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Freshwater Replacement Piers Docks

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Mason County Community Services
APPLICATION REQUIREMENTS FOR
REPAIR/REPLACEMENT FRESH WATER DOCKS & PIERS
THE FOLLOWING ITEMS INCLUDED IN THIS PACKET ARE REQUIRED AT SUBMITTAL:
*Incomplete applications will not be accepted*
1. Building Permit Application. Fill out the application completely. This packet is repair or
replacement only, use only blue or black ink. You can find your tax parcel number on the Mason
County Assessor’s office to locate this information. https://property.co.mason.wa.us/taxsifter
2. Site Plan. Your site plan must be no larger than 11”x 17” plain white paper. It must be drawn to
scale, include all existing structures on the property and structures on either side of your
property. Include existing docks, piers or floats on neighboring properties.
3. Construction Drawings and Engineering Calculations. The construction drawings must be
complete and detailed showing ALL construction details. Details must also include: all framing,
sizes and spans of structural members, connection types, decking material, all grating and size of
area of grating and pier plan and details. All replacement piers and replaced or repaired docs
must be engineered. Engineering must include the engineer’s stamp on all plan pages and a
stamped calculation packet. Any pier with pile driving must include a Statement of Special
Inspection. Engineers are licensed by the Washington State, we retain a list of engineers who
choose to be listed with us. This is not a complete list, does not verify license requirements are
met nor does it recommend.
4. SEPA Checklist. This must be completed for the project and any work to be performed on the
shoreline. SEPA fee: $600.00.
https://www.co.mason.wa.us/forms/Community_Dev/environmental_checklist.pdf
5. Shoreline Permit. This must be completed in a replacement or repair scenario. Shoreline
Exemption fee: $300.00.
https://www.co.mason.wa.us/forms/Community_Dev/shoreline_permit.pdf
6. Submittal Fee’s. Building Permit fees are dependent on contractors written bid or cost of
material. You can get a quote on permit fees by contacting a Permit Specialist at
permits@co.mason.wa.us
. Amount of bid or cost must be provided to get a quote. will provide
amount due and submittal.
7. Special Inspection Agreement. Special Inspection is required for any project that includes pile
driving or other design components identified in the International Building Code Chapter 17.
https://www.co.mason.wa.us/forms/Community_Dev/special-inspection-agreement.pdf
8. Washington Department Fish and Wildlife criteria must be included in your project details.
Contact your area Fish and Wildlife Biologist for their repair/replacement requirements. You
should do this prior to Construction Drawings to ensure correct materials and grating
requirements. See document in packet for more information.
https://wdfw.maps.arcgis.com/apps/MapJournal/index.html?appid=48699252565749d1b7e16b
3e34422271
Contact your area Planner HERE. You can get a Planner to call you back by leaving a message at (360)
427-9670 ext. 193.
For assistance you can reach the Permit Center at: permits@co.mason.wa.us or call 360.427.9670
ext.352 for assistance.
