Loading...
HomeMy WebLinkAboutBLD2004-00688 illUILDING PERMIT APPLICA.N MLA04-00622 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00688 Received Date: 10/29/2004 SITE ADDRESS: ,5 n WATERHOUSE LN OWNER: RICHARD W SHAFFER PHONE: (360) 379-3161 MARY E SHAFFER 163 FOXFIELD DR PORT TOWNSEND WA 98368 SUBDIVISION LUDLOW COVE DIVISION 1 PHASE 1 Block: Lot: 6+ PARCEL NUMBER: 968800006 Section: 17 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE PROJECT DESCRIPTION NEW SFR W/ATTACHED GARAGE ALSO A/G 120 GAL PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,255 VALUATION 388,782.00 CODE EDITION: 2003 ADD'L: HEAT TYPE: HTP OCCUPANCY: R-3 HEAT BASE: 1,867 HEAT TYPE: PRO OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: 820 SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: SEW WATER SYSTEM: LUDLOW 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 Flood plain Routing Date: F&W Landslide (( 1O4- VC-1/ Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Permit $2,612.15 KAS 10/29/04 68569 APPROVED Plan Check $1,697.90 KAS 10/29/04 68569 State Building Code $4.50 KAS 10/29/04 68569 DEC 3 2004 Potable Water Application $52.00 KAS 10/29/04 68569 Jefferson County Planning Total: $4,366.55 &Building Department '.--- ,QILL(a4 AL C-c4f-P- t • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD04-00688 Received Date 10/29/2004 SITE ADDRESS: 52 WATERHOUSE LN Issue Date 12/3/2004 APPLICANT: RICHARD W SHAFFER PHONE: (360) 379-3161 MARY E SHAFFER 163 FOXFIELD DR 31.0 437-gt51 PORT TOWNSEND WA 98368 SUBDIVISION: LUDLOW COVE DIVISION 1 PHASE 1 Block: Lot: 6+ PARCEL NUMBER: 968800006 Section: 17 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE ALSO A/G 120 GAL PROPANE TANK CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: 0,4,Z.//S/OS UFFER: 2//S/O5 Footing: Ok 2/05# Foundation: Dk OAS,' Stormwater FINAL Approval: Underground Plumbing: a ,3 a a Underground Insulation. Shear Wall : i_ /DS :;i f4.1. WATI�• Framing: OK 9/05 Plumbing: ex g/�OS Propane Tank/Lines: kr fikaO4,06.-z U6crlik Q//qf /7 Insulation: Ok 9/11495 / / 4Ae.44.&- /,usucark-h R-2(milts e 38 CE'Uruz Sheetrock: eW 5 Septic Sytem Fiv(al ff pproval (If not on sewer): Road Approach Final Approval: Zo Final Approval: inal/ cupancy Approval: Q 4 Litt/, 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 CASE t BLD04-00688 1.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 2.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC)Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 3.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 4.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 5.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 6.) 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. 7.) To help prevent seawater from intruding landward into underground aquifers, all new development activity on Marrowstone Island, Indian Island and within 1/4 mile of any marine shoreline shall be required to infiltrate all stormwater runoff onsite. 8.) VOLUNTARY MEASURES OF COASTAL &AT 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.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 10.) MANDATORY MEASURES FOR COASTAL 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 requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 11.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 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.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 15.) 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). 16.) Maximum lot coverage is not to exceed 45%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 17.) The building height is not to exceed 35 feet. 18.) Minimum setback from Waterhouse Lane right-of-way shall be 20 feet. Minimum rear yard setback shall be 5 feet. 19.) 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. 20.) 