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HomeMy WebLinkAboutBLD2005-00603i 562 atUILDING PERMIT APPLICATION IeviewTy Type: Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00603 Received Date: 9/16/2005 SITE ADDRESS: HWY 101 SEQUIM, 98382 OWNER: STEVEN V ROSS PHONE: 425-788-6200 DIANE N ROSS 18814 185TH AVE NE WOODINVILLE WA 980778227 EAGLE CREST DEVELOPMENT SUBDIVISION: Block: Lot: 7 PARCEL NUMBER: 948400007 Section: 34 Township: 30 N Range: 02 W CONTRACTOR: TERHUNE CUSTOM HOMES PHONE: (360) 681-8898 PO BOX 3125 SEQUIM WA 98382 Contractor's License TERHUCH984MA Expires 7/1/2006 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW DETACHED GARAGE UNHEATED TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 54,000.00 ADD'L: HEAT TYPE: UH CODE EDITION: 2003 OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: 120 SHORELINE: CONST TYPE: GARAGE: 840 SETBACK: DECK: 32 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 0 Prop: 0 Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $671.75 SLE 09/16/05 76589 APPROVED n R O V/E D Plan Check $436.64 SLE 09/16/05 76589 ,�+� r State Building Code $4.50 SLE 09/16/05 76589 OCT 2 '! 2005 Total: $1,112.89 Jefferson County Planning &Building Department I • 0 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00603 Received Date 09/16/2005 SITE ADDRESS: 240 VIEW RIDGE DR Issue Date 10/24/2005 SEQUIM, 98382 APPLICANT: STEVEN V ROSS PHONE: 425-788-6200 DIANE N ROSS 18814 185TH AVE NE WOODINVILLE WA 980778227 SUBDIVISION: EAGLE CREST DEVELOPMENT Block: Lot: 7+ PARCEL NUMBER: 948400007 Section: 34 Township: 30 N Range: 02 W CONTRACTOR: TERHUNE CUSTOM HOMES PHONE: (360) 681-8898 PO BOX 3125 SEQUIM WA 98382 Contractor's License: TERHUCH984MA Expires: 7/1/2006 PROJECT DESCRIPTION: NEW DETACHED GARAGE UNHEATED CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS:94--- UFFER: Footing: 112-1-D cr— Foundation:9l. /2--1)..,-(0.3"— Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Exr SNiFAR._ OW- 1/2a c6, Sheathin . �/ Framing: �/jl� Plumbing. I/ Propane Tank/ Lines: /A/Ty-6-6/A2k7 Insulation: Sheetrock: Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: fiu' (Ail(n k,f)h(V 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 L SPECIAL CONDITIONS FOR CIE # BLD05-00603 • 1.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 2.) A Stormwater Plan has been submitted and approved by the Department of Community Development. Once the subject permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 3.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 4.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 5.) The building height is not to exceed 35 feet. 6.) There is a 20 foot setback from the edge of the right-of-way of View Ridge Drive, a private road (P474). The side setbacks are 5 feet from the property lines. The rear setback is 25 feet from the property, which is a plat condition. I:\F_BLD_Permit_Buildng.rpt 1 0/29/1 9 • 411, OWNER BUILDER ST The signer of this statement hereby certify that ey are the of the parcel ref ced herein,tha not lice ed contractors and that they will be assumipg the responsibility of the G ral Co or for the proposed p ' d. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALL PHONE: FAX: `1.t2-.r 4‘ ..L-iil.¢., S ►'tb n A-4(3 Y'Y1Q._5 (aCO)OCf--7� (�1o611--1 ,MAILING ADDRESS: O. 6x v1--'( '-emu-- S k n, . 1 , -12.;-70 CONTRACTOR'S LICE 'A , ' Vc 1 U� WAINS T NUMBER: ' y' c \� u - V lr4 NUMBER ARCHITECT/ENGIN J� PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Dispo I: X. New 61 Wood Existing: Li Sewe J Addition r Li Steel Proposed: Bank a Comm nity Syst I Alteration/Remodel LJ Concrete Total: Height: LI Individu Syst 0 Repair 0 Masonry SEP Permit I Demolition ❑ Other. Bedroom Water Suppl Existing: Setback: U Private II a Two Party Type of Heat: Proposed: LI Public T al: Name o ystem: If this is a Commercial Project you must answer the fo Number of Parking Space . Current --- —Prop, ed:_ m er ADA Parking Spaces: Nu t of occupants udes o ;tenants,employe ,etc) C P -rBC Occupancy: IBC Type of roost oi� a Food ce? Yes ! Nn If this is a Pro ank and/or Appliance Installation permit.mark all items below that apply: i Underground Tank I Above ground Tank Size o Pr�ha e Tank: i Heat Stove i Cook Stove i Woodstove i Firep Insert i at_1bf ank i Pellet Stove i Other Is this