HomeMy WebLinkAboutBLD2005-00199 • •
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-001 99 Received Date 03/31/2005
SITE ADDRESS: 251 SUNSET BLVD Issue Date 06/24/2005
PORT TOWNSEND, 98368
APPLICANT: KYANNE ANDERSEN PHONE: 360-379-5225
ROGER ANDERSEN
11QUINALT LOOP
PORT TOWNSEND WA 98368
SUBDIVISION: CAPE GEORGE COLONY DIV 2 Block: 4 Lot: 14
PARCEL NUMBER: 938100414 Section: 12 Township: 30 N ° Range: 02 W
CONTRACTOR: LITTLE & LITTLE CONSTRUCTION PHONE: (360)385-5606
2009 4TH STREET
PORT TOWNSEND WA 98368
Contractor's License: LITTLLC157C5 Expires: 2/28/2007
PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE &
A/G 500 GALLON PROPANE TANK
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: -71 o=c sr
UFFER: , ''Icy Os
Footing: 162i w -n, p'-/o-
Foundation: ,e,X.r7 40,4�iZ.d r 8iyi ts,
Stormwater FINAL A proval: ,
Underground Plumbing:At s/waAp./NEA;'t0 gC..?-2q-o5
Underground Insulation: t t ' �' CV--- U,.)L&1 r 1 ci:,;,t,u
Shear Wall : 4.1. P e u s (E ee-PIr Up `vr vc) Dk_ li/r0
Sheathing: � �
Framing: 5?RAps �ibco or.,,u5 OK i/is/a. OK 28,0A �0rsd 2-e)olautakiasa)l
Plumbing: Ok ,�//44A �J
Propane Tank Lines: / t NE5 Di< Woz, _ * hoc OKWON-
Insulation: t�� O l? -- lamMR-5EAc. OK. 2. fat
Sheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval:;rC C A3 -EOc'
HEALTH DEPARTMENT/AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION
THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED
BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
HOT LINE AVAILABLE 24 HOURS A DAY
SPECIAL CONDITIONS APPLY -SEE REVERSE
•
SPECIAL CONDITIONS FOR CASE BLD05-00199
1.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water
quality degradation. The submitted proposal does not require additional aquifer
protection measures. However, during construction the project shall follow the Best
Management Practices (BMPs) and facility design standards as identified and defined in
the Stormwater Management Manual for the Puget Sound Basin.
2.) 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.
3.) MANDATORY MEASURES FOR COASTAL 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 requirement:
a. Chloride concentration of a laboratory-certified well water sample submitted with
building permit application.
3. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water.
4.) 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.
5.) Maximum impervious surface coverage is 25% of the parcel. Impervious surface is
defined as a surface area that creates a barrier to the entry of water into the soil in
comparison with natural conditions prior to development, or that causes water to run off
the surface in greater quantities or at an increased rate of flow in comparison with the flow
prior to development. Common impervious surfaces may include roofs, driveways, patios,
packed earth, and oiled surfaces.
6.) The building height is not to exceed 35 feet.
7.) Minimum setback from Sunset Blvd right-of-way is 20 feet. Minimum side and rear
setbacks are 5 feet.
Note: Cape George Colony Div 2 Restrictions requires a minimum 25 foot front
setback.
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.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
11.) 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).
12.) A minimum of two (2) on-site parking spaces is required for the single family residence.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
JILDING PERMIT APPLICATiuN ML Revviewiew TyTy196
pe:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00199 Received Date: 3/31/2005
SITE ADDRESS: 251 SUNSET BLVD
PORT TOWNSEND, 98368
OWNER: KYANNE ANDERSEN PHONE: 360-379-5225
ROGER ANDERSEN
11QUINALT LOOP
PORT TOWNSEND WA 98368
SUBDIVISION: CAPE GEORGE COLONY DIV 2 Block: 4 Lot: 14
PARCEL NUMBER: 938100414 Section: 12 Township: 30 N Range: 02 W
CONTRACTOR: LITTLE & LITTLE CONSTRUCTION PHONE: (360)385-5606
2009 4TH STREET
PORT TOWNSEND WA 98368
Contractor's License LITTLLC157C5 Expires 2/28/2007
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NEW SFR W/ATTACHED GARAGE &
A/G 500 GALLON PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 889
VALUATION 350,000.00 ADD'L: 1,408 HEAT TYPE: RAD
CODE EDITION: 2003 HEAT BASE: HEAT TYPE: PRO
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 455 SHORELINE:
CONST TYPE: DECK: 180 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: CAPE GEO
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 2 Prop: 2
Total: 2 Total: 2
Routing Date: . // /05
Type ... Amount Paid By: Date: Receipt: r d a e
Permit $2,393.75 BAC 03/31/05 71771 A t V E
Plan Check $1,555.94 BAC 03/31/05 71771
State Building Code $4.50 BAC 03/31/05 71771 JUN 2 4 2005
Potable Water Application $53.00 BAC 03/31/05 71771 Jefferson County Planning
Total: $4,007.19 & Buildin Department
\.
