HomeMy WebLinkAboutBLD2005-00655 ILDING PERMIT APPLICAAN MLA05-00609
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00655 Received Date: 10/12/2005
I SITE ADDRESS: 293 BOARDWALK AVE
PORT TOWNSEND, 98368
OWNER: ROGER R DELMAR PHONE: 425-888-8534
DIANE DELMAR
7815 MOON VALLEY RD SE
NORTH BEND WA 98045 FULTZ SHORT PLAT
SUBDIVISION: Block: Lot: 2+
PARCEL NUMBER: 001342002 Section: 34 Township: 30 N Range: 01 W
CONTRACTOR: ARMSTRONG CONSTRUCTION CO INC PHONE: (253) 833-3355
2715 AUBURN WAY N
AUBURN WA 98002
Contractor's License ARMSTC*373N0 Expires 4/29/2007
REPRESENTATIVE: SHAWN SQUIER PHONE: 253-833-3355
2715 AUBURN WAY N
AUBURN WA 98002
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PROJECT DESCRIPTIOr NEW SFR W/ATTACHED CARPORT/SHOP& A/G PROPANE TANK
0
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION 150,000.00 MAIN: 1,599
CODE EDITION: 2003 ADD'L: HEAT TYPE: RAD
OCCUPANCY: R_3 HEAT BASE: HEAT TYPE: (Un(Nr+�
OCCUPANCY: UNHEATED: #OF STORIES: 1 1'
CONST TYPE: 5N OTHER: 242
GARAGE: 462 SHORELINE:
CONST TYPE: DECK: 137 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 2
Total: 3 Total: 2
Routing Date:
14,\a){ - 191)
Type Amount Paid Bv: Date: Receipt: A PPR it : E tD
Potable Water Application $53.00 SLE 10/11/05 77125
State Building Code $4.50 SLE 10/11/05 77125 NOV - 4 2005
Plan Check $827.94 SLE 10/11/05 77125
Permit $1,273.75 SLE 10/11/05 77125j:ferson Courtly Planning
Building Department
Total: $2,159.19
. BUILDING PERMIT el
Jeffe Coupm
621rson Sheridannty De Streetart, Portentof TownsendCommunity, WA 98368 Development
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00655 Received Date 10/11/2005
SITE ADDRESS: 293 BOARDWALK AVE Issue Date 11/4/2005
PORT TOWNSEND, 98368
APPLICANT: ROGER R DELMAR PHONE: 425-888-8534
DIANE DELMAR
7815 MOON VALLEY RD SE
NORTH BEND WA 98045
SUBDIVISION: FULTZ SHORT PLAT Block: Lot: 2+
PARCEL NUMBER: 001342002 Section: 34 Township: 30 N Range: 01 W
CONTRACTOR: ARMSTRONG CONSTRUCTION CO INC PHONE: (253) 833-3355
2715 AUBURN WAY N
AUBURN WA 98002
Contractor's License: ARMSTC`373N0 Expires: 4/29/2007
PROJECT DESCRIPTION: NEW SFR W/ATTACHED CARPORT/SHOP& A/G 500 GAL
PROPANE TANK
CALL IN FOR THE F QUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: /ylv r ,-,4, / -0-t)
UFFER: /•�d.,7 -06
Footing: . /_d, 7 -
Foundation z13JQ(o W'�: 0
Stormwater INAL Approval: / G
Underground Plumbing: Al&f - r7 O6
Underground Insulation:
Shear Wall :
Sheathing:Framing:chuorCF o,c.-A()C.) 6,ANc1/04A )aS oK ulco,a' 2/z1 b Q-Y'�G�6
Plumbing: WWTC-11-Ski dA- /12 9t- /a/vL /
Propane Tank/Lines: 4.4N,5 5/7/�
Insulation: Mict,t ir 4i-7eifeSheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval. ?2Q.fXo
HEALTH DEPARTMENT ND 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 2.4 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
! ... . .
