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HomeMy WebLinkAboutBLD2004-00233 • BUILDINGPERMIT APPLICIION MRLA04-001 Ype95 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00233 Received Date: 4/9/2004 SITE ADDRESS: 121 GEORGE LESLIE DR PORT LUDLOW, 98365 OWNER: GE LAND LLC PHONE: 1125 57TH ST E STE D SUMNER WA 98390 ( 53 826-4261 SUBDIVISION: GARTEN ESTATES Block: Lot: 15 PARCEL NUMBER: 952900015 Section: 34 Township: 28 N Range: 01 E CONTRACTOR: GE LAND LLC PHONE: 1125 57TH ST E SUITE D SUMNER WA 98390 Contractor's License GELANLL966DD Expires 3/4/2006 REPRESENTATIVE: GE LAND LLC PHONE: (253) 826-4261 X 123 THOMAS ANSMAN 1125 57TH STE STE D PROJECT DESCRIPTION NEW SFR W/ATTACHED GARAGE AND COVERED PORCH TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,856 VALUATION 176,488.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 400 SHORELINE: CONST TYPE: DECK: 30 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: LUDLOW PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: 3 Prop: 2 Seismic Streams Total: 3 Total: 2 Flood Way Floodplain Routing Date: / �� F&W Landslide ? Up Q K Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: APPRO V Fr Permit $1,424.95 KAS 04/09/04 64139 State Building Code $4.50 KAS 04/09/04 64139 APR 2 3 2.7 Potable Water Application $52.00 KAS 04/09/04 64139 Jefferson COW Total: $1,481.45 &Building n€ Col „ 1. 0-6-K `bo c 0 • Jefferson County Department of Community Development �' 't)N 621 Sheridan Street,Port Townsend WA 88368[36D1318-445D f ate.` Jar�� ,2i -YS'_ „ ' 0 f{ ,t,; 1 p O :-. .,,,i,s,. . .,: ,_,... Project Descrption: Buildin_ 4.e: Project Type: Frame Type: ioo Garage Attached/Detached Addition ,tecl Modular Alteration/Remodel Concrete • Commercial Repair Masonry Multi-family/#of Units Demolition Other: Industrial Other: Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: Existing: Sew Community System Electrici Oil Proposed: Z. Proposed: 3lividual System Woodstove Propane 2 Total: Total: E If not sewer,fill out the following: Heat Pump Conventional Alternative Other Permit# SEP Ott 66O/ Water Supply: A /� Private well Two Party Well Public:Name of water system: l� �Y\6 N( V1 Square Footage: S--(�th For Office Use Only Main Floor !' `0 (6fc. 53•7a Consistency Review D Q `00 2ND Floor Base fee I4 24- • cis 3r'Floor Plan Check fee Uf,4:RAO 2004 —SO Htd Basement State Surcharge fee 4-•SiD Unhtd Basement 4 A Subtotal I 411 - �S- Q Garage/Carport t42.Z5 Pot Water Review fee 7S •00 Decks 911/Rd Approach fee 0 Commercial TOTAL (%2 •4 S Industrial Receipt# ,i-(-59 Other Q 101.it Cash/Check# ©Dn 1p`D33 Total Valuation: c 1 SZ.tl' iu� 7,v, nitials nn 1' f�-J Or Date ''c 1 g j ock Estimated Cost: If within 200' of the Shoreline, I Distance to Bank or Ordinary High Water Mark ft.Bank Height ft. By signing the application form,the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which mar in any way accrue against Jefferson County as a res It of or in consequence of the granting of this permit. I further agree to provide acc s and right of my to leffer n County and it's employees,representatives or agents for the purpose of a plicatjon review and any required later inspections. Access and right of entry to c pplicant's pr perry or stet re shall be requested and shall occur during regular business hours. �� Signature: i Date: 1 � OVER ► I-I:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermit\pplication 11-8-01 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD04-00233 Received Date 04/9/2004 SITE ADDRESS: 121 GEORGE LESLIE DR Issue Date 04/23/2004 PORT LUDLOW, 98365 APPLICANT: GE LAND LLC PHONE: (253) 826-4261 1125 57TH ST E STE D SUMNER WA 98390 SUBDIVISION: GARTEN ESTATES Block: Lot: 15 