HomeMy WebLinkAboutBLD2005-00563 •
BUILDING PERMIT 4Iq05
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00563 Received Date 08/29/2005
SITE ADDRESS: 1228 E LUDLOW RIDGE RD Issue Date 01/24/2006
PORT LUDLOW, 98365
APPLICANT: LANDER CUSTOM DESIGNED HOME PHONE: (360) 437-2501
PO BOX 65437
PORT LUDLOW WA 98365
SUBDIVISION: Block: Lot: 3
PARCEL NUMBER: 821104009 Section: 10 Township: 28 N Range: 01 E
CONTRACTOR: LANDER CUSTOM DESIGNED HOMES PHONE: (360)437-2501
PO BOX 65437
PORT LUDLOW WA 98365
Contractor's License: LANDECD022JT Expires: 3/25/2006
PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE
ALSO A/G 120 GAL PROPANE TANK
CALL IN FOR THE REQUIRED,I EC��T.J� 1S THAT APPLY TO YOUR PROJECT.
SETBACKS: Ok Zj/ 46
UFFER: Alp
Footing: &PIME72E2- 42177uV6 buc.yOK ,z-v/ooW lArror.,ae.OK Ark 3/2b/"
Foundation: CA `E LJK 3/0/aG ;IR •Faoro r er & fi�acesE D1k 3/s6/a�L�
Stormwater FINAL Approval:
Underground Plumbing: ()k 3/2-13/01 /V
Underground Insulation: O/ 3 iB aCfr
Shear Wall : dk q/,g/o
Sheathing: j
Framing: O /R dG y
/� (�2E1�.,aC'6 L NtMu�•� L,CE�4K.t►�viFs /;1C MC
G'7
Plumbing:7' � (N I" 1.//b' L4 p-
Propane Tan /Lines: fi /1J1 OTC-040/04WInsulation: pi SE)1 6/L 9/WOL �iJAi`S a°� Ottfr
Sheetrock: /b//L/p6a�
Septic Sytem Final f�pprrovaV(If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: �/��ar �,„�,) (��g; ACCESS -ri, ("l ECK S�Pli2eh- Na , uq�iGl '/3//7
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION rr
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
I
IPUILDING PERMIT APPLICA1N MLA05-00527
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00563 Received Date: 8/29/2005
SITE ADDRESS: E LUDLOW RIDGE RD
PORT LUDLOW, 98365
OWNER: HENRY K NELSON TRUSTEE PHONE: (707) 953-0532
MARGARET J NELSON TRUSTEE
PO BOX 38
UKIAH CA 9582-0038
SUBDIVISION: Block: Lot: 3
PARCEL NUMBER: 821104009 Section: 10 Township: 28 N Range: 01 E
CONTRACTOR: LANDER CUSTOM DESIGNED HOMES PHONE: (360)437-2501
PO BOX 65437
PORT LUDLOW WA 98365
Contractor's License LANDECD022JT Expires 03/25/2006
REPRESENTATIVE: LANDER CUSTOM DESIGNED HOME PHONE: (360)437-2501
PO BOX 65437
PORT LUDLOW WA 98365
PROJECT DESCRIPTION NEW SFR W/ATTACHED GARAGE
ALSO A/G 120 GAL PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 2,530
VALUATION 500,000.00 ADD'L: HEAT TYPE: HTP
CODE EDITION: 2003 HEAT BASE: 996 HEAT TYPE: PRO
OCCUPANCY: R-3 UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 880 SHORELINE:
CONST TYPE: DECK: 350 SETBACK: 75
BANK HEIGHT: 200
SEWAGE DISPOSAL: CON
WATER SYSTEM: TALA PT
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 3 Prop: 3
Total: 3 Total: 3
Routing Date:
10c)6z2:
Type Amount Paid By: Date: Receipt: .Bp 511 5 -F r
Permit $3,233.75 KAS 08/29/05 76493 if._7(L_7 rL�l �1//
Plan Check $2,101.94 KAS 08/29/05 76493
State Building Code $4.50 KAS 08/29/05 76493 JAIL 206
Potable Water Application $53.00 KAS 08/29/05 76493 Jefferson County Plannirw
Total: $5,393.19 &Building Department