MASON COUNTY COMMUNITY SERVICES
PERMIT ASSISTANCE CENTER:
BUILDING
PLANNING
PUBLIC HEALTH
FIRE MARSHAL
615 W. Alder Street, Shelton, WA 98584
Phone Shelton: (360)427-9670 ext. 352 • Fax: (360)427-7798 Phone
Belfair: (360)275-4467 • Phone Elma: (360)482-5269
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION:
NAME:_______________________________________
MAILING ADDRESS:___________________________
CITY:_______________ STATE:______ ZIP:________
PHONE #1:____________________________________
PHONE #2:____________________________________
EMAIL:_______________________________________
PARCEL INFORMATION:
PARCEL NUMBER (12 Digit Number) _______________________________________ ZONING____________________
LEGAL DESCRIPTION (Abbreviated) _______________________________________ FIRE DISTRICT_______________
SITE ADDRESS_____________________________________________________CITY___________________________
DIRECTIONS TO SITE ADDRESS ____________________________________________________________________________
__________________________________________________________________________________________________________
IS THE PROJECT WITHIN 300 FT OF SLOPE(S) GREATER THAN 14%: YES⎕ NO ⎕ SNOW LOAD:_______psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER ⎕ LAKE ⎕ RIVER/CREEK ⎕ POND ⎕ WETLAND ⎕ SEASONAL RUNOFF ⎕ STREAM ⎕
TYPE OF WORK: NEW ⎕ ADDITION ⎕ ALTERATION ⎕ REPAIR ⎕ OTHER ⎕_______________________
USE OF STRUCTURE (Residence, Garage, Commercial Bldg, Etc.)__________________________________________________________
IS USE: PRIMARY ⎕ SEASONAL ⎕ NUMBER OF BEDROOMS_________ NUMBER OF BATHROOMS_______
HEATED STRUCTURE? YES (Whole Bldg) ⎕ YES (Part[s] of Bldg) ⎕ NO ⎕
DESCRIBE WORK__________________________________________________________________________________________
SQUARE FOOTAGE: (proposed)
1ST FLOOR________ sq. ft. 2ND FLOOR________ sq. ft. 3RD FLOOR________ sq. ft. BASEMENT________ sq. ft.
DECK________ sq. ft. COVERED DECK________ sq. ft. STORAGE__________ sq. ft. OTHER________ sq. ft.
GARAGE________ sq. ft. Attached ⎕ Detached ⎕ CARPORT__________ sq. ft. Attached ⎕ Detached ⎕
OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by
signature below. I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed. I have
obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or legal
representative, represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s) for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON
COUNTY CODE 14.08.42)
X_____________________________________________ _________________________________
Signature of OWNER (Must be signed by the OWNER) Date
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE___________________________ MODEL_______________________ YEAR______________ LENGTH_____________
WIDTH___________ BEDROOMS____________ BATHS______________ SERIAL NUMBER________________________
CONTRACTOR INFORMATION:
NAME:_________________________________________
MAILING ADDRESS:_____________________________
CITY:_______________ STATE:______ ZIP:_________
PHONE:________________ CELL: _________________
EMAIL :________________________________________
L&I REG #______________________ EXP. ___/___/___
DEPARTMENTAL REVIEW
DATE
DENIED
DATE
TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
Permit No:___________________
PUBLIC HEALTH
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC ⎕ SEWER ⎕ / NEW ⎕ EXISTING ⎕
PLUMBING IN STRUCTURE? YES ⎕ NO ⎕ If yes, attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES ⎕ NO⎕ EXISTING SQ. FT. _________________
EXISTING BEDROOMS __________ PROPOSED BEDROOMS __________ TOTAL BEDROOMS __________
PRIMARY CONTACT: OWNER ⎕ CONTRACTOR ⎕ OTHER ⎕
NAME ______________________________________________________________________ EMAIL ________________________________________________________
MAILING ADDRESS _______________________________________________________ CITY ______________________ STATE __________ ZIP____________
PHONE ______________________________________________ CELL _______________________________________________________
click to sign
signature
click to edit
SITE PLAN REQUIREMENTS:
A complete, accurate and detailed site plan is important to avoid delays in the review
and approval of your project. Use the checklist below as a tool to help you complete
the site plan.
1. Scale: A scale of 1”=20’, is typical but other scales such as 1”=10’ or 1”-40’ are
also acceptable. Do not exceed 1”=60.
2. North arrow
3. Property line location and dimensions.
4. Label abutting streets
5. Shoreline/Surface water: Indicate creeks, streams, lakes, ponds, wetlands, and
other bodies of water within 300 ft of the proposed project.
6. Wetlands and Seasonal Drainage: Show setback distances from wetlands or
seasonal drainage.
7. Easements: Indicate location and size of road, utility, and private easements.
8. Show All Existing Development: Identify existing and proposed structures.
Include porches, decks, roof overhangs, cantilevers, and structures that will be
demolished.
