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HomeMy WebLinkAboutBLD2005-00515 tUILDING PERMIT APPLICATit)N BLD05-00515 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00515 Received Date: 8/5/2005 SITE ADDRESS: 1492 HAZEL POINT RD QUILCENE, 98376 OWNER: HARRY D SCHWIER PHONE: JENI D SCHWIER 7379 INDIANA AVE RIVERSIDE CA 925044547 HAZEL POINT LARGE LOT SUBDIVISION: Block: Lot: TXA-7 PARCEL NUMBER: 501025003 Section: 2 Township: 25 N Range: 01 W CONTRACTOR: REALITY HOMES INC PHONE: (253)926-6330 1308 ALEXANDER AVE E FIFE WA 98424 Contractor's License REALIHI984CN Expires 2/15/2006 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NEW SFR W/ATTACHED GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION 215,408.00 MAIN: 2,159 CODE EDITION: 2003 ADD'L: HEAT TYPE: EEE OCCUPANCY: R_3 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: 5N OTHER: GARAGE: 761 SHORELINE: CONST TYPE: SETBACK: DECK: 168 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date: (4\5\ 051k - Type Amount Paid By: Date: Receipt: APR.-16' 1'1/ ED Potable Water Application $53.00 SLE 08/04/05 76381 State Building Code $4.50 SLE 08/04/05 76381 2006 Plan Check $1,068.18 SLE 08/04/05 76381 JUL I� Permit $1,643.35 SLE 08/04/05 76381 Jefferson County Planning Total: $2,769.03 &Building Department • BUILDING PE RMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00515 Received Date 08/5/2005 SITE ADDRESS: 1492 HAZEL POINT RD QUILCENE, 98376 Issue Date 07/12/2006 APPLICANT: HARRY D SCHWIER JENI D SCHWIER PHONE: 7379 INDIANA AVE RIVERSIDE CA 925044547 SUBDIVISION: HAZEL POINT LARGE LOT Block: Lot: TXA-7 PARCEL NUMBER: 501025003 Section: 2 Township: 25 N Range: 01 W CONTRACTOR: REALITY HOMES INC 1308 ALEXANDER AVE E PHONE: (253)926-6330 FIFE WA 98424 (253) 926-8515 PROJECT DESCRIPTION: NEW SFR WI ATTACHED GARAGE CALL IN FOR THE TUIRED INSP CTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: Q —t.1 V UFFER: Footing: -O 'w Ctrw7J Foundation: QK 129/6Z, Stormwater FINAL Approval: alti'I'eles DewoSpCu1�s 4 4 Pi* �.ui,sec OK. G/I/ Underground Plumbing: Underground Insulation: Shear Wall : cxr 3g1t4p OA //f 9/4L 1/ Sheathing: Framing: U)�1 -f1- 1 4 , R c ..wr�..srio)55t 1t-z.1• 06 Plumbing: A85 4.k.sLY 614 </I3/0 /�' Propane Tank/Lines: U �?eYLYtSt_y SIG�lE1� GFF fly <Tr el, Iv127��J Insulation: I -21 •0 b Sheetroc L-14(o Septic Syt Final Approval MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: OR Tal_ (16 GAP HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL RE' VI Q RED IOR 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 CAS• BLD05-00515 • 1.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 2.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC) Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 3.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 4.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 5.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 6.) 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. 7.) 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. 8.) 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. 9.) 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. 10.) MANDATORY MEASURES FO OASTAL SIPZ: • FZ t 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. 11.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 12.) 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. 13.) 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. 14.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 15.) 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). 16.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 17.) The building height is not to exceed 35 feet. 18.) 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. 19.) 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. 20.) Minimum setback from Hazel Point Road right-of-way shall be 20 feet. Minimum side setbacks shall be 5 feet. Minimum setback from top of bank (as identified on submitted site plan) shall be 110 feet. If an Environmentally Sensitive Area (ESA) is present, then the more restrictive setback(s) shall apply. 21.) Residential developers and individual builders shall be required to preserve shoreline vegetation and reduce the associated risk of erosion during construction and any future activity which may impact the stability of the shoreline. 