Loading...
HomeMy WebLinkAboutBLD2004-00781 • MANUFACTURED/MOBILE Jefferson County DepartmentOM omNSTALLATION PERMIT of 621 Sheridan Street, Port Townsend, WA 98368 ent 360 379-4450 FAX 360 379-4451 PERMIT#: BLD04-00781 SITE ADDRESS: 2541 HASTINGS AVE W Received Date: APPLICANT: PORT TOWNSEND, 98368 Issue Date: 12/8/2004 JENNIFER A ELIAS 1/6/2005 JOSEPH E ELIAS 934 THOMAS ST SUBDIVISION: PORT TOWNSEND WA 98368 PARCEL #: Block: 001053003 Section: 5 T Lot: + CONTRACTOR/ Township: 30 N Range: 01 W DEALER INSTALLER: HAI PHAM CONSTRUCTIOfhfIAIPHC"999PP W/HERITAGE HOME OF SEQUIM LACEY WA Expires: 10/17/200 98503-7975 PROJECT DESCRIPTION: NEW MANUFACTURED HOME MAKE: MARLETTE YEAR: 2004 SIZE: 70 X 26'8" THIS PERMIT IS VALID FOR ONE YEAR. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSE THE EXPIRATION DATE IS 1/6/2006.D WITHIN THAT YEAR. CALL IN F• -EQUIRED INSPECTIONS THATAPPL ' SLAB noting (CONTINUOUS FOOTI', oUR PROJECT. o PADS USED): Stormwater FINAL Approval: Blocking/Plumbing: - 2_ Propane Tank/Lines Zoning Final Approval: Septic System Final Approval (If not on sewer): Road Approach Final Approval: ✓/ �. Final kirti /Vents/PorchesiSteps: IfiPK ,7 6s 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 HOT-LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY-SEE REVERSE MLA04-682 Review Type:I MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00781 Received Date: 12/8/2004 SITE ADDRESS: 2541 HASTINGS AVE W PORT TOWNSEND, 98368 APPLICANT: JENNIFER A ELIAS PHONE: (360)379-1320 JOSEPH E ELIAS 934 THOMAS ST PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 001053003 Section: 5 Township: 30 N Range: 01 W CONTRACTOR/ HAI PHAM CONSTRUCTION PHONE: (360)455-4158 DEALER: W/HERITAGE HOME OF SEQUIM 6642 5TH WAY SE LACEY WA 98503-7975 Contractor's License HAIPHC*999PP Expires 10/17/2005 INSTALLER: HAI PHAM CONSTRUCTION HAIPHC*999PP 10/17/2005 (360)455-4158 W/HERITAGE HOME OF SEQUIM LACEY WA 98503-7975 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION: NEW MFH TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: MARLETTE SETBACK: VALUATION 77,317.00 YEAR: 2004 LABOR & INDUSTRIES APPROVAL? SIZE: 70 X 26'8" BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO STORMWATER: YES NO Exist: Exist: AREA Plat Conditions Prop: 3 Prop: 3 Wetland Erosion Total: 3 Total: 3 Seismic Streams Flood Way Floodplain Routing Date: F� F&W Landslide � a 'lb �C Shoreline Aquifer Type Amount Paid By: Date: Receipt: 'PROVED Manufactured Homes $154.00 KAS 12/08/04 68790 Potable Water Application $52.00 KAS 12/08/04 68790 iht, 6 . ,,) Total: $206.00 Jefferson County Plannin co &Building Department difFFERSON COUNTY ASSESSOR JACK WESTEIOAN III JEFFERSON COUNTY COURTHOUSE ASSESSOR CO PO BOX 1220,PORT TOWNSEND WA 98368 (360) 385-9105 MOBILE HOME INFORMATION FORM OWNER'S NAME / MAILING ADDRESS: THIS IS NOTA TAX STATEMENT NAME: Et if�5 The purpose of this questionnaire is to obtain information ADDRESS: ���) regar�ng either the current location of a mobile home or the previous ownership and location of a mobile home. This will P- `, , ` q _ C , � r 5 ' help our office determine whether the mobile home is already ," on the tax rolls in Jefferson County or if it has been moved to TELEPHONE - `� J - 71 > this county from another area. Please see reverse side for NO: adcltional information. 