PARCEL NUMBER: 952900015 Section: 34 Township: 28 N Range: 01 E CONTRACTOR: GE LAND LLC PHONE: 1125 57TH ST E SUITE D SUMNER WA 98390 Contractor's License: GELANLL966DD Expires: 03/04/2006 PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE AND COVERED PORCH REQUIRED INSPECTIONS: [ ] SETBACKS: Ok 5/3/44/ [ ] UFFER: J�A [ ] Footing: OK [ ] Foundation: DR &,&A cii6oitS SS/7/Gyp [ ] Underground Plumbing:/og/10412:0 E1JG/ 04/6 -liarn.husBFr Det Est o5 o& 511410 i [ l Underground Insula ion: [ ] Shear Wall : ty--17-01 GYP 5a 42. OK 7/zf ' X ifr [ ] Framing: q�.3 f 1 1 Plumbing: 7?K <,��` �/$1 /'�,f` [ ] Propane Tank/ Lines: d� [ ] Insulation: Ok 4,(7.4A4 ��� �i 2 ��xc OK 09/ "U" ' f 1 Sheetrock: 7/Z/o4I [ ] Stormwater FINAL Appror-I: [ ] Septic Sytem Final Approval: 1 1 Road Approach Final Approval: [ ] Zoning Final Approval: f 1 Final/Occupancy Approval: ,Ok Cr efr 8/19/.017/ HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL EQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY-SEE REVERSE SPECIAL CONDITIONS FOR yRASE A BLD04-00233 1.) The application was reviewed by the Jefferson County Department of Community Development staff on April 15, 2004 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: SARPA& SUSC aquifer recharge; High Risk SIPZ. 2.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 3.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 4.) Critical Aquifer Recharge Areas are defined as Seawater Intrusion Areas, and Special Aquifer Recharge Protection Areas and the following land uses located within Susceptible Aquifer Recharge Areas (1)All Industrial Land Uses (2)All Commercial Uses (3)All Rural Residential Land Uses requiring a Discretionary Use or Conditional Use Permit(4)All Rural Residential Land Uses with nonconforming uses that would otherwise require a Discretionary Use or Conditional Use Permit(5) Unsewered Planned Rural Residential Developments (6) Unsewered residential development with gross densities greater than one unit per acre. All of the above listed uses shall be subject to the applicable requirements and standards of the Jefferson County Unified Development Code. 5.) Marine shorelines and islands are susceptible to a condition that is known as seawater intrusion. Seawater intrusion is a condition in which the saltwater/freshwater interface in an aquifer moves inland so that wells drilled on upland areas cannot obtain freshwater suitable for public consumption without significant additional treatment and cost. Maintaining a stable balance in the saltwater/freshwater interface is primarily a function of the rate of aquifer recharge (primarily through rainfall) and the rate of groundwater withdrawals (primarily through wells). The Washington Department of Ecology is the agency with statutory authority to regulate groundwater withdrawal for individual wells in Jefferson County. New development, redevelopment, and land use activities on islands and in close proximity to marine shorelines in particular should be developed in such a manner to maximize aquifer recharge and maintain the saltwater/freshwater balance to the maximum extent possible by infiltrating stormwater runoff so that it recharges the aquifer. 6.) The parcel is located within a High Risk SIPZ(seawater intrusion protection zone) according to the County GIS map. There are mandatory measures identified in the Jefferson County Seawater Intrusion Policy (Resolution 44-22, effective September 23, 2002) that apply to well drilling proposals and building permit applications on existing lots of record. A High Risk SIPZ is defined as: areas within 1,000 feet of a groundwater source with a history of chloride analyses above 200 milligrams per liter(mg/L). 