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HomeMy WebLinkAboutBLD2005-00658 • • Review Type: I MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development LA05-00612 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00658 Received Date: 10/13/2005 SITE ADDRESS: 262 PORT HADLOCK HEIGHTS RD PORT HADLOCK, 98339 APPLICANT: BRODERS INC PHONE: 4503 OLD GARDINER RD PORT TOWNSEND WA 983689778 SUBDIVISION: PORT HADLOCK HEIGHTS MH PARK Block: Lot: 1-45 PARCEL NUMBER: 989500001 Section: 11 Township: 29 N Range: 01 W CONTRACTOR/ PREFERRED HOME SERVICES PHONE: (360) 808-1830 DEALER: GREG DECKER 61 HOUSE RD SEQUIM WA 98382 Contractor's License PREFEHS981RR Expires 12/19/2006 INSTALLER: PREFERRED HOME SERVICES PREFEHS981RR 12/19/2006 (360) 808-1830 GREG DECKER SEQUIM WA 98382 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION: MFG HOME INSTALL(MODEL#6626-ICK-2B-CATH) William & Karin Blanchand TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: SKYLINE SETBACK: VALUATION 86,900.00 YEAR: BANK HEIGHT: LABOR & INDUSTRIES APPROVAL? SIZE: SEWAGE DISPOSAL: CMY WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date: APPROVED Type Amount Paid By: Date: Receipt: N V proved/Date Manufactured Homes $157.00 SLE 10/13/05 77129 Potable Water Application $53.00 SLE 10/13/05 77129 Jefferson County Planning Total: $210.00 Building Department FFFERSON COUNTY ASSESSOR 1N JACK WESTER III EFFERSON COUNTY COURTHOUSE ASSESSOR PO BOX 1220,PORT TOWNSEND WA 98368 (360) 385-9105 MOBILE HOME INFORMATION FORM OWNER'S NAME / MAILING ADDRESS: I 11 THIS IS NOTA TAX STATEMENT NAME: 14/( I m i< r i B I ci n c 114 w d lop e Y r The purpose of this questionnaire is to obtain information ADDRESS: C v , L.h, n9 the current location of a mobile home or the previous ownership and location of a mobile home. This will (i o r-}- H a �o c l`1 t-�, A E 3 39 help our office determine whether the mobile home is already t on the s'n Jefferson County or if it has been moved to TELEPHONE NO: 3 6 o —— 3 % S O 2 73 -- times W f vau �c ' side for addti i �:. v L` � .( OC► 13 2005 'H');! 1) MOBILE HOME DATA: (A) MAKE S }� I i v1C_ (B) MODEL to 2 - C — 8—c fjTF (C) YEAR 'z o a S (D) LENGTH 6 6 (E) WIDTH 2 7 (F)SERIAL NUMBER (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) o 1 °CI (H) PURCHASE DATE 2 I Szp-/ 2.0oS 2) PREVIOUS OWNER/ LOCATION OF MOBILE HOME: COPY (A) FROM WHOM DID YOU PURCHASE MOBILE C o i cie vI 0° 1. S ADDRESS q �; vvl (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? YES ()(IF NO,WHAT COUNTY? IF YES,WHAT WAS PREVIOUS ADDRESS OF MOBILE? 3) WHERE MOBILE HOME IS TO BE LOCATED: (A) WILL THE MOBILE HOME BE IN A MOBILE HOME PARK? �YESI NO (B) IF LOCATED IN A MOBILE HOME PARK: NAME&ADDRESS OF PARK (m F 4 I- 4 LI l o c J( r_1 f , 4 S L-5P-Ac-E NO. / 3 (C) IF NOT LOCATED IN A MOBILE HOME PARK: NAME OF LAND OWNER LOCATION(ADDRESS) . REAL PROPERTY PARCEL NUMBER/DESCRIPTION THANK YOU FOR YOUR HELP! SIGNA URE -o✓ 6un iY1 I�� dnL KELLI LARSON, roperty Technician THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION. • • MANUFACTURED/MOBILE HOME INSTALLATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 360 379-4450 FAX 360)379-4451 PERMIT#: BLD05-00658 SITE ADDRESS: 262 PORT HADLOCK HEIGHTS RD Received Date: PORT HADLOCK, 98339 10/13/2005 Issue Date: 11/17/2005 APPLICANT: BRODERS INC 4503 OLD GARDINER RD PORT TOWNSEND WA 983689778 SUBDIVISION: PORT HADLOCK HEIGHTS MH PARK PARCEL#: Block: Lot: 1-45 989500001 Section: 11 Township: 29 N Range: 01 W CONTRACTOR/ DEALER INSTALLER: PREFERRED HOME SERVIBEBFEHS981 RR GREG DECKER SEQUIM WA 98382 Expires: 12/19/20( PROJECT DESCRIPTION: MFG HOME INSTALL (MODE:L#6626-ICK-2B-CATH) MAKE: SKYLINE YEAR: SIZE: THIS PERMIT IS VALID FOR ONE YEAR. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 11/17/2006. CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. Setbacks/Footing (CONTINUOUS FOOTING, SLAB or PADS USED): J �, 6 Stormwater FINAL Approval: Blocking/Plumbing: Propane Tank/Lines Zoning Final Approval: Septic System Final Approval (If not on sewer): Road Approach Final Approval: Final/Skirting/Vents/Porches/Steps HEALTH DEPARTMENT AND PUBt1IC WORKS APPROVAL REQUIRED PRIOR TO FINAL THIS PERMIT IS VALID FOR ONE YEAR OR IUT B SE PROPERLY RENINSPECTION T M BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INS Office Hours 9:00 a.m. -4:30 p.m. PECTIONS. HOT-LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY-SEE REVERSE • SPECIAL CONDITIONS CASE # BLD05-00658 1.) The application was reviewed by the Jefferson County Department of Community Development staff on November 15, 2005 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: SAPRA aquifer recharge area; coastal SIPZ. 2.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 3.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 4.) Critical Aquifer Recharge Areas are defined as Seawater Intrusion Areas, and Special Aquifer Recharge Protection Areas and the following land uses located within Susceptible Aquifer Recharge Areas (1)All Industrial Land Uses (2)All Commercial Uses (3)All Rural Residential Land Uses requiring a Discretionary Use or Conditional Use Permit(4)All Rural Residential Land Uses with nonconforming uses that would otherwise require a Discretionary Use or Conditional Use Permit (5) Unsewered Planned Rural Residential Developments (6) Unsewered residential development with gross densities greater than one unit per acre. All of the above listed uses shall be subject to the applicable requirements and standards of the Jefferson County Unified Development Code. 5.) Marine shorelines and islands are susceptible to a condition that is known as seawater intrusion. Seawater intrusion is a condition in which the saltwater/freshwater interface in an aquifer moves inland so that wells drilled on upland areas cannot obtain freshwater suitable for public consumption without significant additional treatment and cost. Maintaining a stable balance in the saltwater/freshwater interface is primarily a function of the rate of aquifer recharge (primarily through rainfall) and the rate of groundwater withdrawals (primarily through wells). The Washington Department of Ecology is the agency with statutory authority to regulate groundwater withdrawal for individual wells in Jefferson County. New development, redevelopment, and land use activities on islands and in close proximity to marine shorelines in particular should be developed in such a manner to maximize aquifer recharge and maintain the saltwater/freshwater balance to the maximum extent possible by infiltrating stormwater runoff so that it recharges the aquifer. 6.) The parcel is located within a coastal SIPZ (seawater intrusion protection zone) according to the County GIS map. There are voluntary and mandatory measures identified in the Jefferson County Seawater Intrusion Policy(Resolution 44-22, effective September 23, 2002) that apply to well drilling proposals and building permit applications on existing lots of record. A Coastal SIPZ is defined as: all islands and area within one-quarter mile of marine shoreline, but no history of chloride concentration above 100 mg/L in groundwater sources within 1000 feet. 