22.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 23.) Within 100 feet of the top of the bluff, no land disturbing activities or residential development shall be allowed with the exception of beach access systems constructed in accordance with the requirements of the Jefferson County Shoreline Management Master Program. 24.) This project shall comply with thiald Eagle Site Management Plan sine of this parcel and The Washington Departmentansigned by Wildlife on November ie owners 2004. This project shall also comply with the addendum signed by the owners on April 18, 2005 and signed by WDFW on April 22, 2005. I:\F_BLD_Perm it_Bu ildng.rpt 10/29/1999 4rilik)-`19°Nc .� JEFFERSON WJNTy b DEPARTMENT OF COMMUNI 621 Sheridan Street • Port To ns • LOPM '� & 360/379-4450 • 360/379-445 'F F r----- rigt(zn- 3 rash c 'gS.�NG�O www.co.jefferson.wa.us/com ;�le�elopment I j t� Master Permit Application AUG - 4 2; }5 ' i ' Project Description include separate sleets as ne essa Mom: D ' 7 w( ry)' C SI-' , 7 N.t c)jam �'r it (}L� F L,. J •j._. /.� �./liar•, Tax Parcel - ) - -- - :_ .. 9 Number: 5oI - Property �' Z-- - on' Size: `- , 0 /`a�Site Address and/or Directions to Pro merty: A _ .Site feet) Property Owner s)of Record: •MEIR �t cat)cat)Telephone: / -2 L �' �' ]U [ Fax: -•3 _ � �—��'t Mailing Address: 0"-- I N = 1 p email:©,i-I gr -..t ' t / r — � I./ Applicant/Agent(if different from owner): t t 2Sc� Telephone: / 4001 MailingFax: email: Address: What kind of Permit?(Check each box that applies) Building O Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) Single Famil 0 Conditional Use[C(a),C(d),or C]** .Garage 4, . a- / , ❑ Discretionary"D"or Unnamed Use Classification ID Manufactured ome 0 Special Use(Essential Public Facilities)** ❑Modular ❑ Boundary Line Adjustment ❑Commercial* 0 Short Plat** ❑Change of Use 0 Binding Site Plan** ❑Address 0 Road Approach ❑ Long Plat** ❑Propane 0 Planned Rural Residential Development(PRRD)/Amendments** 0 Allowed"Yes"Use Consistency Analysis D Plat Vacation/Alteration** 0 Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD 0 Shoreline Management Substantial Development❑Temporary Use ) ❑Shoreline Management Variance ** ❑ Comprehensive Plan/UDC/Land Use District Map Amendment 0 Wireless Telecommunication* D Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment *Ma •.uire a Pre-• ..lication Conference **R Please identify any other local,state or federal permits required for this proposal, if known Conference I hereby designat 6 OWNER SIGNATURE ADESIGNATION OF AGENT to act as my agent in matters relating to this application for permit(s). �� _ __ Date: By signing this application form,theattests = his,her or it's knowledge. Any material falsehood o ny omissiont of informationthe material fact made by the vided herein,and 1owne/agent with at is tachments, �andicorrect to the best of may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson Countyagainstrespect to this application packet expenses which may in any way accrue against Jefferson County as a rult of or in consequence of thudgments,egrantinggof thisonable attorneys fees and I further agree to provide access and tight of entry to Jefferson County and its employees,representatives or a permit review and any re uired later ins ors.Access and right of entry to this property shall be requested and shall occur only duri regular business hours. gents for the sole purpose of application Signature: —�� I, .�/ - Date: The action or actions Appti- I will ertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and co d 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 action(s)even if you are in compliance with the Jefferson County development code.The and non-transfe ble responsiac species regarding your ! dherang to d complying with the ESA. The Applicant rhas tread nti is d eainmer that hnd sig nd dates e,she or it holds it below. Signature: 2 Date: G:\Pem,itCenter\FORMS\DRD RMS\Master Permit Application 7-8-04•doc — 1 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: ��L r i' cm--t e:-5- ,A/C (2.5 —3 ) 926- G3.3c� MAILING ADDRESS: /�65 fir= _ ( ) CONTRACTOR'S LICENSE Xfli( Z f; Nt tG EMAIL: r FF c era .9 F(-/2 WAINS NUMBER: 6:.. NUMBER ARCHITECT/ENGINEER: _ MAILING ADDRESS: _ PHONE ( ) FAX:( ) EMAIL Project Type: Frame Type: New Bathrooms: Shoreline: Type -Wood Existing: of Sewage Disposal: Addition ❑ Steel Proposed: El Sewer ❑ ❑ ditiAlteration/Remodel ❑ Concrete Total: Bank CI Community System ❑ Repair ❑ Masonry --�- Height: ❑ Individual System ❑ Demolition ❑ Other: Bedrooms: SEP Permit# �'.5 )_.L Existing: Water Supply: ,14 Type of Heat: Proposed: Setback: Private well ❑ Two Party 5LG c722.c_ Total: El Public /7,2c4� A9 az- Name of System: If this is a Commercial Project ou must answer the followin : Number of Parking Spaces: Current: Number of occupants(includes owners,tenants,employees,etc) Current ed: Number of ADA Parking Spaces: IBC Occupancy: IBC Type of construction: pooposed Will you have F If this is a Pro are Tank and/or A liance Installation ermit mark all items be ow that a rod.Service? Yes / No [1 Underground Tank ❑ Above ground Tank Elne Tank: Heat Stove EllCook Stove ❑ Woodstove ❑ Fireplace InsertSiz o❑P Hot aWater Tank Cl Pellet Stove ❑ Other Is this a liance bein 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. S•uare Foota•e For Office Use Only Current Pro•osed Main Floor Amount „ �' I r I 1 Consistency Review:- 2`' Floor /�(jl'O� ads, 11rd �9b Base fee: 71 4f _t`'l Floor /�— �.`8•_.. ---- 1 5. 35 dditioi '-ec-lon ' ',� , ", �� Mezzanine: Plan Cnc c. ee: Cr�" Heated Basement I 1 L t State Surch-g f , ' Unheated Basement { ' 1- Se Pot Water Reviewi'fee:- ._..----_...__ ___ Other Unheated _ _ 911/Rd'Approach fe : Garage/Carport Decks l `t tP• _ TOTAL: $ A l�J . D3 Receipt Number: 1 65 Other .,,t.,,c -D r_ "s2,a, Cash/Check Number dot ESTIMATED COST(REQUIRED) aapl I • . ' Date: •Fair market value of all labor and materi. _ ,,,of• 5; J C:C�U . • . nitials 0 ` G.\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc ! . .? • PERMIT # BLS I ez JEFFERSON'COUNfYr Mk-t _ 44.4 DEPA j I I J I RTMENT epyMUNI V PMEI# .i, �; I rLu t, r _ j 621 Sheridan Street• Port Townsen • asfii on 98368 A�' 4 r I t j I 360/379-4450 • 360/379-4451 Fax (I I http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL ' TEMPLATE I MLA# Q - l, PROJECT/APPLICANT NAME: E �4 LIA...."--/ `Sc/7 cv;G"/e I Please answer all of the following questions to the best of your ability. Where the question calls for depiction 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. 6.-. 1/„57%f2./c.7 �t `S__g ..2a d 59 f r. Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. /'t2 c P r 2-y h•� i sL.cti. S Loh,E `c,1'-7 '�-Z c P-7 /2.1)f_ A2 w ,Ley -- --,a ' -c.4.-.) , sLo r / -2 60 o T�/2_ .4.f/O✓%`ir2 760 ' �a / f/F'oD ci-.vf G 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. . //4 2>.i- �/4.A-sS%c .d r- ..,w,i/L'-.i,av S')% f=:,?., r/'o0cty Gve-Tfir fz��A-/4vs ti.1-7 cvf w.--4 r=r-fz {,- ,Q,t,0 C',( j.J) e_3z Exs� 4. Describe the existing soils. Indicate soil type on the site map. ,S.09-ti D - -,g01----1. 5. Describethe 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. 792 ��>e-T l ..- 7.,o- c -- SL-/G,iT .��0/e1� o /� --3 o.> T 2 Po c 7- AA /7'Ag Cc_ /77- E.D 'Tti,N __..5"Lo�t c ,S O_j li .3 0 ° -. G _,t��_z> C�.t..,.r9G // .4-XI 4 7da c 6. Describe any excess levels of noise generated by the proposed use or activity: ti,, - APPROVED STORMWATER-PLAN . �I Storrnwate ' ''1 �'I I p AUG 2 5 2005 ii AA, sto ater site plan template—rev.1 W Required I/2003 ' JEFF DEPT.OFC' t IO f OU 1 Y 5 SIGNATtiRE: , DE OPMENT 411 • R, 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. 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.). cj//G J 4,t 1 . 16/ Prfre oti g S,2�'s aG 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. g. 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. ,/3 -,L 70.1 6 s.' i s 10 . /?o/ 6-2-2.4L ,�Xs,,f Fc., ,sii P/2 5tr7 cv, I/ .?L= . Co- Act 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.] 11. Describe the performance goals and standards applicable to the project. A7/A- 12. Describe the flow control system. 