HomeMy WebLinkAboutBLD2005-00009 BUILDING PERMIT APPLICAN MRLA05 00007 eview Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00009 Received Date: 1/5/2005
SITE ADDRESS: 690 PIONEER DR
PORT LUDLOW, 98365
OWNER: JAMES W O'NEIL PHONE: (360) 437-0252
CHERYL O'NEIL
161 NORTHBAY LN #5
PORT LUDLOW WA 98365
SUBDIVISION: PORT LUDLOW NO. 2 Block: Lot: 227
PARCEL NUMBER: 990603227 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: LIDIJA GREGOV PHONE: (360) 437-7629
62 KELLER LN
PORT LUDLOW WA 98365
REPRESENTATIVE: GREGOV ARCHITECTS PHONE: (360)437-7629
62 KELLER LN
PORT LUDLOW WA 98365
PROJECT DESCRIPTION NEW SFR W/ATTACHED GARAGE AND DECK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,820
VALUATION 7-119(000-DO ADD'L: HEAT TYPE:
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 522 SHORELINE:
CONST TYPE: DECK: 336 SETBACK:
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: 2 Seismic Streams
Total: 3 Total: 2 Flood Way Floodplain
Routing Date: F&W Landslide
7�0 S Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: A roved/Date
Permit $1,609.75 BAC 01/05/05 2796.59 APPROVED
Plan Check $1,046.34 BAC 01/05/05 2796.59
State Building Code $4.50 BAC 01/05/05 2796.59 JAN 3 1 2005
Potable Water Application $53.00 BAC 01/05/05 2796.59 Jefferson County Planning
Total: $2,713.59 & Building Department
COel2an'n
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• •
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00009 Received Date 01/5/2005
SITE ADDRESS: 690 PIONEER DR Issue Date 01/31/2005
PORT LUDLOW, 98365
APPLICANT: JAMES W O'NEIL PHONE: (360) 437-0252
CHERYL O'NEIL
161 NORTHBAY LN #5
PORT LUDLOW WA 98365
SUBDIVISION: PORT LUDLOW NO. 2 Block: Lot: 227
PARCEL NUMBER: 990603227 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: LIDIJA GREGOV PHONE: (360) 437-7629
62 KELLER LN
PORT LUDLOW WA 98365
PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE AND DECK
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: Gib
UFFER: *X 5//6/1.:3 'Footing: a< ld/G'e%rrildiz,y 5// LS5,f'
Foundation: oL - 5.1Z• b.5
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation.
Shear Wall : OK B//
Framing: 8//05��
Plumbing: 7k 104/A5A
Propane Tank/ Lines:
Insulation: I,c7cc Attoeane,J OK gAhloS
Sheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: O --Pnts- V")
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
y��ON Ci�
JEFFERSOIDUNTY •
'�� '_\� 'AAj DEPARTMENT OF COMMUNITY DEVELOPMENT
`� 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
�qSING O� www.co.jefferson.wa.us/commdevelopment i� .'' `" f .,_
•
Master Permit Application MLA: 0 5 l
Project Description(include separate sheets as necessary):
/iV ; FAN !L s/1O/Vc — c,W/A7YA—c#f6--,0 -2Q.44 6-
Tax Parcel Property • 28 ,4C S
Number: Size: /2 /0 �0 5
/ (acres/square feet)
Site Address and/or Directions to Property: 6 30 P/10N6 -) f);?. �:i7- „LU DLO U1 urn 9g
Property Owner(s)of Record:.,/AC'/e6 7 C-I-/:y i yL. O'ic/e/L-
Telephone:('.j60 ) -4-�j�-Q?.S. Fax: email:
Mailing Address: 10/ 1271-t ):i -4t-5 to T-- DLL w 8 ac 5
Applicant/Agent(if different from owner): l//J/./.4 ��� C),/ i 0-0,0 AR,C,f.f/-r-E-- -
Telephone: (00 437 7629 Fax: 60 437 7 24 email: C. e 1e.5r,e ,
Mailing Address:az l.ce LE',e_ _1 ,r f40� L7- 11 iD j iv*cm -t��
What kind of Permit?(Check each box that applies) —
)J Building 0 Variance(Minor,Major or Reasonable Economic Use)
0 Demolition Permit 0 Conditional Use[C(a),C(d),or C]**
14 Single Family 0 Discretionary"D"or Unnamed Use Classification
❑Garage Attached/Detached 0 Special Use(Essential Public Facilities)**
❑Manufactured Home 0 Boundary Line Adjustment
❑ Modular Commercial* ❑Short Plat**
0 Binding Site Plan**
0 Change of Use 0 Long Plat**
❑Address 0 Road Approach ❑ Planned Rural Residential Development,(PRRD'Amendments**
❑ Propane ❑ Plat Vacation/Alteration**
0 Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions'"`
0 Stormwater Management ❑ Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance
❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment
0 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, J 2 , z--� G�'Lys'//L j,e_.k l;t.,,.,, to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE 11/7• '.il //A ice- . 'f ((�'�..C:-t / Date: /. ) - J,( -< ' - .: '
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 attorneys 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 requiredfiater inspections.Accc" and right of entry to this property shall be requested and shall occur only during regular business
hours. -/ / ,•,/ , ) �)
Signature f1/ ,/,- l.;/' fiL F- 6. L. (I' '✓+_'(C•L Date: /•- J 6, j G G-V
--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 ig compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable responsibility/ for adhering to and complying with the,ESA. The Applicant has read this disclaimer and signs and date it below.