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, _ - °< JEFFERSON COU __
W i \ti �,a DEPARTMENT OF C NI _
621 Sheridan Street•
360/379-4450 • 360/ 51 Fax
1, 4,0 www.co.jefferson.wa.I c mdOjopip 1t 5 t I
Master Permit Application ---.--_�_,______ ,' MLA: O 3- (D O°.
Project Description(include separate sheets as rjecessary):
N c.,.,) con�t-rura,svt - s;ni t t -FC '11 --r e. i .c... ,AyArri CcRQoirrISAor
Tax Parcel C)Q I 3 y Z Do Property
Number: 2" Size: 2 . ci I ( square feet)
Site Address and/or Directions to Property: 293 Qoa.rdu.Ju.,t L. Ave.
Property Owner(s)of Record: Roq c.r' • C)I .L, 13e 1 rvt o-f-
Telephone:042,5) 8$8- 8S34 &Gr.C3(.,„...) Dig- 1482_ email: rr^de-I awl'c Comcw4,nct-
Mailing Address: 7 R is Illi„el Valley led. S E Nor'Wt pull_ L A. 9 f;o 4S'
Applicant/Agent(if different from owner): h a.w r1 ..S t,a,a tr-
Telephone: (Z53) $3 -33sS Fax: (251) 3 I._CP`-t?1 email: E.hci ,i c arrnt{ a_F�oo�cf,.
Mailing Address: 2/15 Au n W ►4u
iy• N. loorn r c,c,)a• g8boZ, �,DA"
Wt1at kind of Permit?(Check each box that applies)
h(building U Variance(Minor, Major or Reasonable Economic Use)
U Demolition Permit U Conditional Use[C(a),C(d),or C]**
i!! Single Family U Discretionary'D'or Unnamed Use Classification
U Garage Attached I Detached U Special Use(Essential Public Facilities)**
U Manufactured Home U Boundary Line Adjustment
U Modular U Short Plat**
U Commercial* U Binding Site Plan**
U Change of Use U Long Plat**
❑ Address I Road Approach ❑ 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**
I/Site Plan Approval Advance Determination(SPAAD)* U Shoreline Management Variance
U Temporary Use U Comprehensive Plan/UDC/Land Use District Map Amendment
U Wireless Telecommunication* U Jefferson County Shoreline Master Program Amendment
U Forest Practices Act/Release of Six-Year Moratorium
*May require a Pre—Application Conference **Requires a Pre-Application Conference
Please identify any other local, state or federal permits required for this proposal,if known:
DESIGNATION OF AGENT
I hereby designate S to act as my agent in matters relating to t is application for permit(s).
OW .,/' 1�NER SIGNATURE i ( (C- Date: 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 required later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours.
Signature: — rn " _ Date: c9 /.
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 this disclaimer and signs and dates it below.
Signature: �- '�, U Date: / /.-—e=:.S
C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc
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OWNER BUILDER STATEMENT
The signer of this statement does hereby rtify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be a suming the responsibility the General Contractor for the proposed project. .
Signatur • NL c: .---- Date: _ "C, 1 e, ,-----
i cif L'— n
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTAI I FR: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE f f-rhs-rrvnJ. Cc,,7,st-,-,.(_71 - WAINS
NUMBER: tetArrl STC. *.3 73 rl/o S-7-o6. NUMBER
ARCHITECT6NGINE (ttS t�l 11 n i PHONE (23 ) FAX: S
MAILING ADDRESS: ncGr� U1�1-94�1y (2�3 k{-it _of 3
a90 I S, L{o^_ S} -Th,�o EMAIL
clh4ocl
Project Type: Fr9me Type: Bathrooms: Shoreline: T
►l New Wood Existing: -Or' of Sewage Disposal:
I Sewer
J Addition U Steel Proposed: 2,. Bank 11 Community System
J Alteration/Remodel U Concrete Total: Z. Height: Individual System
J Repair U Masonry SEP Permit# 5 EPOS-Ooo91
J Demolition U Other: Bedrooms: Water Supply:
Existing: Setback: f_1 Private well U Two Party*. Type of Heat: Proposed: 3
Ra.d.i aunt - Total: 3 �Q Public
Name of System: Pit'
S n f I ex,,- Hz:,,-w,,,,Yc(-
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: WII you have Food Service? Yes / No
if this Is a Propane Tar k and/or Appliance Installation permit mark all Items below that apply:
i Underground Tapk `i Above ground Tank Size Propane Tank -- TOO J CA .
