Loading...
HomeMy WebLinkAboutBLD2004-00323 • BUILDING PERMIT APPLIAION MLLA0400 284 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00323 Received Date: 5/18/2004 SITE ADDRESS: ' SAN JUAN DR PORT TOWNSEND, 98368 OWNER: JOHN D GIESER PHONE: (360) 385-3287 PO BOX 2073 PORT TOWNSEND WA 98368-0250 SUBDIVISION: CAPE GEORGE COLONY DIV 3 Block: 5 Lot: 43 PARCEL NUMBER: 938400542 Section: 12 Township: 30 N Range: 02 W CONTRACTOR: J D G CONSTRUCTION INC PHONE: (360) 301-3136 PO BOX 2073 PORT TOWNSEND WA 98368-0250 Contractor's License JDGCOI*044BJ Expires 11/14/2005 REPRESENTATIVE: J D G CONSTRUCTION INC PHONE: (360) 301-3136 PO BOX 2073 PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOr NEW SFR W/ATTACHED CARPORT & DECK(S) ABOVE GROUND 250 GALLON PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 828 VALUATION 159,000.00 ADD'L: 1,645 HEAT TYPE: PRO CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: 3 OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 370 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: 3 Prop: 3 Seismic Streams Total: 3 Total: 3 Flood Way Floodplain Routing Dater F&W Landslide �/9/0 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid Bv: Date: Receipt: Permit $1,324.15 KAS 05/18/04 64433 APpitvivED Plan Check $860.70 KAS 05/18/04 64433 State Building Code $4.50 KAS 05/18/04 64433 JUN 2 1 2004 Potable Water Application $52.00 KAS 05/18/04 64433 Jefferson County Planning Total: $2,241.35 & Building ilepartm nt • Ant g oz�r �, --� r r, _-_- : ;on Cou il�Department of community Development °� [ ii - vi.; I : Ian Street,Port Townsend WA 88368(360]378-4450 , _) ti ' \n 1 O ApGcfl© �__ ,� n prmd 0 _ CO ulil On ,,s,,N„.. , T.OF Cf r.. , t .,EvELOPMt.,I ,-- Project Description: -- - - _ Building Type: Project Type: Frame Type: r74Single Family x New Wood ❑ Garage Attached/Detached ❑ Addition Steel ❑ 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: ❑ Sewer ❑ Community System ❑ Electricity ❑ Oil Proposed: -:3 Proposed: 3 rye{ Individual S stem Total: 3 Total: �` y ❑ Woodstove y Propane If not sewer,fill out the following: ❑ Heat Pump ❑ Conventional ' Alternative ❑ Other Permit# SEP '� —C G Lyfc Water Supply: Private well ❑ Two Party Well❑ Public:Name of water system: quare Footage: For Office Use Only Main Floor / Consistency Review 46100 2ND Floor i/e''1(-q 1,0 p .�� Base fee 1 I j 3a1. 3rd Floor 7S Plan Check fee—65% 860. �° Htd Basemen State Surcharge fee -4. bo Unhtd Base mr, Subtotal cgi a31. 5 Garage/' arport Z? t q 515.91.2 q Pot Water Review fee e J . Decks 370 O la . 9° _ 911/Rd Approach fee 1 j 4 Commercial 4� TOTAL g� 35 13�1499 // (Q(2o. Industrial Receipt# CD�l % 3 Other Cash/Check# /(0 3(o f CAS l4 `? .0 3 „ /pQ Total Valuation: I - ' Initials may vhC � Or d _ Date `5/ tt / l Estimated Cost: /'� c7/ o, '0 If within 200' oft 'ne 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 he applicant owner with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify a d hold har ess Jefferson County against all liabilities,judgments,court costs,reasonable attomey's fees and expenses which may in any way accrue against Jefferson County as a result f r in c sequence of the granting of this permit. I further agree to provide access and ht o ntry to Jefferson County and it's employees,representatives or agents for the purpose of application view and any required later inspections. Access and right of entry to the applic'nt's roperty or structure shall be requested and shall occur during regular business hours. Signature: Date: 5 /7 Z ) / OVER H:HOME\PLNCNTR\INFI6BLDG\FORMS\BLDpermitApplication 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 #: BLD04-00323 Received Date 05/18/2004 SITE ADDRESS: 52 SAN JUAN DR Issue Date 06/21/2004 PORT TOWNSEND, 98368 APPLICANT: JOHN D GIESER PHONE: (360)385-3287 PO BOX 2073 PORT TOWNSEND WA 98368-0250 SUBDIVISION: CAPE GEORGE COLONY DIV 3 Block: 5 Lot: 43 PARCEL NUMBER: 938400542 Section: 12 Township: 30 N Range: 02 W CONTRACTOR: J D G CONSTRUCTION INC PHONE: (360) 301-3136 PO BOX 2073 PORT TOWNSEND WA 98368-0250 Contractor's License: JDGCOI*044BJ Expires: 11/14/2005 PROJECT DESCRIPTION: NEW SFR W/ATTACHED CARPORT & DECK(S) ABOVE GROUND 250 GALLON PROPANE TANK REQUIRED INSPECTIONS: ,� SETBACKS: OK 0/6 41 ,p4 UFFER: N Footing: Oi< 8/8/DT Calf) 4# '*EC/Ac. ri�arI S M Oahe, .po Foundation: ,Q174L e k B/Z7/o1 ar/Cc4d/e/OsS f .K1 Stormwater FINAL Approval: (lye, oJ- UndergroundPlumbing:6ASt✓ivf)aL 9-AI-D{ 1 7' 49s-b-/o.o3 ,s(j Undergroun nsulation: N Shear Wall : G-6zos- Ki Framing: Xr311.51T/T//'UoI7/ �` elk .03. 