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HomeMy WebLinkAboutBLD2004-00824 IIIJ ILDING PERMIT APPLICATIN ML vT Reviewiew Ty 719 ype: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00824 Received Date: 12/28/2004 SITE ADDRESS: 1465 RIPLEY CREEK RD QUILCENE, 98376 OWNER: GREGORY A FAY PHONE: (360)765-0275 CONNIE LEA FAY PO BOX 429 QUILCENE WA 983760429 SUBDIVISION: Block: Lot: T 10 PARCEL NUMBER: 802352008 Section: 35 Township: 28 N Range: 02 W CONTRACTOR: EVERGREEN FRAMERS PHONE: (360)683-6658 690 PRIEST RD SEQUIM WA 98382 Contractor's License EVERGF*196KR Expires 7/16/2001 REPRESENTATIVE: EVERGREEN FRAMERS PHONE: (360) 683-6658 690 N PRIEST RD SEQUIM WA 98382 PROJECT DESCRIPTIOP NEW POLE BUILDING/SHOP TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 50,352.00 ADD'L: HEAT TYPE: UH CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: 2,604 SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: Prop: Seismic Streams Total: Total: Flood Way Floodplain Routing Date: F&W Landslide , / .„ , DPI ( ç' ) Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: APPIld/ t VEr: Permit $650.75 BAC 12/28/04 68946 e{•. Plan Check $422.99 BAC 12/28/04 68946 State Building Code $4.50 BAC 12/28/04 68946 JAN 3 1 2005 Total: $1,078.24 Jefferson County Plannine & Building Department etagiten -trio ta— eaccot (f)r I BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD04-00824 Received Date 12/28/2004 SITE ADDRESS: 1465 RIPLEY CREEK RD Issue Date 01/31/2005 QUILCENE, 98376 APPLICANT: GREGORY A FAY PHONE: (360)765-0275 CONNIE LEA FAY PO BOX 429 QUILCENE WA 98376-0429 SUBDIVISION: Block: Lot: T 10 PARCEL NUMBER: 802352008 Section: 35 Township: 28 N Range: 02 W CONTRACTOR: EVERGREEN FRAMERS PHONE: (360)683-6658 690 PRIEST RD SEQUIM WA 98382 Contractor's License: EVERGF*196KR Expires: 8/18/2005 PROJECT DESCRIPTION: NEW POLE BUILDING/SHOP CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: UFFER: Footing: ( ^K ;3/45/7 ,7- Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear W9II : Framing:?/-4/ .5"` Plumbing: Propane Tank/ Lines: Insulation: Sheetrock: Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: :-'4 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 * BLD04-00824 • 1.) A setback of 225-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. 2.) The project is located in close proximity to an identified wetland and is subject to the delineation provisions of Section 3.6.9 of the Jefferson County Unified Development Code. Based upon the proposed location of the project in relation to the identified wetland, the applicant has agreed to maintain a buffer(setback) that exceeds the standard buffer requirements by fifty(50) percent. The applicant acknowledges the additional setback and agrees to maintain the extra 50 percent buffer, therefore, waiving the wetland delineation requirements of the Unified Development Code. 3.) Wetland 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." 4.) 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. 5.) The identified Fish and Wildlife Habitat Area (Type 3 & 5 Streams), shall maintain a vegetative buffer setback of 100-feet for the Type 3 and 50-feet for the Type 5. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to any proposed development. 6.) An additional setback of five (5) feet is required from the edge of the stream buffer area to the proposed development. 7.) A permanent physical separation along the boundary of the 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. 8.) 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 be in place prior to and during construction activities. The signs shall contain the following statement: "Buffer- Do Not Remove or Alter Existing Vegetation." 9.) 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. 10.) 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. 11.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 12.) 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). 13.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 14.) The building height is not to exceed 35 feet. 15.) Minimum setback from Ripley Greek Road right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. If an ESA is present, then the more stricter setbacks shall apply. 16.) 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. 17.) 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. I:\F_BLD_Permit_Buildng.rpt 10/29/1999 (f) CCDD O ' >L yn CO 9 o3 49. a (D =� \ \ V. 110 chi ��e e o—m m ��O'cO�� N2O.A I- g lq 2 g A-m 04 aig u� . mmo> 4.y1'J S .A p L m 12ZV z y "d g� VI ' ' Y •, Y 4 Fiji ''Y . . Dp `e`.'' yy mg v � `_CA 0 py1 z liN> m V1 y �"H T 7 �"iqn > orn N coxl ..1 .,1 zisy, ____: ,Imm ,r.....orn y -i0z m AAO , yOy� A& O 40 OO�t; 112R / t Gzl�mo�op4p° i x _ � NTZ� `y.