project. [heipl 2a. Name (Last, First, Middle) Sawyer, Jeff B. 2b. Organization (If applicable) Washington State Department of Transportation 2c. Mailing Address (Street or PO Box) P.O. Box 47440 2d. City, State, Zip Olympia, WA, 98504-7440 2e. Phone (1) 2f. Phone (2) 2g. Fax 2h. E-mail (360) 570-6701 (360) 790-9646 (360)357-2601 sawyerj@wsdot.wa.gov iAdditional forms may be required for the following permits: • If your project may qualify for Department of the Army authorization through a Regional General Permit (RGP), contact the U.S. Army Corps of Engineers for application information (206) 764-3495. • If your project might affect species 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 army,mill isgi� /�lvilV : (kf „ 1 fOrLP, rn€t rres l� e€arc: rfl s i _ s X. • Not all cities and counties accept the JARPA for their local Shoreline permits. If you need a Shoreline permit, contact the appropriate city or county government to make sure they accept the JARPA. 2 T access an online JARPA form with [help] screens, go to tiff lr';'�FrF«�sh:Rr i/ri��/fi _r €. ��€iJl f 1rlll farm.. For other help, contact the Governor's Office for Regulatory Innovation and Assistance at (800) 917-0043 or (ij7Qr t . �ia..zpL. JARPA Revision 2012.2 Page 1 of 12 Part 3—Authorized Agent or Contact Person authorized to represent the applicant about the project. (Note: Authorized agent(s) must sign 11 b of'this application.) ire 3a. Name (Last, First, Middle) 3b. Organization (if applicable) 3c. Mailing Address (street or PO Box) 3d. City, State, Zip 3e. Phone (1) 3f. Phone (2) 3g. Fax 3h. E-mail c ) c ) c ) 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.ht !-,M ❑ Same as applicant. (Skip to Part 5.) ❑ Repair or maintenance activities on existing rights-of-way or 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) 41J. Organization (If applicable) 4c. Mailing Address (street or PO Box) 4d. City, State, Zip 4e. Phone (1) 4f. Phone (2) 4g. Fax 411. E-mail JARPA Revision 2012.2 Page 2 of 12 Part 5—Project Location(s) Identifying information about the property or properties where the project will occur. [bQlp ❑ 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.)h[ els] ❑ 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] SR 507, milepost (MP) 13.64 to 14.72, MP 27.38 to 32.60, MP 34.67 to 36.22 and SR 702, MP 0.00 to 0.30. 5c. City, State, Zip (If the project is not in a city or town, provide the name of the nearest city or town.) [help] Tenino WA, 98589, Yelm WA, 98597, and Roy WA, 98580. 5d. County heir Thurston and Pierce Counties. 5e. Provide the section, township, and range for the project location. hel '/4 Section Section Township Range SR 507, City of Tenino 19 16 N 1 W SR 507, City of Yelm 25, 30, and 29 17 N 1 E SR 507, City of Roy 28 and 29 17 N 2 E SR 702, City of McKenna 21 and 28 17 N, 2 E 5f. Provide the latitude and longitude of the project location. [heipi • Example: 47.03922 N lat. / -122.89142 W long. (Use decimal degrees - NAD 83) Project begins at: 46.851648 / -122.861951, and ends at: 46.988763 / -122.547955 5g. List the tax parcel number(s) for the project location. [heipi • The local county assessor's office can provide this information. N/A 5h. Contact information for all adjoining property owners. (If you need more space, use JARR6 Attachment Q.) hei . Name Mailing Address Tax Parcel # (if known) Numerous property owners .................................................................................................................................................................................................................................................... JARPA Revision 2012.2 Page 3 of 12 5i. List all wetlands on or adjacent to the project location. [help] There are numerous wetlands throughout the project area. 5j. List all waterbodies (other than wetlands) on or adjacent to the project location. [help Mill Pond at MP 27.75, Yelm Creek at MP 29.41, Centralia Canal at MP 30.52, Unnamed Drainage at MP 30.60, Nisqually River at MP 30.65 and Muck Creek at MP 35.85. 