9. Proposed Building Footprint: Use scale to show distances to property lines,
existing structures, septic tank and drainfield. Stake or flag footprint of
proposed structure.
10. Sewage Disposal System: Identify septic tank location and drainfield.
11. Existing and proposed Buffers: Include open space, fences, sidewalks and
parking areas.
12. Retaining walls: Proposed and existing.
13. Slopes/Site contours (Topography): Identify any slopes greater than 15%,
fills or cuts greater than 4ft. that are located within 300ft. of the proposed project.
Use Contour lines or arrows to show the direction of the slope.
14. Wells: Show existing and proposed, need to include all wells located within
100 ft of property.
15. Waterfront projects: Show all structures on adjacent property.
16. Driveway/ Site Access
17. Stormwater Run-off Path: Identify stormwater run-off path and direction of
flow.
18. Neighboring parcels: Include location of neighboring structures including
docks, piers and floats.
SEPA Environmental checklist (WAC 197-11-960) (MC version - non project portion omitted): 2016 Page 1 of 11
Mason County Permit Center Use:
SEP -
Parcel #:
Date Rcvd:
SEPA Environmental Checklist
Single Family DNS: $600.00
Other DNS: 0 to 9.99 acres: $730
10 to 20 acres: $880
Over 20 acres: $1100
DS / EIS: $5000 + $90 per hour
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: [help]
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.
A. BACKGROUND [help]
1. Name of proposed project, if applicable: [help]
2. Name of applicant: [help]
3. Address and phone number of applicant and contact person: [help]
SEPA Environmental checklist (WAC 197-11-960) (MC version - non project portion omitted): 2016 Page 2 of 11
4. Date checklist prepared: [help]
5. Agency requesting checklist: [help]
6. Proposed timing or schedule (including phasing, if applicable): [help]
7. Do you have any plans for future additions, expansion, or further activity related to or connected with
this proposal? If yes, explain. [help]
8. List any environmental information you know about that has been prepared, or will be prepared,
directly related to this proposal. [help]
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. [help]
10. List any government approvals or permits that will be needed for your proposal, if known. [help]
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.) [help]
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. [help]
Parcel #(s):
Address:
Legal Description:
Twp/Range/Section and/or GPS location:
SEPA Environmental checklist (WAC 197-11-960) (MC version - non project portion omitted): 2016 Page 3 of 11
B. ENVIRONMENTAL ELEMENTS [help]
1. Earth
a. General description of the site [help]
(select one): flat, rolling, hilly, steep slopes, mountainous, other:
b. What is the steepest slope on the site (approximate percent slope)? [help]
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. [help]
d. Are there surface indications or history of unstable soils in the immediate vicinity? If so,
describe. [help]
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. [help]
f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. [help]
g. About what percent of the site will be covered with impervious surfaces after project
construction (for example, asphalt or buildings)? [help]
h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: [help]
2. Air
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. [help]
b. Are there any off-site sources of emissions or odor that may affect your proposal? If so,
generally describe. [help]
c. Proposed measures to reduce or control emissions or other impacts to air, if any: [help]
SEPA Environmental checklist (WAC 197-11-960) (MC version - non project portion omitted): 2016 Page 4 of 11
3. Water
a. Surface Water: [help]
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. [help]
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. [help]
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. [help]
4) Will the proposal require surface water withdrawals or diversions? Give general description,
purpose, and approximate quantities if known. [help]
5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. [help]
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. [help]
b. Ground Water:
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. [help]
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. [help]
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. [help]
SEPA Environmental checklist (WAC 197-11-960) (MC version - non project portion omitted): 2016 Page 5 of 11
2) Could waste materials enter ground or surface waters? If so, generally describe. [help]
3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If so,
describe.
d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage pattern
impacts, if any:
4. Plants [help]
a. Check the types of vegetation found on the site: [help]
____ deciduous tree: alder, maple, aspen, other
____ evergreen tree: fir, cedar, pine, other
____ shrubs
____ grass
____ pasture
____ crop or grain
____ orchards, vineyards or other permanent crops
____ 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? [help]
c. List threatened and endangered species known to be on or near the site. [help]
d. Proposed landscaping, use of native plants, or other measures to preserve or enhance
vegetation on the site, if any: [help]
e. List all noxious weeds and invasive species known to be on or near the site.