615'1 APSFarLt, i/4S NI Plumbing: 4 °/ f.7?.3/O5- p.?vasregnix Qk 8 / os Propane Tank/Lines: Ll ./c 7 z e . - 44/4. C../ A Joe xi p ��/�� 9' / k] Insulation: dX B/ZO QS��;�t064a.s + ✓Auiip G°6,iiwcs, 4.< Sheetrock.' ./cr 11°'G -5 _ k] Septic SyterY Final Approval: fk1 Road Approach Final Approval: N 114 [ ] Zoning Final Approval: N f t E4 Final/Occupancy Approval: oK -C,r 0 .3/L fd6*- HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED 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 APE # BLD04-00323 • 1.) The application was reviewed by the Jefferson County Department of Community Development staff on June 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: Critical Aquifer Recharge Area (Susceptible), slight landslide, and stormwater. 2.) A Geotechical Report dated August 15, 2003 from Northwestern Territories Inc. was submitted in conjunction with the application to address the landslide hazard. 3.) 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. 4.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 5.) 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. 6.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. 7.) A site visit conducted as part of BLD 04-107 confirmed that there are no wetlands located approximately 75 feet south of the proposal. 8.) The following are recommended conditions from the NTI Geotechnical Report dated 8/15/03. These conditions are incorporated by reference. 1. For the hillside areas the following recommendations that bare areas should be revegetated and that native vegetation (small trees &shrubs)that require no irrigation should be established. 2. Surface water from upslope should be routed around the house. 3.Heavy irrigation or other activities that contribute large quantity of water to the soil should be avoided. 4. Surface run-off from impervious surfaces should be controlled and routed to drainage control devices to ensure that discharge does not significantly exceed pre-development rates. 5. Silt fences or other devises should be employed to control sedimentation. 6. All drainage controls should be maintained and inspected at least once a year. 7. Septic drain fields should not be located on the hillside above the home. 8. An engineered drainage and erosion control is recommended to address items 2,4,5, and 6 above. 9.) 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. 10.) The applicant is proposing to create or add 4,010 square feet of impervious surface and 5,580 square feet of land disturbing activities. Sections 6.6 and 6.7 of the Jefferson County Unified Development Code requires that your proposal submit a Stormwater Plan for a Medium Project. 11.) The project shall adhere to the'8est Management Practices (BMPs)to conl 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. 12.) A Stormwater Plan for a Medium Project 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. 13.) 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). 14.) The site plan as submitted with the building permit application (BLD 04-323)on May 18, 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 June 18, 2004 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 15.) This approval is for a single family residence with attched carport and decks 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. 16.) The property is Lot 43 Block 5 Cape George Division 3 recorded August 8, 1961. The property is designated Rural Residential 1 dwelling per 5 acres by the Jefferson County Comprehensive Plan Adopted August 28, 1998. 