1) MOBILE HOME DATA: (A) MAKE MNL& #e (B) MODEL '/ (C) YEAR �0�'7 'Ck/ (D) LENGTH 7 0 y (E) WIDTH 2 G ; (F)SERIAL NUMBER (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) 7 7, / ., d,ZS (H) PURCHASE DATE v Z'S 2) PREVIOUS OWNER/ LOCATION OF MOBILE HOME: (A) FROM WHOM DID YOU PURCHASE MOBILE ADDRESS (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: (A) WILL THE MOBILE HOME BE IN A MOBILE HOME PARK? YES ' a (B) IF LOCATED IN A MOBILE HOME PARK: NAME at ADDRESS OF PARK SPACE NO. (C) IF NOT LOCATED IN A MOBILE HOME PARK: NAME OF LAND OWNER: `I b(: ���)) LOCATION(ADDRESS) r� 1 1 H/4`,]j ti S /"/t/ p e5 REAL PROPERTY PARCEL NUMBER/DESCRIPTION Of.) J /0 53 '3 5/ Rttts THANK YOU FOR YOUR HELP! F - - EC - 8 2004SIG' KELLI LARSON, roperty Technician THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION. • SPECIAL CONDITIONS CASE # 1.) Site plan refers to cut and fill for foundation of home. Foundation must be on bearing soil or fill compacted to 95% Home installed to mgf. spec. 2.) The road approach permit (RAP04-00267) must be inspected and finalled by the Jefferson County Department of Public Works prior to the final inspection/certificate of occupancy of this residence. Contact Terry Duff at 360-385-9159 for the road approach inspection. 3.) The application was reviewed by the Jefferson County Department of Community Development staff on January 4, 2005 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, the following ESAs were confirmed to be present on the subject property: Wetland - Category III, Susceptable Aquifer Recharge Area (SUSC). 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.) A setback of 75-feet, measured perpendicularly from the wetland edge, shall be permanently maintained as a buffer. No filling, grading, clearing, or other alteration of the wetland or its buffer is allowed. 7.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or every one hundred (100)feet, whichever is less. Signs shall contain the following statement: "Wetland & Buffer- Do Not Remove or Alter Existing Vegetation." 8.) A permanent physical separation along the upland boundary of the wetland buffer area shall be installed and permanently maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC Administrator. 9.) The applicant is proposing to create or add 2,763 square feet of impervious surface and 36,900 square feet of land disturbing activities. 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 #10 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.) 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. 11.) 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. 12.) 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). 13.) The site plan as submitted with the building permit application on December 8, 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 January 5, 2005 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 14.) This approval is for a manufactured home 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. 15.) Outdoor residential storagetll be maintained in an orderly manner and s all create no fire, safety, health or sanitary hazard. 16.) 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). 17.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 18.) The building height is not to exceed 35 feet. 19.) Setback from Hastings Avenue W right-of-way is no less than 20 ft., side setbacks are no less than 5 ft and the setback from the Wood Street right-of-way is no less than 20 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 20.) 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. 21.) 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. 22.) Stormwater shall be retained and infiltrated on site. The owner shall control all sedimentation and erosion on the property. 23.) This is a legal non-conforming parcel designated as Rural Residential 1:5 under the Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998. 