i Heat Stove VCook Stove i Woodstove i Fireplace Insert u'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 For Office Use Only
Current Proposed Amount
Main Floor tJ Q-� Consistency Review: /,
2—Floor 159q lo�1/�()� 1 "r LI cl. VD
a- Ba CSC [ i E � as .73. 3
3fd Floor Addlt Section:
-0`
Mezzanine: Pl i Ch �k fe"CT 1 1 2005 i,.1j ' G a
Heated Basement -0� d-1
�! State Surhargefi -ee ------- i
Unheated Basement Pot.Water.Raviewfec. p���7���
Other Unheated �' T o / • b0
SholO 24 2- C�n 911/Rd Approach fee: // ff
Garage/Carport r /� A(57 l''1
Decks 4-1 Co lo)(68 i..5- TOTAL: $ ML1d , I
(Pa-as) ti O /LID so Receipt Number: '/ 7 1 .
Other ec 1 Porc�1 aaVaaqCash/Chk Number:
LIo84 ESTIMATED COST(REQUIRED) Date:
•Fair market value of alLlabor and materials foundation to finish ii6II I 05
L5c 100 o I aLlaoS, Initials: J
—. ----
C:\Documents and Settings\mochil\Desktop\Master Permit Application 7$04.doc
SPECIAL CONDITIONS FOR CASE A BLD05-00655
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.) 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.
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.) 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.
14.) 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.
• •
15.) Minimum setback from Boardwalk Avenue right-of-way shall be 20 feet. Per recorded
plat, a 13 foot wide open space tract has been dedicated and no permanent structures
except for a fence may be erected within the open space. If an ESA is present, then the
more stricter setback(s) shall apply.
16.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
17.) The open space graphically portrayed on the face of the recorded short plat is hereby
dedicated and set aside as open space for the use and benefit of the lot owners within
said subdivision. The open space area on each individual lot is for the exclusive use and
benefit of the owner of that lot. Maintenance and operation of the open space area on
each individual lot shall be the responsibility of the owner of that lot.
18.) Per recorded plat, a drainfield easement has been identified on Lot 2 for the benefit of Lot
1 together with a 15 foot wide underground effluent transport line. These easements may
be canceled only with the approval of the Jefferson County Environmental Health
Department.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
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ON c i I J rci
�� JEFFERSON COUNTY {{ ,
ti DEPARTMENT OF COMMUNITY DEVELOPMENT OCT .2005 j
621 Sheridan Street• Port Townsend•Washington 98368
360/379-4450.360/379-4451 Fax
http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
C)
c)C1 Pf20JECT/APPLICANT NAME: &inl et/-
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. D✓G/' a a c — /)a.77 'C_ ✓f..f,'t-.i ;ti not be de../fc-i•cfC
N cw Cons fn c_c-?-2,ri-) Sl - s ri� it bee.,
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Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
/i�hr" /orac. -
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.
scz.,-�� /v�r„ `moo /tea-•��, .S � o ,--erc..)