5. Animals
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: [help]
birds: hawk, heron, eagle, songbirds, other:
mammals: deer, bear, elk, beaver, other:
fish: bass, salmon, trout, herring, shellfish, other:
SEPA Environmental checklist (WAC 197-11-960) (MC version - non project portion omitted): 2016 Page 6 of 11
b. List any threatened and endangered species known to be on or near the site. [help]
c. Is the site part of a migration route? If so, explain. [help]
d. Proposed measures to preserve or enhance wildlife, if any: [help]
e. List any invasive animal species known to be on or near the site.
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. [help]
b. Would your project affect the potential use of solar energy by adjacent properties?
If so, generally describe. [help]
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: [help]
7. Environmental health
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. [help]
1) Describe any known or possible contamination at the site from present or past uses.
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.
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.
4) Describe special emergency services that might be required.
SEPA Environmental checklist (WAC 197-11-960) (MC version - non project portion omitted): 2016 Page 7 of 11
5) Proposed measures to reduce or control environmental health hazards, if any:
b. Noise
1) What types of noise exist in the area which may affect your project (for example:
traffic, equipment, operation, other)? [help]
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. [help]
3) Proposed measures to reduce or control noise impacts, if any: [help]
8. Land and shoreline use
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. [help]
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? [help]
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:
c. Describe any structures on the site. [help]
d. Will any structures be demolished? If so, what? [help]
e. What is the current zoning classification of the site? [help]
f. What is the current comprehensive plan designation of the site? [help]
SEPA Environmental checklist (WAC 197-11-960) (MC version - non project portion omitted): 2016 Page 8 of 11
g. If applicable, what is the current shoreline master program designation of the site? [help]
h. Has any part of the site been classified as a critical area by the city or county? If so, specify.
[help]
i. Approximately how many people would reside or work in the completed project? [help]
j. Approximately how many people would the completed project displace? [help]
k. Proposed measures to avoid or reduce displacement impacts, if any: [help]
L. Proposed measures to ensure the proposal is compatible with existing and projected land
uses and plans, if any: [help]
m. Proposed measures to ensure the proposal is compatible with nearby agricultural and forest
lands of long-term commercial significance, if any:
9. Housing
a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-
income housing. [help]
b. Approximately how many units, if any, would be eliminated? Indicate whether high,
middle, or low-income housing. [help]
c. Proposed measures to reduce or control housing impacts, if any: [help]
10. Aesthetics
a. What is the tallest height of any proposed structure(s), not including antennas; what is
the principal exterior building material(s) proposed? [help]
b. What views in the immediate vicinity would be altered or obstructed? [help]
c. Proposed measures to reduce or control aesthetic impacts, if any: [help]
11. Light and glare
a. What type of light or glare will the proposal produce? What time of day would it mainly
occur? [help]
b. Could light or glare from the finished project be a safety hazard or interfere with views? [help]
SEPA Environmental checklist (WAC 197-11-960) (MC version - non project portion omitted): 2016 Page 9 of 11
c. What existing off-site sources of light or glare may affect your proposal? [help]
d. Proposed measures to reduce or control light and glare impacts, if any: [help]
12. Recreation
a. What designated and informal recreational opportunities are in the immediate vicinity? [help]
b. Would the proposed project displace any existing recreational uses? If so, describe. [help]
c. Proposed measures to reduce or control impacts on recreation, including recreation
opportunities to be provided by the project or applicant, if any: [help]
13. Historic and cultural preservation
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 located on or near
the site? If so, specifically describe. [help]
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. [help]
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. [help]
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.
14. Transportation
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. [help]
SEPA Environmental checklist (WAC 197-11-960) (MC version - non project portion omitted): 2016 Page 10 of 11
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? [help]
c. How many additional parking spaces would the completed project or non-project proposal have?