24.) This parcel is served by a private well. 25.) A septic permit (SEP04-00282)was approved December 24, 2004 for a capacity of 360 gallons per day. 26.) Hastings Ave W (C691008) is a county minor collector road. A road approach (RAP04-00267)was approved on October 22, 2004 and an address of 2541 Hastings Ave W has been assigned to the parcel. 27.) Enforcement case COM04-00072 was filed with this department on October 21, 2004 for clearing and grading without a permit. This complaint was reviewed and finalled on January 5, 2005. Stormwater was reviewed under this building permit. An e-mail from the Department of Natural Resources was received on January 4, 2005 stating that the applicant"does not need to satisfy any DNR requirements at this time (unless he plans to clear more trees)." 28.) A minimum of two (2)on-site parking spaces is required for the single-family residence. IVED ggoN eo STORMWATER PLAN g JEFFERSON COUNTY JAN - 5 2005 DEPARTMENT OF COMMUNITY DEVELOPMENT ,,�0.r�. 621 Sheridan Street • Port Townsend •Washington 98368 JEFFERSON COUNTY vit4NzInsio . 360/379-4450 . 360/379-4451 Fax r�rHT su ti,rrl 1.car c e (IN . http://www.co.jefferson.wa.us/commdevelopment/ rn'v .o►'NCNr STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# (its PROJECT/APPLICANT NAME: t> "�-464J I+3I)G . /,�i 1 I4 r 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. V--tt/N5 ,9 10 g gyri g. W624 a P/ Niciut , foi s: ter) G 1 At„Us CL.eAefwa /5a . at 2-4i a Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. MIS tL{ J •FLea wi+h A e,N3 g Si S1of i*c 1 f A 4 1fe S g 3`t ,C 'o 0 , two i yid A 4.013 5 a`M- -*He 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. �� /4 flv f� t teoi�,t� 'C? w I � A :cr�q�L 4. Describe the existing soils. Indicate soil type on the site map. �41L 1aechtAl 1U xi M t: 5AnIC# 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. {' 1 Wi Ie)2, i�.��� fx4*3+ '91 �T `'a LeA i2 en • ,q cr Qv0 K7 H Q f' kA/i'lge, ALL it a " �, .r A 6. Describe any excess levpjs of noise generated by the proposed use or activity: /147)1-1 0 4 - 0 7 8 1 DEC - 8 2004 stormwater site plan template—rev.10/12003 5 JEFFERSON COUNTY DCD 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. 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.). _L, i i0C6 i t ttl A 1; . Aeta SE 5 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. Les.Pte ►a N C1_zw2:to AciA 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 pro ects that involve the potential for dispersion of contaminants.] f\O A 11. Describe the performance goals and standards applicable to the project. ALL MAILkAn c i a+H /�� faRoOs 1.M ctAgL f4 S a1.6k b2A040 ..Size a f fri.likla ,KNA 12. Describe the flow control system. VISp Fin�. h3AtPvt_4.L1,1 • lj • DEC - 8 2004 stormwater site plan template—rev.10/1/2003 6 13. Describe the water quality system. 1,4 6 4, /rhist J' o Lwt l .) Lod 1 14. Describe the conveyance syste analysis and design. :VI 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. ' ' lit �'4 -F,'t 4 4 1.,,M4:$ 144t,4 K144 Of tioVeS6 _4 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 17. Describe the proposed surfacing material. ) EAJ_ t' 0 "'i.dE4 J 18. Describe methods for restoration of the site. A Nil (1 t" � � ��� #Z6i.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. tJ(f 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 54.E If_ fI Ee 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.• Th J y 1 I-kap (u Z /V J ,s I o w.i J h )4 -f 4 Amu:1.' eutfoN, +setTERM # DEC - 8 2004 stormwater site plan template—rev.10/1/2003 0 4 - 0 7 8 1 7 JEFFERSON COUNTY OCD 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. Establish Construction Access. 3. Control Flow Rates. 4. Install Sediment Controls. .rai L.+ .pqA eA".. to< 6!» . 