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. 21.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 22.) Per MPR Code Section 3.17, Accessory dwelling units (ADU's) shall not be allowed in the MPR-SF zone. 23.) Motor vehicle parking between new structures and the Ordinary High Water Mark (OHWM) is prohibited. 24.) No fence, wall, hedge or barrier greater than 42 inches in height shall be placed or enlarged nearer to the water than the building set back line (BSBL). No fence, wall or similar structure shall be placed water ward of the Ordinary High Water Mark (OHWM). 25.) Mechanical apparatus rather than chemicals shall be used for brush clearing maintenance wherever practicable. 26.) Herbicides used for maintenance along roads and drainage systems shall follow the performance standards outlined under"Chemical Application"of the"Forest Management" Section of the Jefferson County Shoreline Management Master Program". 27.) Lot owners shall be aware that Jefferson County has approved the Habitat Management Plan (HMP) dated June 6, 2003 and should be aware of the contents of the HMP. 28.) As delineated in the filed by orange painted 1"X 2"stakes, no earth disturbing activity shall be allowed in sensitive areas unless witnessed by Larson Anthropological/Archeological Services (LAAS). 29.) In the event archeological items are discovered during construction, builders and lot owners shall observe the following protocol: STOP WORK. DO NOT FURTHER DISTURBE THE AREA OR REMOVE ANY MATERIALS THERE FROM. NOTIFY IMMEDIATELY THE JEFFERSON COUNTY DIRECTOR OF COMMUNITY DEVELOPMENT (360) 379-4450. THE DIRECTOR OF COMMUNITY DEVELOPMENT WILL IMMEDIATELY NOTIFY THE WASHINGTON STATE OFFICE OF ARCHEOLOGY AND HISTORIC PRESERVATION ("OAHP"), (360) 407-0752. PROTECT THE AREA FROM VANDALS AND COLLECTORS. OBTAIN SERVICES OF A QUALIFIED ARCHEOLOGIST TO EVALUATE THE SITE AND MAKE RECOMMENDATIONS FOR FURTHER WORK IN THE AREA. IF FURTHER EXCAVATION OR DISTURBANCE OF THE SITE IS NECESSARY, OBTAIN THE APPROPRIATE PERMIT FROM THE OAHP. PROCEED ONLY IN COMPLIANCE WITH THE TERMS AND CONDITIONS OF SAID PERMIT. 30.) Construction of housing units within 10 feet of an adjacent housing unit on these residential lots shall be built with "one-hour"wall construction. 31.) Existing asbestos cement sanitary sewer pipe across Lots 1 and 5 and Tracts A and C have been pumped with grout and abandoned in place pursuant to Jefferson County Health District requirements. 32.) Lots 1 through 7 of said plat shall have an equal and undivided 1/7th ownership and maintenance responsibilities for the guard rail located within Tract"A". Refer to Declaration of Conditions, Covenant's and Restrictions for Ludlow Cove Division 1 Phase 1 for further information. 33.) APPLICANT AND/OR CONTRACTOR SHALL CONTACT JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT (DCD)AT 360-379-4457 TO SCHEDULE A SITE VISIT WITH THE PORT LUDLOW DRAINAGE DISTRICT, DEVELOPER/OWNER, AND DCD PRIOR TO ANY LAND DISTURBING ACTIVITY BUT AFTER FOUNDATION IS STAKED. 34.) The proposal was reviewed for consistency with the Shoreline Management Master Program Section 3.402.5 and found to be consistent. The proposal is (1) a single family residence, (2) does not exceed 35 feet in height, (3) does not involve over-water construction and is located landward of the OHWM, and (4) meets all required setbacks as set forth in said SMMP and the MPR Code. I:\F_BLD_Perm it_Build ng.rpt 10/29/19 • OWNER BUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed con and that they will be a p ing the res i ity o General Contractor for the proposed project. Lc it { ; i Signature: Date: /o�t2/e 7 is Y _ i f, i I !! `l OCT 2 i i; 1 9 2004 i L I' GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: j. + FAQ i s ( ) ;......, �. �_..