5k. Is any part of the project area within a 100 -year floodplain? net ❑. Yes ❑ No ❑ Don't know 51. Briefly describe the vegetation and habitat conditions on the property.n[ pfd Native vegetation occurs along both sides of the existing roadway. Habitat conditions vary from sparsely vegetated to fairly dense mature timber. 5m. Describe how the property is currently used. net The project is on SR 507 and SR 702. Both are transportation corridors within state owned right of way. 5n. Describe how the adjacent properties are currently used.Md The adjacent properties are currently used as residential, commercial and forest. 50. Describe the structures (above and below ground) on the property, including their purpose(s) and current condition. het The structures are all transportation related and include guardrails, roadway surface, culverts and bridges. The condition of the roadway is in need of resurfacing and sidewalks within city limits need to be upgraded to current ADA standards. 5p. Provide driving directions from the closest highway to the project location, and attach a map. [help] From the City of Tenino at MP 13.66, head east on SR 507 to the city of Roy at MP 36.22. Part 6—Project Description 6a. Briefly summarize the overall project. You can provide more detail in 6b. [heipi This paving project will use a mill and fill process to rehabilitate the existing roadway in both directions of SR 507, milepost (MP) 13.64 to 14.72, MP 27.38 to 32.60, MP 34.67 to 36.22 and SR 702, MP 0.00 to 0.30. The project will remove .15 depth of existing pavement and replace .15 depth with Hot Mix Asphalt (HMA). Other work activities will include pavement repair, pre -level and tack coat. Project work also includes miscellaneous pavement repair. No new impervious surfaces will be added and no earthwork is anticipated. Pedestrian ramps at street crossings will be evaluated and upgraded to meet current ADA standards. The work will be performed within 200 feet of the following shorelines of the state: • Nisqually River at MP 30.65 in Thurston and Pierce Counties. Paving will occur up to bridge abutments, bridge deck has concrete surface.. 6b. Describe the purpose of the project and why you want or need to perform it. h[ The purpose of this project is to rehabilitate the road surface to extend the life of the roadway and to update pedestrian sidewalks and pedestrian access ramps. JARPA Revision 2012.2 Page 4 of 12 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 Measurement Device ❑ Boat Lift ❑ Dock / Pier ❑ Marina / Moorage ❑ Stairs ❑ Bridge ❑ Dredging ❑ Mining ❑ Stormwater facility ❑ Bulkhead ❑ Fence ❑ Outfall Structure El Swimming Pool ❑ Buoy ❑ Ferry Terminal ❑ Piling/Dolphin ❑ Utility Line ❑ Channel Modification ❑ Fishway ❑ Raft ® Other: Road maintenance. 6e. Describe how you plan to construct each project element checked in 6d. Include specific construction methods and equipment to be used. heE • Identify where each element will occur in relation to the nearest waterbody. • Indicate which activities are within the 100 -year floodplain. This project will resurface both directions of SR 507 from MP 13.66 to 14.22 in the city of Tenino, SR 507 from MP 27.38 to MP 32.60 in the city of Yelm, from MP 34.67 to 36.22 in the town of Roy and SR 702 from MP 0.00 to MP 0.30 in the town of McKenna. Existing asphalt surface will be leveled using a grinder. This will be followed by repairs to damaged surface in select locations. The new asphalt will be applied and then a roller will follow behind and compact the new asphalt to create a smooth wearing surface. This project will resurface over Yelm Creek culvert at MP 27.75, the Centralia Canal culvert at MP 30.52, and an unnamed drainage culvert at MP 30.60. No work will be conducted within a 100 -year floodplain. The types of equipment to be used include the following: • pavement grinder • asphalt spreader • dump truck • rollers • sweepers • paint truck • plastics truck • striping equipment • pickup broom/sweeper. JARPA Revision 2012.2 Page 5 of 12 6f. What are the anticipated start and end dates for project construction? (MonthNear)hi ems] • 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: April 2015 End date: August 2015 ❑ See JARPA Attachment D 6g. Fair market value of the project, including materials, labor, machine rentals, etc. [heipi $2,987,462 6h. Will any portion of the project receive federal funding? [helpi • If yes, list each agency providing funds. ® Yes ❑ No ❑ Don't know Federal Highway Administration 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 This project has avoided impacts to wetlands by staying within the existing roadway prism. 