HomeMy WebLinkAboutBLD2005-00371 - BUILDING PERMIT 0
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Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00371 Received Date 06/6/2005
SITE ADDRESS: 220 N STROMBERG AVE Issue Date 08/11/2005
PORT TOWNSEND, 98368
APPLICANT: MERIDIAN MTG INVESTORS FUND II PHONE: 206-621-9301
605 5TH AVE S STE 850
SEATTLE WA 98104-4438
SUBDIVISION: IRONDALE Block: 151 Lot: 40-44
PARCEL NUMBER: 962115129 Section: 35 Township: 30 N Range: 01 W
CONTRACTOR: MERIDIAN GREENFIELD LLC PHONE: (206)621-9301
605 5TH AVE S STE 850
SEATTLE WA 98104-4438
Contractor's License: MERIDGL973BG Expires: 1/11/2007
PROJECT DESCRIPTION: NSFR W/ATTACHED GARAGE
CALL IN FOR THE REQUIRED I SPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: 4444, &rfr-
UFFER: Dk f //aS
Footing: 4/C' 0//IFS*
Foundation: 9-8-05
Stormwater eNAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall : ‹-Le-A- 1f4*7.F,iz- /An` $NEge& t OX I/3A1. rte. J,r
Sheathing:
Framing:Stu-aecT -Bt..ouci.4 ,` to-v-t-oy `_ t-1-C4
Plumbing: t --0 to r
Propane Tank/ Lines: /a: L k,c—, 6k_ r/3/MG Per"-- -3-c
Insulation: / -i1'Li - 1-9-C,,. „ OK i///e)E Pe I J: .
Sheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: -}c r (/D /i/t'7
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 CPE A BLD05-00371 •
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.) VOLUNTARY MEASURES OF COASTAL &AT 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 Storm water 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.
4.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ:
1. Installation of a flow meter.
2. On-going well monitoring for chloride concentration.
3. Submittal of monitoring data to County.
5.) 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.
6.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
7.) 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.
8.) A Stormwater Site Plan has been submitted and approved by the Department of
Community Development. Once the subject permit has been issued the applicant shall
fully implement the provisions of the submitted plan and contact the Jefferson County
Department of Community Development to arrange a schedule to inspect the property for
plan compliance. A Certificate of Occupancy will not be issued until the Department
verifies plan compliance. No clearing for roadways or utilities shall occur on the project
site until clearing necessary for the installation of temporary sedimentation and erosion
control measures have been completed.
9.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
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10.) 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).
11.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
12.) The building height is not to exceed 35 feet.
13.) Minimum setback from North Stromberg Avenue right-of-way shall be 20 feet. Minimum
side and rear yard setbacks shall be 5 feet.
14.) 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.
15.) 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.
16.) A minimum of two (2) parking spaces shall be provided for the single family residence.
I:\F_BLD_Permit_Buildng.rpt 10/29/1999
VI ILDING PERMIT APPLICAIN MRAO-003345
Jefferson County Department of Community Development
eview Type: I
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00371 Received Date: 6/6/2005
SITE ADDRESS: STROMBERG AVE
PORT TOWNSEND, 98368
OWNER: MERIDIAN MTG INVESTORS FUND II PHONE: 206-621-9301
605 5TH AVE S STE 850
SEATTLE WA 98104-4438
IRON DALE
SUBDIVISION: Block: 151 Lot: 40-44
PARCEL NUMBER: 962115129 Section: 35 Township: 30 N Range: 01 W
CONTRACTOR: MERIDIAN GREENFIELD LLC PHONE: (206)621-9301
605 5TH AVE S STE 850
SEATTLE WA 98104-4438
Contractor's License MERIDGL973BG Expires 1/11/2007
REPRESENTATIVE: KEITH HAMMER PHONE: 21:1f_621=NOQ
605 5TH AVE S STE 850
SEATTLE WA 98104
PROJECT DESCRIPTIOP NSFR W/ATTACHED GARAGE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,485
VALUATION 147,600.00 ADD'L: HEAT TYPE:
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N SHORELINE:
GARAGE: 483
CONST TYPE: SETBACK:
DECK: 140
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 3 Prop: 2
Total: 3 Total: 2
Routing Date:
. . (e c t 7 c,c- f(2
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Type Amount Paid Bv: Date: Receipt:
Permit $1,262.55 BAC 06/06/05 73254 � � D�� �
Plan Check $820.66 BAC 06/06/05 73254 AUG 1 1 2005
State Building Code $4.50 BAC 06/06/05 73254
Potable Water Application $53.00 BAC 06/06/05 73254 Jefferson CountyPlanning
&Building Department
Total: $2,140.71 C 1 d`a-t
