Loading...
HomeMy WebLinkAboutBLD2004-00073 MLA05-00085 GILDING PERMIT APPLICA A N Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00073 Received Date: 2/10/2005 SITE ADDRESS: TEAL LAKE RD PORT LUDLOW, 98365 OWNER: ERIC VON SEGGERN PHONE: JODI VON SEGGERN 6320 PONDAROSA BLVD NE HANSVILLE, WA 98340 SUBDIVISION: 360-638-1715 Block: Lot: PARCEL NUMBER: 821333044 Section: 33 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NEW SFR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 954 VALUATION 186,730.00 ADD'L: 954 HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: GARAGE: 172 SHORELINE: CONST TYPE: SETBACK: DECK. BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PUD PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: 0 Wetland Erosion Prop: 3 Prop: 3 Seismic Streams Total: 3 Total: 3 Flood Way Floodplain Routing Date: F&W Landslide " - Shorelin9 Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: t Permit $1,480.95 BAC 02/10/05 69088 AP ' eoVEr. Plan Check $962.62 BAC 02/10/05 69088 State Building Code $4.50 BAC 02/10/05 69088 APR 2 9 2005 Potable Water Application $53.00 BAC 02/10/05 69088 Jefferson County Planning Total: $2,501.07 &Build'n Department Vic- P • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00073 Received Date 02/10/2005 SITE ADDRESS: 3284 TEAL LAKE RD Issue Date 04/29/2005 PORT LUDLOW, 98365 APPLICANT: ERIC VON SEGGERN PHONE: 360-638-1715 JODI VON SEGGERN 8319 NE 360TH ST HANSVILLE WA 98340 SUBDIVISION: Block: Lot: TX99 PARCEL NUMBER: 821333044 Section: 33 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: NEW SFR CALL IN FOR THE REQUIRED IN�SPEC I NS THAT APPLY TO YOUR PROJECT. SETBACKS: 'A( 5//� Di UFFER: IIIDNE Footing: OK s /?,05 Ai � 1( Mr� ome ze� - Foundation: OJ( i/&,i11 IOiS 4j127/%15 ." Stormwater FINAL Approval: Underground Plumbing: 7/3`0$ [may Underground Insulation: // Shear Wall : dk / 8115, Sheathing: Framing: aid SA/44, Plumbing: Zilk 04/04 Propane Tank/ Lines: 42t Dk /WfL Ao i er tGs D,uts Of g/ Qir i Insulation: e law, OK-- 3/G/uL l)ALL3 4 IAaii eelI-U ll 35/a Sheetrock: SL/ex* Lai�L-4S 4k 5/23A 111 Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: /5le -oar CJ" 9 O,LL HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL R QUIRED 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 A BLD05-00073 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 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.) 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. 7.) The identified Fish and Wildlife Habitat Area (Type 5 Stream), shall maintain a vegetative buffer setback of 50 feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to the proposed residence. 8.) An additional setback of five (5) feet is required from the edge of the buffer area to the proposed residence. 9.) 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. 10.) 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." 