appliance being installed in a Manufactured I Mo e H ? es No When applying fora 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 Current Proposed Amount Main Floor Consistency Review: —2°D Floor Base fee: t 33 Floor Additional Section: . , Mezzanine: Plan Check fee Heated Basement State Surcharge fee: Unheated Basement Pot Water Review fee: Other Unheated 911/Rd Approach fee: Garage/Carport EL0 TOTAL: $ i Its. Decks�ete4 3Z Receipt Number: OtheraAreAso Cash/Check Number: lea I7-0 ' ESTIMATED COST(REQUIRED) Date: Fair market value of all labor and materials foundation to finish € 51;C/00 — Initials: J ,,,rt ii ,ti C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc • • glier". JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 1/41 621 Sheridan Street•Port Townsend•Washington 98368 360/379-4450. 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: V. S(QDN Project Description(include separate sheets as necessary): Nv Pk Yv1CI C:'-.---ONA \-YQ-C_.•+- O\ 'Ct -C__ 1-/ CiliZiC3/k 6Th(I A C.I ri,e- N-)d PfecL.-f- Tax Parcel u a , Property Number: O (�(�� Size: 2_0.. C(a-csquare feet) Site Address and/or Directions to Property: 1 j , D 1'. JJJ Property Owner(s)of Record: Telephone:H2S — — C07 On Fax: email: Mailing Address: (Fs? i U \ j►'c,.. { . E 1_rL y\U Lli_g_ �l'yn-1 1 Applicant/Agent(if different from owner): • Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) • Building U Variance(Minor,Major or Reasonable Economic Use) LI Demolition Permit U Conditional Use IC(a),C(d),or Cj** U Single Family U Discretionary"D"or Unnamed Use Classification et._ Garage AttachedOetached ' U Special Use(Essential Public Facilities)** U Manufactured Home U Boundary Line Adjustment U Modular U Short Plat•* u Commercial* U Binding Site Plan** Li Change of Use U 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 Li 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 I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: 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 a later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business hours. p� Signature: �_A,,... Date:g—k 1 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 are4n compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfe Jo retponsiij'ity for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date:'> —'v�—US C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc S E P 1 6 2005 MF-P.:i 1 • 4 . \ °1, JE�ERSON COUNTY '-s .A '4 DEPARTMENT OF COMMUNITY DEVELOPMENT - 4, `��� . 621 Sheridan Street•Port Townsend•Washington 98368 1404 360/379-4450•800/831-2678 •360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment Master Land Use Permit Application Form PROPERTY INFORMATION Tax Parcel Number. EIRBODEIDOCil Subdivision Name: C �X Si- .V' Lot Number: Property Size: Z O acres/;:stuare feet) Existing Use of Property:P rty:\j Ct_CC�y\-r Site Address and/or Directions to Property: v t Q-. j Q C Imo— i-3v t rse see ct_-}}chi c\ V%. C k p APPLICANT&OWNER INFORMATION Applicant(if applicable): kreArl t. , r RLl`..�_� L Telephone: �z5-1-22 (62__(,)0 Address: (a ?j'- ( `a L-i-1-1 Q.E. City: L‘30c 1cr)U I. (ACC., State: Lk c . Zip Code: C--A�61-I Email Address Applicant's Signature; Property Owner(s)of Record: - -V'k() Telephone: Address: City: State: Zip Code: Email Address I acknowledge that the applicant above is applying for a building permit on my property. Owner's Signature: I hereby designate to act as my agent in matters relating to this application for permit(s). Agent's Contact Telephone: Address: (PROPERTY OWNER SIGNATURE) (DATE) DESCRIPTION OF PROPOSED USE OR ACTIVITY(include separate sheets as necessary) Cc..-Arv; "Lvc-t-- a_ ac,- i C lf2rf / Lb \v,ti,4 G:-Ee 4, fJ 0 Q�uL:vu.jrvl u c ?