B8/17/2005 88:32 360379445.... •5 r�-
JEFF CO DCD HACIE 113I114
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DEPAICI MENT OFCOM UNITY lA'' I 821 Sheridan street-Port Townsend +w:'r groc4ntla5
, . r AUG 1 5 2005
.24 ... 3600379.4493- 360137g-4451 Fax
Wrww.tb.letferson.wa_usfcamnc4evdopmertt
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• . Master Permit Application MLA:~ `��tnfi. , r
Ptvjectr DesalPeo n[ndu to separate sheets am necessary): •
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Number: Z/ I 0 41DC] `? Property- szz .3. 2 4 1-c °.lc: (etxrearsquara*set)
( Site Address autdlor Deoctlons to Property: TY L 1k I'o t 1 :5, 1 1 +-N�"S,.r`' Lima Co L....., Aria Ci 47:
??MINIMs owner(*)art Racank t r C.ra r-y r Ait+4.25 ev2..ir 1' 1- r::L..,. 0/.4.__. . R ` (,-i.:(5,�1.a'�r
• j Telephone:. el0q) ''t'(Q 3`- O to3 Fax anion? •A.A.4`JEM0.t 1{d b►ok�,t,�,r 1•FtTsur•
Ma
• • Wiling A ldiess: ''31 Cr - . to o to 4 A V e t Qa toJ' LCA 9 S t '9S 2,
ApptioanUAgent(If different*om owner): _(-).t'rr fig- c..w..t.i'!°r••r ,PC--,t f 5 P-re:. h 0✓t,f .S '
Telephone: :3 2 .9 3 7- ...r-G' 1 Fwc Tis D -_112, 7 ,.? t o " emery:LA P-14W egc;7-.CiLti yz1.0,T e
_Winne Address: .C10,c- A..S"+t �? "1 Pr t..oilrny-) fies.:1'Cs- _ -
What kind of Permit?(Chock each box lhat applies)
n Building U Valiance(Minor.Major or Reasonable Economic Use)
U Demolition Ponent U OoncitOonel Us.1C(a).C(d).or al" .
1s4r Fart* . U DIseretlonary'Or or Unnamed Use Classilicatoml
Garage�'Altacdred:/ red u Spend Use(Ea Public Fealties)"'
• _ Cl Monwfa .are"3fiame n Boundary Line Adjustment
O Modular rt Short Plat"
0 Commercial- • n Binding Site Plan"
d Address_ USA0 Road Ayprosartl C Paned Rural Residential Development(PRRofAm ndrnends"'
Propane 0 Plat Va ..
. Q Nlowod'Yes Use Consistency Anatole 17 Shoreline Meter Program E Cn Permd Revisions"
• u Siamrwoec Management U Shoreline Management Substar�rat Development"
U Site Plan Approval Advance Determinablen(SPAADI)• • fl Shamans Management Variance
I ❑Temporary Use Cl(barprehenslve Pta n/UDCLLand Use Minot Map Amenchneett
u Melee.Teleoonenunleatfon• Cl Jefferson County Shoreline Meister Program Amendment
El Forest Praclic ae Actrftelo a of Eris-veer Moratorium
`WAY NV**a Poe-Appf¢iwn CaArerwnce '"Requlrvs a Pre-Appetinfoor conference
PMaaee identify any other local,state orfsinral permits required for this proposal,if known:
1
ESIGNlkfl0N of MEM'
i hereby designate L t $2 I G load as my agent in matters rotating to this application for pormit(e). •
Owri�StraraaTtJat=\ � k_;it, ,� . ' 1 -. , ,Nr v Date: / -s1 1 .,
ai Waning this appa®ton form,Ito &teats that the infornnottgn*evicted herein,and In any*llitehmentt,Is hue and cormet 10 the heel of
Iris,trey or We ka soiOdgs. Any matllrtWW tebbhood or any omission eta maferlalI tat*mode by bo a+rnsrl.gant wnh taap.ot 10*is application°adtnt
may/soot b flint*penult being null arKPOrt.
