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HomeMy WebLinkAboutBLD2004-00483 • • MANUFACTURED/MOBILE HOME INSTALLATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD04-00483 Received Date: 7/20/2004 SITE ADDRESS: 422 FREDRICK ST Issue Date: 10/21/2004 PORT TOWNSEND, 98368 APPLICANT: CRAIG W GOSS CAROL E GOSS 1044 WATER ST PORT TOWNSEND WA 98368-8227 SUBDIVISION: COVE ADDITION Block: 18 Lot: 1 &2 PARCEL#: 945901802 Section: 16 Township: 30 N Range: 01 W CONTRACTOR/ DEALER INSTALLER: BUYRITE HOMES BUYRIH*0840B Expires: 5/20/200E 269403 HWY 101 SEQUIM WA 98382 PROJECT DESCRIPTION: NEW MFH MAKE: KARSTEN YEAR: 2004 SIZE: 60 X 26.8 THIS PERMIT IS VALID FOR ONE YEAR. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 10/21/2005. CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. ,� Setbacks/Footing CONTINUOUS FOOTING)SLAB or PADS USED) >21 /3 �O ick Stormwater FINAL Approval: Blocking/Plumbing: ..v G--.1!'©,)--- J.J Propane Tank/Lines Zoning Final Approval: Septic System Final Approval (If not on sewer): Road Approach Final Approval: r\ Final/Skirting/Vents/Porches/Steps:' , 3 f 7 65 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 CASE # BLD04-00483 1.) The application was reviewed by the Jefferson County Department of Community Development staff on (date) 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: Level I (Slight) Landslide Hazard Area, Susceptible Aquifer Recharge Area, Coastal Seawater Intrusion Protection Zone (SIPZ). 2.) Port Townsend City Water provides potable water to this parcel. As such, this proposal complies with the mandatory measures identified 3.6.5d.(9). 3.) Environmentally Sensitive Area mapping identifies the slopes on this parcel as gradual over the entire parcel, less than 10% grade with no defined top or toe to a bank. This department will not require a setback or buffer to the slope due to landslide hazard area mapping. 4.) 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. 5.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 6.) 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. 7.) The parcel is located within a coastal SIPZ (seawater intrusion protection zone) according to the County GIS map. There are voluntary and 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 Coastal SIPZ is defined as: all islands and area within one-quarter mile of marine shoreline, but no history of chloride concentration above 100 mg/L in groundwater sources within 1000 feet. 8.) 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. 9.) The applicant is proposing to create or add 1,983 square feet of impervious surface and 6,683 square feet of land disturbing activities in a landslide hazard area. Sections 6.6 and 6.7 of the Jefferson County Unified Development Code requires the project applicant submit a stormwater plan meeting Minimum Requirements#1 through #5 of the Department of Ecology Stormwater Management Manual for Western Washington. The stormwater plan shall address measures to control stormwater, erosion and sediment during construction and shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. • 10.) A Stormwater 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. 11.) This parcel is a legal nonconforming parcel designated Rural Residential 1:5 under the Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998. 12.) These lots were created through the Cove Addition subdivision September 27, 1889 through the Cove Addition Plat recorded with the Jefferson County Auditor under Vol 2, P 27. 13.) A septic permit(SEP04-00122)was approved June 18, 2004 for a system with capacity of 360 gallons per day(3 BR). The cancelled septic permit application (SEP99-00032) is now filed with SEP04-00122. 