/ ti, o Z c O JEFFERSON COUNTY
al ��, l DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend • Washington 98368 MAR n 1 }2 nr
•
360/379-4450• 360/379-4451 Fax
1`S$INGO www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: 05 - l CI(0.
Project Description(include separate sheets as necessary):
Tax Parcel Property I
Number: 3g - too — Lit Li( Size: L 3,,5(,G, (acres/ uare feet)
Site Address and/or Directions to Property: Z S( .5,4 s G. '3I c( .F0,4 7`4.)1-L -44,0`
Property Owner(s)of Record: '*oIrt•tle.' •t- )0.r,,*W.014"^. "ACC H•GC•L�w6.1.
Telephone: 3141"" .Z Z.5• Fax: email:
Mailing Address: I‘. CD V11•0%M6+t 4- (ivvr. -FA7 ✓4- Tpww1-t44. ,(
Applicant/Agent(if different from owner): Li -l-+ ._ 4- L.; •1-}{.4. . (c,1„igA.ytX ,�.......
Telephone: 3 440 364'— Stop(. Fax: 34O 34.5' -?7 33 email:41(JcE (i4-4Lc.—Ui#4-1e„ier m
Mailing Address: Z.C7l7 at L{P.• .5. . go r f.. - re 4.4•..,•yi K a
What kind of Permit?(Check each box that applies)
(Building L I Variance(Minor,Major or Reasonable Economic Use)
I I Demolition Permit u Conditional Use[C(a),C(d),or CI**
KSingle Fa ' U Discretionary"D"or Unnamed Use Classification
arage ( .l-./Detached u Special Use(Essential Public Facilities)**
u Manufactur•. "ome U Boundary Line Adjustment
U Modular U Short Plat**
u Commercial* u Binding Site Plan**
U Change of Use LI Long Plat**
U Address I Road Approach U Planned Rural Residential Development(PRRD)/Amendments**
U Propane U Plat Vacation/Alteration**
U Allowed"Yes"Use Consistency Analysis u Shoreline Master Program Exemption/Permit Revisions**
u Stormwater Management U Shoreline Management Substantial Development**
u Site Plan Approval Advance Determination(SPAAD)* u Shoreline Management Variance
U Temporary Use U Comprehensive Plan/UDC/Land Use District Map Amendment
U Wireless Telecommunication* U Jefferson County Shoreline Master Program Amendment
U 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
"'4'r
I hereby designate L-'t ' �*_t- �44,,s.._ to act as my agent in matters relating to this/ application for permit(s).
OWNER SIGNATURE . R.ww.A..... Date:S(LQ(65'
By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet
may result in this permit being null and void.
I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attomey's fees and
expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any required later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours.
Signature:�� � ry`� _ Date: 6,13 v/D 3--
The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or
endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the
"Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this
permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable resp n ibility for acfheri to and complying with the EISA. The Applicant has read this disclaimer an signs and dates it below.