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.
j
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6. Describe any excess levels of noise generated by the proposed use or activity:
'lL APPROVED
STORMWATER PLAN
stormwater site plan template.doe-rev.10112 2003 Stormwat@( g ^`P OCT 2 3 2005 5
Required
JEFFERSON/ UNT
DEPT.OF T DE EL Ti
SIGNATURE:
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7. Describe significant geographic features and critical areas (i.e., environmentally i itive areas such as wetlands ktt4 ms,
steep slopes,etc.)on the site. Indicate location on the site map. I E
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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.).
t9,2)-S/9e- 71-C- — Mgr
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., r BMP T5.30
in the Manual)or, if not, what types of stormwater flow control will be utilized for the site or specific threshold di harge areas
within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities.
SP/ash b/oc dorvr��patfs3
t1J w zt— / c u f�_eC .
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.
/4
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12. Describe the flow control system.
stoi mvater site plan template.dac-rev.10/12/2003 6
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11 1,
13. Describe the water quality system. Y E f
OCT 112005 JJ
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14. Describe the conveyance system analysis and design.
M44
15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material.
C a-44 a# /-4-tit/ i n l, - J toa r1Ge.+7 ry "Cell UtG4J eery
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
A/19
17. Describe the proposed surfacing material.
Se-c- 1° /5-
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. q
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a.nn.rer site plan tereplete.doc—rev.10/12/2003 7
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CONSTRUCTION STORM WATER POLLUTION PREVENTION PLAN(SWP€T 1 1 2005 I
The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applica 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.
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2. Establish Construction Access. ✓ r
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3. Control Flow Rates.
by /7& '- — -.
4. Install Sediment Controls.
5. Stabilize Soils.
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COL.)�� �5a� /.t c s c ctLc�
6. Protect Slopes.
Cc ✓G,r SiSo I S 61,S /?t
7. Protect Drain Inlets.
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storTnwater site plan template.inc—rev.10/12/2003
12 Required Elements-Construction SWPPP(continued)
Ei�� ' t 6V.
8. Stabilize Channels and Outlets. OCTlr4 1 1 2005 I f,''
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9. Control Pollutants.
A/4 -
10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
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11. Maintain Best Management Practices(BMPs).
12. Manage theth Project.
Jo bL /Y? ¢ .d.( 19 J- " I/!Jihc� n7
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2. Adjacent Areas.
a. Description of the adjacent areas that may be affected try site disturbance (e.g., streams, lakes, wetlands, residential
areas, roads).
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
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3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
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9
stortnwater site plan template.doc—rev.10/12O 3
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b. Description of special requirements for working in or near environmentally sensitive areas. ,
At 1 1 2005 ; : f
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.
a. Construction sequence
(S C et..s /7-c.ti=ott�5)
b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
Provide a proposed construction schedule.
Forc.�GC 7 21,t-, �o be.. A oc7/Dcc1 — cv�• ii �a+iG�s
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II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
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b. Proposed wet season construction activities for environmentally sensitive areas.
7. FinanciallOwnership Responsibilities.
a. Identify the property owner responsible for the initiation of bonds and/or other financial securities.
Roy -- Di-cA-4 2)‹... --
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
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.the—rev.10/12/2003
1
Stormwater Site Plan Changes
construction. The submittal shall include substitute pages that include all proposed changes, revised
If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shallbe
subdrawings
to prior u ralchanges,
supporting information that explains and supports the reason for the change.
drawings showing any structural changes,and any other supp 9
Final Corrected Plan Submittal
MPs
If the project included construction of conveyance systems, treatment
facilities,
t shall ilsubmit oa f contral ol
plan (aructuial source s)when the control B project is
BMP
(not standard h site oudstormwater managementneeringrwings) asp
completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as
constructed.
APPLICANT SIGNATURE
a
B si ning the Construction SWPPP worksheet, I as the applica�h wner onisbanst s m that the
i tnormatiohe full n provided
ded her rein
i s true
of d
correct fio the best of my 9 y g knowled e. I also certify that this
app
all
owners of the affected property.
(DATE)
(LANDOWNER R AUTHORIZED REP ENTATIVE SIGNATURE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: vV ,
1 OCT 1 1 2005 :/
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stannwater site plan template.doc—rev.10/12Y2003
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