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 standard maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. Per UDC Table 6-1, note 15, "Pre-existing legal lots of record less than one acre in size in Rural Residential districts are subject to the stormwater requirements in UDC Section 6.7 and must meet the"Area of Impervious Surface Coverage" to the maximum extent practicable as determined by the Administrator." 16.) The building height is not to exceed 35 feet. 17.) Minimum setback from the edge of the parcel boundaries adjacent to Fredrick St and 7th St is 20 feet. Minimum setback from the eastern and southern parcel boundary is 5 feet. 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.) A minimum of two (2) on-site parking spaces are required for the manufactured home. 21.) Building permits (BLD99-00216 and BLD99-00217) fora manufactured home installation and detached garage were cancelled February 7, 2002. Associated critical area review was conducted under CAR99-00061. 22.) Fredrick St adjacent to this parcel is a private access road. An address of 422 Fredrick St has been assigned to the parcel. 23.) A complaint case (COM99-00016) for clearing over 10,000 SF without a stormwater plan was closed September 5, 2001. A complaint case (COM02-00050) for clearing and grading without a stormwater plan was closed August 30, 2002. 24.) A boundary line adjustment(EXM98-00021)was approved June 8, 1998 consolidating Lot 1 & 2 of Block 18 and a portion of West 1/2 of Tax 55. 25.) The site plan as submitted with the building application on October 13, 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 October 13, 2004 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 26.) This approval is for a manufactured home installation 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. 1110 • MLA04-00451 Review Type: I MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00483 Received Date: 7/20/2004 SITE ADDRESS: 422 FREDRICK ST PORT TOWNSEND, 98368 APPLICANT: CRAIG W GOSS PHONE: ((360) 385-3914 CAROL E GOSS 1044 WATER ST PORT TOWNSEND WA 98368-8227 SUBDIVISION: COVE ADDITION Block: 18 Lot: 1 &2 PARCEL NUMBER: 945901802 Section: 16 Township: 30 N Range: 01 W CONTRACTOR/ BUYRITE HOMES PHONE: (360) 681-0777 DEALER: 269403 HWY 101 SEQUIM WA 98382 �36 1-0780 Contractors License BUYRIH*0840B Expires 5/ 0/2 INSTALLER: BUYRITE HOMES BUYRIH*0840B 5/20/2006 (360) 681-0777 269403 HWY 101 SEQUIM WA 98382 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION: NEW MFH TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: KARSTEN SETBACK: VALUATION 67,000.00 YEAR: 2004 LABOR & INDUSTRIES APPROVAL? SIZE: 60 X 26.8 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: CITY BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO STORMWATER: YES NO Exist: Exist: AREA Plat Conditions Prop: Prop: Wetland Erosion Total: Total: Seismic Streams Flood Way Floodplain Routing Date: F&W Landslide 7701- Shoreline Aquifer AlertiptV E D Type Amount Paid By: Date: Receipt: Permit $154.00 KAS 07/20/04 66619 OCT 2 1 2004 Potable Water Application $52.00 KAS 07/20/04 66619 Jefferson County Planning Total: $206.00 & Building Department 0.01kxo„n oc 4 �5 c06 JEFFERSIII COUNTY ! � r A 1 n , .ti DEPARTMENT OF COMMUNITY D I ,� z t.0 _ LOPMENT 621 Sheridan Street • Port Towns-nit 1 Wa gt n 836 j ) _. p�, W360/379-4450 • 360/379-4451 FeW L i JUL L U /-UJ4 i• -;� �4S NG Ww.co.jefferson.wa.us/commdwphnen elot Master Permit Application i DEPT. OF COiv "t;dT r DEVEL I' ,E A Project Description(include separate sheets as necessa ): Tax Parcel Property Number: 9 iO/ 2 2_ Size: 1/c? j� t � (acres/square feet) Site Address and/or Directions to Property: Ff�f_f� �I � T �l y �/� tom'.l"L- 4 P / Y' Property Owner(s)of Record: 6-c, S V n ��'�-- Telephone: - c Fax: `� �/ / Mailing Address: __ email: p-3 ican ,A Ant(if different from owner): A, ,f, �, Telephone: �560 t3(S5cs3q/� Fax: r �� `IJ em Mailing Address: . C ) (' /q�f-6i C r cJ (4)-0 qua c,,,� hat kind of Permit?