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HomeMy WebLinkAboutBLD2005-00188 II? UILDING PERMIT APPLICAlitN MRAOW00185 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00188 Received Date: 3/28/2005 SITE ADDRESS: HELM LN PORT LUDLOW, 98365 OWNER: THOMAS E JOHNSON PHONE: 360-379-6950 JENELL S JOHNSON 62 GARDEN CLUB RD NORDLAND WA 98358-9610 SUBDIVISION: PORT LUDLOW NO. 1 AREA 1 Block: Lot: 35 PARCEL NUMBER: 990400135 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW SFR W/ATTACHED GARAGE & A/G 300 GALLON PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,671 VALUATION 193,903.00 ADD'L: HEAT TYPE: HTP CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: 348 SHORELINE: CONST TYPE: GARAGE: 441 SETBACK: DECK: 108 BANK HEIGHT: SEWAGE DISPOSAL: SEW WATER SYSTEM: LUDLOW BEDROOMS: BATHROOMS: . Exist: Exist: Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date: I Type Amount Paid By: Date: Receipt: Approved/Date Plan Check. $988.10 BAC 03/28/05 71739 APPROVED State Building Code $4.50 BAC 03/28/05 71739 Potable Water Application $53.00 BAC 03/28/05 71739 MAY 1 9 2005 Permit $1,520.15 BAC 03/28/05 71739 Total: $2,565.75 ff aunty Planning & : 1ki 'epartment WI g tee.. s 6. BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00188 Received Date 03/28/2005 SITE ADDRESS: 95 HELM LN Issue Date 05/19/2005 PORT LUDLOW, 98365 APPLICANT: THOMAS E JOHNSON PHONE: 360-379-6950 JENELL S JOHNSON 62 GARDEN CLUB RD NORDLAND WA 98358-9610 SUBDIVISION: PORT LUDLOW NO. 1 Block: Lot: 35 PARCEL NUMBER: 990400135 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE & A/G 300 GALLON PROPANE TANK CALL IN FOR THE REQUIRE I SPE TIONS THAT APPLY TO YOUR PROJECT. SETBACKS: D/L 7 / oS^ UFFER: of, Footing: dZ 7051 J J 006romertly Foundation: 4< /46.5 Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Q(6:psl c Sheathing: Framing: O1i q/i�o5 7 Plumbing: /)K S/Z/5, Propane Tank/ Lines: �,.rge,o &P M fL/uv J 8/76/4S Insulation: 2/( f/2/O5 4112.45; VA*Lr e/'it *ArewAr/o0, ) Sheetrock:,A' Septic Sytem Find Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: 3/, 64 HEALTH DEPARTMENT AND PUBLIC WORKS APPR VAL 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 A BLD05-00188 • 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 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 Helm Lane 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.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 11.) Per MPR Code Section 3.17, Accessory dwelling units (ADU's) shall not be allowed in the MPR-SF zone. 12.) The driveway intersection with Helm Ln be graded such that when rainfall runoff slows down the driveway the water is diverted to Helm Ln roadside ditch. This should be done to prevent water from flowing out onto the street and into neighboring properties. 13.) A curtain drain interceptor across the entire width of the West end of the lot and drain this system to the approved drain-line discharge location. A utility easement exists along the West (uphill) boundary of the lot. The applicant must install the curtain drain outside of this easement. Before any excavation is accompolished near this easement, location of utilities with the easemnt is strongly recommended. 