`i'Ch�� ,((:1ig. t MAILING ADDRESS: Lfit F'I. (7 ,,:`f�Q f f�I E J ,"} EMAIL: r;_trt-.___ _ _ h'i i..,,f-51:VE(.OPriiET!1 CONTRACTOR'S LICENSE T NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAx( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: I of Sewage Disposal: 4 New Wood Existing: Sewer ❑ Addition 0 Steel Proposed: '), i,/z Bank I .ommunity System ❑ Alteration/Remodel ❑ Concrete Total: 9,Irt- Height: ❑ Individual System O Repair 0 Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: ,3 <Public heck p;,tn1p Total: -3 Name of System: If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: ❑ Underground Tank FcAbove ground Tank Size of Propane Tank:CI j ,L=��;I ❑ Heat Stove El,Cook Stove Woodstove Fireplace Insert ❑ Hot Water Tank ❑ Pellet ove ❑ Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all properly lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage For Office Use Only''' t,air �1` .r ;,, Current Proposed ,' Main Floor i : ' ,.- ; 4� � 4 a � •cx"' 2'. Floor ,• 'fee: 0 � • • dltlonal Section, ;,.‹- ,!,‘: . -03,44',' ,j.: siov,,, r,"?.,,,,A?, ' pp� .}3'Floor � _ , ,, - v ,j �Mezzanine: lan Check-fee: . a V ;n , 3 Heated Baseme Ip y State Surch ai ,z . io_iA ' Unheated Basement � A Ayt' ''o viefey : r 'r' A -> .:{ IYr: .� Other Unheated 911/Rd Approach fee: ':**ti.,44:::„... ....-.,,..,j'IWAVIE44., , Garage/Carport a .,.� w ,,� , � ,� §R_ I r .t TOTAL: $ a Decks --— // _ ,�.F ReceiptNlutn r a( � ,``. " �, , Other -Cash/Oheck Number ,� -- -, c ., ESTIMATED COST(REQUIRED) , - , _•x k ( ) Date: �.� tt� � �. . �"�3 _; r�� f 1r *Fair market value of all labor and materials foundation to finish `�"{ ' . # ACC) ADO . Initials: s � ` G:\PcrmitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc ,/ ON Cod. JEFFERSON dillJNTYs. • A DEPARTMENT OF COMMUNITY DEVELOPMENT ' 621 Sheridan Street• Port Townsend •Washington 98368 OCT 2 9 2004 360/379-4450 • 360/379-4451 Fax �q p� wow.co.jefferson.wa.us/commdevelopment • t. $INS 1 i Master Permit Application MLA:- """ Z Project Description(incl de sep ate sheets s necessary): ,� � -je Tax Parcel Property u � Number: LAC) C 0 CO Size: Jst o (acres/square feet) Site Address and/or Directions to Property: Vi A( \i C..E l�(� Property Owner(s)of Record: R i(',K '(1(1 ct,r Telephone: ';')(DO - -3 ( (6j Fax: email: F'S fL of(1sp�3 J et; Mailing Address: I tc ) F G 1(f;�l� Zyr} p(>r t U) R— clot. 6s-' Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) i$ Building El Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]** Single Family___ ❑ Discretionary"D"or Unnamed Use Classification tiLGarage �ttached1Detached ❑Special Use(Essential Public Facilities)** ❑Manufactured Home ❑ Boundary Line Adjustment ❑Modular 0 Short Plat** ❑Commercial* ❑ Binding Site Plan** ❑ Change of Use 0 Long Plat** ❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRDWAmendments** »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: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent 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 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 ired later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business hours. /v f (0(e/ Signature: Date: / The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as 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 wi the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfera I �esponsibility f• .d v ering • nd compl 'ng with the ESA. The Applicant has read this disclaimer a sig an dates it below. Signature: �� Date: !'tg G:\PemutCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc .4?.. ‘ cv, PERMIT # BLD JEFFERSON COUNTY OCT a ~ DEPARTMENT OF COMMUNITY DEVELOPMENT 0' 4 t 360/3794450idan S• 360/379 o4451rt wnasXend •Washington 98368 CFFFRSOi1 . coUI1' I HD NO� r http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# l �Z'L PROJECT/APPUCANT NAME: 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. , p q i- ;Lj (-6-114.12.