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.) VOLUNTARY MEASURES'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 FOR COASTAL SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 11.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 12.) The applicant is proposing to create or add 2,782 square feet of impervious surface and 4,200 square feet of land disturbing activities. Sections 6.6 and 6.7 of the Jefferson County Unified Development Code requires that your proposal submit a Stormwater Plan for a Medium Project. 13.) 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. 14.) 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. 15.) The site plan as submitted with the manufactured home installation application (BLD 05-658) on October 13, 2005 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated November 16, 2005 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 16.) This approval is for a manufactured home installation only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 17.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 18.) Not more than two (2) unlicer'f5ed or inoperable vehicles shall be stored ony 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). 19.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 20.) The building height is not to exceed 35 feet. 21.) The front setback is 20 feet from the edge of the right-of-way from Port Hadlock Heights Road. The minimum side and rear yard setbacks are 5 feet from the boundary of Space 13 of the Mobile Home Park. 22.) A minimum of two (2) on-site parking spaces are required for the manufactured home. 23.) This parcel is a legal non-conforming lot designated as Rural Residential 1 dwelling per 5 acres under the Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998. 24.) This parcel was created through the Port Hadlock Heights Mobile Home Park Bindig Site Plan, filed of record April 15, 1998 under AFN 409746 in Vol 1, pp28-32 with the Jefferson County Auditor's office. The binding site plan was reviewed by Jefferson County Department of Community Development under BSP94-00001. 25.) Port Hadlock Heights Road (P516) is a private road. The road approaching is existing and an address of 262 Port Hadlock Heights Road, Port Hadlock has been assigned to space 13. 26.) A tank only permit(SEP 05-342)was issued on 11/13/05. The tank will be connected to a community septic system approved through (SEP 95-291). 27.) Jefferson County PUD provides potable water to this site. 28.) Open space within the Mobile Home Park will be utilized to infiltrate stormwater. This is approprate base on the small size of the spaces within the mobile home park&that the area utilize is part of the development. , migillir! }v V ..-1-", .....-., , Nu • t�, ,, . n . ..cf, - , „ , i -t :-_ .. 3 -I- I Li r---- , , 1. s OCT 13 .2005 i t tll = ., -1. A r _^f _ o LA In �i t CA , r "b 5.3 .Q- r- ,, ,,aiiiiiiiiNfigr _r Jj ' 4 T. - 11 ► c--dil /G V1 - _ :: ; ; .�� - 1\(/ 1 ^ / g. (4'.-' --- -. *- itil°0' OP ,,A A.% .."". . a . p lb MI ;.k. 411 .W // %,, t*it tw***:/Plit7 • -1- .-1-- -1- 7_1_ _1:\71-'' _\-'! 4-- k. -.' / _ k, - D Z -1 A iiitiveitoppt,414/* r 1► : n .a , 4 • • ` --e � ° JEFFERSON COUNTY I.,..' I o% t s.