14.) Houses in known drainage problem areas may be required to install a Curtain Drain system usually this will be located up-slope from the proposed home. This system will usually be required to have a separate drain-line to the approved discharge location. The drainage plan must show the location of the curtain drain and a cross section indicating the depth and back fill material. 15.) The applicant must have all easement documents related to drainage finalized and recorded prior to PLDD drainage plan approval for Jefferson County building permit and Ludlow Maintenance Commission Architectural Control Committee approval. • 16.) Approval drain-line discharge locations are road ditch and drainage easement with a defined ditch either natural or man made. 17.) No dry wells, dispersion ditches, infiltration swale, holding and slow release systems etc. will be approved unless designed by a Licensed Civil Engineer or Licensed On Site Designer. Any plans of this type must include the designer's current State of Washington stamp, signature and date. 18.) The Drainage Plan should be drawn at a scale of 1-inch equal 10-ft and must show: 1. Outline of the lot with dimensions of each side. 2. Contours at 2-ft intervals, (The Drainage District can supply the applicant with this information) 3. Outline of the footprint for the proposed house showing setback dimensions from property lines. 4. Locations, size, type (perforated or tight), and route that the drain lines follow to drain line discharge location. 5. Locations of roof drain downsprouts. 19.) Houses must have as a minimum: perforated footing drains and separate tightline for roof drains. Details of these drains must be included with the drainage plan. 20.) Driveways that slope downward from the road must have a method to collect rainfall wter into the roadside ditch at the driveway entrance. A detail drawing of this grading must be included with the drainage plan. I:\F_BLD_Permit_Buildng.rpt 10/29/19 14 STORM%VATE}� PLAN W °� JEFFERSON COUNTY ti�gy r 2005 + f� ►• DEPARTMENT OF COMMUNITY DEVELOPMENT 4 , , 621 Sheridan Street • Port Townsend • Washington 983:: bFhT JEFFERSON COON 7Y Z� htp:%7www co.jeffer6son wa4 s/ommdevelopment/ St( of t CfTY t)J;v1si.OPMfiNT HIN nrr raE: STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# c .3- PROJECT/APPLICANT NAME: sT74 or-tAS 7"6NNSv N/ 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 --- 1-6/ 3S / /I'( LAVE 1 Po :r /- tDi o ' 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site map. t-oy c OA/ /IC«( 1 /.Ir-� UJ'GL RI he r:ic/.c:.IJc I` t�� <I=�j ,f/;,'cam- ol-c . '77 f-!Dart w/t.L s/i oAJ /-) /-= ' ,J_- PAL) iN 11/r I1 rbb�� 1-67. 7/-/ r A/Z Yi i ii c✓'i:L BE L.(1-:ct. j//r L120k/7 Ol" 7// 70'P/l(i= Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. —Z/3 of TI l e- rz iS L v*CL PRo or L_O l" 14Pr S- 'Po wti 7-o I-/C/A( '&ie _ 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. LeY 7- 1.s 1-c.'k 'f7 (p c c,3/-7/-/ C 14 &A r 'rr G,JJ r c v row lt1 $ v/./LI W c / -7 4 -7;&AA1 i1/ .'&'6 y2-c(S. 4. Describe the existing soils. Indicate soil type on the site map. u�=-r-V �o,a,frr ;yy �- r- , —ce L -(I.