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• <br /> AGENCY USE ONLY <br /> WASHINGTON STATE Date received: <br /> Joint Aquatic Resources Permit Agency reference#: <br /> Application (JARPA) Form1'2 [bop] <br /> USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. <br /> RECEIVED <br /> DEC 082016 <br /> Part 1—Project Identification CITY OF EVERETT <br /> PLANNING DEPT <br /> 1. Project Name (A name for your project that you create. Examples: Smith's Dock or Seabrook Lane Development) help] <br /> Riverside Business Park <br /> Part 2—Applicant <br /> The person and/or organization responsible for the project. [help] <br /> 2a. Name (Last, First, Middle) <br /> Kessler, Dave <br /> 2b. Organization(If applicable) <br /> Latitude Development, LLC <br /> 2c. Mailing Address (Street or PO Box) <br /> 1801 W Valley Hwy N #101 <br /> 2d. City, State, Zip <br /> Auburn, WA, 98273 <br /> 2e. Phone(1) 2f. Phone(2) 2g. Fax 2h. E-mail <br /> (425)466-7119 ( ) - ( ) - dave@dbros.com <br /> Additional forms may be required for the following permits: <br /> • If your project may qualify for Department of the Army authorization through a Regional General Permit(RGP),contact the U.S.Army Corps of <br /> Engineers for application information(206)764-3495. <br /> • 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 <br /> prepare a Biological Evaluation. Forms can be found at <br /> fittp.//www.nws.usace.army.mil/Missions/CivilWorks/Regulatory/PermitGuidebook/EndangeredSpecies.aspx. <br /> • 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 <br /> government to make sure they accept the JARPA. <br /> 2To access an online JARPA form with[help]screens,go to <br /> http://www.epermittinq.wa.gov/site/alias resourcecenter/iaip_a Ldfpa form/9984/iarpa form aspx. <br /> For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or help(6 oria.wa.gov. <br /> JARPA Revision 2015.1 Page 1 of 18 <br />