� � A= T r�i 1"m< $.g 0 °a0 m m o> AS CZ gu 0A Z 00 CO NNR a m'�A e qy C7 - Mh 1 i \ °til•' I 1 O' 0,4 tOs\ 53 i o°o °C m a \, ,lif ig ,9 TWA VI 4— J I Como iI o • rilhg,SON cow JEFFERSONUNTY DEPARTMENT OF COMMU E `OP E I c riq -.. ii, 621 Sheridan Street• Port Tpw4 end'•Washington-gt36$'i i; 360/379-4450 . 360/379-44151 .qS, N��p www.co.Jefferson.wa.us/comr t velo �nt2 $ 2004 l,�' Master Permit Application �";1.-� `r,l<<ar�. ' Milq.. 0 4 --'1 1 j �.Fc , ,....,:. Project Description(include/ separate sheets as necessa y). -;.- `t Z 1.!%Z. lJ`tr J♦ , ' Tax Parcel �`.. Property Number: t✓" :k7Z MS Size: 20 t; (acres/square feet) Site Address and/or Directions to Property: 1 LI(.� R'.0IE:et et1 X Et" `r',,mce,,,, 1/4)(;, Ctt j(( Property Owner(s)of Record: C re() rr0.-i Telephone: 3( t 1 E S C;L1 j Fax: email: Mailing Address: V.O. (:`- 92 ci4 tC t. ',0),.... Ctel 31I Applicant/Agent(if different from owner): flue r•e":,,,t F•r�v.v.e. Telephone: 3t-e, V t 3 (re-tr B Fax: email: Mailing Address:�� C lU, �r;�'� � C r _ A., 4 rS3''L W at kind of Permit?(Check each box that applies) Building 0 Variance(Minor,Major or Reasonable Economic Use) 0 Demolition Permit 0 Conditional Use[C(a),C(d),or C]** ❑Single Family 0 Discretionary"D"or Unnamed Use Classification Garage Attached Detached ❑Special Use(Essential Public Facilities)** ❑ Manufactured Home 0 Boundary Line Adjustment 0 Modular 0 Short Plat** ❑Commercial* 0 Binding Site Plan** ❑Change of Use 0 Long Plat** ❑Address 0 Road Approach ❑Planned Rural Residential Development(PRRDYAmendments** ❑Propane ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions'"` 0 Stormwater Management ❑Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance ❑Temporary Use El 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: 0 R r �^- DESIGNATION OF AGENT I hereby designate' ri t �'-_' , f� °61.%4'�j to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE -�_�=-,�� � Date: Z. 2-0 1 By signing this applicati fors orm,'the owner" / nt attests that e informati on on provided herein,and in any attach ents,is e and correct to the best of his,her or it's knowledge. Any material falsehood or any • ission 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 required later inspections.Arrl.cs and right of entry to this property shall be requested and shall occur only during regular business hours. Signature:4 ' ) .� Date: (�y)..C., G ` 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 with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable respon ibility fQr adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: )21t 1 Date: V2.• 'N G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc • OWNER BUILDER STATEMENT ^.• �. The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that owl .sec coma svi tt It , they will be assuming the responsibility of the General Contractor for the proposed project. ,l I.J r Signature: Date: l f ' E DEC 2 8 2004 GENERAL CONTRACTORN OR MANUFACTURED HOMEINSTALLER: PHHOONE: /�.}(. FAX +} -{-�y.I[., '`[ C.�II li cuA V 1I e-rS (✓VC' ) .3a5— Sr! t )t(F : .. ,) '1Y5 i`F-rrr kF:t.! 7 MAILING ADDRESS: (je® f Vt 'f e't" �e SG ,-t, Cj 3 EMAIL. CONTRACTOR'S LICENSE WAINS NUMBER: Ve'r(;F (14K a NUMBER ARCHITECT/ENGINEER: -Z a PHONE (3 ti ) y 0 CS fL I FAx:()t) )I) OJ,`� c�a MAILING ADDRESS: CI l ell, 5 fi"' `.ifi t Z'Z EMAIL P, koi-c. 41730. P Jett Type: Frail Type: Bathrooms: Shoreline: Type of Sewage Disposal: New Wood Existing: ❑ Sewer ❑ Addition 0 Steel Proposed: Bank ❑ Co unity System ❑ Alteration/Remodel ❑ Concrete Total: Height ndividual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other. Bedrooms: Water Supply: Existing: Setback: ❑ Private well 'Two Party Type of Heat: Proposed: ❑ Public `y ��� Total: Name of System: tjt 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 0 Woodstove ❑ Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove ❑ 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 �-� crl? �tyt',, k� Y ;x Current Proposed - r i +�a • " Main Floor 1 tils '--:y Review: .- 0, .:, 4,y4x -' f.rt*, �z. ,2""Floor a $ A 4 3`0 Floor • _Add' otf' ion: , ,s s a a,,�-a'. :A Mezzanine: ,,, ,,.�¢, w ` a Vic= w.�Y1 1 +,yam-. anz Heated Basement -State Surcharge fee: t�', v; f .