� JV( V o f6.7reAvLL Y -oi t__ -a 7-6 OrQS-F[ cryif-- 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. kfo P6 rvI-S J./VG- f La 7 - Lc S/ 7 tiG P77/ _CO 7}-/ , wA 7 C,� SI-ICES S-7-1 C Cr C 7 2t-( _ctvA)L-7_ 6 iv /ar'./t-t LJt, 6. Describe any excess levels of noise generated by the proposed use or activity: 7YP/ G.6&I S i 1?it cricA/ l v///L-1_ Rid%L L)/IVG ;-NOh mac _ _ SOUS AM& Gnats CFG _ ,varsr w • I E iil XI p00 ' stormwater site plan template.doc—rev.10/12/2003 _ -�v r 5 • 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. r ~�- C/;,';'c k / :'a (V,. s/'J( t� 1 `�%// �Lb 1'r ,!1 ( a i-c_ (-v/u r -r r/Zrfii (., / 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.). • Hot(S r: AA',/..)7/7/ -<-6 I(/%V ,/� fi/1.c5 r e,o �i �%G r%V C` 7 l.:a; 1 r i C^ i.'�(. 11/[%'C 'L CA C. r - 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. P6�7" fv-(1 oPcP S/7C LL;//-L c/ x/t(/-ortce 140 s-e Gr/11.6 t-c7it/ze k'cor . rO -,//v( - Q/tY-1 ;'( 1-4---ec.-r L /2 cc-7- i-t'N/r!7_ 7G roe../ .Sr{>k/lf Sit/;1t -' AL.G/V(,- D J l''i r tA% 7G S/7 e y' S -K LA Je • 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.] 71r=A i,.,.(CA. .7 I71c/i_.i/.1 cs ARC. RAC �t/2 c.1 /Q : 7/1 I'f CT - 11. Describe the performance goals and standards applicable to the project. 6Tc 7 MUST S7 AcC -/ ; ,,(rc/Jic.t,k-c t.L( kf,lk-trlv"rj' 41 1 F - c N,w77I Akn/AJ,lg6-r= - ,uLt.,/ i)/SPiRs-c cou/ 7 rat 1-rc2 12. Describe the flow control system. . /Oo/ foe7fNtr 1)RA//vs k«.x v.,/ e /-11/. ,o C3r /wit/<ir-Ay r� s7Rve S 6p_Ai it/At< -"l ' ryr i i slonnwater site plan lemplale.doc—rev.10/12/2003 13. Describe the water quality system. ;. N tet-•T6, GuA7e><? _r_:Y;-/( A( h;..1C zC/?t/{ /16r(SC 14. Describe the conveyance system analysis and design. X// ( /1i Jltil'( i ,;,r(,c(—. i�r/tJATe2 ( L-LCcy/b1) coi ve`(4/(/cl_ ( BUG(_ e((y/l-/"" r�•/�,{�•�, cT 1R/1( 5L✓/1LC 6 i 7-6_14 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. il S(MFIG/f 7114--- r6 t( /Dfl'//G N - j; (t ,7/NU3^ l{l it-t (;.%v—/-( 4.1 '-t//7"/I NA7%!'c /-f ( RIifL ,Ar-rek DRAWROO( (S Pl.-A(1=O /) f61-:A/Q I 7A/G- DR/-1/ "/P P(" / !-vIJ.! jir' ///)/r/ .(0 (;K/ (/'i 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. ,410 SIG-n//FirG i-Nr 17. Describe the proposed surfacing material. • G42410/z ej- _' 11-2/V 6-11-t//-i y . 18. Describe methods for/' restorationti/ of the site.'- y /�/ CL. .J)1-`/ LU 7- /�i(L �,f4r�rio ''Am/.c /S R-"ri1._`l.. 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for large"projects only and only those for which facilities are required to control flow or treat runoff.] If included, list the Manuals here. / 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or restrictions here. 51'Arc1-LC L M tl/Ly N6t-tSE P(',Citc- - E>K//--JJ d6067"J tie f. c 1JtUIL) ASS°c//37/o/V !'/Pciv c'7 APk v`/-} j_ q • stormwater site plan template.doc—rev.10/12/2003 _ 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. t(C C. 1(1?.. .A/ 1. -S/'i, 0 1.,-r5 AR& cUARClJ/1 ato--c f Y.1-tdc7 7o A/co/a7/-i / sjz-r71/ . /-IC/'( `A,JC. r 457 2. Establish Construction Access. ZC777 I2 L ;irk/ OFT /-/C /—( !-A k1r- . PO(l< OVC/. P/PF OPP /-/C2/'-( 1-Ak c26 T c s7-6,e/t, /-r%' , t c/< ,%t-dNG- OF IV /U . 