11.) MANDATORY MEASURES OF HIGH 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 Stormwater 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. • • 12.) MANDATORY MEASURES FOR HIGH RISK 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 requirements: a. Variance from Chapter 173 WAC standards granted by Ecology per WAC 173-160-106 for a new groundwater well within 100 feet of a sea-salt water intrusion area per WAC 173-160-171 (i.e., within 100 feet of a groundwater source showing chloride concentrations above 200mg/L or within 100 feet of the marine shoreline); or for an existing or proposed groundwater well not subject to an Ecology variance, applicant must provide evidence through a hydrogeologic assessment (relevant components of an Aquifer Recharge Area Report per UDC 3.6.10.e) of a reasonable probability that the subject aquifer will not be degraded by the proposed use of well. b. Installation of a flow meter. c. On-going well monitoring for chloride concentration. d. Submittal of flow and chloride data to the County per monitoring program. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 13.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 14.) •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. 15.) A Medium 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. 16.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 17.) 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). 18.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 19.) The building height is not to exceed 35 feet. 20.) Setback from the private easement right-of-way is no less than 20 ft., setback from Teal Lake Rd. right-of-way is no less than 20 ft.side and rear setbacks are no less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. • I:\F_BLD Permit_Buildng.rpt 10/29/19 ��`S�N c06, JEFFERSON'AUNTY IIIG�, ' A DEPARTMENT OF COMMUNITY DEVELOPMENT �a ` '� 621 Sheridan Street • Port Townsend •Washington 98368 360/379 4450 • - ax F E B l 0 • 4.1„fr www.co-jefferson.wa.360/379 us/c4451ommdeFvelopment bi7NG i - t Master Permit Application MLA -' ��" ,_ Project Description(include separate sheets as necessary): 4' - Tax Parcel /7 ,� Property , ,--,�, 77 Number: .� Size: ,j, m ee A- i (acres/square feet) Site Address and/or Directions to Property:JJ / (;, 1. ✓1A '/A 5. <_ r,I R I E. c.r j ( 01 I• t r rri I-' r i Property Owner(s)of Record: ,'-7G' ,'', ,' , is i 111-,-, Gi '�.�e,r r`; l {(fir/1 t/)� ? j ii > Telephone: ✓f,,. V Fax- t 7 a Fax: 407 '6=.E & i✓'��.c ( r. „' ? ' '' . „' t ) email: ,01: , .,, - - ... f.1 :,r^rj- Mailing Address: 7 11 NI I- ?`;O'/ -- `fir (-1 t r?`iV i Le j�J fT (')314-j J Applicant/Agent(if different from owner): ;d.nI L Telephone: Fax: - email: Mailing Address: -- What kind of Permit?(Check each box that applies) Building ❑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 ❑ Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** 0 Commercial* ❑ Binding Site Plan** 0 change of Use ❑ Long Plat** Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)IAmendments** ,,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 ccess and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any,requir'dI er insp ons.Access and right of entry to this property shall be requested and shall occur only during regular business r hours. t Signature: t \ r. ^'./�' c.. Date: ? (I `1/U --) The action or actions Applicant will un4 k as result of the issuance of this permit may negatively impact upon one or more threatened or endangered spe/ties 