Signature:— -", (t. -G7/742.1 l�� 4� (' �� .F
/ _. �( �t Date: �.; . .:: L •. .. 1 G I'G
G:\PeunitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
0 I_1 4 1 E',: 03 -603794451 JEFF .;.'..tti;• - .,
ARCHIT CO DOD ECTS 360.111,T. 768 P. 03
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OWNER BUILDER STATEMENT " rr
it''' 0 • lir) Pi''. ,
letat,‘)er of ti tb statement does heteiby comfy that they ere the Owners or os parcel retarenod heroin,the -,.
e).,ep be assuming the respond:laity of the General Contractor for the proposed orolect.
Signature: ...— Date: -DEC 2 9 2004
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ADDRESS -
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- — a Y
Frame Typo: 15ethr0001$:
Shoreline: Type Cif teweas0 •• -• i,...
X •.,', Wood Existing; — $Sewer
O ...'tion CD Steal Proposed: Sank Li Crommunity System :110..,,..,,
O *fation/Remociel 0 Concrete TOW: ; Height: 0 iRdtvid Yi4 SYstern
o F14)02ir a Masonry — SEr Porn*#
Ci eteMontion 0 other, Bedroom; Water 80.ippl ':'•
Existing: Setback; 0 Private well 0 Tim)Pali.
. .,
iYixo of Heat: Propo Public
sed:
Total: 4 )4 '' 1
--- Nan*of System' If •
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. following; ,,,,
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N ' 'of Perking Spaces: Current . _ Proposed:_ Number of/WA Parking Spaoest____ ,:,,,,....1
Norm of occupants(Includes owners,tenants,employees,etc) Olirrent Proposed
MC(),OcOParle'Y', IOC Type of construction: WI41 you have Food Service? Ya.,_j No '• '',1
gagii*Leisziagaitisatandisabulanaluditaltion pernift,mark' ell tt001;Xl2w that*gory:
0 UndergroUnd Tank 0 Above ground Tank We of Propane Tank:„ , '•,•.',1 I, :4,,
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O H I Stove 0 Cook Stove 0 Woodatove CI Fireplace Insert o Hot Water Tank 0 Pellet Stove 0 Other 4, , ,,Z,i,. ,
, . ,.,
7 Yes / No . ),.... ,i.
141790 Plying for a permit to install a propane tank you must also submit e site plan showing all alba buildings,ali • .,•
lineS1 tank location and site,distances from the propane tank to sit properly lines,buildings and septic system Oompotien6,
incinctJpg the reserve area.
.: •uare Foe ,• - . • * co VP/Only .., ,.
Currant •ro_posed ,'.'c -- .,-',-, ' • , ,, , , - . ,, .
Main or 1 e,2.0
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Floor . 74:1ditional Siction: . .,':'; • ', ",, .,,,,,,;:!'i .....",c1,11,')',`$',',1'.i"-:i'',-,:-.4-Pe,
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Mazianine. Irn Check foe: • • • -•,,,;),-
Heateaasement um - • - - • '.st#0.4rxthaty c :-,,,, . ,.c" , • -- _ '.. 4:,5c),
Unheed basement- ,,,_ - ,.,1'.‘",`••.; .fipt",ate '',',I'r '.;tWf :;" ., :.,,.;"?:'
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SPECIAL CONDITIONS FOR CASE A BLD05-00009
1.) 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.
2.) 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.
3.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
4.) 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).
5.) Maximum lot coverage is not to exceed 45%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
6.) The building height is not to exceed 35 feet.
7.) Minimum setback from Pioneer Drive right-of-way shall be 20 feet. Minimum side and
rear yard setbacks shall be 5 feet.
8.) 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.
9.) 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.
10.) Per MPR Code Section 3.107, Accessory Dwelling Units (ADU's) shall not be allowed
within the MPR-SF zone.
11.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
I:\F_BLD_Permit_Buildng.rpt 10/29/1999
%. ib
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"A. JEFFERSON COUNTY ; 1
k4A, DEPARTMENT OF COMMUNITY DEVELOPMENT jLI U JA � '�
621 Sheridan Street • Port Townsend •Washington 98368
� JEFFERSOti i OU°'!YY
360/379-4450. 360/379-4451 Fax DEPT. er CO��°A.�t1��i?Y C�EU�LOs'��+E�iT
o http://www.cojefferson.wa.us/commdevelopment/ ---w------------.------._.. ..._..._.__..-.^
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# 05-7 PROJECT/APPUCANTNAME: O'Neil Residence/James & Cheryl O'Neil
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.