How many would the project or proposal eliminate? [help]
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). [help]
e. Will the project or proposal use (or occur in the immediate vicinity of) water, rail, or air
transportation? If so, generally describe. [help]
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? [help]
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.
h. Proposed measures to reduce or control transportation impacts, if any: [help]
15. Public services
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. [help]
b. Proposed measures to reduce or control direct impacts on public services, if any. [help]
16. Utilities
a. Circle utilities currently available at the site: [help]
electricity, natural gas, water, refuse service, telephone,
sanitary sewer, septic system, other
SEPA Environmental checklist (WAC 197-11-960) (MC version - non project portion omitted): 2016 Page 11 of 11
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. [help]
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: _____________________________________________
Date Signed:
Print Name of Signee: _______________________________________
If applicable, Position and Agency/Organization: _____________________________
Date Submitted: _____________
Rev. March 1, 2018
RECEIVED:
PE
RMIT NO.: ___________________
SHORELINE PERMIT APPLICATION
SHORELINE PERMITS
CONDITIONAL USE* SUBSTANTIAL DEVELOPMENT
VARIANCE* EXEMPTION
The
Washington State Shoreline Management Act (RCW 90.58) requires that substantial developments within designated
shorelines of the state comply with its administrative procedures (WAC 173-14) and the provisions of the Mason County
Shoreline Management Master Program. The purpose of this Act and local program is to protect the state’s shoreline
resources. The program requires that substantial development (any development of which the total cost or fair market
value exceeds $7,047.00 or materially interferes with the normal public use of the water or shorelines of the State be
reviewed with the goals, polices, and performance standards established in the Master Program.
Ans
wer all questions completely. Attach any additional information that may further describe the proposed development.
Incomplete applications will be returned.
*Sh
oreline Variances and Conditional uses require public hearings and have additional pages that shall be
attached to this application.
APPL
ICANT: ________________________________________________________________
ADD
RESS: ________________________________________________________________
(street)
________________________________________________________________
(city) (state) (zip)
TEL
EPHONE: ___________________________ _________________________
(home) (business)
AUTHORIZED REPRESENTATIVE: ________________________________________________________________
ADD
RESS: ________________________________________________________________
(street)
________________________________________________________________
(city) (state) (zip)
TEL
EPHONE: ________________________________________________________________
PRO
PERTY DESCRIPTION:
General location (include property address, water body and associated wetlands—identify the name of the shoreline):
_______
_____________________________________________________________________________________________________
615 W. Alder St. – Bldg. 8, Shelton, Wa 98584
Phone: (360) 427-9670 ext. 352 ♦ Fax: (360) 427-7798
Include all parcel numbers: Projects located in open water areas, away from land shall provide latitude/longitude.
OWNERSHIP:
Contract
Applicant _______ Owner _______ Lessee _______ Purchaser _______ (Identify) _______ Other _______
Owner:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
(street) (city) (state) (zip)
DEVELOPMENT DESCRIPTON:
Development proposal (identify and describe the proposed project, including the type of materials to be used, construction
methods, principle dimensions, and other pertinent information):
Existing Use (identify current use of property with exist improvements):
Reason for requesting development:
The applicant shall provide, at a minimum, the following information:
a. SITE PLA
N - drawn to scale and including:
i. The boundary of the parcel(s) of land upon which the development is proposed;
ii. The ordinary high water mark (OHWM). This may be an approximate location provided, that for
any development where a determination of consistency with the applicable regulations requires a
precise location of the OHWM the mark shall be located precisely and the biological and
hydrological basis for the location as indicated on the plans shall be included in the development
plan. Where the OHWM is neither adjacent to or within the boundary of the project, the plan shall
indicate the distance and direction to the nearest OHWM of a shoreline;
iii. Where appropriate, the proposed land contours using five-foot intervals in water area and ten-foot
intervals on areas landward of OHWM, if development involves grading, cutting, filling, or other
alteration of land contours;
iv. The dimensions and location of existing structures which will be maintained;
v. The dimensions and locations of proposed structures; parking and landscaping;
vi. The location of proposed utilities, such as sewer, septic tanks and drain fields, water, gas and
electricity;
vii. The location, source, composition, and volume of fill material;
viii. The location, composition and volume of any extracted materials, and proposed disposal area;
b. CROSS SECTION, drawn to scale including:
i. The existing ground elevations;
ii. The proposed ground elevations;
iii. The location and height of existing structures;
iv. The location and height of proposed structures;
v. The OHWM.