7b. Will the project impact wetlands?hf eM ❑ Yes ® No ❑ Don't know 7c. Will the project impact wetland buffers? [nelpl ❑ Yes ® No ❑ Don't know 7d. Has a wetland delineation report been prepared? [heipl • If Yes, 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? hey • If Yes, 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 • If Yes, submit the plan with the JARPA package and answer 7g: • If No, or Not applicable, explain below why a mitigation plan should not be required. ❑ Yes ❑ No ® Not applicable The project is staying within the existing roadway prism, so there won't be any adverse wetland impacts. 7g. Summarize what the mitigation plan is meant to accomplish, and describe how a watershed approach was used to design the plan. [tea N/A JARPA Revision 2012.2 Page 6 of 12 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. [hgjA Activity (fill, drain, excavate, flood, etc.) Wetland Name' Wetland type and rating category' Impact area (sq. ft. or Acres) Duration of impact3 Proposed mitigation type Wetland mitigation area (sq. ft. or acres) N/A If no official name for the wetland exists, create a unique name (such as "Wetland 1"). The name Should be consistent with other project documents, such as a wetland delineation report. 2 Ecology wetland category based on current Western Washington or Eastern Washington Wetland Rating System. Provide the wetland rating forms with the JARPA package. 3Indicate the days, months or years the wetland will be measurably impacted by the activity. Enter "permanent' if applicable. 4 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: 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. het N/A 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. het N/A Part 8—Waterbodies (other than wetlands): Impacts and Mitigation In Part 8, "waterbodies" refers to non -wetland waterbodies. (See Part 7 for information related to wetlands.) [het ❑ 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. [bel ® Not applicable This project has avoided impacts to waterbodies by staying within the existing roadway prism. 81b. Will your project impact a waterbody or the area around a waterbody? bel ❑ Yes ® No 8c. Have you prepared a mitigation plan to compensate for the project's adverse impacts to non -wetland waterbodies?bL ] • If Yes, submit the plan with the JARPA package and answer 8d. • If No, or Not applicable, explain below why a mitigation plan should not be required. ❑ Yes ® No ❑ Not applicable The project is staying within the existing roadway prism, so won't adversely impact non -wetland waterbodies. JARPA Revision 2012.2 Page 7 of 12 8d. Summarize what the mitigation plan is meant to accomplish. Describe how a watershed approach was used to design the plan. • If you already completed 7g you do not need to restate your answer here. [heli] N/A 8e. Summarize impact(s) to each waterbody in the table below.h[ els Activity (clear, Waterbody Impact Duration Amount of material Area (sq. ft. or dredge, fill, pile name' location of impact3 (cubic yards) to be linear ft.) of drive, etc.) placed in or waterbody removed from directly affected waterbody N/A If no official name for the waterbody exists, create a unique name (such as "Stream 1") The name should be consistent with other documents provided. 2 Indicate 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. Enter"permanent" if applicable. 