17.) The primary and reserve area for this property is located on Lot 11 Block 8, Cape George Division 3 (parcel 938400811). This was recorded in a declaration of easement file by Auditor File Number 435533 recorded on 7/21/00. 18.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 19.) 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). 20.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 21.) The building height is not to exceed 35 feet. 22.) The front setback is 25 feet (plat condition)from the edge of the right-of-way of San Juan Drive (private road #158) (west). There are 5 foot side and rear setbacks from the property lines. I:\F_BLD_Permit_Buildng.rpt 10/29/19 JUN-17-2004 THU 10:38 AM WRP ASSOCIATES FAX NO, 2063248708 P. 02 '0) -ei Legal Description L:, J \A - i Lot 43, Block 5, Division 3 of Cape George Colony mom er .on 12, Township 30 North, Range 2 West, W.M. JET _� ew �Ek°t\M" efferson County, Washington avimommemirn cv 8 ;so ---- 41ano•Vrw' I 01 tD1 a M 111 M L: '4411,1, 0 sg tt4Marg, IAo a) a 2° 4 c .171 %.• - 4%* ow, c WROVED v p j Ot5. +M E. 30B Na. O 5fl5 ST kR PLAN % `cb --- SATE SHEET NUMBER 4 JUN 1 8 2004 En arged Partial Site Plan A 100 JEFFERSON COUNTY DEPT.OF COMMUNITY DEVF- PMEIV SIGNATURE. � D r lip, c, t t,, Nc I ' 1"14'4 JEFFERSON COUNTY 1 1 DEPARTMENT OF COMMUNITY DEVELOPMENT I L' Li MAY 1 8 2004 ;I : 621 Sheridan Street • Port Townsend •Washington 98368 ; . - $ ` Q 360/379-4450 . 360/379-4451 Fax L L PTTOOF C�� .;E v E LO P M L .I http://www.co.jefferson.wa.us/commdevelopment/ - -- STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# C) ` agto‘l PROJECT/APPLICANT NAME: I4 vt 6[tsar1t` 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. 116 oDs F 4otiz 'iD b e-- Lit- o J - 6 v- iJ G/J�� G ere- c . (�Vr / Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. —tai6O hs oil/ p%S ',4"-.' 4'�c", ,-..ra..._' :;:r.3u"• ; ° a • ., :at.... j '�,it i '1i1 *--t tt + 3. Describe the existing vegetati&iIhtiicate native vet etatibri areas on t ie ma` -t• 4. Describe the existing soils. Indicate soil type on,the site map. / j Egto ll C h1 c- ioee.-1, o/ / 'e e- L f ke p ie �.dp�s' - X a, -i s'n4ouo q�, ,y e3/•✓( L/)c 7-4 �dd4 pi 0(84 *76 ewe hi/15/.0-i . QV`rertttruUS. uSCTAwL 4' 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. 4 . /i ebb svieq a67 bLiA-- AAA° idv,e k-s kiie 11 6. Describe any excess levels of noise generated by the proposed use or activity: APPROVED felem _ - STORMWATER PLAN - JUN 1 8 2004 stormwatersiteplantemplate-rev.10/1/2003 JEFFERSON COUNTY DEPT.OF CO . UNITY EVELOP ENT s SIGNATURE: t_ _Y , 3 ., 7. De cribe-s' ' nt geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streamsc, teep slopes,e . on the site. Indicate location on the site map. p WN po SLtaws hr)w &4r4. is 6,4 SITY- .• A atar>'t ves 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.). ` An erne>zj Cam el rt- (7 • �/t1- ccsze4At . �loia- r G6304 / 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. 9. 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 sit plan and differentiate proposed facilities from existing facilities. CA ‹. C€0,176. reAcy h 45, A Ae-oti ioircl► -,- 6,0-c s -.exlsnu5 a kJ 126 A 0 -.J hm' 6 S?Pc. D ./ peoyZo_T7 • i 7 s r.,�e�.� 14� .Sbaty-,. / by -QA_ tA';a 44(/AJ N c$\ty,ittovs. P.- 6/ 1 7/nit -1`t',a.-�- w 0��d o.rc vrF1.x.i -to- c�,1/�L gv 4 t -t � ( A.todve. 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.] 11. Describe the performance goals and standards appl"r-•le to the project. 12. Describe the flow control system. stormwater siteplan template—rev.10/12003 6 13. Describe the water quality system. E !' 1 IL MAY 18 luu4 L J; 14. Describe the conveyance system analysis and design. ;cPT. OF C_) r E ti E�IJ!'hit t 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. cit/l,S Of KON 'Fa•4 e4/Zrs aE URA'1.,..44y A , tin tiM 4 r- sTa ova 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. tk -I / G ?41 / atiipnc J S l 17. Describe the proposed surfacing material. 164 000 Q.