c. VICINITY MAP, including:
i. The location of subject parcel using natural points of reference (roads, state highways, prominent
landmarks, etc.).
ii. If the development involves the removal of any soils by dredging or otherwise, identify the
proposed disposal site on the map. If disposal site is beyond the confines of the vicinity map,
provide another vicinity map showing the precise location of the disposal site and its distance to
nearest city or town.
iii. On the map, or separately, give a brief narrative description of the vicinity of the proposed project
including identification of the adjacent uses, structures and improvements, intensity of
development and physical characteristics.
d. ADJACENT LANDOWNERS. Provide names and mailing addresses of all real property owners
within 300 feet of property line boundaries where development is proposed as mailing labels or
pre-addressed envelopes.
ACKOWLEDGEMENT:
I hereby declare, to the best of my knowledge and belief, the forgoing information and all attached information is true and
correct.
_____________________________________________________________ _____________________
(Applicant or Authorized Representative) (date)
1
Residential
Overwater Structure
Guidance
for
Mason Lake
Washington
Department
of
Fish
and
Wildlife
Hydraulic Project Approval Requirements
Mason Lake provides essential habitat to various fish species including;
Brown bullhead, Kokanee,
Largemouth bass, Northern pikeminnow, Rainbow trout, Yellow perch, Coho, Steelhead, and Chum.
Due to the diversity of fish species and number of structures in the lake, it is important that
replacement and new structures are built to minimize impacts to their habitat while also maximizing
your recreational use benefit. For more information on the relationship between fish and overwater
structures: https://www.govlink.org/watersheds/8/action/greenshorelines/Dockfactsheet2012.pdf.
Along with Mason County permitting, you will need a State Washington Department of Fish & Wildlife
permit called a Hydraulic Project Approval (HPA).
To apply for a WDFW HPA permit go to: https://wdfw.wa.gov/licenses/environmental/hpa
WDFW permitting biologist contact:
Allison Cook
Habitat Biologist Region 6
Covering South Mason & KGI Pierce County
Allison.Cook@dfw.wa.gov
Work Cell: 360-480-3510
WDFW REQUIREMENTS FOR REPAIR AND REPLACEMENT OF DOCKS, PIERS,
RAMPS, FLOATS
Definition:
To be considered a repair or a replacement there must be no changes to the size,
configuration, or dimensions of the existing structure and associated components. The
structure
must
have
been
usable
at
the
site
within
the
past
twelve months,
prior to
application
submittal,
to
be
considered
a replacement
structure.
Usable
means
no
major
deterioration
or
loss
of
critical
structural
components.
Grating:
• The department will require solid decked piers and docks come into compliance with grating
requirements if more than minimal deck boards are being replaced.
• In water bodies with a high density of piers and docks, the department may require that
grating cover entire deck surface of the pier or dock. Mason Lake has a high density of docks,
so 100% grating will be required with 60% open space.
•
60% open space = 60%
of
the
light
at
the
location
must
reach
beneath
the
pier.
SteelDek
Eco
series
(xccent
marina
decking)
is
an
example
of
a
decking
product
on
the current
market
that
provides
60%
open
space.
2
Structural:
•
Repair and replacement of framing and structural components (e.g. caps, stringers) with
approved materials is allowed.