^' ;, 1 - OU TY i { ,..4 DEPARTMENT OF COMMUNITY DEVELOPMENT I f� 1 , OCT 1 3 ?_005 ,:f,) 4 621 Sheridan Street • Port Townsend • Washington 98368 I .O 360/379-4450 • 360/379-4451 Fax " INO http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# \i✓ ',A. ; -.., PROJECT/APPLICANT NAME: 15'i 0 D E 2 S I NC. (P/414—A1 I+r3 t_„} I3) 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. M 6\h u f,,,A e, 1-}, .-z , A 66 ' PERMIT # BID © 5 " 0658 Existing Conditions Summary y 2. Describe the existingtopography. Indicate contours on the site map. �Ef f ERSUN C UNTI n f /a.�- w 1'-- h x a ' c J( f }`.a 3 0° J e4..1)4� 71-0 a. ,,e l a.�i lit r- 1 A (J v " L 3. Describe the existing vegetation. Indicate native vegetation areas on the site map.tFiala';1P S1LarcL rgiS Avt ...r. c,i, e-eclS ! ✓) 7/�C 4 b, / / ,1 S C t e , J e'lie, /.3✓'.S 4 a 7 J rj r 4$s r ll f )C a i e 4_ I- 9- o .f 1)( he S-1 GI d /)C Ie ,1.IC ;es 4✓41 C/ der- ,(' OYy F/�1 v.S (n 40 / r1C 58,-/ 4. Describe the existing soils. Indicate soil type on the site map. U Ve`1 .5-4,1�, . g eq vell _ , 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. _S_.lo, L,. , -le. 1 / ? j/C1C t / 1l rh;SeS G11 J iPI % f-71` a -71e� h70 7 .)-f t- da b.se Jul S- 6. Describe any excess levels of noise generated by the proposed use or activity: APPROVED /Ut. 'f STORMWATFR PLAN NOV 1 6 2005 storrnwater site plan template—rev.10/1/2003 JEFFERSON 7OUNTV _I i_ DEPT.OF OMMUN1 p NI— PM SIGNATUR 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. A o c,,,i 4'r i ea ,e•,s or 51r) h1i Civ4 1 el-f,✓eJ. 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.). V A <A✓tl /0 4 / ?:) ('9 /30,--E- !-/Qc)1.r,_ 1-)et:/ -)5 /V ; ) /7)ame /) a. ,' \;a(a 4-1 10--E 1/2 -{v S v,-/11 , / �)C i 51;i t c Al 9, �" 14 0,�n o n /o .1 /LI 4v /l,/a.-lti, / n ) 571-,n r( o _-eh ' 5f-4(- be 1v/1 1 ��.t c! 1 /%o' 1- l- Pa i) /Cl�l 4f 4h 0 56 IA, 1i1%,td Y o ac.) -4, A or-)A we 5.1 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. -11.9rv1 1....,4. 4 r f voM M J (°rhe 4,iI) )t t /1`. 1��i15�ele ('14v e >ek 5 :4". ro,- c.s-�- j).,5 � do i 5) runs V P�C'.7gTr`o>7� 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. Me _r t.N'1 S i 'r ! r o d 'a.4 J L.131 c c-�-' 'f v ;v%i h i V11 t-0N Ve ��.,reVnel4S'' AI ) -i- hv.9vh A# S c."t .fh/e. /4 , 20� / m w&40Ya 4r /�4vl Vemo/d- AA dnval i�0Y �/1S 7G'7v1 4 c4 i n, -/o /I . 12. Describe the flow control system. `}p- -—- — F____ _ \. iF,- ir &- -v,i IF j.,/ i �` I 1 fit i i OCT ? 3 :uu�) 1 ) r stormwater site plan template-rev.10V1/20D3 - 6 i • • 13. Describe the water quality system. N )n I-- If 7, , , ID) ...„ fr.fr T, tr.'02_. k 5---\'‘ ii 14. Describe the conveyance system analysis and design. OCT i 3 2005 ` ° N ) I- 15. Describe the source of fill material,physical characteristics of fill material, and deposition of excess material. I'l I it 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. r\rII 17. Describe the proposed surfacing material. J • h t A v l 1,_,-4 i Gc n - Cu ; f i a�, ea J a l i" S iJ z =t---"L I",j-- 18. Describe methods for restoration of the site. �. --I��h � � he d,, ve w ay ,J�h 4A �:U✓1 CtVI i }) al- d a. rL'ti� 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. �� rJ / 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. n;/ ,, 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. 