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. [helpj N/A 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. hel Agency Name Contact Name Phone Most Recent Date of Contact City of Yelm Tami Merriman (360) 458-8496 9/8/2014 City of Roy Debbie Dearinger (253) 843-1113 9/10/2014 9b. Are any of the wetlands or waterbodies identified in Part 7 or Part 8 of this JARPA on the Washington Department of Ecology's 303(d) List? [hgi j • If Yes, list the parameter(s) below. • If you don't know, use Washington Department of Ecology's Water Quality Assessment tools at: htt:fCvloM€r9lwf30rl ❑ Yes ® No 9c. What U.S. Geological Survey Hydrological Unit Code (HUC) is the project in? ft1pl • Go tot 111 f 3 t.ok y,t9 to OM to help identify the HUC. Deschutes Watershed — 17110016 and Nisqually Watershed - 17110015 JARPA Revision 2012.2 Page 8 of 12 9d. What Water Resource Inventory Area Number (WRIA #) is the project in? [belp] • Go to http://v�wiv.ec-g.vua-govtservicesigistmapsfwria/wria.htm to find the WRIA #. WRIA 13 — Deschutes and WRIA 11- Nisqually 9e. Will the in -water construction work comply with the State of Washington water quality standards for turbidity? [belp] • Go to http./fvvww.ecy_wa.qov/programsfwglswgstcriteria.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?h[ esu] • If you don't know, contact the local planning department. • For more information, go to: h4.tta:l•/vwpv_ecy.wa.gov/programs/sea/sma/laws rules/173-26/211 designat€ons.html. ® Rural ❑ Urban ® Natural ❑ Aquatic ® Conservancy ❑ Other 9g. What is the Washington Department of Natural Resources Water Type? [help] • Go to http:f/wv�w.€ nr_wa.qov/BusinessPermitsrFopics/ForestPracticesApplications/Pages/fp watertyping.aspx for the Forest Practices Water Typing System. ® Shoreline ® Fish ❑ Non -Fish Perennial ❑ Non -Fish Seasonal 9h. Will this project be designed to meet the Washington Department of Ecology's most current stormwater manual? heI • If No, provide the name of the manual your project is designed to meet. ❑ Yes ® No Name of manual: WSDOT Highway Runoff Manual, April 2014, M31-16 9i. Does the project site have known contaminated sediment?hf ell • If Yes, please describe below. ❑ Yes ® No 9j. If you know what the property was used for in the past, describe below. [help] Transportation corridor. 9k. Has a cultural resource (archaeological) survey been performed on the project area? [heI • If Yes, attach it to your JARPA package. ❑ Yes ® No 91. 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. hei. None 9m. Name each species or habitat on the Washington Department of Fish and Wildlife's Priority Habitats and Species List that might be affected by the proposed work. [tom] There are no priority habitats and species that will be affected by this work within the project action area. JARPA Revision 2012.2 Page 9 of 12 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://aDos.ecy.wa.gov/opas/. • Governor's Office for Regulatory Innovation and Assistance at (800) 917-0043 or helpaora.wa.gov. • For a list of addresses to send your JARPA to, click on agency addresses for completed DARPA. 10a. Compliance with the State Environmental Policy Act (SEPA). (check all that apply.) [help • For more information about SEPA, go to www.ecy.wa.gov/programs/sea/sepa/e-review.htmi. ❑ A copy of the SEPA determination or letter of exemption is included with this application. ❑ A SEPA determination is pending with (lead agency). The expected decision date is ❑ I am applying for a Fish Habitat Enhancement Exemption. (Check the box below in 10b.) [helpl ® This project is exempt (choose type of exemption below). ® Categorical Exemption. Under what section of the SEPA administrative code (WAC) is it exempt? WAC 468-12-800(1)(u) ❑ Other: ❑ SEPA is pre-empted by federal law. 10b. Indicate the permits you are applying for. (Check all that apply.) [het LOCAL GOVERNMENT Local Government Shoreline permits: ❑ Substantial Development ❑ Conditional Use ❑ Variance X Shoreline Exemption Type (explain): Maintenance to an existing roadway 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 Ex€ tbn Form Effective July 10, 2012, you must submit a check for $150 to Washington Department of Fish and Wildlife, unless your project qualifies for an exemption or alternative payment method below. Do not send