(Check each box that applies) Building❑ Demolition Permit ❑ Variance(Minor,Major or Reasonable Economic Use) ❑ Conditional Use[C(a),C(d),or C] 0 Single Family ❑ Discretionary"D"or Unnamed Use Classification ❑ Garage Attached/Deatached ❑Special Use(Essential Public Facilities)** Manufactured Home ❑ Boundary Line Adjustment 0 odular ❑ Short Plat** ❑Commercial* ❑ Binding Site Plan** ❑Change of Use 0 Long Plat** ❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Propane ❑ Plat Vacation/Alteration** ❑Allowed"Yes" Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions*'" ❑ Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: 0A(ZoL �C��� DESIGNATION OF AGENT I hereby designate gto act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE fi ...>.` Date: 7/Y/0 V By signing the application form,the owner attests that the information pi armed 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,indemnity and hold harmless 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 of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections.Access andlight of entry to the applicant's property shall be requested and shall occur only during regular business hocs. Signature: y� Date: -7/5-7o(The action or actions Applicant will underta a as a result of the issuance of thisyy or endangered species and could lead to a potential"take"of an endangered species asttho a terms defined n d act in the federal law known as pon one or more the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-traAsferab responsibility fora eying e pi complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature` +� - Date: G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 05-12-2004 Revised.doc J•ERSON ERSON COUNTY ASSESSOR JACK WESTERMM1 III COUNTY COURTHOUSE ASSESSOR PO BOX 1220,PORT TOWNSEND WA 98368 (360) 385-9105 A, . . •RMATION FORM . Si, , OWNER'S NAME / MAILING ADDRESS: THIS IS NOTA TAX STATEMENT NAM , `fibE //Y/- r SON yg IOS S The purpose of this questionnaire is to obtain information _ � ` regarding either the current location of a mobile home or the ADDRESS: �� / LL��CQ�{ 9iq f previous ownership and location of a mobile home. This will � �// help our office determine whether the mobile home is already l ?✓LI�.L�1i'(i QcS3C©,k on the tax rolls in Jefferson County_or if it has been moved to _ i this county from another area. Please see reverse side for TELEPHONE NO: 86'0 �3:f $ - 3 /V additional information. 1) MOBILE HOME DATA: C°PY (A) MAKE KAP 5 , EN (B) MODEL[(y( (00��-j (C) YEAR 'ROO/ (D) LENGTH 61) (E) WIDTH 1,t ' /I (F)SERIAL NUMBER nd (( t�1 ��(�4( t� (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) 4 6 7L OD (H) PURCHASE DATE ‘-'r`"' 2) PREVIOUS OWNER/ LOCATION OF MOBILE HOME: (A) FROM WHOM DID YOU PURCHASE MOBILE 13 q q TF Y 'LL j �j ADDRESS � 403 /J( L{laiy /O I (5(-y(11 LLk / V. (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? YES NO (IF NO,WHAT COUNTY? ) IF YES,WHAT WAS PREVIOUS ADDRESS OF MOBILE? 3) WHERE MOBILE HOME IS TO BE LOCATED: CPPY (A) WILL THE MOBILE HOME BE IN A MOBILE HOME PARK? YES (B) IF LOCATED IN A MOBILE HOME PARK: NAME a ADDRESS OF PARK SPACE NO. --- (C) IF NOT LOCATED IN A MOB LE HOME PARK: CiZCi11Je'L ,yi f (ter J NAME OF LAND OWNER: 0 cl0 0 ( oSS (,J' is fade/i4 i t 1 LOCATION(ADDRESS) q(9A f i 0 f'_ (c PI Y- K rn -vi dJ a.( vo(e RELPRTY PARCEL NUMBER D ON fit ���lgels- ��O _ � �� RO ( l /eyvi4 J -t. a-it u-v( eC 4-ccod LJfI) 42 70 � 4. „ ec..cjG • Iv t.� ,e ,f,. 