The parcel size is 12,100 sq.ft.100% of the site will be developed.
Propbsed lmprovements:2856 sq.ft. Structure (all roof area), 196 sq.ft. Patio and
Walkways, 1,587 sq.ft. Driveway and 7,975 sq.ft. Landscaping. 0--
Existing Conditions Summary - 0
m
2. Describe the existing topography. Indicate contours on the site map. '•
The site slopes from west to east. For 75% of the site length the slope is
approximately 8%. The existing topography is indicated on the attached Stormwater
Site Plan and Survey Plan.
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
The entire site is covered with native vegetation of grass and weeds. There are
fourteen (14) existing fir tree (size less than 1 inch diameter)
4. Describe the existing soils. Indicate soil type on the site map.
The existing soil is a mixture of clay, silt, sand and gravel. Based on visual
observation the existing soil is in a very compact condition.
•
5. Describe the existing site hydrology(Le.,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
a licable,and indicate acreage of each.
The site drains from west to east to the existing ditch at Pioneer Drive. There is no " ' _
existing storm water drainage system.
6. Describe any excess levels of noise generated by the proposed use or activity:
The proposed use of building is Single Family Residence.,No any P D� '
nuise is expected.
STORMWATER PLAN
r
_.;'mW8ter PT s �(0 JAN 3 i 2005
Require
d
stormwater site pan template-rev.1 d120a r 5
JEFFERSON COUNTY
DEPT.OF COMMUNITY DEVELOPMENT
SIGNATURE.
•
7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes,etc.)pn the site. Indicate location on the site map.
There are no environmentally sensitive areas on the site (based on visual
observation)
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.).
All adjacent land uses are single family residences. .
•
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.
The building structure has roof putters and downspout system that collects water to
two (2) 4" pipes. The roof, the footing drain and the drain at the rockery wall
connects to the two pipes and transmits water to the existing ditch.
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.]
NA
11. Describe the performance goals and standards applicable to the project.
WA
12. Describe the flow control system.
•
NA
stomnvater site plan tenplate—rev.10,1/2003 6
,
13. Describe the water quality system.
NA
14. Describe the conveyance system analysis and design.
Refer to Item #9 for the description of the conveyance system.
4
15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material.
The onsite material suitable for fill will be used for backfill. The excess material will
be deposed by the General Contractor.
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
Fill shall be placed in controlled layers, the thickness of which will no exceed of
maximum 8 inches. All fill shall be compacted to minimum of 90% of maximum
density.
17. Describe the proposed surfacing material.
Proposed surfacing material: Bituminous Concrete driveway, concrete ratio and
walkway.
18. Describe methods for restoration of the site.
The site will be landscaped by the Owner.
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.
NA
20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
NA
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.
PA
stormwater site plan template—rev.10/1/2003
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.
Sift Fence at rock wall defines edge of vegetation maintenance.
2. Establish Construction Access.
Construction Entrance per B.M.P. CLO5
3. Control Flow Rates.
Maintain Silt Fence + Straw Bales
4. Install Sediment Controls.
Silt Fence per B.M.P. 233
Maintain vegetation from rockery to ditch
5. Stabilize Soils.
Replant immediately after completion
6. Protect Slopes.
Silt Fence, maintain vegetation strip
7. Protect Drain Inlets.
N.A.
8
stormwater site plan template—rev.10/1/2003
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
N.A.
9. Control Pollutants.
N.A.
10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
N.A.
11. Maintain Best Management Practices(BMPs).
Maintain construction entrance and silt fence, limit activity downhill from silt fence
12. Manage the Project.
Complete drainage system in foundation phase.
Maintain fence and construction entrance.
2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas, roads).
None
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
To County storm ditch at road, than Puget Sound
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
N.A.
stormwater site plan template—rev.10/12003 9
b. Description of special requirements for working in or near environmentally sensitive areas.
N.A.
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).
Soil on the lot is stable
•
5. Construction Phasing.
a. Construction sequence
Silt fence — Clearing — Gravel Drive — Foundation — Drainage — Complete House
b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
Provide a proposed construction schedule.
Begin March 2005 — Complete October 2005
II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
Foundation
b. Proposed wet season construction activities for environmentally sensitive areas.
N.A.
7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for the initiation of bonds and/or other financial securities.
James and Cheryl O'Neil
■
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
None
8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable.
a. Sediment Ponds/Traps. N.A.
b. Diversions. N.A.
c. Waterways. N.A.
d. Runoff/Stormwater Detention Calculations N.A.
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.
147
(LANDO ER AUTHORIZED REPRESMTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
stormwater site pan tenplate—rev.10/1/2003 12
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