7.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water quality degradation. The submitted proposal does not require additional aquifer protection measures. However, during construction the project shall follow the Best Management Practices (BMPs) and facility design standards as identified and defined in the Stormwater Management Manual for the Puget Sound Basin. 8.) MANDATORY MEASUREEF HIGH RISK SIPZ: • Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 9.) MANDATORY MEASURES FOR HIGH RISK SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirements: a. Variance from Chapter 173 WAC standards granted by Ecology per WAC 173-160-106 for a new groundwater well within 100 feet of a sea-salt water intrusion area per WAC 173-160-171 (i.e., within 100 feet of a groundwater source showing chloride concentrations above 200mg/L or within 100 feet of the marine shoreline); or for an existing or proposed groundwater well not subject to an Ecology variance, applicant must provide evidence through a hydrogeologic assessment(relevant components of an Aquifer Recharge Area Report per UDC 3.6.10.e) of a reasonable probability that the subject aquifer will not be degraded , e proposed use of well. b. Installation of a flow meter. the �� 4 9/0,�� c. On-going well monitoring for chloride concentra io d. Submittal of flow and chloride data to the County per monitoring 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 10.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 11.) The applicant is proposing to create or add 3367 square feet of impervious surface and 4205 square feet of land disturbing activities. 12.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 13.) A Stormwater Site Plan has been submitted and approved by the Department of Community Development. Once the subject permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 14.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act(SEPA) pursuant to WAC 197-11-800(1)(b)(i). 15.) The site plan as submitted th the single family residence building permi application on April 9, 2004 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated April 15, 2004 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 16.) This approval is for a single family residence with attached garage and covered porch only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 17.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 18.) Not more than two (2) unlicensed or inoperable vehicles shall be stored on any lot less than one-half acre unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Unified Development Code (UDC) Section 6. Outdoor storage of thirteen (13) or more unlicensed or inoperable vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage)yard and allowed as a Permitted Use in Table 3-1 of the UDC, and such storage shall meet the requirements of UDC Section 4.10. In no case, shall any such unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area (ESA). 19.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 20.) The building height is not to exceed 35 feet. 21.) Minimum setback from George Leslie Drive right-of-way shall be 20 feet. Minimum side yard setbacks shall be 5 feet. Minimum setback from south property line shall be 20 feet due to an adjacent right-of-way on the adjacent property. 22.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 23.) Lighting fixtures shall be designed and hooded to prevent the light source from being directly visible from outside the boundaries of the property. The intensity or brightness of all lighting, during construction and after project completion shall not adversely affect the use of surrounding properties or adjoining rights-of-way. 24.