-(. C� („Lc/ c e l [THIS SECTION FOR OFFICE USE ONLY] Refer to the specific sections of the UDC referenced below for more information and further requirements.An asterisk(*)indicates that a supplemental application or questionnaire may be required. Type I Permits U ❑ Septic Permit/Evaluation of Existing System(EESto: ❑ Building/Demolition Permit ) UDC Section 6.4.1 and Chapter 8.15 JCC ❑ Allowed"Yes"Use Consistency Analysis UDC Section 3.2.1 and Table 3-1 ❑ Home Business UDC Section 3.2.1 and Table 3-1 Table 3-1 and UDC Section 4.20 ❑ Stormwater Management* ❑ Road Access* UDC Section 6.7 j ❑ Boundary Line Adjustment* UDC Section 6.8 ❑ Minor PRRD Amendments UDC Section 7.2 ❑ Sign Permit* UDC Section 3.6.13.15 ❑ Site Plan Approval Advance Determination(SPAAD) UDC Section 6.15 ❑ Shoreline Master Program Exemption/Permit Revisions UDC Section 8.7 ❑ Temporary Use(based on use may be Type II orT e UDC Section 5 yP Type III)* UDC Sections 4.38 and 4.39 i6 R) MASTER LAND USE PERMIT.DOC REV.11/18/2003 I EVENT Type II Permits • Refer to: ❑ Discretionary"D"or Unnamed Use Classification UDC Sections 3.202.2 and Table 3-1 - ❑ Cottage Industry UDC Section 7.3 and Table 3-1 ❑ Short Plat, Preliminary and Final* UDC Section 7.3 ❑ Binding Site Plan* UDC Section 7.5 ❑ Conditional(Administrative)"C(a)"Use UDC Table 3-1 and Section 8.8 :, ❑ Conditional (Discretionary)"C(d)" Use UDC Table 3-1 and Section 8.8(Discretionary Permit Review Process Determined by Administrator) ❑ Variance, Minor* UDC Section 8.9 ❑ Wireless Telecommunication Ordinance 06-0712-99(UDC Appendix C) ❑ Shoreline Substantial Development(Primary Use) UDC Section 5 ❑ Forest Practices Act/Release of Six-Year Moratorium for Single- UDC Section 4.16.5(c) - • Family Residence ❑ Appeal UDC Section 8.4.2 SEPA 8.10.12(b) Type III Permits ❑ Conditional"C" Use UDC Section 8.8 ❑ Long Plat, Preliminary* UDC Section 7.4 ❑ Planned Rural Residential Development Preliminary Approval UDC Section 3.6.13(must be in conjunction with an (PRRD)and Major Amendments* underlying land division application) ❑ Plat Vacation/Alteration UDC Section 7.1.3(d) ❑ Variance,Major* UDC Section 8.9 O Reasonable Economic Use Variance* UDC Section 3.6.4(h) ❑ Wireless Telecommunication Ordinance 06-0712-99 UDC Appendix C ❑ Shoreline Management Substantial Development,Secondary Use* UDC Section 5 ❑ Shoreline Management Conditional Use* UDC Section 5 ❑ Shoreline Management Variance* UDC Section 5 ❑ Appeal UDC Section 8.4.3 SEPA 8.10.12(c) Type IV Permits ❑ Long Plat, Final UDC Section 7.4 O PRRD, Final UDC Section 3.6.13 Type V Permits ❑ Special Use(Essential Public Facilities) UDC Section 3.3.5 ❑ Jefferson County Comprehensive Plan/UDC/Land Use District Map UDC Section 9 Amendment* O Jefferson County Shoreline Master Program Amendment* UDC Section 5 ❑ Appeal of SEPA. UDC Section 8.10.12(d) Other Local, State or Federal Permits ❑ Please identify any other local,state or federal permits required for this proposal,if known: ACKNOWLEDGEMENTS [PLEASE NOTE THAT TWO SIGNATURES ARE REQUIRED] By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property.Any 1 material falsehood or any omission of a material fact made by the applicant/owner 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. This right of entry shall expire when the County (through the Administrator or the Administrator's representatives)concludes the application has complied with all applicable laws and regulations.Access and right of entry to the applicant's property shall be requested d shall occur only during regular business hours. 1. -;� t .:-,.-. i/ /• —— v —1 c- L S PROPERTY OWNER (DATE) 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 responsibility for adhering to and complying with the ESA. The Applicant has read thisl disclaimer and signs and dates it below. 2. < _ V ,;1 25 — c:: f �—trr� PROPERTY OWNER (DATE) A F. ,s JEFFERSON COUNTY (,r } (� , -- g e . tii .,-4, R I DEPARTMENT OF COMMUNITY DEVELOPMLII(T. r l , t 621 Sheridan Street • Port Townsend • Washington �6360 SEP 2 , 5 " i' 1' 1 l 360/379-4450 • 360/379-4451 Fax Q` httpi/www.co.Jefferson.wa.us/commdevelopment/ L_.__ s •FiAt f 4 ` F~ " i`'J '°"'`' STORMWATER SITE PLAN SUBMI I MLA# O -. r Z PROJECT/APPUJCAM NAME: .------______________ . V-6.N‘i 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. QAC I.Sti rn OCIO rIS 010)A. C1.43 • Existing Conditions Summary See_ SL L_f.`G`.v1 2. Descnbe the existing topography. Indicate contours on t site map. hc' )e_ s l O P�� d ou �C.I (1 40 lAA 1'3 C51V� pre/NAl 1•3. Describe the existing vegetation. Indicate native vegetation areas on the site map. • 4. Describe the existing soils. Indicate soil type the site map. 1_CO Yin Ct +0 z.4''? 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. � th t qof.!� l.