Forest Practices ApplicationBulletin #072 – November 10, 2016 Page 1 of 2 k:/Handouts/Forest Practices Application
FOREST PRACTICES APPLICATION
CLASS IV - GENERAL
TYPE OR PRINT IN INK
1. Landowner, Timber Owner, and Operator Information
Legal Name of LANDOWNER Legal Name of TIMBER OWNER Legal Name of OPERATOR
Mailing Address: Mailing Address: Mailing Address:
City, State, Zip City, State, Zip City, State, Zip
Phone ( )
Email:
Phone ( )
Email:
Phone ( )
Email:
2. Contact Person Information
Name Phone ( )
Email:
3. Enter the Applicable City of Federal Way Development Permit Application Number(s):
_______________; ___________________; __________________
4. Enter the Forest Tax Reporting Account Number of the Timber
Owner:____________________________
For tax reporting information or to receive a tax number, call the Department of Revenue at 1-800-548-8829.
5. Legal description where the forest practices will occur.
Parcel Number Within ¼ section of: Section Township Range E/W
6. Answer each question as it applies to your proposed forest practice.
( ) No ( ) Yes Is the activity within the “Natural Environment” as regulated by Federal Way Revised
Code (FWRC) Title 15, “Shoreline Management”?
DEPARTMENT OF COMMUNITY DEVELOPMENT
33325 8th Avenue South
Federal Way, WA 98003-6325
253-835-2607; Fax 253-835-2609
www.cityoffederalway.com
Bulletin #072 – November 10, 2016 Page 2 of 2 k:/Handouts/Forest Practices Application
( ) No ( ) Yes Is the activity within 200 feet of an environmentally sensitive area and its associated
buffer area (wetland, stream, wellhead capture area, and/or geologically hazardous area)?
( ) No ( ) Yes Have you reviewed this forest practices activity area to determine whether it may
involve historic sites and/or Native American cultural resources?
7.What is the intended future use of the land proposed to be logged?
( ) Single Family Residence
( ) Residential Subdivision (includes plats and short plats)
( ) Commercial or Multifamily Residential
( ) Other ______________________________
8.How much merchantable timber are you cutting and/or removing?
Complete the table below and indentify all timber harvest and salvage activity boundaries on the site plan.
Unit # Acres (net) Volume of Merchantable Timber
to be harvested (board feet)
Percent (%) of Total
Merchantable Timber on site.
9.Summarize below the proposed timber harvest method, how the site will be accessed, and the
proposed timing of the timber harvest within the context of the overall project timeline.
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
We affirm that the information contained herein is true and understand that this proposed forest practice is subject to
the State Forest Practices Act and Rules and FWRC Chapter 19.120, “Clearing, Grading, and Tree and Vegetation
Retention,” as well as all other federal, state, or local regulations. Compliance with the State Forest Practices Act and
Rules and FWRC Chapter 19.120 does not ensure compliance with the Endangered Species Act or other federal,
state, or local laws.
Signature of LANDOWNER
Print Name:
Date:
Signature of TIMBER OWNER
(If different than landowner)
Print Name:
Date:
Signature of OPERATOR
(If different than landowner)
Print Name:
Date:
Department Review
(For Office Use Only)
Department of Revenue Notified (date):__________________________________________
Date Approved: ____________________________________________________________
Comments/Conditions:__________________________________________________________________________
Dmitriy Mayzlin for RMJ Holdings LLC
10/18/19