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� 06di, JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPM
621 Sheridan Street• Port-Tewn n • Washington 9 368
ki‘i
360/379-4450 • 3T607379-4451 Fax
94 wvvw.co.jeffersoil wa.ustdommdevetodrnent \ /
Master Permit Application ,y % MLA d� ��� J
Project Description(include separate sheets as necessary):
Tax Parcel Property
Number. Ci(92— 4 ---- I' -�' Size: (acres/s(are fe�c t)
Site Address and/or Directions to Property: LpT 4 —44 x, '-4- i z�g4; •r k..kr.—„
Property Owner(s)of Record: r"► .1e_s-b. cgectivu
Telephone: ?c 9 Cs2 t ct 3o1 Fax:7�(c cc7 1 CI email: Pt cr` ' 1 -cow
Mailing Address: f7 �� t51) ..,A.-r- \/ 6l
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
/iiqiiiilding ❑ Variance(Minor,Major or Reasonable Economic Use)
Demolition Permit ❑ Conditional Use[C(a),C(d),or C]**
<Single Family 0 Discretionary"D"or Unnamed Use Classification
❑ Garage Attached/Detached 0 Special Use(Essential Public Facilities)**
❑ Manufactured Home 0 Boundary Line Adjustment
❑ Modular ❑ Short Plat**
❑ Commercial* 0 Binding Site Plan**
O Change of Use 0 Long Plat**
. Address I Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments**
ropane 0 Plat Vacation/Alteration*•
❑ Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program ExemptioNPermit Revisions**
❑ Stormwater Management 0 Shoreline Management Substantial Development*"
o Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
o Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
0 Wireless Telecommunication* D Jefferson County Shoreline Master Program Amendment
0 Forest Practices Act/Release of Six-Year Moratorium
"May require a Pre—Application Conference **Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal, if known:
1- DESIGNATION OF AGENT
I hereby designate &= tT ,
44 i4#&A r•AccZ to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date: W4_745)1
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 attorney'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 regt\ired ater,inspeetions—Access an`d-ttght-of.entry to this property shall be requested and shall occur only during regular business
hours.
Signature: --: Date: ( C7
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 ar insompltance-viiththe Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-tra,,feh responsibility for adhering to andremplying with the ESA. The Applicant has read this dis ai er a d signs and dates it below.
Signature'
-,,.z____ Date: 1
C:\Documents and Settings\mochit\Desktop\Master Permit Application 7-8-04.doc
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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 pr 'ect.
Signature --- rate----.
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
r-J1/4cAz, ...) G e_-5-xi-t (6-D tk--/-11,) Imo,TA-I ( )c02-1 1 ( )coo ctiiie7
MAILING ADDRESS: �SX-)S'_ ` t EMAIL: C 1 ,
CONTRACTOR'S LICENSES �_�—$�� WAINS p Werrc�tg-. 1 w,PPA iPw Cc
NUMBER: lotle2t0GC.ci aG NUMBER
ARCHITECT/ENGINEER: s'
AILING ADDRESS: ,'�� PHONE (2� ) -3 33e nFAX:(Zr _ )UZ3 417110410
M .� v
EMAIL Citt 'J ® A.tt lLn�-t0%n.
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New Wood Existing: 0 Sewer
❑ CAddition 0 Steel Proposed: a Bank 0 Community System
❑ Alteration/Remodel ❑ Concrete Total: 7 Height: Individual Systm
❑ Repair 0 Masonry Permit# U 5- q g
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: 0 Private well 0 Two Party
Type of Heat: Proposed: 3— public
Total: W Name of System: ?$
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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:
1 Underground Tank I Above ground Tank Size of Propane Tank:
I Heat Stove I Cook Stove I Woodstove 1 Fireplace Insert t Hot Water Tank I Pellet Stove I 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 kxFor Office°Usep f taj 1 1*'�ry;t` v i�, :? 1 +" +�
Current Proposed ��a 4�„,t : t,, r. , Amount i
Main Floor CO f"�j5 ;' ri
y„ I
2Nu Floor :..
Base fee. c.�Z.. ems.
3f°Floor -.
'/Additional Section �,,..--
Mezzanine: _ Plan Check fee:
Heated Basement ' State Surcharge fee:
94*
Unheated Basement : . Pot Water.Review fee:
L .,
. .
Other Unheated 911/Rd Approach fee: tr r7 03
Garage/Carport TOTAL: $'Z 4`"�1
Decks \�
Pr Receipt Number: 'l 'Zt
�'
Other Cash/Check Number: T
ESTIMATED COST(REQUIRED) Date: t fc(6C
'Fair market value of all labor and materials foundation to finish �O
1A�/ Initials.
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Architects+Designers+Planners 0
Pier 56,1201 Alaskan Way, Ste.200 Seattle,WA 981o1 TEL 206 623.3344 FAX 206 623.700! A 6C 2004 MRHIJN,INC.