\ CL.Lt .l.,1r ,�\ cttll� (/n Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. 7 ) ti :1—ei( _ C.ec 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. 4. Describe the existing soils. Indicate soil type on fthe site map.•; . / Ct^ �c' ����; _. er,�, �j ZC.,C. e—� '�.�(jJ it Zt :` fir ' `� 5. Describe the existing site hydrology(i.e.,drainage; behavior of water on the site—above,below, and on the ground). Indicate existing stonnwater 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. 6. Describe any excess levels of noise generated by the proposed use or activity: APPROVED k) if- , STO&MWATER PLAN Stormwater DEC — 204 Required , stormwater site plan template—rev.10/1/2003 JEFFER O O TY DEPT.OF C . I DE ELOPM NT 5 SIGNATURE: 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. /V, 1-1. 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.). 1-7 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. 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 applicable to the project. 12. Describe the flow control system. OCT 2 9 2004 stormwater site plan template—rev.10/1/2003 6 13. Describe the water quality system. 14. Describe the conveyance system analysis and design. pfRMIT # BUJ 0 4- - 68 8 If # CITY 8C[1 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. • 17. Describp the proposed surfacing material. , �, - U 1 18. Describe-methods for restoration of the site. 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. 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. 2. Est blish Construction Access. 3. Control Flow Rates. 4. Install Sediment Controls. , 5. Stabilize Soils. 6. Protect Slopes. LL/J GG i-- -Al 'a 7. Protect Drain Inlets. OCT 2 9 7004 , stormwater site plan template—rev.10/1/2003 8 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. PERMIT # l th 04 6 8 8- 9. Control Pollutants. 1E f%ERS/Th tU U n ' a"L 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). 12. Mane the Project. 1 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). AV b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). /II.0 1 EE E>F Liv I/— �ittL( c) . G(;''. ttt-e_ Cs--!! � ��t�i x t 3. Environmentally Sdnsitive Areas. G; a. Description of environmentally sensitive areas that are on or adjacent to the site. l oG E ,i 9 2004 stommrater 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 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). i(.`-et,(Li ;L-�: C- 1�.�� e , (c_ 14- k tA att. ' ( (a a--(. fA_Vit.4,ALa r- P ,` 5. Construction Phasing. a. Construction sequence 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. FinanciaVOwnership Responsibilities. a. Identify 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. 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations Il ( 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-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. \,..,,,, „,_/4„,,,,..... 6, /0(4 (LANDOWNER©R` IZED REPRESENtiT SIGNATURE) DATE /ATIVE THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED: OCT 2 9i:l' 1 stormwater site plan template—rev.10/1/2003 12 e SHAFFER_PERMIT REV-6AR Model (1) 11:46:22 10/29/2004 A fAr O O 0 G 40 cQ co co ' \ / \ (5.> c/ / \ \ --I / \ / / \ \/ / \ ,0 \ s,.-- c\ \ .0, \ 4-3 -13 . / / \ \ .0• 1%-__,„ / // \ \1:5' / / ,-; ,K\ / \ -o \ \ 0 / /0 \ 0 \ '< CD/k / cy \ \ \ \ N. / \ 17\ A I) 4 \ , ,e \ \ / \d -o \ r- \ \ A/A,. (4C ', \ / i __ze; 11.,, cp itt i ii / co \ ,, / �, illi -6., i i -% %./ / th- �A, )" `\ N ter' .� A lb'- > a m N , i, Ei <1, g 0 i). -o — 0 D 0 -6,- u) 0 0 s-- ,;,i (7). Ft) 6 71) 5: (6. o `(; 6,1 Tx 10 I> ‘j3 _,z (0), c(---) —0 Q D �� 0l4 ? � p 6 z —F � � � Q NN E _ m 3 z o 0 o g c,0 D i. N N CJ3 I O �, 1 VI —§ rrn Ai -Q • D rto w ^' w (1 � Q w R w -� m 0 2 0 (n r. � w OS' z ho 0, cmi -I E� 6 0 A 0