SR509Stage2 401 JARPA Water Quality Request

use black or blue ink to enter answers in the white spaces below. Part 1–Project Identification 1. Project Name (A name for your project that you create. Examples: Smith’s Dock or Seabrook Lane Development) [help] SR 509/24th Avenue South to South 188th Street – New Expressway (SR 509 Stage 2) Project Part 2–Applicant The person and/or organization responsible for the project. [help] 2a. Name (Last, First, Middle) Amiri, Ali, P.E., SR 509 Stage 2 Project Manager 2b. Organization (If applicable) Washington State Department of Transportation (WSDOT), SR 167/509 Puget Sound Gateway Program 2c. Mailing Address (Street or PO Box) 999 3rd Avenue, Suite 2100 2d. City, State, Zip Seattle, Washington 98104 2e. Phone (1) 2f. Phone (2) 2g. Fax 2h. E-mail 206-805-5313 AmiriA@wsdot.wa.gov 1Additional 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. • 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. To access an online JARPA form with [help] screens, go to http://www.epermitting.wa.gov/site/alias__resourcecenter/jarpa_jarpa_form/9984/jarpa_form.aspx. For other help, contact the Governor’s Office for Regulatory Innovation and Assistance at (800) 917-0043 or help@oria.wa.gov. AGENCY USE ONLY Date received: Agency reference #: Tax Parcel #(s): 3/24/2022 edoc Verified Section 401 http://www.bing.com/images/search?q=washington+state+seal&view=detailv2&qpvt=washington+state+seal&id=B01254F63F98016403555280BD9F8AF37E74F06D&selectedIndex=7&ccid=YCEifXXq&simid=607995554416365522&thid=OIP.M6021227d75ea02f3359b33a23b13cc55H2 http://ptjguidance.epermitting.wa.gov/DesktopModules/help.aspx?project=0&node=471 http://ptjguidance.epermitting.wa.gov/DesktopModules/help.aspx?project=0&node=547 http://ptjguidance.epermitting.wa.gov/DesktopModules/help.aspx?project=0&node=534 mailto:AmiriA@wsdot.wa.gov http://www.epermitting.wa.gov/site/alias__resourcecenter/jarpa_jarpa_form/9984/jarpa_form.aspx mailto:help@oria.wa.gov ORIA-revised 12/2021…
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