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 v/tl 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 i9 compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable resppnsibil (or adhering to and complying with the ESA. The Applicant has read this disc) mer an signs and dates it below. Signature: 7 ° 1'4. ' .ri.1 l -C t vt'\-____, Date: ! I it :i c) G:\PemvtCent F RMS\DRD FORMS\I st' P 't Application 7-8-04.doc • OWNER BUILDER STATEMENTII The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be un1ing e re ponsibility of the General Contractor for the proposed project. ' Signature: r 1� V 1,I ,� ..L� { r4/___- Date: 4 `✓) • I GENELT oRACTOR OR MANU�AC URED HOME INSTALLER: PHONE: FAX: ( ) FEB 1)0 2005 MAILING ADDRESS: EMAIL: i ! f. CONTRACTOR'S LICENSE WAINS F NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: .1 Shoreline: Type of Sewage Disposal: A New id Wood Existing: / ❑ Sewerfi--. ❑ Addition 0 Steel Proposed: B nk ❑ Community System 4)11 ❑ Alteration/Remodel 0 Concrete Total: He ht: jndividual System ❑ Repair 0 Masonry P Permit# . 36i(,=' I' ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: t. S a : D. Private well ❑ Two Party Type of Heat: �) II , ., Proposed: Public ) k I i c r-; U 1` "t -I Total: N m of System: `�j(P ,A t1 i ci) C ,. 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: 0 Under round Tank Above ground Tank Size of Propane Tank: ZCj3 He9P ove 1$ Cook stove 0 Woodstove ❑ Fireplace Insert A Hot Water Tank J 'Pellet Stove 0 Other fs this appliance being installed in a Manufactured/Mobile Home? Yes 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 For Office Use Only Current Proposed Amount /Main Floor pp' [ • ConsistencyReview: yam} <':X ^ 1� C`c%t,i• y-i`-'^ - (FA p1.pZ '4 0 2N"Floor J .0 Base fee: 3rd Floor Additional Section: Mezzanine: 'o ) F:r 1 t5 j(r 'r Plan Check fee: q 62. 67i-; Heated Basement "t Y7 �O State`Surcharge fee: if Unheated Basement of Water Review fee: ' I7A;(3D-'tip gl-0 0 - • Other Unheated 911/Rd Approach fee: till-© Garage/Carport TOTAL: $ 23 C .O7 Decks Receipt Number. ro t O n Other Cash/Check Number: 141tg ESTIMATED COST(REQUIRED) Date: Zi.Fair market value of� ��all! or and materials foundation to finish 'r' ����� t T '�t l � Initials: (4 , G:\PemtitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc • • ? f. �3_ 1 i ":t 5�r7 �-y rlwy.ay r..y a,,. F JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Washington 98368 ',� °;(!, O 360/379-4450 • 360/379-4451 Fax 1FF L ' f�t TIN http://www.co.jefferson.wa.us/commdevelopment/ 1.. ' -` STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# I Lt!7 l' v' PROJECT/APPLICANT NAME: \,:" 's. e• C,c�.\:— :ke of- •,( 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. ') I •,,, t-'' L k_ .. 'f t i it -( z - . , r:ii v l A p; Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. .I u,-. @- S :,6 .. e: t v � 0•9"o y i't !..a o' :°a l ! (:-.f `'^'.. 4. Describe J3 the existing soils. Indicate soil type on the site map. A--A. .0/ .'ft' ic"'„4.1.i L.,;-rz r`. ' i. , / i !t f i t... t P /,I 0 4 -- 'f;.-t t '; 0 1.77,r0..( 4A,,,.