ECY Form 070-38 "Dam Construction or Decommissioning Permit Application" - Washington

What Is ECY Form 070-38?

This is a legal form that was released by the Washington State Department of Ecology - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2019;
  • The latest edition provided by the Washington State Department of Ecology;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of ECY Form 070-38 by clicking the link below or browse more documents and templates provided by the Washington State Department of Ecology.

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Download ECY Form 070-38 "Dam Construction or Decommissioning Permit Application" - Washington

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For Ecology Use
(Date Stamp)
Water Resources Program
Dam Construction or Decommissioning
Permit Application
One of the following non-refundable fees must accompany this
FOR OFFICIAL USE ONLY
application (choose one):
FILE NO: ______________________
☐ $1,977.00 Initial Dam Construction Fee
COUNTY: _____________________
☐ $10.00 Dam Decommissioning Fee
WRIA: ________________________
Send to:
DEPARTMENT OF ECOLOGY
INITIAL FEE PAID: _____________
CASHIERING UNIT
PO BOX 47611
OLYMPIA, WA 98504-7611
1. Dam Owner Information
Phone No:
Cell Phone No:
Contact Person:
Organization Name:
Address:
State:
Zip:
City:
Email Address:
2. Property Owner Information (if different than dam owner)
Phone No:
Cell Phone No:
Contact Person:
Organization Name:
Address:
State:
Zip:
City:
Email Address:
ECY 070-38 (Rev 06-2019)
1
For Ecology Use
(Date Stamp)
Water Resources Program
Dam Construction or Decommissioning
Permit Application
One of the following non-refundable fees must accompany this
FOR OFFICIAL USE ONLY
application (choose one):
FILE NO: ______________________
☐ $1,977.00 Initial Dam Construction Fee
COUNTY: _____________________
☐ $10.00 Dam Decommissioning Fee
WRIA: ________________________
Send to:
DEPARTMENT OF ECOLOGY
INITIAL FEE PAID: _____________
CASHIERING UNIT
PO BOX 47611
OLYMPIA, WA 98504-7611
1. Dam Owner Information
Phone No:
Cell Phone No:
Contact Person:
Organization Name:
Address:
State:
Zip:
City:
Email Address:
2. Property Owner Information (if different than dam owner)
Phone No:
Cell Phone No:
Contact Person:
Organization Name:
Address:
State:
Zip:
City:
Email Address:
ECY 070-38 (Rev 06-2019)
1
3
. Project Engineer Information
Phone No:
Cell Phone No:
Project Engineer for Dam Design:
Washington State P.E. #:
Expiration Date:
Address:
State:
Zip:
City:
Email Address:
4. Construction Engineer Information
Project Engineer for Oversight of Dam Construction:
Phone No:
Cell Phone No:
Washington State P.E. #:
Expiration Date:
Address:
State:
Zip:
City:
Email Address:
5. Project Information
Project Name:
Project Type (choose one): ☐ New Construction
☐Modification
☐Decommissioning
Brief Project Description (note any attachments included with this form):
Proposed Start Date of Construction:
Anticipated Completion Date of Construction:
Section:
Township N:
Range (E. or W.):
County:
County Parcel #
Project Location:
Latitude (in decimal degrees):
Longitude (in decimal degrees):
ECY 070-38 (Rev 06-2019)
2
Link to Location Map:
Or Upload Image of Map (Click on the Icon to Upload Image):
6. Dam Information
Dam Name(s) (Also list the names of any other impounding structure associated with the project):
Dam Height (Crest to Downstream Toe):
Dam Crest Length:
Dam Crest Width:
☐Irrigation
☐Recreation
☐Water Quality
Dam Purpose (check all that apply):
☐Flood Control
☐Hydroelectric (FERC License #:
)
☐Water Supply
☐Fish and Wildlife
☐Tailings ☐Stock/Small Farm Pond
☐Navigation
☐Other (explain):
☐Small (<15’)
☐Intermediate (15’ - <50’)
☐Large (≥50’)
Dam Size (based on height):
☐3
☐2D
☐2E
☐1A
☐1B
☐1C
Downstream Hazard Classification (choose one):
☐No
☐Yes
Is the Dam Regulated by a Federal Agency?
If Yes, list the name of the Agency:
☐No
☐Yes