Signature: �"'(r� rmil Date: 0343D7o S"
C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc
• -
OWNER BUILDER STATEMENT
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the responsibility of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
Li 4U-- t- ( i 44-Lt-- Co 4w c)c b. . (364) 3 SS—Sal,, (3G4))3.ss-- ?7 3,3
MAILING ADDRESS: ZOO 1 14>K 514, p7 EMAIL:
CONTRACTOR'S LICENSE � a,�C K �t ff�~/� �C .4....,
WAINS
NUMBER: L 7 /_f,/ is-7 G5 NUMBER
ARCHITECT/ENGINEER: PHONE
( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
` New X Wood Existing: ❑ Sewer
Addition ❑ Steel Proposed: 'Z Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Z. Height: ,Individual System
❑ Repair ❑ Masonry S P Permit# Oy "�w 0
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: Private well [1 Two Party
pe of Heat: Proposed: _Z______ Public
(Awl.i C I.,'P) Total: •Z— Name of System:
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces:
Number of occupants(includes owners,tenants,employees,etc) Current Proposed
IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply:
I U .- . ound Tank I ve ground Tank Size of P ••- - .nk: S'GaC›
I Heat Sto ' I ook Stove I Woodstove I Fireplace Insert - Hot Water Ta I Pellet Stove I Other
Is this appliance Ermgtnstalled in a Manufactured/Mobile Home. 'es / 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 For Office Use Only
�(It-� 05�" Current Proposed 1`Z5� , Amount
Main Floor r> AlConsistency Review:
�� --plc:, S% -8e Wig,
2 Floor o Base fee:
c e �•
lko lace 1°6. a, 3`.3 '7S
3rd Floor Additional Section:
Mezzanine: Plan Check fee:
555. q r
Heated Basement State Surcharge fee: 5 0
Unheated Basement Pot Water Review fee:
Other Unheated �f 911/Rd Approach fee: r-xl3{�n�
t Garage/Carpor 14SS 0 ?� 25 TOTAL: $ 1 v 90
? 1 Ci
Decks I 11 ( P1 n i
( Receipt Number:
Other �,/ 1.4- Cash/Check Number:
VOYC,� 'l�► l l IN. CI i 3
ESTIMATED UIRED) 84-�v , Date:
'Fair ma of all labor and materials f dati o rots 1 13) '0�
C4,00t> e9-15 LJ✓�•� ials:
Cti,�,
t',`!.is 3 1
C:\Documents esktop\Master Permit Application 7-8-04.doc
.�J
1�,�gON cO
4 , % JEFFERSON COUNTY
w �t A
DEPARTMENT OF COMMUNITY DEVELOPMENT ,JA',j 3 1
621 Sheridan Street• Port Townsend •Washington 98368
3ING' 0 http:%7www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# S• - 1 1 PROJECT/APPLICANT NAME: A(A41+ rso✓S Eel!"►v4
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.
S C lam. {si vi•► L yc rei5“.44 / a Arrs z,7oo si F+
Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
/kr?,,o c l o`er s(0 -
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
4. Describe the existing soils. Indicate soil type on the site map.
.6411
&YadLll y _C.y�trse_ 5w.•
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. -
. rVew._ w...•l-c.••• ✓If.g • �•s a��� •;..c
pc, S S a �- e ws -.
• i •
6. Describe any excess levels of noise generated by the proposed use or activi :
, .0" _. c4,\,: •RMW TER PL
111111A�
stormwater site plan lemplate.doc—rev.10/12/21H13
bEP .OF(OM SO COUNTY 5
S1(;NAT y3 /;1TY DIM'.O
7. Describe significant geographic features and critical areas (Le., environmentally sensitive areas such as wetlands, streams,
steep slopes,etc.)on the site. Indicate location on the site map.
8_ Describe the general vicinity of the site, including adjacent land uses and structures, utilities,roads,and sensitive/critical areas
(streams,wetlands, lakes,steep slopes,etc.).
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.
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.]
WA
11. Describe the performance goals and standards applicable to the project.
12. Describe the flow control system.
4vtw."-6 w4-Tt-YZ. '10 lis.W.sciik Pula S.
-AR 1t star txtarnaiL Um 196
stormwater site plan template.doc—rev.10/12/2003
6
13. Describe the water quality system.
14. Describe the conveyance system analysis and design.
15. Describe the source of fill material,physical characteristics of fill material,and Rosition f excess material.
CUT` 1&& % M—.. 112 t L tOa TV T-3-s
Syl CAW q c< fry'.
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
lu5a+ % (DM 1 Wfl J $ +`� bat-t u A sob qr .
411 17. Describe the proposed surfacing material.
al 64464Cvt3L -
18. Describe methods for restoration of the site. p
C r) "/1re44,a !� bq,4 1 C or>
lv►Kdsc,4,4l
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.