1, :. A hs lc .L ' l.AC.M. 5. Stabilize Soils. I-4 VA) `11 743146C-5 "4 Fatir -rAw: 6. Protect Slopes. 1 _&A .t4 �"�e /V "ba •i.t'�,*` 7. Protect Drain Inlets. fli/ nc - 8 2004 stormwater site plan template—rev.10+1/2003 8 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. kyA 9. Control Pollutants. j� 1-4t LL �.� k 74)&1( i s oet k 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). Al/A1 11. Maintain Best Management Practices(BMPs). P • ry- r • J 1 ggfl 4 , Nsir c.tot 1,Iof, -$ !t I'?E 4.014 gttg.• e 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). b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). 1 i 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. +� $n34 et cc. ! ` W,DLr ;: too' •,GSA' 'j u J1l NJa& 44 Ztz r-e-mrce- -tOtV4 PrWtit, PERPab 4 JUL* stonnwater site plan template—rev.1a1r2003 0 4 - 0 7 8 1 DEC - 8 2004 s JEFFERSON COUNTY OCO • b. Description of special requirements for working in or near environmentally sensitive areas. 26 IA ;' s qt Ai c N4+Nr0* t Tn/186 .. 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 fY)#1•11*-411 c � b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). 1. Provide a proposed construction schedule. II. Wet Season Construction Activities. a. Proposed wet season construction activities. ; y 'Awe,e, S):AP1 b. Proposed wet season construction activities for environmentally sensitive areas. P/ 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. f�:. -,f -JEN' 4ek-. / 4 b. Descnbe 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. DECd. Runoff/Stormwater Detention Calculations t t - p stormwater site plan template—rev.10'1/2003 10 SECTION II—EROSION AND SEDIMENT CONTROL PLAN Sediment and erosion control measures may be depicted on the master land use application plot plan,a stormwater site plan,and/or a separate Construction SWPPP site plan. This is a checklist to ensure that the following are depicted on a site plan: 1. General. a. Vicinity Map b. Jefferson County Approval Block c. Erosion and Sediment Control Notes 2. Site Plan. a. Legal description of subject property. b. North arrow. c. Indicate boundaries of existing vegetation(e.g.,tree lines,pasture areas,etc.). d. Identify and label areas of potential erosion problems. e. Identify FEMA base flood boundaries and Shoreline Management boundaries(if applicable). f. Show existing and proposed contours. g. Indicate drainage basins and direction of flow for individual drainage areas. h. Label final grade contours and identify developed condition drainage basins. i. Delineate areas that are to be cleared and graded. j. Show all cut and fill slopes indicating top and bottom of slope catch lines. 3. Conveyance Systems. a. Designate locations for swales,interceptor trenches,or ditches. b. Show all temporary and permanent drainage pipes,ditches,or cut-off trenches required for erosion&sediment control. c. Provide minimum slope and cover for all temporary pipes or call out pipe inverts. d. Shows grades,dimensions,and direction of flow in all ditches,swales,culverts and pipes. e. Provide details for bypassing off-site runoff around disturbed areas. f. Indicate locations and outlets of any dewatering systems. 4. Location of Detention Best Management Practices(BMPs). Identify location of detention BMPs. 5. Erosion and Sediment Control Facilities. a. Show the locations of sediment trap(s),pond(s),pipes and structures. b. Dimension pond berm widths and inside and outside pond slopes. c. Indicate the trap/pond storage required and the depth,length,and width dimensions. d. Provide typical section views through pond and outlet structure. e. Provide typical`details of gravel cone and standpipe,and/or other filtering devices. f. Detail stabilization techniques for outletlinlet. g. Detail controVrestrictor device location and details. h. Specify mulch and/or recommended cover of berms and slopes. i. Provide rock specifications and detail for rock check dam(s),if applicable. j. Specify spacing for rock check dams as required. k. Provide front and side sections of typical rock check dams. I. Indicate the locations and provide details and specifications for silt fabric. m. Locate the construction entrance and provide a detail. 