, Jun-06-05 OT:56am From-Meridian Group of Companies 2066219/50 T-918 P.009/016 F-906
�' , JEFFERSON COUNTY i -,,
7 k t t
� DEPARTMENT OF COMMUNITY DEVELOPMENT r-- --.9
621 Sheridan Street•Port Townsend•Washington 98368 1 J 0 N — 6 2005 ! /
.. • 360/379-4450.360/379-4451 Fax -
'if c http:/lwww.co.jefferson.wauslcommdevelopment/
* - JEJEFFERSONcou r
STORM W _ �•ESITE PLAN SE UBMI ! 1A it if, ';r M Ail- PEVELOPMENT
b+lA 4 d c-' c PRO.jEcT,APPLICANT NAME: '
Please answer ail 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 Lend Use Application or to submit e
. separate stormwater site plan map.
Project Overview •
1. .Describe the proposed developed conditions tithe site. Indicate position and relative size of nrnonied improvements an the
site map. _r. .4__- 'S kr.1 G1!-' Ka./ C c 'I..1C
, . ..,t,rc%.--41�'�. .t LA.s..3 t 3C i J. G
Existing Conditions Summary •
2. Describe the existing topography. indicate contours on the site map.
1Zsc Cn t.0,re i_tcrtt ly 47orrxc .,'-1,..x;1 Lir,silt . __
3. Describe the existing vegetation. Indicate native vegetation areas on the site mart.
u�et ec+oM.yQ 11-, .tst .f-th[4V%,
4. Describe the existing sena. Indicate soil a on the site map.
` -;�
�,s tG Y {�y S i ar..- e LAwklSrr ak.Z1 s•..c,..� �lvt.kc 145
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5. Describe the existing site hydrology(i.e.,drainage;behavior of water on the site—above,below,and on the ground). Indicate
existing stormwator drainage to and from the site on the site map. Depict separate drainage basins on the site map, if
a licable and indicate acne of each.
3# tc;l
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1
6. Desert :enLv,ey excess(rivals of noise generate by the.•rrs.•- use or activi
.o.1 , .• ... .. w.., � r .i le. S 1%.15• its cit. ;Si. h . 1
— — ' APfROVD----1
STORMWATER PLAN
uorrnmar&s An wow=-.NM,1r42.1 wet r 1S JUL l 2 2005
Storm
Require
JEFFERSON U Y
_ .,.. DEPT.OF�i� i ' 'l V PMti
SIGNATUR
. Jun-06-05 07:56am From-Meridian Group of Companies 2066219750 T-918 P.010/016 F-906
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• 7. Describe significant geographic features and critical areas (Le., environmentally sensitive areas such as wetlands, streams,
steep sl 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 sensitivekriticat areas
Sstreams wstiands,lakes,step slopes,etcl •
tl/l 1 '`C'sk's Yt, • .v ta ,,,,,‘ i — AItC a<
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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 air impervious surfaces, pollution-generating impervious
surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment faculties and flow control
facilities are not exceeded. .
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g, Describe the developed site hydrology,es proposed. Indicate whether stomrwater will be fully dispersed(i.e.,per BMP T5.30
in the Manuel)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 'te plan and differentiate propos facilities from a sting faCilitii�$.
• ,os • 0 "Vtp.a 1 0 G- (4-iA =lam
sash lvxsier --+ =�
i10. if the project requires the use of stormwater treatment facilities,describe the types of stonnwater treatment faciilties proposed
for use n the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilites. (this is
( normally for large*projects orprojects that invotvn,the potential for.dlsperslon of contaminants.
0�
l �� ot�.v ��ti..
11. Describe the performance goats and standards eppiicable to the project,
Q.C i"kc-G�ec wipe y. 1
12. (Describe the flow control system. t '~
e
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.Jun-06-05 OT:56am From-Meridian Group of Companies 2066219750 I-918 P.011/016 F-906
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13. Describe the water quaff M r --20A-------�--
. wee._,_ _
14, Describe the conveyance system art+alysis and design.
15. Describe.the rce tfll material,physicat characteristics of fill material,and deposition of excess material.
_T ' 40 .L
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform 8uildi g Qodei • 1
17. Describe the{p�r"opos surfacing material. Ann
1
al 2
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18. Describe methods for restoration of the site, .titiit�tOr.SL..
I.