3. Control Flow Rates. /-/A Y 6AGG cN s ivA!-r AI-OkJ - cant c7/oAtl 6,P'1116-v✓/1 y� Acc.ass , 4. Install Sediment Controls. l--AY, fl Le. S Uvla I A Lc/V Cr- �R/UE - �(,( � /key Al-oA4/ 7�✓-fP CokiS71?4 C7/04J _9kP11 5. Stabilize Soils. Cc'VC l%o14AUWtiY/oh/ vA7c/) 5:6IL. Yr l• /11►J1NG-. 6. Protect Slopes. . e A cF F RAN .SL.cf& 7a �-1 c/I? 7 �R T , '7/-7 FeAvc� /is l&ccc_E'.Snky 7. Protect Drain Inlets. oyc,v Sraki( StvH 6iTcf/ A/ /-/ce.A't /-4A/, P,e 7 ec7c.) . Y iKCASt F.S Move , 0.. 2005 • stormwater site plan lemplate.doc—rev.10/12/2003 - 8 12 Required Elements-Construction SWPPP(continued) 8. Stabilize Channels and Outlets. 1'/ wit H1YEAt_es/ floc/( 2/kCS-, . (pv(kC'D 5P6//S 9. Control Pollutants. $>' /-(r/ 5uPC, A/3ctni- FOR sr-a/' cA'-r- - Sr�s $>'• KecP )0U A P1/EC /iq 77lc/t? (G,v77I;Noe S 7fl eRe_ s//C'1( /3i= ,Fcc v ?r.":r°4. f;'I( koLLGr7i17UTS u sui 7u I."(t/f a 7Xis HouSc 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 'iI'e lr;,7 eer.`G (/112 ; ( < 'S),% /lc ) SHo. -L-v c ' t'J 7-U D(7(VA->C'Wl G k) 7'1//�' Lire. r e.. 11. Maintain Best Management Practices(BMPs). /-'f/I/Ny%1/il 7�/C WA/CS / Rock tjil-e_3� C.GUC/ /) Spci/LS' S/L7- /=Cn/ci= �S /Uccc;Sc ,rey 12. Manage the Project. A lA/AJ--Al 0%1 %G-r AJC(- f (r ...I f.16 /�..v f/J 77/Ro14JJ&U CbNSTRArcrk,Af t(.1u7%L P/- e t t'\EJ c n/( S _7:;03"/41-1_E1) 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). F)cc .. ?Jot.tCS `/G 11/C /-( /7/) CrriL(7// FORES7C(J 1-67 76 7/16 wcST /3- ueH/1-t LrlV-1>`"tcC7e,U _ c2rietOr C7oefr Siv4( C -76 '.ti7' %S Man' APT(C7 'A ;•'WL t v e 1-c r,r_ 1•P.`>-rcc-/£C) R'/ 77 f3�(d s b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). C9Pe14. S76R/`( cS AC-6 uG I JG1A(_ tUC , 0t(7`Lcir ptiAl/U/16-E- btu) LvAI-1<c/Z•• Maki 7/iAty 't c Y1-talc of P)s7%I / c/cv6v6, iiy ( . toy/rfr _ 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. M^CS/VS/7/ve.- 61,V O% TM1c.AvT_ To S/T /»//N'4G./, CIA'AL< A7" 7/jt. FE(J,v7' (weS1 S/eF Cf l r W 13E P Rim ct c-0 /3V BA4 p s I • l stormwater site plan template.doc—rev.10/12/2003 - 1 9 b. Description of special requirements for working in or near environmentally sensitive areas. �9 JS// 7'VE Ak'(/LS .AI /),0,7- 6c4✓f 72, Yr 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). <-7 S/7`C c6 /L A.8S3�3�' LvIrreR G J f i j` t/ '`/ Po i C.17 YA L FoR ek&c/n N 7c- /)T 4/ PR o1 e ( N/) S/G // &-/-1.v7` /,A) 1'fz.nPLl 1f fler AKI7.t(/i 17€) >"c��. 71-/S cl7-e. 5. Construction Phasing. (N7- a. Construction sequence � I I_�fA/! MPS -� SST 2/u M Aknt.� C1 E..�IP LOT/ r:iAi1p/)j`.l(,IN1 f/L4wr�7F✓G Izao/ /NG-ee S/D/it/F /A//sw £4 'Ek !?AcKr,L/ / 64-011)E J S7Y14'1L/`1'- - 'r b. Construction phasing(if proposed) ti//k -- A/-1 2 Pi-I Sr 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. MAY o c D<C os II. Wet Season Construction Activities. a. Proposed wet season construction activities. Nfie-kto2 /C"i NISI-f- wit 1,18E /4s/4 k 4AVe)T S--te Ri4 c iktro.4- P1-11c b. Proposed wet season construction activities for environmentally sensitive areas. NU Sl 5l7JVC t1pp4 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. i w,j/G/Z/f>I(/L wc,C G4/-0/ F//W( c/A-/C y ki=S Ns/&C 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable. a. Sediment Ponds/Traps. AJA- b. Diversions. c. Waterways. � .... _..._. _.._ _.