6. Detailed Drawings. Any structural practices used that are not referenced in the Ecology Manual should be explained and illustrated with detailed drawings. 7. Other Pollutant BMPs. Indicate on the site plan the locations of BMPs to be used for the control of pollutants other than sediment(e.g.,concrete wash water). 8. Monitoring Locations. Indicate on the site plan the water quality sampling locations to be used for monitoring water quality on the construction site. Sampling stations should be located upstream and downstream of the project site. 0 4 - Q 7 8 1 D E C - 8 2094 stormwater site plan template—rev.10tll/2003 11 JEFFERSON COUNTY OCO ► y 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. 72-.41t. I 7A/a ( NER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED: DEC — 8 2004 ':: stormwater site plan template—rev.10/12003 a t:•,i r14 -.... \ • Orrillik ff ' \,,, (36:,1 oN oJEFFERSONN DEPARTMENT OF COMMUNITY DEVELOPMENT v e `4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax �q O� www.co.jefferson.wa.us/commdevelopment SNOrS Master Permit Application MLA: 04 _19 Project Description(include separate sheets as necessary): 7,3' L ifee 1, i!9s rcCS;0ENfs )j�iv Ati,A,--fir4„ate-b t-1o1? Tax Parcel Property i Number: 00 / 3 b r) 3 /Size: '`�, ,j/ , G e s (acres/square feet) Site Address and/or Directions to Frdpertty:41 ) (.1- � i-/i)s1, -r' A't;A;Ci.( () Property Owner(s)of Record: J 6E: ..rE.ti ti.;It-K L C..A Tele hone: c3(.3 3 7) - /3 e P ) Fax: email: Mailing Address: r>3</ i f�), 4s -Re- r4 l)0.-1) L 0.4'i > 1P S'-3 6- Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) X Building 0 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 p•Garage Attached/Detached, ❑ Special Use(Essential Public Facilities)** .Manufactured Home ❑ Boundary Line Adjustment ❑ Modular 0 Short Plat** ❑Commercial* ❑ Binding Site Plan** ❑Change of Use ❑ Long Plat** AltAddress -f'lt -Si-Read 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)* El Shoreline Management Variance 0 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 r ired later inspections.Access and right of entry to this property shall be requested and shall o r only during regular business hours. lC rF Signature: ''' 1 �'' g Date: / , * . f 1 The action or actions Applicant will undertake as a result of the issuance otthis 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.termsi:aredefined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes nd assurances to the applicant that the action.$that will be undertaken because this permit has been issued will not violate the ESA. Any individual,gI oup or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if ibu are in compliance with the Jefferson County development code.The Applicant acknowledges that he she or it holds individual and non-transf ble res abty for adhering to and complying with the E Lrhe A li as read this disci - `/er d signs and dates it below. Signature: (1 ,. Date: 7I (Y) G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc , OWNER BUILDER STATEMENT The signer of s statement does hereby certify thaZTney are the Owners of the parcel referenced erein,that they are not licensed contractors and that they will be ming nsibility of the General Contractor for the proposed project. Signature: ElQ Date: /// 1/' el/ GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: H1'9-T -?i/Am (.