+ ` • r 9 f. /j+, 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. a77 `i i 1E.,a `e'' }1 / t .F ( ., s.l V`r..a 1%--4 1.:r r -•- 6. Describe any excess levels of noise generated by the proposed use or activity: t �� Of i ; c n-e-`--, v '' `; ___, APPROVED STORMW ATFR PLAN APR 2 6 2005 stormwater site plan template—rev.10/1/2003 5 JEFFERSON COUNTY DEPT.OF CO NIY DEVELOPMENT SIGNATURE: 0 /f,L's6.0.1 • • 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. 771 I _ .- zr. �. • 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.). r� l • °fit .:- ice` ° :i .-' •f,. � j � 1 • F..t �_. rl / ''f 6 l I L i( I i ,e/ 11 �, 1 J i/y 1 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. i /�v •;;k�-�-i Ave-- t.:-t,� -�, 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.] i- 1 v; 11. Describe the performance goals and standards applicable to the project. 12. Describe the flow control system. -1 1 1 t stormwater site plan template—rev.10/1/2003 g 6 • • 1 13. Describe the water quality system. i i '+ '"' V' / _ 5/ �?yS 14. Describe the conveyance system analysis and design. Vi $ 1-` ` 4 vl i / (ir-- 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. \.;' i f - 17. Describe the proposed surfacing material. (\ / /� 18. Describe methods for restoration of the site. 1\2. 'y4k`_. t LI L... -:At-77 L-\J f'-7< s.1$; '-2 -- 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. i 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. f �.. 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. / . I J/7 - 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. Establish Construction Access. ..--9 1 3. Control Flow Rates. ..f-• - !\,l L_C.e_ . r ►i;L-- iri.( I- . �j<`a=p _ j - 4. Install Sediment Controls. 4 (--,,-1 E 7'''' r r<" t . -r C_h;Iv v4L&, i:74 t e"L ) (� , � � ( C ` t 1. > / fit` � 1 `� �'�'-�: 'et� ,y j,r -..'- L .i, Lvv- t t. 1.-r7i ,--34Lti 5 l':, r".0 tt ,2.. I-;:di ' 1 ..., si. /)jt *l1 -_t ..-1- %4 ez rL }/%r1:tt• 5. Stabilize Soils. .,,':V i. 4 .. .e. `i if piFf..j /.,I�... '_"i/'L-i./ g.... .J^`'}�L3i' •�✓ , , j 6. Protect Slopes. /,! -` h f..tea''". 4 � 1 'd ! l E �/ �it , 2( ' _,.,`t h. .; � • (( - r � J , 7. Protect Drain Inlets. l V / — i r I stormwater site plan template—rev.10/1/2003 8 • • : 12 Required Elements—Construction SWPPP(continued) ,:°r. ' 8. Stabilize Channels and Outlets. 9. Control Pollutants. • 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). (P.') i'1 �e -' e / 1.-� f /,s°%�'/ ... �,_ i J`T A 12. Manage the Project. y 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). �) �L�- b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). L 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. stormwater site plan template—rev.10/1/2003 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. .7l C' t. 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 Y • .c �..�} L Tice `s. `.'e>1.l �v;� �`;``i'1r2, c { L t L Pk. c 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. �� 1 t r FYI li:• f l t. `\JY`: II. Wet Season Construction Activities. a. Proposed wet season construction activities. b. Proposed wet season construction activities for environmentally sensitive areas. N 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. t �. es 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 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 tote 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. i t- L7 (LANDO ,ER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: 12 stormwater site plan template—rev.10/1/2003 ,_._.