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19. An Operation and Maintenance Manual is required for each flow control and treatment facility, [This Is normally required for
large"projects oniiy a only those for which facilities are required to control flow or treat runoff." If included,list the Manuals
here. .-i r
20. List hare and Include an special ports ors 'die conclude to prepare the Stormwater Site Plan.
A
21. List other necessary permits and approvals as required by other regulatory agencies. if these-pa.. its or approval include
conditions that aff the drainage planar contain more restrictive drainage,related-ete-rement%describe those nditions or
restrictions her® J i
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Jun-06-05 0Ts56am From-Meridian Group of Companies 2066219750 T-918 P.012/016 F-906
CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP)
The Construction SWPPP addresses sediment and erosion control during construction. The BMPe Indicated by the applicant in the
template that follows must be installed on the ground during all ca?structbn phases
of the project. TM proponent to responsible for
preventing sedimentand erosion ImpactsManagement environmentally
areas.ite Construction d
water
Pollution Prevention Best Pratices (EMPS) Packetforguuidance, particularly rural residential
,
development
pECTIQN I-CONSTRUCTION PP AkR _ . -
f• Construction Pollution Plan eacholbe how element.SWPPPof the Construction elements
addressed. identify the type and of BPssed to satisfy required an g element is applicable
to the proposal,justify in writing.
t5esoripiivns of the 12 Eler+'Grts are found at section 7.5.2 of the Manual(beginning on page
1 2-15)
I92 Required Elements-Construction SWPPP
t 1. Mark Clearing itg. C. t,,,
ec
2. Establish Construction Acccess. c _ .
l - ,-
I
3. riOntrUs 1•f Rates. .
--��-
4. install Sediment Controls. AP -:.sr= tS
• 5. Stabilize SONS.
6. Protect sio es. 1
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-- -- .-
7. Protect D in Inlets. � - �L t
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Jun-06-05 0T:56am Fron-Meridian Grove of Comas ies 2066219750 T-918 P-013/016 F-906
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12 Required Elements-Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
4!r ___ --
• 9. Control Pollutants. L —_rec � a•. 0
1CO ontrel De-Watering(the act of pumping groundwater or stormWater away from an active construction site).
/ ...... . . .- •••• -...-.
11. Maintain Best Management Practices(Ei✓
�g�t ct • �� _sa
------------
12. Manage the Project.
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' 2. Adjacent Areas.
a. Description of the adjacent areas that May be affected by sits disturbance (e.g., streams, lakes, wetlands, residential
areas.roads).
�J .
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distar ee
. yards) .
4k__=______
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3. Environmentally Sensitive Areas.
.a. - 0 ptton of environmentally sanative)roes that are On or adjacent to the Sete. , r
s
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Jun-06-05 07:57am From-Meridian Group of Companies 2066219750 T-918 P.014/016 F-906
• b. Description of special requirements for working In or near environmentally sensitive areas.
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4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site
soils(e.g.,erodlbliity,settieabluty,permeability,depth,texture,soil structure). �-
5. Construction Phasing. - 1.
a. Construction sequent..e _ 1
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ee
repl
Construction haSing(if proposed) 1
b. P
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
i. Provide a or000sed construction schedule.
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U. Wet Season Construction Activities.
a. Prcposod wet season construction activities.
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— b. Proposed Wet season construction activities for environmentally sensitive areas. ' ,
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7. FinanclaU0wnershtp Responsibilities. "
a. Identify the property owner responsible for the Initiation of bonds and/or other fin cla)\securities
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
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ti. Engineering Calculations. Provide Deslg Calculations on a separate street for the folowing,if applicable.
a. Sediment Ponds/Traps.
b. Diversions,
c. Waterways, 0 . . •
d. Runoff/Stormwntor Detention Calculations . - 111M—Mr , —_.--""
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Stormwater Site Plan Changes Stomtwater Site Plan,the proposed revisions shalt be
If the designer wishes to make changes or revisbns to the originally approved
submitted to OCO prior to construction. The submittal shad Include substitute pages that include all proposed changes; revised
drawings showing any structural&lariges,and any other_upporting Infom!atton that explains and supports the reason for the change.
Final Corrected Plan Submittal
If the project Included construction of conveyance systems,treatment facIllties,tlbw control facilities,or structural source control BMPs
(not standard on-site storrnwater management BMPs),the applicant shall submit a final corrected plan("as-buiits")when the project Is
completed. These should be engineering drawings (stamped by a licensed cvii engineer) that accurately represent the project as
conat(uctcd.
AppLICANT
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Construction By signing SWPPP worksheet, I as the applicant/owner attest that the information provided herein Is true and
correct to the best of my knowledge. I aiso certify that this application is being made with the full knowledge and consent of all
owners of the effected property.
(LANDOWNER OR AUTHORIZEDtiEPRES£NrATIVE 81GNATURE) {nose}
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T hire SPACE MAY SE USED FOR ADDITIONAL NOTES,IF NEMEC),
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nmwat Me OwIMnpuls.doc—Nv.'ell 2I2003
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