1 farther agree to save.Moronity and hold twunlee*Jvttertan County epaulet at 14asttties.judo menu,wort costs.rraamnabla attorneys fees and
expenses etllrlh may In 9nynay roomer against Jefferson County as a rsautt shy to consequence of the CettOthfi DI this peanit
' I further agree le pre'iide access and right of entry to Jegge on Cot.my and its employees.reprintaSrres or agents for tie raise purpose of application
review and aytieQried Inlet inspection b W.Arreaa sad rlphtof eney e on oetty shall be requested end shall occur only luting regular business
hours. 11 t(\ '-`•`
SOStuco \i -wV N.AJ' "� ---� '�. .. '. oa►= 8 Z-.- -- O I
The an ion or notion*Am will as a re stAt of Mho rosuarnoe Wags scar*may ne0sfnie1y impact capon one or more t et*tenad nr
• wneoupared,;Peeles�end could ;b a polanliar lake of an endeidered species as N th
those rem**redefined In e wane raw lower as the
lagianoeted Spec**.Act"or"ESA.'Jelter*on C:aarrts[lames no aosur ncee to tore appnGint that the actions drat vue be undertaken because ihta
•
paned has been bored wit rook violate the E-StA. Any individual,gaup or agent can the a leuruiit on baba of an endangered sped as regarding your
*pe(s)even>t you are I oomppprwo,.fth the JeHeas n County deuntopnrant eDde The MoUcerd sclnoviredges tnet he,oho or it hot&lottMduot
and ,aaporr>;It>ti a tium/4 i to and lying vAI%me ESA The Applicant has rsad this lane end:glna and dales It tome-
• . t` Date_ s 2 ? O�
Signature.. .w v j _ ,...-
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OWNER BUILDER STATEMENT r
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ihe Signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they ate no4h se.3 c5ntr and?`tfiat/,
they Milli be assuming the responsibility of the Owlet-al Contractor for the proposed project, '
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Signature:_ -- Date:
GENERAL CONTRACrOR OR MANU°ACTURED HOME INSTALLER: PHONE: Fax:
_c.-r, ,,,r CO3,.,S\-one\ 1�e,s i c h_ P 1 l r»S (3loo)L13 7, ast)) ( 3 t.o) 4 31-Q o;-
MAILING ADDRESS: f/��r rt `1 q A `
��� ��X T./J t1,I.i�O(- 1 O-W-Iw 1 K EMAIL: `G.n AO,f^. 0 k.ky12 11. C.-i'!+-N,
CONTRACTOR'S LICENSE 9.334AINS
FNUMBER: \..PtN0 C. 0a. ._31- NUMBER
ARCHITECTIENGINELR: PHONE ( ) y Z Ax:( )
1C.0✓IL pa.-r', c k A i-6\4ec. --S
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MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New
f1 Addition
)5. Wood Existing: U Sewer
El Steel Proposed: Bank u Community System
f', Alteration/Remodel n Concrete Total: Height: Individual System // "1
/
7 Repair rl Masonry ,zn(') SEP Permit#_93- t)�o `I'i t
0 Demolition n Other: Bedrooms: Water Supply: F
Existing: Setback: Cl Private well U Two Party
Type of Heat: Proposed: _3 Public
Total: r._:.
f1 :-IN I- _�1.:1.-:r. ` - Name of System: A;..) /
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,employeos,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:
El Underground Tank U Above ground Tank Size of Propane Tank: ,
u Heat Stove fl Cook Stove Li Woodstove U Fireplace Insert u Hot Tank Li Pellet Stove U Other_
Is this appliance being installed in a Manufactured I Mobile Home? Yes No
When applying for a permit to install a propane tank you must also subm- 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,
L including the reserve area. _
S uare Foo...e For Office Use Only
Current Proposed Amount
Main Floor ( Consistency Review: j 0
2141'Floor Base fee: % c)
3 FFloor Additional Section:
Mezzanine: Plan Check fee: ) 0 ' CiI 1
Heated Basement • tate surcharge fee:
Unheated Basement ` Pot Water Review fee: -C r, f.
Other Unheated 4 /Rd Approach fee: 4 __.
Garage/Carport TOTAL: $
Decks t �, Receipt Number: 1(04(13
Other - Cash/check Number:
E-turIMATED COST(REQUIRED) __-. . Date:
c:r rrwrkct va/uv of all labor and roateri�alc frvrn tion to finish
LJ �, C� 1
J 6 .40 g Initials: C (L 1
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G:\PGt,ita-ntcr\FORMS\L)HD FORMS\Master Permit Application 7-8 04-doc
SPECIAL CONDITIONS FOR CIE A BLD05-00563 •
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.) A Geotechnical Report prepared by Alkai consultants, LLC dated December 9, 2005 was
submitted in conjunction with this application. The report addressed the stability of the
geologic hazard area. The proposed building location is approximately 200 feet from the
top of slope. The septic drainfield is located upgradient near East Ludlow Ridge Road and
is designed with a pump system. A minimum of 30 feet from top of bank shall remain in a
natural vegetative buffer.
3.) 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.
4.) 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."
5.) All construction activities shall not encroach upon the landslide hazard area buffer. This
includes the storage or preparation of materials.
6.) 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.
7.) 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.
8.) 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.
9.) The applicant shall fully adhere to all conditions and requirements of the eagle habitat
management plan.
10.) 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.
11.) 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.
12.) MANDATORY MEASURES IPR 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.
13.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
14.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater,
erosion and sediment during construction. BMPs shall address permanent measures to
stabilize soil exposed during construction, and in the design and operation of stormwater
and drainage control systems.
15.) A 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.