14 La-
20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
NONE
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.tis.ju
It lit Kei nut Salikt,C,
stormwater site plan temptate.doc-rev.10/12/2003
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.
filskotr MA pr'a 11) AI wank
2. Establish Construction Access.
9VU €4464V at. Arcs t314. .r veto— Lo t'ydTt
tnr 1:7nv13-w
3. Control Flow Rates 11111
.
aW soars 4 Wan u 011,0
4. Install ediment Controls.
4air i4a6.4c3a6 04, Aki. ill> A 6 ciL iir 8f- cA ItroA
5. Stabilize Soils.
As RZSQtAA013-0 . Oter S38 ),) ,aEys.woil
6. Protect Slopes.
7. Protect Drain Inlets.Mc ►4..) t Sit+ C01tc
stormwater site plan temptate.doc—rev.10112J2003 8
WI 3 1 2Or,7
12 Required Elements—Construction SWPPP(continued)
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).
IA Pk
11. Maintain Best Management Practices(BMPs).
12_ Manage the Project.
2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas, roads).
oPV
b. Description of the downstream drainage path leading from the site
to the receiving-�bo1ody of water(minimumdistance of 400
yards). D� C- o rc a -\ �storww` S� N1 135c6Il
T l
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
111111
stormwater site plan template.doc-rev.10/12/2003
•
b. DK,ription of special requirements for working in or near environmentally sensitive areas.
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).
NnUcs
5. Construction Phasing.
a. C •
onstruction IcJebAl- ;
uence r N
GN Idyl ei ; lifzi-MosCiar
we
b. Construction phasing(if proposed) J
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide `lroposed-f construction schedule.-/7cfivitie
AA . /II. Wet Season Construction Activities. ///" illks el44)( 1141 I
a. Proposed wet season construction .
b. Proposed wet season construction activities for environmentally sensitive areas.
J1/4)60'5
7. Financial/Ownership Responsibilities.
a. Identify th e property owner responsible for the initiation of bonds and/or other financial securities.
MIA
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impaqs.
N /4.
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.doc—rev.10/12/2003 1'L f1 I (f �:
7n
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.
e".,/3//64."
(LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
•
31
stormwater site plan template.doc—rev.10/12/2003 _ 12
•
,. ' isON co& JEFFERSON COUNTY
�
al .;;„ DEPARTMENT OF COMMUNITY DEVELOPMENT
j„' , 621 Sheridan Street • Port Townsend •Washington 98368
144rING`S'O 360/379-4450 • 360/379-4451 Fax
http://www.co.jefferson.wa.us/commdevelopment/
Stormwater Calculation Worksheet
MLA# 6J ' `Y PROJECT/APPLICANT NAME %rSa)10` leiG,61'l4rt.c.L,
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 V 31 acres An acre contains 43,560 square feet. Multiply the acreage by this figure.
Size of parcel in square feet 13,SO . - sq/ft
Land-disturbing activity is any activity that results
sults 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 ACTIVITY,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 q sq/ft native vegetation to lawn or landscaped areas?
Drainfield,septic tank,etc. �,,�,...,... sq/ft Circle: Yes ( .
Well,utilities,etc. )1Zsq/ft Does the project convert 2'A acres or more of
native vegetation to pasture?
Driveway,parking,etc. tit()C. sq/ft
7
Circle: Yes No
Lawn,landscaping,etc. 1VOO sq/ft
Other compacted surface,etc. 5oct. sq/ft Indicate Total Volumes of Proposed:
Total Land Disturbance 3 4 f sq/ft Cut 110 ty Fill S (cu/yd)
[over]
Ilistormwater cal:worksheet.doc—REV.10/12/2003 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.
ior11
STORMWATER CALULATIONS—IMPERVIOUS SURFACE
NEW EXISTING
Structures(all roof area) 0 sq/ft Structures(all roof area) sq/ft
Sidewalks I Jam'® sq/ft Sidewalks sq/ft
Patios !SO sq/ft Patios sq/ft
Solid Decks sq/ft Solid Decks sq/ft
(without infiltration below) (without infiltration below)
Driveway t100 sq/ft Driveway sq/ft
Other bi sq/ft Other sq/ft
Total New Z1O> sq/ft Total Existing sq/ft
TOTAL NEW+TOTAL EXISTING* 190Q 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. fr
DEVELOPMENT v. REDEVELOPMENT
Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: cL %
Does the site have 35%or more of existing impervious surface? Circle: Yes No
FURTHER INSTRUCTIONS: If the answer is yes, the proposal 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 Chart 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 "small" 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 Stormwater Site Plan Instructions and Submittal Template or
prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual.