___....___,: ... :. r d. Runoff/Stormwater Detention Calculations L stormwater site plan template.doc—rev.10/12/2003 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. /0/-0- 11 f t ia-1)//) Io rt-- — I—C(LANDOWNER OR AUTHORI REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: • • stormwater site plan template.doc—rev.10/12/2003 12 I N0Q J EFF COUNTY % s DEPARTMENTERSON OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend•Washington 98368 ? - � 1-4 ! I el360/379-4450.360/379-4451 Fax ,!tg f http://www.cojefferson.wa.us/commdevelopment/ Stormwater Calculation Worksheet • MLA# C '� I SD PROJECT/APPLICANT NAME: 'TNGIV 4S b i4A/So aV DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater calculation worksheet should be completed first to classify the proposal as"small,"'medium,"or large." The size determines whether a Stormwater Site Plan is required in conjunction with a stand-alone stormwater management permit application, building permit application, or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan,if required. PARCEL SIZE(I.E.,SITE) Size of parcel •7-86 acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet I t/H 60 sq/ft Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover(both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation,and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species,other than noxious weeds,that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir,western hemlock,western red cedar,alder,big-leaf maple,and vine maple;shrubs such as willow,elderberry,salmonberry, and salal;herbaceous plants such as sword fern,foam flower,and fireweed. LAND DISTURBING AC1IVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared,graded,filled, Answer the following two questions related to excavated,and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: Does the project convert'acres or more of Construction site for structures 1` P sgfft native vegetation to lawn or landscaped areas? Drainfield,septic tank,etc. / e G we .) sq/ft Circle: Yes Well,utilities,etc. /i/4- ( PH 81-/C ) sq/ft Does the project convert 234 acres or more of Driveway,parking,etc. Z,000 native vegetation to pasture? Circle: Yes �� Lawn,landscaping,etc. ,846 to sq/ft Other compacted surface,etc. AM" sq/ft Indicate Total Volumes of Proposed: - Total Land Disturbance /27 '16 0 sq/ft Cut Fill 50 (cu/yd) [over] stormwater calc worksheet—REV.10/1/2003 1 • Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof tops, walkways, patios, driveways, parking lots or storage areas,concrete or asphalt paving, gravel roads, packed earthen materials, and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater. STORMWATER CALULATIONS—IMPERVIOUS SURFACE NEW EXISTING Structures(all roof area) f 2 00 sgift Structures(all roof area) sclift Sidewalks 4 0 sq/ft Sidewalks sciftt Patios sq/ft Patios sqfft Solid Decks 10,-S0 sq/ft Solid Decks scit (without infiltration below) (without infiltration below) Driveway 11 6 sq/ft Driveway sq/ft Other _ sq/ft Other Total New �! 7 !