1) 1 \-\ A/�g T! A - 42005 o ti ,\ t • • 6 stormwater site plan template—rev.10/1/2003 , i • 13. L,escrine the water quality system. -- — _ _ 1111 ell a HVV -- 4 j;195 1 I r - 14. Describe the conveyance system analysis and design. r 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. • .Self 1-34-1 . amYI 7" P ,L)�/ S / .0 t7 So0 .17r.S 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 17. Describe the proposed surfacing material. 18. Describe methods for restoration of the site. 27/2. 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for large"projects only and only those for which facilities are required to control flow or treat runoff.] If included,list the Manuals here. 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 rmits or aprovals include conditions that affect the drainage plan or contain more restrictive drainage-related requirements describe those conditions or restrictions here. stormwater site plan template—rev.10/1/2003 7 • COW;i'1-WC'IiLrl STORMWAIER POLLi rrrtr TION it-LAN(SWFrw) 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. L.A" r 2. Establish Construction Access. fjr 5/5 7 G 3. Control Flow Rates. 4. Install Sediment Controls. ///' 5. Stabilize Soils. j v SOVI PT/a/ ���.L. c A(A)G4-- f?i 5 PAD/Al-6 6. Protect Slopes. /1"--1. %' -me,/l'Jit/ S' / 7. Protect Drain Inlets. "/ r ^� /or - ti AtfG - 4 25 I A 8 storrnwater site plan template—rev.10/1/2003 • . 12 Required Elements- Construction Sl 4i'PP(continued) ---- 8. Stabilize Channels and Outlets. `1 9. Control Pollutants. J AUG - 4 ^ ; r C/o.vim 4i:1/ • u -6 o,v 5//f 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). /[/o iv i 11. Maintain Best Management Practices(BMPs). ;l/ Pa5:f2v.� M /Y j- 12. Manage the Project. Oc��v�� AV-.vt7 ��(j%! cj d� Cc,i .71, //dts ±/ Ec 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). o/t/C, tis��2�. io o . i i / a✓ /vcic) i=T -A--vD /.f/f.L T2�e i�� o,--v S> 7_. b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). Sf� lR0d✓� 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. s c-->vEiez- /Od0 stormwater site plan template—rev.10/1/2003 9 1 • • _— ______... ... ____ _ __.= b. Description of special requirements for working in or near environmentally sensitive areas. / V /- 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility,settleability,permeability,depth,texture,soil structure). 5. Construction Phasing. a. Construction sequence G'-G,%6z ,e5)-?P-2Q-d y< t.. ?O 'z ,5-9 T/— /2 es=3.6/5%J c7 r oet„) b. Construction phasing(if proposed) C�,vs 7-- --,c— S 1%(2 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction schedule. ,.y-. ( cf-- 5/P i II. Wet Season Construction Activities. a. Proposed wet season construction activities. is f r 1 ;z —.. 1 I b. Proposed wet season construction activities for environmentally se ' e.ar:eas 1 l l� ill AUG - 4 2005 I 1 I) i y 7. FinanciaVOwnership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or lther financial securities. .D, NA / -3-c.,/-/cviE2 b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. /11/� 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 10 stormwater site plan template—rev.10/1/2003 1 • • . 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 is attest that the information provided herein is true made with the full knowledge and consent of d correct to the best of my knowledge. I also certify that this applicationbeing owners of the affected property. (LANDOWNER OR RIZED REPRESENTATIVE SIGNATUR (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: .1iE ` ;I -. Tfi 1 4 h 1.` Lc; 1'I i AUG — 4 20oa I 12 stormwater site plan template—rev.10/12003 -",-n— Oc, l)". ,)t. d LI) 0 s--__ ,- ,__c , ., Fir /os - IV:-./.00 Ai, 2... g I_ )2, 7--../ty.t(p - MIL" ci i , inn N 1 ...... .. ...... .... ... /GG I 0 1 111 t� 1 ' Q1 1 el • �( -rM 1 G l r g _ ` M. � f1 ti - >. (a`\ - 7y Q ` � i ik.w . -a _ _3_ 7z k N , \ N ki 6' > 1. r • 11_ y 1� � 'A. � tU � v vA. g ,.. ____ __- -,. . 4,.„) "1 '4 kk. \N - 1- -..,:ri... gz — 8G i G��OSS i S YM Bot- (4./Drc 417.erS CI — -- Df?,4t 1wA.CE FLU I I P%rt- / a - — /`elVZ. r / _S 7 ._: — _ - ---(71t 76 .2y — '— GOr Sc',a,c�' dated REVISED S7. PLAl�i ncii. coo/ d�5 003 " r Has been APPROVED p I by JEFFERSON ' • k DEPT.OF CO ,i� , // \ i/�' SIGNATURE: -i r 41) 411k 7zi''''' ,:I' 'y — ' , .\(— — rrs r-r1 O rri ccf:,) (.71 = \ __ \ [-.) s , AUG 14 2006,T Y .\CP ItVEI:OPMENT . CT