�,,,s-/- L,e_.+r�,.., (.3(to)4.65 -4/s ( ) MAILING ADDRESS: � L_42_ 5 1f7 v,lii-I ti $I EMAIL: CONTRACTOR'S LICENSE AC U " . ( -A ig�d 3 WAINS NUMBER: H A r P F-ic y 99.9 -PP NUMBER PO iv 50 f !& ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: $ New ❑ Wood Existing: — ❑ Sewer ❑ Addition 0 Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: '-i Height: IS Individual System ❑ Repair 0 Masonry SEP Permit# SCE OCkt. a a ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: - Setback: Private well ❑ Two Party Type of Heat: Proposed: ❑ Public L.E.Cf11 cleat 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 ❑ Above ground Tank Size of Propane Tank: ❑ Heat Stove ❑ Cook Stove ❑ Woodstove ❑ Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove 0 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 property 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 F r Office USe Only ill i s"w-,`, �' ,,7.4., 4411 ,..' Current Proposed 0. la. � r.,, 4. Main Floor � i C onsis e it ; zx NU r4 2q =t-b 4'L----•.`c'V'7 5 f s ita "6 2 Floor Base fee: s. 4 - ,,� ' 3"1 Floor • Additional Secto ?S it• i,-4 "*! A: 2 mot• Mezzanine: Plan Check fee. 1� x k; N ` ` w , - t { fi y i... t S t • Heated Basement archgfee 4 1! =•. - • Unheated Basement 1I -1' [� L F i�r _ new r Y 1+Sa .d;�� ,�t ld {k. I .�.� _"'�1.'wa.'.'�Yr�"+ }'�fi U-1 t Y'S }tY�at .\ J r.,.SR ,.y5,,. k,` 'T}�' '�1 Other Unheated i 14 ' ` �`e; ` 1/�' I♦1(�(� I fad Approach fee -� " :tr ,<r ,... Y� 2004 i-1.=. ''t� r' :Y r c 3 h. :. :' i S t t� rr-a Garage/Carport E $ s ,e. � #� '/ k Decksit' 4:' fpt ;- R Numb�`i~ � , a � � .,��: Other Cas Check Nu • ., a ?.. < �� '� g.. ,;,..- ` r . 7,' y'ar' ESTIMATED COST(REQUIRED) Date:` ,a°', 't�„ x :iti t-fix; t 3- �1 9 K .Fair market value of all labor and materials foundation to finishEY- `, r w .. °+ •,^; initials 1.4, ,e t , •y� xix{� i G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc - /73 ter- t 90r— ! ----- 113ITINflin N siriffir ,-- " -° - --- -- 11 .-_,:, i Nkii . 0" Ql8 # IIW�3d._ - / s ,r G . 72 cqQ1 I 1 "41-ip q IQ ceic) (-40 ....7 atici - , , ,, . . �D _' r , + lai1 • -, .4 1 , h. I l,," {t' ds T 7 / < , WI r� r E jtt 1 7 ; 2/b'9 07pr11A14 i 1 'NV �M `;� \ _ 1. :.}� .. . ! r/ 71' _A .4) I _,/t ...r,‹ ,.,, r ,i, / 1 .1 j,./ �5� cpV� \ � � 2 1 *ilke. /_/ 1 . . (�" iE - -1- • " / _t 1, , k rt7t ht, f v l [ i r'!t. ' '•J tr(y r�,j�t..� { 4' `/r ,p• // 7 7 r t ! let n 0 1 e! ( 1L'.2 11: " 1 ' %'''-'‘ '1"•'")1,i ' \ 'i at / Oi r.A ----, ., - • / / ��5 l. 1y I , )' � f• 'f r o�s c 47,. _ rti Y \ 4" .'fi Y' Vic...__.___ r N^ 1 �' al b "--,• .. .. 4.f Ili f. r �i." .t 1� ,' t 0 - •,'1 _ !. 44 t ir it 4---- ,01, i , fr) k K ot ..,...._........_.-.....�.._.,..,.......... _.._ a cagy-+.---�- s /' ► _ • 1 '7- 'T �F .. C f.. r , . /stZ 1 a 0 si : • i mammal A Il M TfILtND1S .J d0 1d3Q S `A.t.xn0�NOS 13333r 4 a - . ficsi t4 V461 - . . .. .. . orn. ,(,.6„ ,..ii„,4_ .76,1„ . 1hc,,„„_ . . NVrIcl LEIS S; 30.;a j ! 73 C`��3 ; . _,�; .