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M <br />y � <br />WASHINGTON STATE US Army Corps <br />of Engineers •- <br />Seattle District <br />Joint Aquatic Resources Permit <br />Application (JARPA) Forml,2 [help] <br />USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. <br />Part 1—Project Identification <br />•------------------------------------- <br />AGENCY USE ONLY <br />Date received: <br />, <br />Agency reference #: <br />Tax Parcel #(s): <br />, <br />L----------- <br />1. Project Name (A name for your project that you create. Examples: Smith's Dock or Seabrook Lane Development)[tPipj <br />811 Street Cross -dock Facility <br />Part 2—Applicant <br />The person and/or organization responsible for the project. hel <br />2a. Name (Last, First, Middle) <br />Fa, Michael G. <br />2b. Organization (If applicable) <br />KW EVT, LLC <br />2c. Mailing Address (Street or PO Box) <br />P.O. Box 979 <br />2d. City, State, Zip <br />Telluride, CO 81435-0979 <br />2e. Phone (1) <br />2f. Phone (2) <br />2g. Fax <br />2h. E-mail <br />(602) 432-3767 <br />(480) 948-7293 <br />mfa@designfusion.biz <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 />http://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.epermitting.wa.goy/site/alias resourcecenter/iarpa iarpa form/9984/iarpa form.aspx. <br />For other help, contact the Governor's Office for Regulatory Innovation and Assistance at (800) 917-0043 or helpCcDoria.wa.gov. <br />JARPA Revision 2015.1 Page 1 of 16 <br />