• Do not use wood treated with oil-type preservatives (creosote, pentachlorophenol) in any
hydraulic project. You may use wood treated with waterborne preservatives (ACZA, ACQ)
provided the wood is approved by the Western Wood Preservers Institute for use in the
aquatic environment. Any use of treated wood in the aquatic environment must follow
guidelines and best management practices available at www.wwpinstitute.org.
•
Skirting
should
be
completely
removed
or
at
least
lessened.
•
Vertical
fenders
may
be
installed
if
boat
safety
is
a
concern
(with
a minimum
spacing
of
4-feet
on
center).
Piling:
•
Existing
piles
may
be
repaired
by
sleeving,
splicing,
and/or
stubbing.
• Each pile may be sleeved only once.
• The diameter of sleeved piles must be no more than three inches greater than the diameter of
the existing piles.
•
The
use
of
creosote
or
pentachlorophenol
piling
is
prohibited.
Replacement
piling
can
be
steel,
concrete,
recycled
plastic,
and/or
untreated
or department-approved
treated
wood.
WDFW REQUIREMENTS FOR NEW
, MODIFIED,
EXPANDED, AND RECONFIGURED
PIERS, RAMPS, FLOATS, DOCKS
Dimensions
(see
schematic
at
the
end
of
this
document):
•
Main
walkway
of
residential
piers
must be
no
greater
than
6-feet-wide
(4- feet-wide
preferred
by
WDFW
and
consistent
with
the
USACE
Seattle District
Regional
General
Permit)
for
the
first
30
feet.
•
After
30
feet,
it
can
be
increased
to
6-feet-wide
if
4-feet-wide
for
the
first
30 feet.
•
L
or
T
should
be
limited
to
6-feet-wide
when
possible,
yet
8-feet
is
common and
10-feet
can
be
allowed.
•
The
underside
of
pier
must
be
at
least
one
and
one-half
feet
above
the
OHWL
elevation
unless
prohibited
by
local
land
use
regulations.
Structural:
•
Only approved materials may be used for framing and structural components (e.g. caps,
stringers).
• Do not use wood treated with oil-type preservatives (creosote, pentachlorophenol) in any
hydraulic project. You may use wood treated with waterborne preservatives (ACZA, ACQ)
provided the wood is approved by the Western Wood Preservers Institute for use in the
aquatic environment. Any use of treated wood in the aquatic environment must follow
guidelines and best management practices available at www.wwpinstitute.org.
•
No skirting is authorized for new structures
•
Vertical
fenders
may
be
installed
if
boat
safety
is
a
concern
(with
a minimum
spacing
of
4-feet
on
center).
Pilings:
3
•
Steel
piling
used
to
construct
residential
docks
should
not
exceed
6
inches
in diameter.
Limit
the
diameter
of
steel
piling
used
to
construct
public recreational
docks
to
the
minimum
width
needed
to
accommodate
the intended
use.
•
The
use
of
creosote
or
pentachlorophenol
piling
is
prohibited.
New
and replacement
piling
can
be
steel,
concrete,
recycled
plastic,
and/or
untreated
or department-approved
treated
wood.
•
Piles
should
be
6
to
8-inches
in
diameter.
Joint-use
piers
may
install
10-inch diameter
piles.
Larger
diameter
pilings
may
be
allowed
in
situations
when
a qualified
engineer
can
document
the
need
for
structural
stability
of
the
pier and/or
safe
moorage
of
large
boats/vessels.
•
Pile
spacing:
12
to
18
feet.
•
Treated
wood
piling
must
incorporate
design
features
to
minimize
abrasion of
the
piling
from
contact
with
vessels,
floats,
or
other
objects.
•
All
pilings
which
provide
such
opportunity
(e.g.
mooring
and
float
pilings)
must
be
fitted
with
devices
to
prevent
perching
by
fish-eating
birds.
Floats:
•
Piers
must
extend
far
enough
from
the
shoreline
so
floats
do
not
impact juvenile
salmonid
migration,
feeding,
and
rearing
areas.
Grounding
of
floats is
approved
in
reservoirs
and
impoundments
only
at
times
of
the
year
when the
water
level
is
dropped.