cash. Check the appropriate boxes: ❑ $150 check enclosed. Check # Attach check made payable to Washington Department of Fish and Wildlife. ❑ Charge to billing account under agreement with WDFW. Agreement # ❑ My project is exempt from the application fee. (check appropriate exemption) ❑ HPA processing is conducted by applicant -funded WDFW staff. Agreement # ❑ Mineral prospecting and mining. JARPA Revision 2012.2 Page 10 of 12 ❑ Project occurs on farm and agricultural land. (Attach a copy of current land use classification recorded with the county auditor, or other proof of current land use.) ❑ Project is a modification of an existing HPA originally applied for, prior to July 10, 2012. HPA # Washington Department of Natural Resources: ❑ Aquatic Use Authorization Complete DARPA 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 FEDERAL 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 permits: ❑ Private Aids to Navigation (for non -bridge projects) JARPA Revision 2012.2 Page 11 of 12 Fart 11—Authorizing Signatures Signatures are required before submitting the JARPA package. The JARPA package includes the JARPA form, project plans, photos, etc. heic 11a. Applicant Signature (required) h[ tele] 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) Applicant Printed Name Applicant Signature Date 11 b. Authorized Agent Signature tele) 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., Authorized Agent Printed Name Authorized Agent-Sig—nature ( / Date 11 c. Property Owner Signature (if not applicant) lhg! 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. Property Owner Printed Name Property Owner Signature Date 18 U.S.0 §1001 provides that: Whoever, in any manner within the jurisdiction of any department or agency of the United States knowingly falsifies, conceals, or covers up by any trick, scheme, or device a material fact or makes any false, fictitious, or fraudulent statements or representations or makes or uses any false writing or document knowing same to contain any false, fictitious, or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than 5 years or both. 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. 08/2013 JARPA Revision 2012.2 Page 12 of 12 SCANNED Adft Washington State Department of Transportation Lynn Peterson Secretary of Transportation October 27, 2014 Thurston County Development Services Thurston County Courthouse Building 1, Second Floor 2000 Lakeridge Dr.. SW Olympia, WA 98502 Olympic Region Environmental & Hydraulic Services 5720 Capitol Blvd Tumwater, WA 98501 P.O. Box 47440 Olympia, WA 98504-7440 360-570-6700/Fax 360-357-2601 TTY: 1-800-833-6388 www.wsdot.wa.gov RE: SR 507 / Old Hwy 99 to East of Water St. — Paving SR 507 / Milepost (MP) 13.64 to MP 14.72 SR 507 / MP 27.38 to MP 32.60 SR 507 / MP 34.67 to MP 36.22 SR 702 / MP 0.00 to MP 0.30 Shoreline Substantial Development Permit Exemption Dear Sirs: Enclosed please find a Joint Aquatic Resources Permit Application (DARPA) for the project referenced above proposed by the Washington State Department of Transportation (WSDOT). This project is located on SR 507 between milepost (MP) 13.64 and MP 36.22 in Thurston and Pierce Counties, and SR 702 between MP 0.00 and MP 0.30 in Pierce County. Also enclosed you will find copies of the vicinity map of the proposed project, a Thurston County Master Application, and check #849844F, issued 9/16/2014, in the amount of $1,194.00 for processing. The Nisqually River at MP 30.65 in Thurston County is a shoreline of the state. No paving or sidewalk improvements will occur over water at this location. The bridge deck is constructed of concrete. No Shoreline Substantial Development Permit Exemption will be required from the City of Yelm for Yelm Creek at MP 29.41 or the Centralia Power Canal at MP 30.52. They are no longer considered shorelines of the state. Please refer to attached e-mail. This project will utilize a mill and fill process to replace the top course of Hot Mix Asphalt to rehabilitate SR 507 and SR 702. Other work will include pavement repair, pre -level and tack coat. This project will also