7, - /O,JAlL.t* �THANK YOU FOR YOUR HELP! % SIGNATURE C, �' \ KELLI LARSON, tsroperty Technician THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION. • \ . _ , F e,a! rl, c• . il I iii,---.-- ----,-,-._,,, I" • • _ l=O car li>trnr o oaf • $'G ,r„ :j ,/ ,K ,K .:. • „e"- + • ''' .-ram ,. =- : .- 1 -nte r•:. ,r k.d' p Dec a ` z- r� S1MLL ' • r .. i *4404:...,f•- - . e`',...4 A ! y� .R. r. • �"�,f1r`t Y • ,Y., _ :;... •_.',.,. . .. is • • • A t'% RO:Vhij ....,.... SIEPI:A . 74' .. I -# r,, .. l': • fi • OC 1 3 2004 . • ... - r', may. ,tt DEPT. :.. ...7...7. .. ‘r•111. z::'• I::• 11 e. • OFIEFFE'SO CO iv, • '• 'lir -;cs S, t . , c° .-get, 5 .: , ,, . IGNA el L • 1 .NI . .:‘..:..: ,...,..,..... ;,.... .. `. : yh� „/, ,11 .�:I' .;:�: '~' • - :. - . :may.:7''� •" f % rialk4;,,,.*I.it .' "'' .,, :',.1 07.7:. •,:..i, . , - ,0 ,,,.....„:.. 4___R. . " . . ..•...._••• • . . .... . . .. .......,,..„.•.:. . • . . .• , .4 ,„„,,....„,,,„. • ,, ....: •3„._ IP.e..1.`' - ,i, • • • ' a • • ``/ �/' .. ff ,, ((+�y�ami • J"'` • i�•\►fir!K^ 4.��1�T ..- .......- 14k-tkV ie4I'i.-. . . : ' ',OMIT # Pm i tom` ,moo L Go55 1 ' `? OCTtAi 3l ;v .�� i .........i.. .... .. r (73 Aliti OO O .+4-. . 5� u� �t,�(. 121 i vd JUL �t�1r 11 2p 2 f t �`► • tea,..-- _M-�, F -k'!.�2' �l ,�, t ( ! DEPT.OfJLi t f••ti I 4,, YTt,Uf�l7Y LOPME� C_ 1. -� 9y 1 I �� zQ �� ":7s:, 8r ( ,' 5 g ,,,,:. I ; ( Lryl- ., - .8 Lii F:f i 1- =i I , b 5' rCt Pa b 3 D7- 4 -El oi M �- CYRAve-i `� �y� .' 9A 2 KiNG .: _ -� � - ; ' a s' C� Gam-S rV 4? ..�s .. AD Ili a'' l f NAIVE �6G-69.. Q-tlJ M - 'R �Zn AID _ .......--- tiaNylicietlir;I' i:,iy----- STORMWATER P AN - t39t \ tR.O L 55 . �. Q�. OCT � T 4 �B� 13 vccAy.,.p....- i 701 ^~Qo JEFFER ON CO mail�,J l!�— O UZ c ' n — DEPT.OFCO I C. MENT l ail ge r/t.-+ �u \144:Lo� , SIGNATUR VED �sazv STORM WA T reen1 °' JEFFERSON COUNTY ER PLAN %42 DEPARTMENT OF COMMUNITY DEVELOPME T OCT 1 3 2004 621 Sheridan Street • Port Townsend • Washington 9;368 ��C?' 360/379-4450 . 360/379-4451 Fax brig: JEFF $IN http://www.co.Jefferson.wa.us/commdevelopment/ s: Tr RF(OM FDjC./ IyCOf p t : !: STORMWATER SITE PLAN SUBMITTAL TE I: MLA# 04—4- 1 PROJECT/APPLICANT NAME: 615S.S. 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. t 6 by Sck PC MAW- t-4 IU M. l49 Ct1•! 315 y PAQk UJt,,-Aereas.. It.11A11tJc Pc.Ats LAt tf cAC N, uw• OF- ST0a:Z002e. u1 IJ c tSTU j a62EA N• Ot 140O.se t tit O tt J e-GAGS. I,nULeAt I t4fer4 As CNcr6- At oe_OF Ct szv¢e. pp Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. 'S-lt*41 CLOP ) r . 4 to/ S`i't2UG"D�P-E . Bib. �.9Ce.bc' $1T`r 1S f TrV feL j PLAT. O ©l 144 P-e.-eVa'uens . 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. St"F-( 2, Bee4J PVP-111009-4 parl1ReeCt 14411\1€.6 S 1S• oc • BikeisoxF Moc Werril M, C.4 . 4. Describe the existing soils. Indicate soil type on the site map. cp 9 t , (?..zr igLL( STANDS. 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. W Artree_ 1E12, 1/49 [itC (ski Sae. W rat- #O cf3 1 A)Now 6. Describe any excess levels of noise generated by the proposed use or activity: ` {y A E "!�" `ct l'� y 1 `i�(!x ' CTTS `.,Yk e ,A- stormwater site plan template—rev.10/1/2003 4��1"""''f' �t 'i� COUNTY tl-r- t-1.).���N .i 5 • • 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes,etc.)on the site. Indicate location on the site map. ►Jto S eAS1 ciCOtm P � eV4'�t 4bUet4- (44.1-00suvE AP-FA _ 1 IS ,W M4-ct.1 SLoPr Zb I�• • F £9t 4`s t`•`' t 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.). ADJ&C 4 ? A A Mtx ©c DeNteLocreo Amp UNte.JFLp t Prealti xt.PPfa Imo. vespeteK S'C To N • 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. Locatep these facilities on the site plan and differentiate proposed facilities from existing facilities. w wA- 'rc t2 gaze& LI)A IA M. lS ee..IN‘ CtSRECSEID V 14114.f i u me c 2 M Oo 1.4313 390TS To weu- S• sceuc ee . Prey t W 6- 4e q MIRY 0.31u- DiscrveSE IVSTo Noilattie, V66, S . 