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 25.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 26.) The lot was created under the Garten Estates Subdivision on February 14, 2003 under AFN 465764. 27.) A septic permit(SEP04-0017)was approved on March 4, 2004. 28.) An address of 121 George Leslie Drive, Port Ludlow has been assigned to the lot. George Leslie Drive is a private road (P581). 29.) The lot is served by a public water system that has been approved by the Department of Health and therefore the SIPZ requirements do not apply since potable water has been proven. I:\F_BLD_Permit_Buildng.rpt 10/29/1999 r ie PERMIT # DLO - 0 4 - 0233 APR — 9 2004 JEFFERSON COUNTY DCD II ..,..,0-39c0:\'''''''' ,..\...\ "-T„,.''I't,',t;'::i:-'::i'':'-',s, I-- r _k, Fleh in ��� U�y. 33Z�` ,la s- iiiir' fie l. 3\ ,. ,N,,f. .17::ii:}.;lee z � � �.;�:a•.Zll•c�bs.:: \(•`••':':���:.A��h��,.:iiiiiiii�°'ii:°i;= 00 Y r:'h::.e: •.,:• 4 Nio'� \ :icizf'f;'e` 5(eFi.. W Z w \ .I--� �--ILli I I •SSZ `" ` ��'� • \ SA ��_rI`—, \ °" 9 iT OS W O anaas // / , 9-5 W N �93 wiad�2_ ,, / (13 a) N .89'£OT ---90 y — E 0 H 0. O O N <W. O F O N A WZ OW �I 3 N �' ro O ^ y N P4 ram\ r_CC 1�1 y W W PO vl ...it. 3 2 6. C w 2 0 r . PERMIT # DLO g t3N � 0_ - 0 2' 3 3` t , JEFFERSON COUNTY 'A DEPARTMENT OF COMMUNITY DEVELOPMENT JEFFERSON ERSON k4, pig , 1 , • 621 Sheridan Street • Port Townsend • Washington 98368 t 4O 360/379-4450 . 360/379-4451 Fax �N http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# 0 l it o f PROJECT/APPLICANT NAME: 0-C L. ,„.,t („C., Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a separate stormwater site plan map. Project Overview 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site map. Cays.:,-...fee,G T 4 So..c/y / 4irs i c. - S�/ ....CnK..E OW .64 c r'F t9iC 7- 'Z Z8 Lars -4 r G1''.4.Zr'.t-I 'Sr-vrd .'. AFA•rcr.E.v Ar 'C'c. o, ---4 .4- b o r w/4-c /3.4. AP/-7.Caxi."CA riY I/3 o, rw,c S,Zk' a. rN C L_o z--. Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. 7'413 iJ/mac. ,5/C- ,yvr icarCrzs, o.n! 4 A . $,rf 1AP. :54..4 4/Z.j- 17i�F � i c.r- L o T' c s V,/, c_ 13 iC J-:0 T Z 4 .11 J 1 3, 1 r 9 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. 7 1//c. 1n/7-,g . /7c-.4.-r- N.4S ,6/Z'E-e Co..,/c,Lr,z-S' Gz./c.o.Lr/„ Low L.r'4•7 4 s-e.d ✓ Gc-i4uc..r� .d.f 4.✓ .4-X.S.w/GG Osue' AJ'.T I 5"" (CSAE. 54&'2 /3.€41a..1, 4. Describe the existing soils. Indicate soil type on the site map. '7s./i_ fi-✓i—,,Z, Pc-.o,-r G-.e. s/srs a .4 V; Y S,a- 'P 4O'4 G'on/S.irpT.Q.✓c.f- 5. Describe the existing site hydrology(i.e., drainage; behavior of water on the site above, below, and on the ground). Indicate existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if applicable,and indicate acreage of each. ?A/X- 5,73 J 12€..4/.,. y6.er Gr- I.L. iiiii/Cg If -en" 57;4 /si,,v , 4J.4t74y STa.e..c_ G.).CT.C. 1Ze ,,f T'. .C-sT.-- 7Ace)tip,y, CQi.4 tl,cie7 v n!TGH . Alo A/ �N1 40-4 T/CG .-✓ i.'1x4-/•04-. A.vY /2/1.4/.✓J. LtJ. .G- /3/. P2 v Tfd GT-1Ce. W/T/-f Si4T Soc,k..S O CA1A-C,4 1C/7 LN A /lA-4:7LIL4K. pA.S/l , 6. Describe any excess levels of noise generated bykpcpb t •41 . Etly: do,J4 ,t'JN/l..a,cr Gon/.r' •f 1 iw 't PL J IeO Ai,44✓/.•✓,j e.4 r,,,a4 /1 o G.. S l�D/C 1�d71-tld.E Ti a'..' t Jti .t c Ga- -r- AJa.S,c /or: NA,t. 4 ,.i"; 3 4 4435 .C7 c.. APR 1 5 2004 JEFFERSON OUN,Y stormwater site plan template-rev.70/t/2003 DEPT.OFCO, t DT:VEiePM NT 5 SIGNATURE,/ j,A 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes, etc.)on the site. Indicate loc tion on the site map. 1—. rS 2 3 z Z 5 Z 4 A/1T Lei c A rifD /A/ cG o SA" PRoxioi r r of A- CAVAdr r S S 8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads, and sensitive/critical areas (streams,wetlands,lakes,steep slopes,etc.). A,OJAc LAAJt7 1is43 A r G+Jd 5i4./4Lr F-4 ' t L. Si7,E,vc tr 4X7 ic..., 57:4rc.7 / GS 3 OLodzi olcF vim' jilt 141 JFruwAr , uwr jog Permanent Stormwater Control Plan This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs and facilities to remain in place after construction of the project is completed. "Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control facilities are not exceeded. g. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed (i.e., per BMP T5.30 in the Manual) or, if not,what types of stormwater flow control will be utilized for the site or specific threshold discharge areas within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. r'ura- ScrL-S f+.KiL v,a4y, F'E.. vious 5ILT S oc4cS wrmac. tSre r,•-isrgc,cEw I,N c c , -cu tc .o.s,,js -ro PRC VT Air GONr-Ari.r&AT,^kt 1.JITL1 1:7141-ty S 4.; A3 v.)sTQtttlr' on/ dn/ AL.t_ Dawnl S LoPTi 19 A irN T1-Nrc. A pogo PPrArrc. 10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is normally for large"projects or projects that involve the potential for dispersion of contaminants.] APR - 9 2004 11. Describe the performance goals and standards applicable to the project. o ►Htr.lr nntZrc AfJL7 e oA/'lot- !1LC, D/S7i-,' O Nl7 AIifO T'a P12>z v,c T- A"J Y GONTA rti//14 T/*OA/ d A•v s „er"..t 5 o2 /141.4 rC . 12. Describe the flow control system. ��--�4� (Za T'!"r � 4, �c c..... _.- F� Mrn�t++s1Z�O t��}� 1►4E. v F. /!.a Y / 4.,r L$ .r r4, d k/Z S i o,Z %IA- -T'2 &c u r s and DawAlN/ L-c. SC;op. ,s , 7'a PdeC✓ ref 4 A ill y d# . lv a.S<! 0f1-s . r stormwater site plan template—rev.10/1/2003 6 PERMIT # BID 04 - 0233 13. Describe,thij water quality system. I..IQ.TY re_ 11 PIZ 0 V 1 ►�t<+� /: N L OG�c._dtffSi��i r"Y[t,O IT T i• .1 1, i 14. Describe the conveyance system analysis and design. A APR _ 2004 I 15. Describe the source of fill material,physical characteristics of fill material, and deposition of excess material. 4.LL S/T-fEs I.J1Lc_ 14A .Va. ►11N/,A4k,.` Di!SrcaitaA:1 /e..FL jp,,AJ AiAr c,.'At Ls.A.cL 5T.4f- p..- /c.o.e.s-L �X,Jr..tvat 5.1": ". _ 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. ,/t'1 JAI/nr z.1/pt. CGj;S To /3d '.aoe,Aid( Sdie_f , 17. Describe the proposed surfacing material. 18. Describe methods for restoration of the site. 4. /ss,/ RC.T TD 7'f,/4 S.T,eE "3atJL Ft'L.c.• A c-c0,2.0/,+/SLj- 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for "large"projects only and only those for which facilities are required to control flow or trea:runoff.] If included,list the Manuals here. /4c- 20. List here and include any special reports or studies conducted to prepare the Stormwate.•Site Plan. 21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include conditions that affect the drainage plan or contain more restrictive drainage-related requi-ements,describe those conditions or restrictions here. /VA, stormwater site plan template—rev.10/1/2003 7 CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP) The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential development. SECTION I-CONSTRUCTION SWPPP NARRATIVE 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or will.be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual (beginning on page 2-15). 12 Required Elements-Construction SWPPP 1. Mark Clearing Limits. 721-p T /5 AAJe--r',44o y, Gir b F-d/t c_d^/.T 3-,tc Lt1 i-,✓ 2. Establish Construction Access. oi✓ " cr/dA./ ,QcGrC.f'S fc//cc dfc 7-ACTL./S14Et7 d,t/ 4 c-tF S, /r -A n/ a /N/ c-42 cads:7C c.Twin/ pL.AA/ 1 JiZ Gd Aid T r P-/rs d v.v c. t/,e'/1 c.t o F aF 7 j4/c /:,x getAtaJ Td /41//v/••,t•r c iv.✓1-• c..n 73,o.