� sq/ft Total Existing �'6' / sq/ft TOTAL NEW+TOTAL EXISTING* 7/0 sq/ft `This amount will be used to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v.REDEVELOPMENT Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: ► % Does the site have 35%or more of existina impervious surface? Circle: Yes FURTHER INSTRUCTIONS: If the answer is yes, the prop_usal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements.: If the answer is no,the proposal is considered new development and the attached Figure 1 should be used. At this juncture,the applicant should refer to the applicable Flow Chad to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements. For proponents of "smalr projects who must comply only with Minimum Requirement *2—Construction Stormwater Pollution Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention (SWPP)Best Management Practices(BMPs)Packet. Proponents of"medium"projects—those that must meet only Minimum Requirements #1 through #5—,and.for 'large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared,a submittal template of a Stormwater Site Plan, principally for rural residential projects. Complete the template in the Stonnwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual. AP.PLI( ANT SIGNATURE By signing the Stormwater Calculation Worksheet, I as_the_applicant/owneratte if at 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. { o ; _ / i�rnacvi. tl y _ 3 "7 L C�� (LANDOWNER ORAUTHO ED REYRESBVTA7NE SIGNATURE) stormwater calk worksheet—REV_10/1/2003 2 ira co JEFFERS.COUNTY i - ---- ' DEPARTMENT OF COMMUNITY DEVELOPMENT !m 1 621 Sheridan Street• Port Townsend •Washington 98368 i 4• 360/379-4450 • 360/379-4451 Fax l 0 ,q ��0 www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: 0 J- 1 Project Description(include separate sheets as necessary): C (//_LE f,./4All 1 - a ,'i/� f L ( iv,/4 r-rAcl/ 64d-4O r Tax Parcel Number: qq®�d0/3S Property Size: .Z2,r6 4c71Z, Z(acres/square feet) Site Address and/or Directions to (��� q8 3 65 Property: 3S /i�'�.nr t.��/� � PoRrl-�c��.aw WA Property Owner(s)of Record: 771O 1AS . ', JoHU SoN Telephone: 3600-379-69So het-tfar360 - 77'I-lz7t email: T,y..:nil oisan61ICli104-com-t Mailing Address: 6Z 6-A2DEM cups Rails , Arm64...aki6 w4 1.9 3 58 Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: at kind of Permit?(Check each box that applies) Building 0 Variance(Minor,Major or Reasonable Economic Use) ❑pemolition Permit 0 Conditional Use[C(a),C(d),or CI** t' Ingle FariIy_____ ❑ Discretionary"Dv or Unnamed Use Classification Garage(Attached Detached 0 Special Use(Essential Public Facilities)" ❑ Manufactured Home 0 Boundary Line Adjustment ❑ Modular ❑ Short Plat" 0 Commercial* 0 Binding Site Plan" ❑ Change of Use 0 Long Plat" 0 Address 0 Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments** ❑ Propane ❑ Plat Vacation/Alteration** 0 Mowed"Yes*Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions" 0 Stormwater Management 0 Shoreline Management Substantial Development" O Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance ❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 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 7liG"IAS ,GNJV So A,1 to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE 71144.