__ ...,........._ .............., ,, . . •. . . . • .. . . , . . , coI . fv-ei-?-Cocrrs 1\ -?3\.,q . . OZ Z ail ' , • 0 . , ,! • •: •• . .. ...........„„....„.....,,,,,„. .....,,,,..„3.....,..,...„,- • . . . ...-..,... ......... •14,...,,,,,,,,, ...••,..„3.vor,.• grogrersta. rawc:vma • c.- VAG III ,11011.; 1574.-.ff'.:' ,01/Z, 1.11115.4` IS"' ....nr•., .09i , .011 • * a - 0-.V.0 ''er .' -3 X V 7 7 V 3 I k 2, saolazog 1‘''10,111;1700.:,1„.04';.'",,t,frV . 11,9i1".1 -,„ • 44* .... COZY j 1 ...„,....7 0 VOn11001 ....,*•., ,.4.T.,-," .4, si„,.. iperevi Into, genUttil 4, • .4k %.`1:, 4,' _:. • A--•-•A—\ .- FT PUTIOXITlpttn ''''arils t• ' \\. ,.**/ . r ,, , _ ...„ ./ •--- ' /.., -44.. \ \ / ,staasisti ,,,,,-.3"7- / .m& :.lItt-NO Itaclik4 3AY S4404tYlLAY134/S P 1, ' /e;''''''. e'''''''.--'\ \ \40.1‘ siri) , ONY lmori VIA0411300 Atos3a 1T/SZVITIP40 0711Y1SNI 36 01.I.ON SI 113/C4V SAO V * i Oa MAY444 z, (44/ .../'''. 4 V0101114/2419041 WV At OiNIV11400 SIN/01173011/Map ( \ \ \ rsacM.-+(i Amin WY MO44116111 *AMMO 403S4/244,4V AO COWAN 3N1?I UAW'S Al ti..76K1 3noloA PA 11.101C10.77f ONY VO61 V AON NO fatraMv AlkiAlS SYY4 AS 024,40111341$Y . i `N.,:OWN arlr A.44.107S AI 0.1421341 V Anal tyro NI 03$W NY A103Arot NOOK$ONO Atti3ootto ztu 'y , \ \ \ \ war't ovo trtilit'WW1 Al3N 3141 JO NI:Alexi atiocAhlti 3141 100 3Yvs OA N'''"L.,, \ c,:\'''''\ / 201ZSCS30 Zit 10 321WISCSY 310 MV2AO oNy sittronso TW AM MOONS titrrasso / ' . . • ,311,0 WASAS lit •tooss.X soii MAI ttoi3Nrrto33 Nt 421414414A344 SYN 443111NIC 341$ON ..1444) . • / ,.. '4.,,, RV..i Ityliatitedv.3itY Mild Sod AV NOOKS SY s3zenns.4 3115 ttlY41433..#1 AMYX;,mi lc . . I t \. ,./\ v.4\ ,\ wiraS 'wow SI NO11130000 AW.IPMS...11Nt JP 0010001 391 ONY CMS 3MY S90N90O SNOW MI 03.10 ' I/ ' •'Ow 3s to CONvor31313 JO 010006 Min.2141 JO NOINGOd 7YZOJ Storm SW/OY'TN \ \41\ • a ,c,20Y440 44S1N4/01 SYlgai 111V,S61 1,CO00‘30 P421,SAS AR(AS alli061464Y 211411/34410 , , Z WINO.7441.10 NSW&*0730,,9 30 77f116 1(1,130 NNYA rflzootwf 71.1.311 aunty . 4 .1 4 ,. -,, ,-, . \ „, ,.. i OVC13113S MVO)1102 Otict3S 31.310,3420 140128Y4010,1 t Ivo coot 44314 TWICNt Z 3titt . I I /.. . ',.\, \'''\,A 7 M zitOANYtzt OW SNIOVA.314 Otero:ism 3410.1706 IOWAN,attoromd to•10011041 3101 314 mak iTrishco Ai 0711251.1 l'aISAS 044M*It 1101 ANYVS3731V X ITII Al 1016AP Mt i / _WAN"--",-3014,0-., , '. \\ r) -0 JO IVO Nil Jog SY 43NOT4411.4347 30 134 ION AYR moaraoi ONY'11104VANAPO MiltAIC lytit SJ.I'AIM Trala.71103 SI Wit Si*MO csur•Rav sv altor=tumid 314 '4 / f i ,• s., . - ......_____ " f i 7,,'• - --... --,,, ..:—..— 4,,,,„ \ p S3LON . , ( --.' 7\. '', / , \ \ vy' - ",, . •1••,1§, N"1*;' —1LiCCA-Z'Z(la1-'i7 I*iC7'N)d-^S. l\\i\vi.. .ga allEdNIvaa\V )1N v‘\v'.tiI 0\,0\0 N11U0K4eU NS44.NX 4A3X-.11M\).s uC1S,\#%7• \\b•,i\\p,'xl. (4. t\ 1 w/t/ ,?\\N\ \ \\ 4 \ 7 \\\\\.., \ \,..\. / \W allosr.e\1 oo ! 1..• 0 cacgCNcj(..I4r,.,: 'N, .1. ', pit(s•, ' )..., , 1 1 ONYS mono 01 3NA „91"4. , p tej \ ‘,... \ \ -.7.• \,...--..00 . ling I 0 I ki.I.S.31 I , • 1 N *.40 N i .0 . N.. '1, •,,,,, . '..',•---*.0°' --'-'\-'-moC ; ' ' . / • ' . --' &Lvov.: ,--- N. <?' . .