16.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
17.) Not more than two (2) unlicensed or inoperable vehicles shall be stored on any lot less
than one-half acre unless totally screened from view of neighboring dwellings and
rights-of-way. Such screening shall meet all applicable performance and development
standards specific to the district in which the storage is kept, and shall be in keeping with
the character of the area. Screening shall meet the requirements of Unified Development
Code (UDC) Section 6. Outdoor storage of thirteen (13) or more unlicensed or inoperable
vehicles is prohibited except in those districts where specified as an automobile wrecking
yard or junk (or salvage) yard and allowed as a Permitted Use in Table 3-1 of the UDC,
and such storage shall meet the requirements of UDC Section 4.10. In no case, shall any
such unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area
(ESA).
18.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
19.) The building height is not to exceed 35 feet.
20.) 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.
21.) 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.
22.) Minimum setback from East Ludlow Ridge Road right-of-way shall be 20 feet. Minimum
side yard setbacks shall be 5 feet. Per geotechnical reported dated December 9, 2005
prepared by Alkai Consultants, LLC the proposed buidling location is approximately 200
feet from the top of slope.
23.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
24.) The stormwater disposal tightline shall be aminimum of 6-inches in diameter and located
behing the Ordinary High Water Mark.
25.) The stormwater tightline shall be placed toward the north side of the site away from the
ara that has appeared to have retreated. The tightline shall be inspected periodically for
potential damage from trees, etc. and repaired accordingly.
I:\F_BLD_Perm it_Bu ildng.rpt 10/29/1999
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`'�� JEFFERSON COUNTY l`; r ' i -`' �E it
V
DEPARTMENT OF COMMUNITY DEVELOPMEN . ) �
AUG 2 9 2005 J
j. .. . 621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax --
�` http://www.co.jefferson.wa.us/commdevelopment/ 1 j .
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# Or.-)-- J{
PROJECT/APPLICANT NAME: 1 irelr\,T i k `'YVAir�,„gypt Ni PASO YTh
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.
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Existing Conditions Summary O r 6
2. Describe the existing topography. Indicate contours on the site map. O
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3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
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4. Describe the existing soils. Indicate soil type on the site map.
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Ad 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.
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APPROVED
6. Describe any excess levels of noise generated by the proposed use or activity:
N / A STORMWATER PLAN
- 4 2006
Stormwat- gis
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SIGNATU E:
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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.
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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.
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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.]
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11. Describe the performance goals and standards applicable to the project.
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12. Describe the flow control system.
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stormwater site plan template—rev.10/1/2003
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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 deposition of excess material.
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16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
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17. Describe the proposed surfacing material.
18. Describe methods for restoration of the site.
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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 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.
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stormwater site plan template—rev.10/1/2003
7
CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP)
The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the
template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for
preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater
Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential
development.
SECTION I—CONSTRUCTION SWPPP NARRATIVE
1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or
will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable
to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual(beginning on page
2-15).
12 Required Elements—Construction SWPPP
1. Mark Clearing Limits. •
7 q _ <4 ,a. I 2. Establish Construction Access.
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3. Control Flow Rates.
4. Install Sed 46 iment Controls.
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5. Stabilize Soils.
6. Protect Slopes.
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7. Protect Drain Inlets. _ f
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8
stormwater site plan template—rev.10/1/2003
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
9. Control Pollutants.
10. Control De-Watering(the act of pumping grou
ndwater
dwater or stormwater� away from an active construction site).
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11. Maintain Best Management Practices(BMPs).
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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).
yet\
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards). �` }
c
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
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stormwater site plan template—rev.10/1/2003 9
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.,erodibility,settleability,permeability,depth,texture,soil structure).
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5. Construction Phasing. 111
a. Construction sequence
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b. Construction phasing(if proposed) t �,(�
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6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a proposed construction schedule. ,
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II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
,
b. Proposed wst.s9ason construction activities for environmentally sensitive areas.
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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.
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8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable.
a. Sediment Ponds/Traps. k
b. Diversions. � € 'r _.._.
c. Waterways. t l I` 1 , F L.
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d. Runoff/Stormwater Detention Calculations H l ! 1 O
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stormwater site plan template—rev.10✓1/2003 10
Stormwater Site Plan Changes
If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be
submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised
drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change.
Final Corrected Plan Submittal
If the project included construction of conveyance systems,treatment facilities,flow control facilities, or structural source control BMPs
(not standard on-site stormwater management BMPs), the applicant shall submit a final corrected plan ("as-builts")when the project is
completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as
constructed.
APPLICANT SIGNATURE
By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and
correct 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.
---
/ /"/G �. i iv= (: 1,
(LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
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12
stormwater site plan template—rev.10/1/2003
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