-- 90A41"341 - _ Date: I3 - 1r OS By signing this application form,the owner/agent attests that the kifu,unation 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 required later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business hours. Signature: /erM /Q" w _ Date: 3• —7) ''bs 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 and non-transfera�b sponsibia for adhering to and complying Applicant acknowledges this disclaimers that he,she sr andit holdsa individual sibl tY nng p ying with the ESA. The Applicant has read this and signs dates it below. Signature: / Date: G:\PennitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc • OWNER BUILDER STATEMENT 1 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 I they will be assuming the responsibility of the General Contractor for the proposed project. 1 —. Signature: ��Lanvr.,� rb.44-1-1417✓ Date: — OS J $ 2005I f GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: 1 FAX: ` GwNTit eka-4' ( ) L ( ) 54 MAILING ADDRESS: _S ,r Peen,jtZ OL AJC EMAIL: 'IG CONTRACTORS LICENSE WAINS NUMBER: K./A- NUMBER ARCHITECT/ENGINEER: iv-4 PHONE ( ) FAX:( ) MAILING ADDRESS: EMA P r9ject Type: F me Type: Bathrooms: Shoreline: Type of Sewage Disposal: V New V Wood Existing: A/.4 Vrgewer ❑ Addition 0 Steel Proposed: 1- Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: 1 Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: 0 Private well ❑ Two Party Type of Heat: Proposed: 3 lePublic Fe/4 G .►& Ai R Total: 3 Name of System: (WWEkr PcuHp) al-YMP/c Wil 7riVsisr.dep If this Is a Commercial Protect 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: O Underground Tank VAbove ground Tank Size of Propane Tank: 3CP0 14-04 ❑ Heat Stove ❑ Cook Stove 0 Woodstove fireplace Insert ❑ Hot Water Tank 0 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 a @} e" .1**,--..,,,,),,*qN,.4 'a,�+ 4'4gs` - 4w J� • --•"-' Current Proposed '� s 1` `, j` i : ti ••mot fFt.- AeL rIi �h j V. r' v� •wx'sy Main Floor t 6 7 I �,. - :,j • r t w%� `' r:A . c.�c-l.G 2' Floor 4�,, , `: ", rr ' ; �4 "4 rat, .; 4 4 r4 ten`'+::t'}=X'":: t ° . �� :.,Z•��..`<i.-�4:'' '`t3 2' ' �; � � '� a t'�"^'' 3f0 Floor ', �. -Y a ''`, .,, +� '` f..It �• '�rt� tfe'!`y iE yx I• g4 ' `-1.` ' 1- k�4y1�k X;., 1�„ray ..._ 3S1iiFvnk I {s. kS ve' �c��j Mezzanine: f. `` 1k7r "` "& ° : 4^e^+ry `'ice a g^s 'iiS ' b', �L ^-t 1 1 }4�.�. 1y� i� 4'�: its ' ' ,r.s t i tita:•'* Litt. .rx. �1n a ci,r t xt, • A r 4; ..t i 1 �1 t.• 2>Intan sn. Cam(", Heated Basement I ,'sl �` `, ` , t-"` " R - r ` >+ 4 Unheated Basement a 4 ri 0...F4'N O f•Gl% >. q 1 R a � ^. s� 7 ,'7 4 Other Unheated '�`ti , - -;-• 40, �.,� �s ,� �y, y ,, r ti t 4'A , a ,r tri''' - i..4 �i 5 t ' � 1 a 1•tx Cyi{, e.P,.M ' 'tzt' I e 6 j.. , �,,,x:-zrr` A,.' r ' C .?�a�.t S g c /��({I/,� .iY-+ c. - � £ yrt,%' 0�'. 9�` '^f.t� �'``7� � v-a s ^ri.�'T>�� nc. � ,H,. '- Garage/Carport / 1 / a '. 4 'S� y(-` b +� Y wM `.ta F51. } Decks v 4 _+'-'E n lyK, nk4> ,r -+4.s- 'S 4 ,. 4 ; ,_ 1 t e ,ri • h -- y J-i'N k'.14 ter y . 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N "'a 70 ret ill ill Z Z -1, •,- n F 1, - ---* •-..