•
Fully
enclose
and
contain
flotation
for
the
structure
in
a
shell
(tub)
or
20
-
25 mm
polyethylene
or
polyurethane
wrap.
The
shell
or
wrap
must
prevent breakup
or
loss
of
the
flotation
material
into
the
water.
The
shell
or
wrap must
not
be
readily
subject
to
damage
by
ultraviolet
radiation
and
abrasion.
•
Limit
the
width
of
residential
ramps
to
four
feet
wide.
Limit
the
width
of public
recreational
ramps
to
the
minimum
width
needed
to
accommodate
the intended
use.
Cover
the
entire
ramp
surface
with
grating.
•
Embedded
anchor(s)
or
other
approved
anchor(s)
or
piling
may
hold
floats
in place.
Mitigation
for new docks for expansions
(In
order
of
WDFW
preference)
•
Reduce
the
size
of
the
structure.
•
Remove
derelict
piling,
piers,
docks,
and/or
floats.
•
Shoreline
softening:
removal
of
hard
shorelines
(rock,
rip
rap,
and/or
concrete
bulkheads
or
bank
protection
and
replacement
with
beach
coves, sloped
shorelines
that
include
native
plantings
and
large
wood
to
stabilize and
protect
slopes.
•
Full
planting
plan
(five
trees
and
seven
shrubs) for a new pier. Two tree and three scrubs for
pier modifications (such as adding on additional fingers or a smaller section, large
modification can require a full planting plan).
•
Gravel
placement
(if
appropriate—usually
only
for
anadromous
lakes)
•
Must
be
placed
during
the
approved
in-water
work
window.
Typically
require
25
cubic
yards
per
50
linear
feet
of
shoreline; however,
USACE
has
a
threshold
at
25
cubic
yards,
so
this
may
be a
reasonable
amount
to
benefit
fish
life
but
not
push
them
into additional
permitting.
•
Outside
of
sockeye
spawning
areas,
we
recommend
a
1-inch
minus mix
(100%
less
than
1
inch,
85%
less
than
0.5
inch,
and
40%
less than
0.25
inch).
•
Removal of
trash,
debris,
etc.
(e.g.
15
or
20
cubic
yards
with
photo documentation,
removed
during
the
approved
in-water
work
window).
More relevant info:
See:
Green
Shorelines,
Bulkhead
alternatives
for
a
healthier
Lake Washington
by
City
of
Seattle,
available
at:
http://www.govlink.org/watersheds/8/action/greenshorelines/
for more
information.
click to sign
signature
click to edit
7
ENGINEER’S
****LIST IS BASED ON ENGINEERS WHO HAVE SUBMITTED ENGINEERING TO MASON
COUNTY AND REQUESTED TO BE LISTED****
THOMPSON ENGINEERING
rthompsonengineering@yahoo.com
509.987.1599
N.L. OLSEN & ASSOC**.
N.L. Olson & Associates
1.800.755.1282
360.876.2284
TRANSOLYMPIC
ENGINEERING INC.
https://transolympic.com/
360.339.5660
HODGE ENGINEERING INC.
http://hodgeengineering.com/
253.857.7055
PRECISE ENGINEERING INC.
preciseengineering@comcast.net
360.736.1137
MC SQUARED**
https://www.mc2-inc.com/
360.754.9339
ENVIROTECH
ENGINEERING**
envirotech@geotechnicalinfo.com
360.275.9374
EASLEY ENGINEERING &
DESIGN**
www.easleyengineeringdesign.com
206.423.8907
ROUTLEY ENGINEERING INC
jesse@routleyengineering.com
https://www.facebook.com/ro
utleyengineering
253-358-3729
This list is a courtesy. Does not recommend or provide verification of license. Please go to:
https://www.dol.wa.gov/business/checkstatus.html to verify license.
If you are an engineer and wish to be added please email tw@co.mason.wa.us
Rev. 3/3/2021
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Freshwater Replacement Piers Docks

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