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AGENCY USE ONLY <br /> %%'jf WAS H I N GTO N STATE o SArmy�Crosrps Date received: <br /> Seattle District <br /> Joint Aquatic Resources Permit <br /> Agency reference#: <br /> Application (JARPA) Form1'2 [help] <br /> USE BLACK OR BLUE INK TO ENTER ANSWERS IN THE WHITE SPACES BELOW. Tax Parcel#(s): <br /> L_ <br /> Part 1—Project Identification <br /> 1. Project Name (A name for your project that you create.Examples: Smith's Dock or Seabrook Lane Development) [helpl <br /> Dagmars Marina Boat Launch Maintenance Sediment Removal Project <br /> Part 2—Applicant <br /> The person and/or organization responsible for the project. [help] <br /> 2a. Name(Last, First,Middle) <br /> Kernan Manley <br /> 2b. Organization (If applicable) <br /> Dagmars Marina <br /> 2c. Mailing Address(Street or PO Box) <br /> 1870 Ross Avenue <br /> 2d. City, State, Zip <br /> Everett, WA 98201 <br /> 2e. Phone(1) 2f. Phone(2) 2g. Fax 2h. E-mail <br /> 425-745-2275 (425)259-6124 425-742-5191 dagmarsmarina@integra.net <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.armv.mil/Missions/CivilW orks/Reoulatorv/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/iarpa iarpa form/9984/jarpa form.aspx. <br /> For other help,contact the Governor's Office for Regulatory Innovation and Assistance at(800)917-0043 or help(aloria.Wa.gov. <br /> ORIA-16-011 Page 1 of 15 <br />