° ; I I . / \ -LAivin 3440V'ONO'TWIN ,41.44-01 • A <:.447 . . . , 04/1:3/441t YU Al01,01 ,Og.0 0.> ••••••,, 30.,„ ,\ q`c.,\ . , \'•-.. 1 I . c ny 1331 4",,.. \.‘,. 14:104ROYY*41 v. . . 4°. ' .1 • .1 / ' I D 'R 42, tt„. , v44.45, 14,n,s N..., ,e, . o4,s c. X.., \ , CVO'S#1n4a3n ATAAW0 .04-0 94 ts. *--1 ., (4"A70:4,44%), '1,41t • '0',., N .. '. .. ':I• %_..• ., , ./''? , ii br Ilion.'"' /et-. . I 1 Ain0 .9-0 Z Del.4.1.1 / ,,, CNC MOW ATDAyol .zz-H7 .... 2 ONYS 114/0311 04 Al/ .11-4 ? gi ' . - . - I , 74 — ------:Tsar ----"". — — . awn 3,40 CM Attv01 ;9-'0 '. ,.......,,,,,, ..444,"" 3 a 4 0 yi A 11,4?41904 1 16/1S11 li r, -* .. . Alt t f.4 ' , ; " • Fl. ....' '. i". 3.20017 -"--'''' '•- 'r \*---;-. • .•.. : I ' ',„/ 'L .. , '''''—,____ . , • . ' ./ . 1 .. (PCP i . 0 4 m Z 1/11/01.11111/1/111111/101* " i i• I ti / "Il. . pr- 0(It XI ni 0 `. C 0 9 i • =4 ?‹3 5.1 p xi. I OA IV _ 1 • ‹1,3 trsi rr -CI • gift IIII0 11116IM --. 1 w* • 14 / Ill tP r )›0, 0> r...) i t144. PI41 o *.• rn,.....0 Vi5 " '1 11. 0 r . in unZm • 411,5 I-. , i , t'll /z N o , m •;:.:I-4 # 0 )>03 li> O °N N:8 rn7C)to" r "IIIMIONMPIIIIM A . "0 ‘.,to — ,. .."' M IP ui 0 : . ., #01.1111011010.0.1.4%. In 0 > '6.4 teerP ".... ' r..'>4.** NW.. / ....1 ,, ... ,1 /‘‘"S""'..../. ' -"\ •'';i', . . ..,., .... ,,'. st, , )14` ."^'• ',, ...•••• I ' ,,,''' ' ... ..1 .:, 00.A. r• \ II ."'"' .0, Mbar OM 11.1.••••••••••••... WM #116 41.• ........), • w 'mem °• '...,0•••• „.........."'.. . :," r'S ./t• ,. ...NM ....... ...Am **, •, ,• •......... /' ' i ''AA • . .....,„ ,............ •?.''''. um... ............ ........, .......,.......... • to." •••••••••' , t.."..... ,....,,,•••••*° • "10 ., •-.^ . $; gm*1 . C N ., ,•" M X . ....--- ..• , ,,..... , M ,,, t$ :' r".—1 "*".'' ?•N''''''''' .' ' , . ., 0 r • - It* i i' /\y --I o# VJ 0 0 < .p•••"''' . • i 'S. t• / 0 W X . if I ,.,_•Z.,...4-<• ,/^ti I N 0 125 -ii 0 ,.• . / ,, ,„‘• .! i a` • \''' .--••4. 6 t.'.° 4re /'" , *" '' * ' A, 5 .0 z rli •• . , ,. ,4 ,•,'. „,....,„ ,, ..„ ,,, ,, a m'z z ,..• i r , co pi, ip CP W . 6 .. i : . ,. . i 03 .g I‘. •V 4 > ill •-si . , . \ N 8 / ,,,, ,I...,..illA411,414.4't ,,,,,•.N. ... NI.. . 1,71 v $..Om r 61 1-4 • 8 ,, , N.'",:t,:‘,,, •,,...oi .7,7, tw 2 , s • ' '.14, 44k.' , '.....:.-%•.;,--,` . GI • . , , ,..... ...„, 7*. ‘, .,5: (7. r r s .. ) i i —.4, i 1..,..4 ... •N\.;,A, x'0 M 743 )fr r, .. • i . .. 03 70 Z . , .„ •- . i•.1 1 Z i . , '''-..,„ '' ' .. - '''., 44.4. '`".•-••• ...,-,.. 7:7--., .• ...10.0. „ 11 •., I-1 4: ,:77....,. . -^•••••,;-.'`-,.,'•••<,...••••,..., 4 •,,,,"0 . . , !Bo • •••, . . ................... , . .. . 7,....,,,„, ''',`• ..,,..., \'144% :'''''•, ...*"•m'''*'''. .. tt Z ... -4,,„, ..... ............ t•WP ••••• .000 601** I to m 4:4 0 ro m •. '1' RI m‘‘' ......................4404.1111..... • 4. . 1.............. .\ ... 1Lvat" 4' M t`l ...0 M 14(I I % FA U4) FA W M fri a/in XS - . 70'''•••`'''10 '4"4 C:- CN C.'"' 0 0 z . . 4,•4' ..,,A. 4,,f,...,,t.i ,z,,"; .: 1..,,r., ,,,.:'..,x,\''':*•\\:",-,,,, ,,,.': 4) I \ ZM I 1 •P I 3> ..........*. "• 5 ''' .. C '''.' 7 > ,' ,:,‘,.•,..•,._,.. " • VS r- .t*,, 4\ , p s;:s - •s. ....,,,f: -4 1 --) °- _____ 1dd