APPLICANT SIGNATURE
By signing the Stormwater Calculation 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.
�.�J
d 3`30�Os
(LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
FOR OFFICE USE ONLY
SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No
116
stormwater calc worksheet.doc—REV.10/12/2003 2
Anil, iiii . it
4 .
1
1....
1
...W. , ,
t [ ' ,
\ '.
1 r ,
il, 1
.1 • o 1 I 1:3 \
—
..,.................. 7 -
\ • t.+•
\
i
lit t 4 ,
, ...
;3.'t f
I • i,
.1.1,
1 11
11'•
re t,I' 1 ‘ kitf t 1 OiLl
i ille
t il '44.1trXi I:id
f I •s'l
1,1 w
kt If , pi
0' • .,,
1 i
41 , [r, , ‘ ..,
,, • i i‘t.
• ,.. :4,1 , 1 n ''; I ...
-I
, , f
, , , • ; 1 i
lig i3O
ril 4.11, 01
i1/4 1 , 1 ii 1 1
. V
i \i I '
> ..,-.
11.
C.4
.-i
•
k ,
‘ .
0 'II C t I V X MI locl Z .
X : 1
-.• - z
Z tli
< z . 0
_ i 1, .......-
.- .<1 -0 , 1
...
A A tri G.. CA al:j
lii
• c- 0•4
> 0 4 c 0-.1 itz. 1 rti z
-Jo
2
....,____
-t -4- Q-- 1Crk
N. •Z'
r c)
t--1
z til
it fro tr 0
• N
- • -4-, ‘1) --- -
-4- 0
-5 -I,- c P
ra er- 41) 0
lt, A i 7-
t.'.1.-
ca o
,n- fp A tn q
111:.
, -
- ic tv
Co ° •-•1- r, -• -:
77 5 ;
"4 7V
1/ „
z,ic..............\..\\„ — k-:.... ,
\-3\ k• vc-,
, ,_ .......,4,,nth hiehllehlhohnhifilhohilihoihhiiiiihhOlooh in ,.... ,,,.
•-. . . / I
'''s, 5) rb ., 'S.'•• 0
__. „.
41 0 ,t
_ .
• K eim : _
d - --------7\ \
, l'.
Q.-
4 ,-I .
• -nP- t . :,,-D 0
L9 cD CA
••• ep (ati (..1 P
,..e.: 0 0 tz = . S ' . . os '
'0 —a
, — (0
4 iii
• t"...) A
w PI S. Z
X I\ i ,
4 8 to
to '1 VI 4
3 -,-4 = ,-- 0 -• .4-
a\ .s a_ p.. <
VI >
o = 4:t1 1
\ 1-., ; I . CD
-0 ;
iv a 4:go Z7P I V) 0
0 g 2 . P 41, cs- ;\ P (-4' o - ..•
(7" 7 5"
61 , -+- ,f1 \
n A
c
0...• -.4 --•-•‘, P a_
(0". 4 - ilT, ' • . it,t* :1 F, r., -- -.-'..)• -- • -- ' it ::_4"
•.. t ,•,#.41 iiiveishihihmehil.* hiochishviihiohimihmoohriminsholhirromithhilihohherni,..W"...................."'''''ll.V .., ,
- I
• /I/ I h.h.......,......... / 1 S 0 r
.......*""' Ol/ '....
to -;
2- -
0-3 IN,D . ft er.' ,•,, . -i- -- r$
0 . cz • 4 F) V =P A T----
g L.1)1 ;,- -4- 0
5
.+ a- pzz., ,,i ,
s) -
-.- (---.1
cn CD -: - 7r- U-1 • N e3, -0 (./3 --i-
--t, Q 0 0 vl
41
c o
=
s19 _ , ,
- - ,,,,
cil
IA c _ _
-4-
- . _ ,
1 () I- ..r.. ..
---- -V .- t)
--
.5 C". 0
(1)
,› .:1
.."R, r •
0, c)
....._„,, (1'