�l ' S� d pe , , �..t" U Iik_Qci...LLA4 . ' Ci\. l 6. Describe any excess levels of noise generated by the proposed use or activity: • STORMWATF"R PLAN stormwater site plan template—rev.1(L7l200.3 u eT 1 `--5 I'i JEFFERSON COUNTY DEPT OF COMMUNITY DEVELOPMENT SIGNATURE • 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. IV CW1.9--. 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 a6d 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. l ._ Ls--L 8 - S &) o cAevsL cS1-112LCV2 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 conta inants j... _.__ _ • Otr b;...,L; It. C;;::!..; 11. Describe the performance goals and standards applicable to the project. caivstrckeilcAk, 12. Describe the flow control system. -A-1-61-*6 ckzukbr\-. ...Thc.-v.A d_hAzyji-el.AL stormwater site plan template—rev.10/1/2003 6 13. Describe the water quality system. 1 11111111111111 14. Describe the conveyance system analysis and design. r DEPT or or) ,; r }' 111111 • 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. , ': " i , 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. CN1 1 ' • 17. Describe the proposed surfacing material. 18. Describe methods for restoration of the site. 3 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. 1 r (A- 21. List other necessary permits and approvals as required by other regulatory agencies. If those rmits or aprols include conditions that affect the drainage plan or contain more restrictive drainage-related requirements describe th se condifio s or restrictions here. 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 wilt 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. esikcols a Pcm-over. _ - 14r.., 2. Establish Construction Access. P-AC-11)r\n . 3. Control Flow Rates. 4. Install Sediment C6ntrols. E3 )*X1t w CN\ P .4c5N, l 5. Stabilize Soils. Sa.arvQ / 6. Protect Slopes. (--L— oc . 7. Protect Drain Inlets. ?Jl t 4 SEP 1 L _.. jl DI t 1. t t • . t. �t t :l r stormwater site plan template—rev.10/1l2003 8 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. • 9. Control Pollutants. i I SEP 1 6 2005 1,i 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Manageq'ent Practices(BMPs). air4)-a_ OVA_ 1.5.eu CJv rct 11') C/V\ 9Z� , Yc-, 1 12. Manage the Project. GA nuL.p.e)>i v\ 0 - 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). 1•3 la- b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). � l�4 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. IV A- storrnwater site plan template—rev.10/12003 9 b. Description of special requirements for working in or near environmentally sensitive areas. 4. Erosion Problem Areas. Description of potential erosion problems on sit in-the context of the characteristics of the on-site soils(e.g.,erodibility,settleability,permeability,depth,texture,soil structure)4 ""— - -- i �1._ , / j::? SEP 76- IBrJ 5. Construction Phasing. a. Construction sequence QACCIA,krialthiAA 1 CA/I o "cr_20,A4-. 1 .- b. Construction phasing(if proposed) rf Pr 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction schedule,`�`S� rn[j� �b�O A' NOV • �} II. Wet Season Construction Activities. a. Proposed wet season construc ctivities. " CJI.A.sI. 2Q (\A9.\r\ lc: C�1(-1C... b. Proposed wet season construction activities for environmentally sensitive areas. N /Pr 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. I ass b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. N /l- 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable. a. Sediment Ponds/Traps. b. Diversions. 1 .. l A. c. Waterways. d. Runoff/Stormwater Detention Calculations 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 aft owners of the affected property. • , ! V -QS (LAN NER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED: l ', SEP LL' • 12 stormwater site plan template—rev.10/1/2003 om 7" Q . o/ (..., 4 b _ � a' rr1 286. 60' NO2 23'57"E a rt 25' BUFFER '. - � baC1 ditip. 0 i con O • a - sr ' - n rs. _ H 1 • d \r • ,4- 41':— A, ,s, 1 : .< 6 "o o 9 ��vFsF _ •co zm '�.\--I \ EA(J CA ( J. \ �I f2 w Cp. I . (A „, G., ....... J / ` E co 196-6 +— Tt 0 r z / � vO 13 \ m ''' CO zi moo ---t D cn 0xi CO 0Km n \ -< m Cr! m o x - -P • ,I 'i \ _ rn a W — \ Ul r� / X , _ COa 109'+- , -I II x z GJ: m o cN xi m m 1 D r VIEW RIDGE DRIVE/ I \ 30' ROAD EASEMENT / N I / -, 31 \-.. --- I / rM* m is'ODtf)n U) mz t / z , in o4 cn pi-it mR'�I - -i_aa -D �8Zo omDo D(- �� ' zxo z K N N M • là ----:,-:,-—-7-: om © •io -n N.) Milir t- T z til _ __ ___ ._ • 1,_ 4 Z , jj mil • F.,,,„_, 1 0