✓1 773 7 /C .7/TA- /0/.247fe/e ,HN pitft- 3. Control Flow Rates. G 6 cnJ fZ.47-1C. GcJ/c.L. i6.E "if /Z �LAC)his I3 43.sr, (jv�c,s /.J • D eioe Gat L.t/ri/27- i7iit.N�C. 4. Install Sediment Controls. $-GT kb L.L Cc /o1 S1-.4 c r 4 e/'/ a Od zci 44/c,c- SGel0.‘s ,.Ai0 ',2(1t/A.) c,gZir' c.'a. a /41ZEAS„ 5. Stabilize Soils. 15ScifZS o .s 77.4.4:5 1,Z Az,r/dt.) 45.' /stsni.on,t+ 0 v .t) d Z c$ /Z 7, 3 I y_ T H� �1 s F rFt rst s' rZ,s d A r/14E-c./ 1-G.0 s.e-",•Cr=•4 C Cs _ 6. Protect Slopes. /^/.2/G a T 0C Ta OS d S. oP'C5 ,a•r/o S>< 7— i(NG/E, 7. Protect Drain Inlets. 5/- T S BGK- -c1/G C, 40iC /ys/STi4�.G/c d APR e 9 2004 8 stormwater site plan template—rev.10/1/2003 : PERMIT # 12 Required Elements-Construction SWPPP(continued) J 8. Stabilize Channels and Outlets. at �o G a x,, - --( c r- .or,6i/A/.d Cr2a-r-GrTS 4 iv F��i �rtl .n m 1 /Al 3 7,43 e c_,-✓ /-WAY 6,4/c - 4-v p J is 7- I:'A ,.✓ 7-H r A 016€CJ,,21 A r-,E L o c, 4.7 o/v 5_ 9. Control Pollutants. /Lr.GG.0 f 6 y 11A 1' J3A /CS 6,4ciefi:27 45' J�/GT �i��vcr'5 -7-c) .sri.ui.../t.E rwic. f=2-641 c)/c / 5 '17i1411-1-%vrg77'or,,/ „dTa �?.�ichis4� rrG. g(the act ofpumping , ) 10. Control De-Watering groundwater or stormwater awayfrom an active construction site). l(4 APR - 9 2004 11. Maintain Best Management Practices(BMPs). ,is't, ✓�.2oP c.2 aeA,•v C114 rz-,G73 Go�c' €s Go.-vc.�c%.G Sze-i.e."- 5-, Td•e GA-6V •v Ue/T-S 12. Manage the Project. SyO�,c.•���-.��.�.,�T GN��-� s. /Loso a.,.1 I111Z-s ee,C S on/ •4, Y ICJ A S 15 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). S G_. STi4t4•G.C/.7 C�2/Z�c.TL r' A c-c>o t- c I/ r 9A .0otv"l1Iic.L S c.oP, .4/7 J C'"-i T' 7-c) .e/r�o,a ,q/2r4J b. Description of the downst eam drainage path leading from the site to the receiving bDdy of water(minimum distance of 400 yards). 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. •4%a,cga C.2>-- 1::7.1 eL c,��,ii %C Z. 3 , Z ' , Zs- 2 6 stormwater site plan template—rev.10/1/2003 g b. Description of special r uirements for working in or near environmentally sensitive areas. 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility,settleability,permeability,depth,texture,soil structure). /VA. 5. Construction Phasing. a. Construction sequence G u7- e-E 5 Fd.G A o ce"Jo. r' QG/y) rd uNbv r,43 G���Si�[I cr Nw140'i3, ,L.c.•n/�Sc i € CL.osr ati L.O/` w/7:41 ALc_ /C 3,tj"J IlISP4 SeiiCY b. Construction phasing(if proposed) P� ` WA- 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). 1. Provide a proposed construction schedule. s4.rl� ,aS SA. I1. Wet Season Construction Activities. APR _ 9 200 a. Proposed wet season construction activities. b. Proposed wet season construction activities for environmentally sensitive areas. .v.3T4erc. .4 /14/E.4St1 sf, ' /Tiv/C /J Z,C4,q Ati.O <- ev sfweic.7 .4c_cd,Co n 4 Z./-, j d 7. Financial/Ownership Responsibilities. a. i lOntify the property owner responsible for the initiation of bonds and/or other financial securities. b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts.. Pc) /.(a, t 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. b. Diversions. /t/A- c. Waterways. NQ- d. Runoff/Stormwater Detention Calculations /4- stormwater site plan template-rev.10/1/2003 10 a Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems,treatment facilities,flow control facilities, or structural source control BMPs (not standard on-site stormwater management BMPs), the applicant shall submit a final corrected plan ("as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing he Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct t .the best of my knowledge. I also certify that t:lis application is being made with the full knowled a and consent of all owner of the affe ed pro erty. (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED: APR - 9 2t394 12 stormwater site plan template—rev.10/1/2003