& 04r/0, of C6.4C1ey-1✓ .ct t c,3,9)6>_1 18. Describe methods for restoration of the site. ex-'a)- iuz_ ck' 5410 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 treat runoff.] If included,list the Manuals here. 20. List here and include any special reports or studies condu ed to prepare the Stormwater Site Plan. 21. List other necessary permits and approvals as requi ed by other regulatory agencies. If those permits or approvals include conditions that affect the drainage plan or contain ore restrictive drainage-related requirements,describe those conditions or restrictions here. stormwater site plan template—rev.1 W1/2003 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. 7)1u " 2. Establish Construction Access. ,r# 3. Control Flow Rates. 4. Install Sediment Controls. 1410-0A1 r1r441,4-eN- cfe 5. Stabilize Soils. ( , e,t S 41 ia1r moth a az.-ilw t, 6. Protect Slopes. 7. Protect Drain Inlets. hgJu44� - h€7. stormwater site plan template—rev.10/1/2003 8 • 12 Required Elements—Construction SWPPP(continued) �R1 8. Stabilize Channels and Outlets. L MAY 1 8 2004 /190/ PT OF CI) ; . . _EvELOPNIL.1 9. Control Pollutants. 10. Control De-Watering(the act of pumping groundwat:r or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). 12. Manage the Project. 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). �� '4c �A q�o N/I c TJ. v 4' i,d S Qeter - �� Cr/ b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). Pu s AZo e' 41,< lve `z c_4 6e; e 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. stormwater site plan template—rev.10/1/2003 9 b. Description of special requirements for working in or near environmentally sensitive areas. 4. Erosion Problem Areas. Description of poten I erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility,settleability,permeability,de th,texture,soil structure). 5. Construction Phasing. a. Construction sequence b. Construction phasing(if proposed) 6. Construction Schedule. Wet seacc,n i.s October 1 through April 0(page 2-21 of the Manual). T • I. Provide a proposed constfifr;tchedule. f ' 'Cl- ii0;1).-Y) 0)/t-li -IL\i S -10+1-4.t., II. Wet Season Construction Activities. a. Proposed wet season constructio activities. b. Proposed wet season construction ctivities for environmentally,sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the property owner rswonsible for the initiation of bonds and/or other financial securities. D l' s4(_, G;'c_ 4 69.0 G'Q -I ('oNt400%,•- 194- Y STaafz o 3F t-001-4 ,9-e� 'p,G. coA6r b. Describe bonds and/or other evidence of financial responsibility for liabilit/associated with erosion and sedimentation impacts. dd_ �� 14Y/ .- 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. -Chi LC r S o%) 'ram, ,p jZoi is AQp b. Diversions. / c. Waterways. d. Runoff/Stormwater Detention Calculations stormwater site plan template—rev.10/1/2003 10 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-bunts")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 th Cons ruction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the bb est f my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the ec d property. (LANDOWNER OR A IZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE Y BE USED FOR ADDITIONAL NOTES,IF NEEDED: P L MAY 1 8 20)0,fi r i i+.-f7. OF l'..A r . , ..E Y i"_OotviL :I 12 stormwater site plan template—rev.10/1/2003 aka �"' i. 6-- to tiCr n'4-, S\ a 11 p 03 4.x 0 c� =` r.-7,1 ice ,.. 0 C H �' O ...., ...,... lit 4. 1 8 ,�j SS 14SIS � � S4, .. 1 ir i . :'is, ,1) IA 10 p CD , a . 4 . # A), � .41)/:cb t:40( 1 . ---- I- ,,, ' 0, , �ir•�� I.. \, ru tfli is : 0_ co gnu uow �,/ 107 So --.. lir / I Co tiill C:4) 41‘ d„. Ali 4,,IY, ' \ Illithl -0 ...1) -- _--CD ,� a , , )11 . Z . A k‘,‘ (:1:" i Pi4c) ' 1 11. aZ _It 4. 1 1 . (7,0 s7 I , �l, I V/ nMil, 00 0i �o0ti / ,, - COii Ror8 O W LOiQ <n �� N �i�f R." ONIN•111 MMIT III al `V O toCI 7 wi.V p 0 O �■ —17-1 � g r-.. Cli i� m B a:- 0 DJ p Residence for: Shearwater Services, Inc. 4873 R ISTERED 1'1' o John Gieser i CT O 3 cm o PO Box 53261 Bellevue, WA 98015 eEX G.ALLEN STATE OF WASHINGTON O JDG Construction, Inc. (206) 949-5033 rallen@shearwaterserv.com r�-r'�' 3A