Is the Dam Constructed on Federal Land?
If Yes, list the name of the agency:
Type of Construction and Material of Which Dam is to be Built:
☐Homogeneous Earthfill
☐Zoned Earthfill
☐Concrete Gravity
☐Other (explain):
ECY 070-38 (Rev 06-2019)
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7. Reservoir Information
Reservoir/Impoundment Name:
Stream Name (if Offstream, indicate Offstream and Name of Nearest Stream):
☐Permanent
☐Seasonal
☐Intermittent Pool
Reservoir Operation Class (choose one):
Number of Acres Submerged at Normal Full Pool:
Number of Acre-Feet to be Stored at Normal Full Pool:
Number of Acre-Feet that can be Stored at Dam Crest Level:
8. Project Operation and Maintenance (Post-Construction)
Who Will be Responsible for Project Operation and Maintenance?
Who Will be Responsible for Project Inspection and Monitoring?
Name of Project Contact (if different from above):
Phone No:
Date:
9. Other Permit Information
☐No
☐Yes
Has an Environmental Checklist Been Submitted in Accordance with SEPA?
If Yes, to what Agency:
Ecology SEPA #:
If No, explain:
Does this project have a Water Right Permit or Certificate that would allow diversion of water to fill the
reservoir?
☐No
☐Yes
If Yes, Permit/Certificate Number:
If No, Explain:
Does This project have a Reservoir Storage Permit and an associated secondary use permit (if required)?
☐No
☐Yes
If Yes, Permit/Certificate Number:
If No, Explain:
ECY 070-38 (Rev 06-2019)
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INSTRUCTIONS
1. DAM OWNER INFORMATION:
Name, address, telephone, and email of individual, corporation, public entity, etc., that is the legal
owner of the project.
2. PROPERTY OWNER INFORMATION:
Name, address, telephone and email of individual, corporation, public entity, etc., that is the legal
owner of the project property.
3. PROJECT ENGINEER INFORMATION:
The Project Engineer has direct supervision in managing the engineering aspect of the project as
representative of the owner.
4. CONSTRUCTION ENGINEER INFORMATION:
The Construction Engineer is responsible for managing the construction of the project as
representative of the owner, in accordance with the construction inspection plan. If same as Project
Engineer, write “Same”.
5. PROJECT INFORMATION:
Project Name: Name given to overall project
Brief Project Description: Also identify any enclosures, attachments, correspondence, etc. included
with this application
Project Location: Description of property including a map.
6. DAM INFORMATION:
Dam Name(s): Name for each dam, berm, dike, involved in project.
Dam Purpose: Indicate the functions of the dam
Downstream Hazard Classification: Indicates level of downstream development that would be
affected in the event of a dam failure:
3 (Low): No inhabited structures
2D (Significant): 1 or 2 inhabited structures
2E (Significant): No inhabited structures, but dam failure could cause significant economic or
environmental harm; or, the impoundment contains regulated material such as waste
1A (High): 3 to 10 inhabited structures
1B (High): 11 to 100 inhabited structures
1C (High): More than 100 inhabited structures
Dam Safety Guidelines – Technical Note 1
Note: See
for assistance in assessing the downstream
hazard classification.
7. RESERVOIR INFORMATION:
Reservoir/Impoundment Name: Name of reservoir, lake, pond, impoundment, etc.
Stream Name: Name of stream, creek, river that dam is to be constructed across. If the impoundment
is not to be constructed across a stream, write “Offstream”. If stream is unnamed, write “unnamed
tributary of _____ Creek”.
Reservoir Operation Class: Indicate how the reservoir is to be operated:
Permanent Pool: Operated year round at approximately same elevation.
Seasonal Pool: Operated at full pool part of the year, with seasonal drawdown.
Intermittent Pool: Impounds water infrequently and for short duration, such as flood control
dams.
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