evaluate and upgrade pedestrian crosswalk ramps to meet current ADA compliance. Thurston County Development Services October 27, 2014 Page 2 Design steps taken to avoid or minimize impacts to the environment include the following: • No in -water work will occur as part of this project. • Construction will occur in the roadway prism within the right-of-way. • Proper use of Best Management Practices will ensure that no related pollutants, sediment or debris enter waters of the State. • Consultation with the National Marine Fisheries Services and United States Fish and Wildlife Service will ensure that project activities do not jeopardize listed species, or destroy or adversely affect designated critical habitat. • Conservation measures outlined in the Biological Assessments will be included in the construction contract. WSDOT has determined this project to be Categorically Exempt from a State Environmental Policy Act threshold determination per WAC 468-12 (1)(u). If you have any questions, please contact Scott Boutilier at 360-570-6742 or Dave Evans at 360-570-6738. Sincerely, 74 L Jeff Sawyer Environmental & Hydraulic Manager Olympic Region JBS:sb:ip Enclosures: Listed above cc: Mike Hoffman, w/enclosures, 47447 Steve Fuchs, w/o enclosures, 47447 Project File w/enclosures SF10272014 (7080) SCANNED 1,11 > 0 cor�Ugz;m.m. N. Z 0 o z m o o > 10 oz ;a;u -4 o m --- Z -- lo - - - -- 00 o o ol z mm . ------------- o m o so 'o % o, o > l z > ig -------- ------- o -- - --------- - ... p aUeeaao a0 ss ------------ ........... --- ---- - ---- - --------- v� A. .......... .... ....... ............. R I E 9-5 --- - ------ ... y mo o o ... .... ......... o........... ... 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AVERAGE DAILY TRAFFIC: 20,000 NUMBER OF LANES: 3 SIDEWALK / CURB WIDTH: 0.0 Lt 0.0 Rt CURB HEIGHT: in Bridge Deck Condition Report MP: 30.64 PAVING VERTICAL CLEARANCE Design Manual 720.04(5): Actual VC under: Traffic Not Under Actual VC over deck: Does not apply BRIDGE RAIL BRIDGE RAIL TYPE: New Jersey Barrier wjiype BP RAIL MEETS CURRENT STANDARDS? YES RAIL CONTRACT HISTORY EXPANSION JOINTS Use Conc/HMA Butt Joint Detail 4, Std. Plan A40.20-02, at back -of -pavement seats: Std Item 6514 Longitudinal Joint Seal, 93 LF = $2,048 EXPANSION JOINT CONTRACT HISTORY BRIDGE PHOTO 91 t WEARING SURFACE or DECK PROTECTION SURFACE TYPE: Original Conc. & ECR LOCAL AGENCY PAVING: No OVERLAY CONTRACT HISTORY BRIDGE RESURFACING / DECK COMMENTS Grade transition improvement required for both approaches due to roadway settlement.. 507/128 BRIDGE DECK HMA PAVING DESIGN OPTIONS Max. Bridge HMA Depth: DESCRIPTION See Microstation cell for Brg Paving Table: PAVING EXISTING MAX PLANE DEPTH PAVING SH DT RDSECBndgeDeckOverlay_Detail CLASSIFICATION NMA DEPTH pART.JFULL. _©ETH NMR DEPTH _._....._ .__.__.._......_._...._......- _,_._-_. _ _._ ... _... ._ _._._ Concrete Deck Paving Excepted BRIDGE CONTACTS See Bridge website for information on Bridge HMA Overlay Bridge Paving/Sheets Support Dick Stoddard 360,705.7217 Policies/Specs, Scoping, Region Design, and Construction Inspection: Bridge Rail/Barrier and Retrofit David Sawahata 360.705.6941 http://wwwi.wsdot.wa.gov/eesc/bridge/bridgeoverlays/ Vertical Clearance George Comstock 360,570.2540 BCRs - Brg HMA - P2 Bruce Thill 360.705.7393 REVIE4 M BY: DATE; Bridge Website: http://wwwi.wsdot.wa,gov/eesc/bridge/ Bruce ThZff 11/18/2013 Structure Details NISQUALLY RIVER Bridge Number 507/128 Structure Identifier 0013055A Location 2.4 N JCT SR 510 Route 00507 Mile Post 30.64 Feature Intersected NISQUALLY RIVER Facilities Carried SR 507 Region OL Owner Washington State Open Close Posted Coda4 Inspections Performed Structure Type PCB Operating Rating Tons 46 Inventory Rating Tons 27 Min Over Deck 99'99" Min Under Bridge 0" Sufficiency Rating 6..22 Year Built 1987 Year Rebuilt SD/FO Neither Report Date Frequency Type Type Routine 2013-09-10 24 Equipment 2011-09-26 48 Informational 2014-01-23 NISQUALLY RIVER Image Page 1 of 1 U http://hgolymbrgsg101 p/InventoryAndRepair/Inventory/BRIDGE/Details/Index/5 cea84ec. 10/31/2014