1V\ ) 1 hoiire I 1'1 (._/-4 1)4 -1 tL"1 Nl.,n, 4 , S.C 1-) —°q l,_ 13 e 1 4,, , t- stormwater site plan template-rev.10✓1/2003 7 • • . . I 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. N1 ' Avea or- �`Ov/S7kvc):0 w ,"� !�/ �)oli✓I� 0r 2. Establish Construction Access. (11 ° ri5 v"c4-ovi p CC-e55 elei 4S 3. Control Flow Rates. L_ f $ -e4 -- ) w',.) 1 ?v1"/.> •aY /l'Sl-i'1<J t/-- `J�4u-71,.e"-7 - Ko 01 Lvu aCv c1, '1) • be pal -i-1-fr - Lrviit. l✓0✓-, , 4 r_S --1-04( isp,ksg, t aYe� of v)a-j:ve l Vege�u)�o., • — 4. Install Sediment Controls. p ,. 1�({11S .1z -A, - ve -e-�u.-,/eon i 11 1lJe I./ S0. .5 1 5. Stabilize Soils. I e p J S, c l A 48" L ✓l W o c-- - S o t S a ) I �e -1a ))0; ` 1 �Z,1 by r< se-e•-1 "- C 6. Protect Slopes. 7. Protect Drain I lets. (!D) - -- 7ci 1 3 2005 stormwater site plan template-rev-10/1/2003 8 • IIII 12 Required Elements-Construction SWPPP(continued) �� » 8. Stabilize Channels and Dutl ts. (` ,. ,ir, co /v o ,' /I v)n< r o f 1S c P h q ', i jjf ---- nii lif 1,o F OCT , 3 ?Qfl, i (j 1 9. Control Pollutants. l A,/ u 1 c /Iu -1•44-5 (AV( 4 ✓i-i-s C.. Y6 4c c . 10. Co trol De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 1 0 d-r-- {�, iz it‘?"-`t 13 a vi -I is C t'/Ja cal J . v 11. Maintain Best Management Praptices(BMPs). l N'v),)ray"' CT.✓1 0-- p.e r/rl d VI,'-' 4--- e r o S j or) Co 0 w o/ Ake u S",> S )-ia I 10 e- fr)Ovj;Jar,j arrd' Wit i1j -1-go-n.41 .4 2, b) )-,.)- 12./ Manage the Project. (,%'5�- w\<t4a1ee t.4.+rr t)r-.tc 'f c(-e -, i) p n WI a i 7-a t--n-e.d b y T h., Co i( .*,—,'-1-Uy . 7-✓1 -I h-e e tt-e 4-I- rvi v h i?"r,n,7- Y e 1/2--eR 13 'f t 1- aL T -f �2� 6 /n 0 S 11 1 j d-er•.}: ;-e. 1 O f pc e- (rl 9.le ir.."a �t-o �-4.-o// , a d d i 4-i-6n .L. I N) e.ts�*oS w1 Ai b� i 411J l'e.h9-.n d- I' .t,S j? r-8 d e.�• 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential 1areas,�/ro/roads). - .///�� 1 / ili i-eG/l a 1, k('e/1-1-" OLr-C-4S Qj-C. Pnos ly iCnre5 /T,.1_ orr- {1K4�''* 1,, j t-4 rc.. (J"e, S c e-e rl 4 6 d- L d c v /u q nZ,e/t ]`— 71-') -t- i 1 e !✓ d c-Irj e sr,5-,1 _5 i7ov(d hv--1 I` b-e of t-ec 4-ed. b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). f ( I C�-el-era/ 1 r. l,1 Y..7G fr t 'r -�%v/ci 6 e //S/ -�= i -5 ova.-liitAz. ,L YI9e ,S�• b R Cra/55 / orrs �5 /4n LI / V V w t r 17 e d t-eS a r.C Gv,,-4 t1 i'7 g(7 v y o r a1 f. 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. Ar e) stormwater site plan template-rev.10V12003 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. /%)( 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). ont 4. f c� . 5. Construction Phasing. a. Construction sequence I rS-jvu� Fnvlcle c,n� f�✓ I'19ob,-! uellt',/ 71a,)� ho v 0) sue ,./occ � �iVeu,ay b. Construction phasing(if proposed) NJA 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. °toJ.e d 4-0 f /4_ /#cam is NOVem f- II. / Wet Season Construction Activities. a. Proposed wet season construction activities. /I b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. ti b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. //4 8. Engineering Calculations. Provide Design Calculations on a separate sheet for t tt ing,i tapp�� 'ble. 7 (F a. Sediment Ponds/Traps. N/ �` �!' ! ( b. Diversions. I" )7 4- f I }i i ( it c. Waterways. /,/IflC,T 1 3 2995 pi d. Runoff/Stormwater Detention Calculations • stomiwater 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. 7 d(4.- 2-005------- (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: OCTirb igi L.',. 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