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.] KVA 11. Describe the performance goals and standards applicable to the project. DtScreecE /u _STC)QIJ1 f ZG. 6,4 SIZE 'iF r w ti'lke 12. Describe the flow control system. ww`` wa go got FjuEl rvio�.IV! $.ve.r stormwater site plan template—rev.10/1/2003 6 • • 13. Describe the water quality system. N/A 14. Describe the conveyance system analysis andFecuA ` t , desiggn.,,e.,, 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. Noy 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. Ni N€ 1 17. Describe the proposed surfacing material. C�NOW:0 rstk MI NU S 18. Describe methods for restoration of the site. LetSTI P.. D Sou-5 U9 Lu.. _ MU LCt+ tN4UJ AIJD EE C 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for large"projects only and only those for which facilities are required to control flow or treat runoff.] If included,list the Manuals here. ^^(( 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or restrictions here. e i s:7$ .1;:_= k v;:,I r b l stormwater site plan template—rev.10/1/2003 JEFFERSON COUNTY D C D 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. l�txc Brit=- P-At4 2. Establish Construction Access. • ' t)ct%i CL C vS P 8AuAsir tU ELL e -Aeix-r'EO -ro/-e-cof . 3. Control Flow Rates. NO Oki FL-(A00 Rows zie 4. Install Sediment Controls. 0 SI CA43 6 I c y d L ice— C Y'�ILS Pt I W tL& A� Q�/ i1p 5. Stabilize Soils. DtS l9 gO(LS mitt.. s-r 1L-12EO .t m stuk u itatal 6. Protect Slopes. 7. Protect Drain Inlets. t % ) 1.16F lE_bRl t e P WAR.17 +: s: � a urEnsm cam: x stormwater site plan template—rev.10/1/2003 8 • • b. Description of special requirements for working in or near environmentally sensitive areas. Ga raa v i tt..-E3F 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). 5. Construction Phasing. a. Construction sequence 4 Vt Ar- 1DN b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction schedule. II. Wet Season Construction Activities. a. Proposed wet season construction activities. b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify t a 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. O JE fit!Leel> 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. �tt // a y.. b. Diversions. IV ¢ a y p= f � a t < LLL 4 k4 �+ i W r 57 c. Waterways. /;•1g,� ; d. Runoff/Stormwater Detention Calculations � { `p�,py�� Io �:/ ,>�I m stormwater site plan template—rev.10/1/2003 � �" k 5 + �I �`F"f 10 • i 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. N oN E.- ON. 511E. 9. Control Pollutants. ANN Q'tr. WILL RE_A-BSoPeicE0 1t Int ,&P Pao Raw' cJJ tt:e_iiifw4372 / eQ ( z c 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). HOSE 11. Maintain Best Management Practices(BMPs). Cat`is-¢vc totu ( MP ct pcf;C w tL.L_ >tiet.y kcs EX9¢-e t-Db-- 6:243 -012.0ertsbN 12. Manage the Project. ow NI ttDee.EKI . W rak Wo t,eJi.At- Aec 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). Nb l zr iS API C +R Z S) b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). 3. Environmentally Sensitive Areas. a. ttDescription of environmentally sensitive areas that are on or adjacent to the site. SU&7 Li JD ju 0Q �4t� -• �- ,��s. � t Y^ f, stormwater site plan template—rev.10/1/2003 l" �'"�t�;`� �r� I TiJ .lcts 9 • • 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 the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. l s. ? 1'/F/d(LANDOWNER ORAUT RI REP ESENTATIVESIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: 01. JEFFERSnN I TY Ce r s stomtwater site plan template—rev.10/1/2003 12