- ..-,, VI ' ' i 7‘ .1- -.,- V It. t-\ IA, --, -- z. z7. ;:.; ..1 ,...p.. ri) I '!. i Z INN 1 1/1 ..41 i IT.44 & --Z ..,. -`41',.' ,•,' 4, .4... 4.' \ . .., +4-- es% ljt1 1 Z ril 6 t..... fli et,r >0 Isl 1/1 4*j .4) A, 0 e1 )1 L'I r - ° m 7-1-i-i r - i riii q � 1`' 4, ,0 i 8 1(\_ z `v rill < cry II_ . • ) \.:1 I'i cii/I , 3 1 I- 1 aoiw ill ill I mm / n 111111111111.111R".1111.1a 2 / VA VI M C 0 (11 ui a, Z � T --IN a No i r �. �, x . \ v, $ In 112. 6�,,V Z a 1 .'3 ' ,N . �� Q 0 N Q �,i \ Q, v� �N�!�1M ' \ N ram, / ' F + w t co \4 \ oia _tk �� 1 7 VI, ;4 4r n, \ l' N, ,c \ CO /11 tt . 1:_n i ii v \ `C N m 4- \ w ' I aaw tipi02\ ' ? la o� \\\ T i r I i TX. n 4 � C , �c, h Tic \ i i t:, �1 11 1 T `, ..\ •-3 cA r ,t.., i1/400 .emu i ti�3 W z G� , r , A SURVEY OF LOT 3 5 IN THE PLAT OF PORT LUDLOW NO. 1, AREA 1, SITUATED IN THE S - W. 114 OF SECTION 9, TOWNSHIP 28 NORTH, RANGE 1 EAST, W.M., JEFFERSON COUNTY, WASHINGTON 7 W E S PORT LUDLOW NO.7, AREA 1 VOLUME 5, PLATS, P.26 SURVEYOR'S NOTES: BASIS OF BEARING: a N N 16'48'09" E, BETWEEN THE ENCASED STREET ,m, MONUMENT AT THL INTERSECTION OF "WALKER WAY' & "HELM LANE" AND THE ENCASED CENTER 0) ome OF CUL-D-SAC MONUMENT AT THE NORTHERLY "HELM Rrn--�m TERMINUS OF CENTER LINE OF LANE" SITUATED IN AND COINCIDING WITH THE PLAT a.�� o:n� OF PORT LUDLOW NO. 1, AREA 1, PER VOL. 5, >am" PLATS, PG. 26. JEFFERSON COUNTY. WA. W EQUIPMENT USED: THIS SURVEY WAS PERFORMED USING A SOKKIA SET 3110 ELECTRONIC TOTAL STATION THEODOLITE/E.D.M. DURING z � CLOSED RANDOM TRAVERSES FROM AND z BETWEEN EXISTING PLAT MONUMENTS. U w CONTROL ACCURACY: THIS SURVEY MEETS OR EXCEEDS STATE MINIMUM MONa ACCURACY REQUIREMENTS OF 1:5,000 FOR a "(b) CITY -RESIDENTIAL AND SUBDIVISION LOTS" PER W.A.C. 332-130-090. � i o U C Y 2-15-05 SURVEYOR'S CERTIFICATE THIS MAP CORRECTLY REPRESENTS A SURVEY MADE BY ME OR UNDER MY DIRECTION IN CONFORMANCE WITH THE REQUIREMENTS OF THE SURVEY RECORDING ACT AT THE REQUEST OF.... TOM JOHNSON IN FEBRUARY 2005 FINIS H. BREWER. CERTIFICATE N0. 36791 AUDITOR'S FILE NO. AUDITOR'S CERTIFICATE FILED FOR RECORD THIS�p,D'A tO,F .L 2�ATiJ�.M. IN BOOK � OF , u1tybT S AT PAGE AT THE REQUEST OF AUDITORFINIS H. BREWER. COUNTY Ito jo v JOB NO.: 05002 FILE: 05002_JOHNSON FIELD BK: 17, PG. 5 SURVEYED BY: WCR/MJL DRAWN BY: RWR CHK'D BY: FHB THIS SURVEY WAS PERFORMED IN JEFFERSON COUNTY, WASHINGTON FOR: TOM JOHNSON O 30 60 90 SCALE: 1'= 30' (ORIGINAL) LINE TABLE LINE LENGTH BEARING L7 10.00 N24'42 34 E CURVE TABLE CURVE I LENGTH I RADIUS cil 24.341 45.W REFERENCE SURVEYS: VOL. 5, PLATS. P.26, IT. LF"LOW 10.1, AREA 1) BK. 26, SURVEYS, P.148, F. BREWER BK. 14, SURVEYS, P.113, L. G. HALL BK. 20, SURVEYS, P.88, A "'DOD BK. 22, SURVEYS, P.40, A DOD BK. 14, SURVEYS, P.51, A. WOOD PROPERTY DESCRIPTION LOT 35, PLAT OF PORT LUDLOW NO. 1, AREA 1, SITUATED IN S.W. 1/4, SEC. 9, T.28N., R.1E., W.M., JEFFERSON COUNTY, WASHINGTON. LEGEND O FOUND MONUMENT AS DESCRIBED FOUND CASED CONCRETE MONUMENT VISITED DEC. 2003 PROPERTY LINE SURVEYED INDEX GRAPH S.9, T28N. R1E, W.M. JEFFERSON COUNTY, WA. 1— L1J W cn AMERICAN LAND SCIENCE PROFESSIONAL LAND SURVEYING POS 547 6396 STATE ROUTE 19 CHIMACUM, WA. 98325 TELE: (360) 732-031 1