- b _ y} —447, Unheated Basement -. ijr € viewfe #tx0E .', � -t�-� A>. r �1 MKT�'@ � V ih � Y Other Unheated t^ ' y ) r e x i i�5s' t3��1 Garage/Carport 4��r,'. l“ r , 4: ' '�iti�'` s ', • •4hJoN� ,r 'r y.., Decks Kern pt„Number: ��` } y , a v ' sk i^ L M 3 r44 kit Check Number ' �" /c", "L k . r Other x �� - � F y N " �� t m " ' " ESTIMATED COST(REQUIRED) Iba YI*r ' ,eyti r tiz .Fair market „ t {- n"�r $ � ` , n 'q G:\PennitCenter\FO DRD"FORNS\taster Permit Application 7-8-04.doc • liffrifitt..4. JEFFERSON COUNTY ` }C M DEPARTMENT OF COMMUNITY DEVELOPMENT 4621 Sheridan Street • Port Townsend • Washington 98368 DEC ) Qry 4 CitO 360/379-4450 .360/379-4451 Fax http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE IMLA# 'le '1 t y PROJECT/APPLICANT 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. j]( j , 5 rT1 Existing Conditions Summary 2. Describe the existingo ra h . Indicate contours on the site m _ t tQp9 PX �. .; 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. CT)-c V) jU t-AC.i-4k I't e. t' Ltj t. , t9 S.Y� v 4. Descnbe the existing soils. Indicate soil type on the site map. L,c, 1 t;+/ 0v�E i t, 1 1 ' 'c .k t 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. C. 6. Describe any excess levels of noise generated by the proposed use or activity: APPROVED f1 k STORMWATER PLAN • - dam! 2 7 2085 - stormwater site plan ter-plate—rev.10/1/2003 Storm Ater tS JEEP O TY DEPT.OF CO F. .1.0P4pT 5 Required S1GNATUR • 7. De6 7scribe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, ep slopes,etc.)on the site. Indicate location on the site map. Uts c.c.. 1 8. Describe the general vicinity of the site,including adjacent land uses and structures, utilities, roads,and sensitive/critical areas (streams,y wetlands,lakes,steep slopes,etc.). y. lc1 C t S(A c�I`CAN '"-:f� c ,i' �_11_i Permanent Stormwater Control Plan This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs and facilities to remain in place after construction of the project is completed. "Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control facilities are not exceeded. 9. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed (i.e., per BMP T5.30 in the Manual)or, if not,what types of stormwater flow control will be utilized for the site or specific threshold discharge areas within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. ter. ter'` t-;. vN 1-te,,.'� 'k vv' r.d �6 c,. 1 k' • c: v 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.] , tzi N2 11. Describe the performance goals and standards applicable to the project. 12. Describe the flow control system,---- UtEt `. 8 zug r-- stormwater site plan template—rev.10/1/2003 6 13. Describe the water quality system. A IA 14. Describe the conveyance system analysis and design. Wit& 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. ttAk 17. Describe the proposed surfacing material. 18. Describe methods for restor tion 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. AVN 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. '1/A 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. fk. dill i,cirth:4011 LUUDIfY DCD 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. r sk ii/ I\ 2. Establish Construction Access. 3. Control Flow Rates. 4. Install Sediment Controls. 5. Stabilize Soils. 6. Protect Slopes. t\-% 7. Protect Drain Inlets. stormwater site plan template—rev.10/1/2003 8 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. 9. Control Pollutants. f it 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). t /f t 12. Manage the Project. 3 � 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). tkc- , b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). ) i•OCINQ-C VC` keICA/L (IS Ic,t' IVJC:E:jC 4 1 Cc C-1 , C i'� c-►ir \ 17),-%ems 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. • 4 ? ( •jI 4 A storrewater site plan template-rev.10/1/2003 JEFFERSON COUNTY DCD 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. V/r} 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 ,r r�y h�,�-fit „.> 1 L ' o Get 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. ik \1 b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership 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. 1ti/ PC 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. b. Diversions. 1''/ N c. Waterways. d. Runoff/Stormwater Detention Calculations �► ..:` 2 8 2004 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. (LANDOWNER OR AUTHORIZED REPRESEMIATIVE SIGN)?TURE) (DATE) / THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED: 21034 stormwater site plan template-rev.10/1/2003 12 mTY FLOOR PLAN PERMIT SCALE. Y4 -1 JE�� E Sa OGUNTY BC X8 HF #2 X8 HF #2 iX8 HF #2 5X8 HF #2 o� I w I N cn WLLJ C', LZ 0 7 LLJ I-- m Lail o a 6 COQ Cr 3 2 WL,�� Lu - J F- F r z W J U SCALE: _1/4„ s 1 , DATE: DECEMBER 200 FILE: ... \ENGR \Structural \044 18 FL P( JOB NO: 04418