__ -© U 1A.OUc cdV . Olympic Wetland Resources, Inc. ilii`r Dixie Llewellin, Principal Biologist \`\ A2 7 '� 856 50th Street ''' .r '1 Port Townsend, WA 98368 360 385-6432 + " 1 dixie@cablespeed.com ir%, October 6, 2004 l Joe Elias 934 Thomas Ave Port Townsend, WA 98368 RFC I:IV-HAT) Level I Wetland Assessment OCT 1 2 2004 Parcel #001 053 003 JEFFERSON COUNTY DCD October 2004 Introduction A Level I Wetland Assessment was conducted on October 6, 2004 on the subject parcel to determine the presence of a wetland mapped by Jefferson County. The purpose of the assessment was to determine restrictions that may influence the placement of a modular home, septic system, or a well due to wetlands and wetland buffers. Wetland analysis was conducted using the methodology outlined in the Washington State Department of Ecology Wetland Identification and Delineation Manual (1997). All wetlands within Jefferson County are subject to requirements outlined in the Jefferson County Unified Development Code (UDC) dated January 1, 2001. Description of Site • Legal Description: Parcel #001 053 003 Section 5 Township 30N Range 1W • Location: Hasting Ave West (West of Jacob Miller), Jefferson County Washington Findings A small portion of a wetland(5' to 15' wide X 130') was identified on the subject parcel and is confined to the eastern property boundary. Along the fence line dividing the properties salmonberry, slough sedge, buttercup, and common rush were identified. The wetland is associated with an excavated a pond on the neighboring parcel which is surrounded by a mowed field. The wetland is in a low-lying area approximately 10-feet lower in elevation and approximately 95 feet from the site proposed for the septic system or modular home. Level 1 Assessment Elias 1 Olympic Wetland Resources, Inc 10/04 Report File Number 2004-3948 As shown on the map included with this report, the isolated wetland is mostly off property boundaries; it is not in the location indicated on the Jefferson County Critical Areas Map. This isolated, impacted wetland will most likely rate as a Class III wetland due to small size, lack of vegetation diversity(mostly a mowed lawn), minimal habitat features, and no connection to other wetlands or streams. All Class III wetlands receive protective buffers of 75 feet if the wetland is not delineated and 50 feet if the wetland is delineated (Tables 3-3 and 3-4 Section 3 Wetlands UDC). The central portion of the 4.5-acre parcel has been recently clear-cut. The 150 X 240 foot cleared area has had several perk holes excavated to 6 feet for septic site location. Hydric soils were not identified in the top 16 inches of the surface in any of the soil test pits (soil colors 10YR 4/4 no mottles). Clay layers and hydric conditions (soils with orange mottles) were identified in the lower levels of the soil test pits. The remaining forested area consists of a healthy stand of cedar and Douglas fir with occasional alders or willows. The understory consists of salal, Oregon grape, and oceanspray. Final authority over wetland determinations and associated buffers rests with Jefferson County Planning Department. If this project requires a delineation or if you have further planning needs please don't hesitate to call. Sincerely, Dixie Llewellin Principal Biologist, Olympic Wetland Resources, Inc. Certified for Wetland Delineation, 1987 Manual. Wetland Training Institute, June 1995. Level I Assessment Elias 2 Olympic Wetland Resources,Inc 10/04 Report File Number 2004-3948 rye: Level I Wetland Assessment Scale: sheer Olympic Wetland Resources,Inc. l"= 100' YmPParcel # 001 053 003 [ . 4? VA b 856 50th Street Hastings Ave West 10/06/04 #1 ,s}. Port Townsend,WA 98368 giant Joe Elias °'' 360 385-6432 dixie@cablespeed.com Port934 Thomas d b 2004-3948 Townsend, WA 98368 Hastings Ave West A ------- Driveway 90' , ------- Fence etland as Mappe By efferson Count i ,` (N at this location) V V e i .,t `t " Excavated Cleared Area • Pond 150' X 240' o 9 o, tn Mowed Area Approximate Wetland Edge 001053019 N Of Subject Parcel 001053003 4.5 Acres • 330' 0 100' 200' This map does not represent a wetland delineation; measurements are approximate. L