HomeMy WebLinkAboutBLD2005-00765 •
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00765 Received Date 12/13/2005
SITE ADDRESS: 78 TERRACE DR Issue Date 01/24/2006
PORT TOWNSEND, 98368
APPLICANT: KELLEY SHIELDS INC PHONE: 360-385-7156
260 KALA POINT DR
PORT TOWNSEND WA 983689530
SUBDIVISION: KALA TERRACE Block: Lot: 7
PARCEL NUMBER: 965900007 Section: 26 Township: 30 N Range: 01 W
CONTRACTOR: KELLEY SHIELDS INC PHONE: (360) 385-7156
260 KALA POINT DR
PORT TOWNSEND WA 98368
360-385-3115
Contractor's License: KELLES1150LF Expires: 6/6/2007
PROJECT DESCRIPTION: NEW SFR W/ATT. GARAGE & 120 GAL A/G PROPANE TANK
AND DECK
CALL IN FOR THE REQUIRED IN PECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: �}wscz� ..'�1
UFFER: v
Footing: 0290 JL 14t®I06
Foundation:}1v0u, 0.15rhw-95T l A0J6.v1Au-) 4[(a j61
Stormwater FINAL Approval: 1
Underground Plumbing:
Underground Insulation: /►/
Shear Wall : £a7 OI /yes;. rlY
Sheathing: 7�
Framing: 0)37)02-GL001"-- ui(- u1) ;,,)IcorN\) 6-7-0�
Plumbing:{.(-1 Ofo
Propane Tank/ Li es:
Insulation: `',� G /Z oG &lex/S A/,Q St-oc,OK AM/z6_,
Sheetrock: ik�, 12Cii F r -Ar-b6'
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval:\C. /O'q"0b
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
•UILDING PERMIT APPLICA N ML Review Ty Ty 719
pe: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00765 Received Date: 12/13/2005
SITE ADDRESS: 78 TERRACE DR
PORT TOWNSEND, 98368
OWNER: KELLEY SHIELDS INC PHONE: 360-385-7156
260 KALA POINT DR
PORT TOWNSEND WA 983689530
KALA TERRACE
SUBDIVISION: Block: Lot: 7
PARCEL NUMBER: 965900007 Section: 26 Township: 30 N Range: 01 W
CONTRACTOR: KELLEY SHIELDS INC PHONE: (360) 385-7156
260 KALA POINT DR
PORT TOWNSEND WA 98368
Contractor's License KELLES1150LF Expires 6/6/2007
REPRESENTATIVE: PHONE:
120 GAL
PROJECT DESCRIPTIOI NEW SFR W/ATT. GARAGE & A/G PROPANE TANK 7, t ;
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,818
VALUATION 177,184.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 484 SHORELINE:
CONST TYPE: DECK: SETBACK:
l 1 (� BANK HEIGHT:
SEWAGE DISPOSAL: CMY
WATER SYSTEM: PUBLIC
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 2 Prop: 2
Total: 2 Total: 2
Routing Date:
I :2 ii,5/0.5 Or,
Type Amount Paid By: Date: Receipt: AP PH
"'�e ate
Permit $1,430.55 SLE 12/13/05 78752 r-+ � V E D
Plan Check $929.86 SLE 12/13/05 78752 JAN a
State Building Code $4.50 SLE 12/13/05 78752 l. 2006
Potable Water Application $53.00 SLE 12/13/05 78752 Jefferson County Planning
Total: $2,417.91 & Building Department
CERTIFICATE OF OCCUPANCY
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451 (800) 831-2678
PERMIT #: BLD05-00765
SITE ADDRESS: 78 TERRACE DR Issue Date: 01/24/2006
PORT TOWNSEND, 98368 Final Date: 10/9/2006
APPLICANT: KELLEY SHIELDS INC PHONE: 360-385-7156
260 KALA POINT DR
PORT TOWNSEND WA 983689530
SUBDIVISION: KALA TERRACE Block: Lot: 7
PARCEL NUMBER: 965900007 Section: 26 Township: 30 N Range: 01 W
PROJECT DESCRIPTION: NEW SFR W/ATT. GARAGE & 120 GAL A/G PROPANE TANK
AND DECK
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING
CODE 2003 EDITION.
OCCUPANCY GROUP: R-3
TYPE OF CONSTRUCTION: 5N
SPRINKLER SYSTEM yes no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 10/9/2006
i0 //0 /OG
Building Official Signature a Date
I:\F_BLD_Occupancy.rpt 10/29/19c
SPECIAL CONDITIONS FOR C E A BLD05-00765 •
1.) 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.
2.) 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.
3.) 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.
4.) 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.
5.) MANDATORY MEASURES FOR AN AT RISK 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 requirements:
a. Chloride concentration of a laboratory-certified well water sample submitted with
building permit application.
b. Installation of a flow meter.
c. On-going well monitoring for chloride concentration.
d. Submittal of flow and chloride data to the County per monitoring program.
3. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water.
6.) 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.
7.) A stormwater plan for a medium project 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.
8.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
9.) Not more than two (2) unlicensed or inoperable vehicles shall be stored on• 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).
10.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
11.) The building height is not to exceed 35 feet.
12.) Minimum setback from Tract B (dedicated ingress, egress and utility easement) and
Terrace Drive right-of-way is 20 ft. Minimum setback from Kala Point Dr right-of-way us
20 ft. Minimum side yard setbacks are 5 ft.
13.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
I:\F_BLD_Permit_Buildng.rpt 10/29/1999
uyss-1. )
ProperttA: Corrractor: i # 8U1
Lot 147, Kala terrace (elleti Shields Inc. *
Parcel #965900007 260 Kala Point 2r, - 0 7 A 5
n 5
Area: 11,750 Sr ( .21 Acre) Por-t fownsend, WA 9856tt '
Owner: 560-585-7156 tuvuisti% tc)111$131 Intl
Kellen 5IiielcI5 Inc, Lic, #C".-I1- 511501-F i
260 Kala Pointl9r.
Port fawnsend, WA 9E3568 I Irower 68' , e.k •
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APPROVED I" - 20'
1 SITE PLAN
JAN 2 0 2006
4') . a.
JEFFERSON COUNTY
DEPT.OF •• UNITY DEN • n
SIGNATURE: 4
ON
.� :; , ,- TO�� JEFFEFN COUNTY •
.g, ` 1 DEPARTMENT O U EV 1..; .,
621,Sheridan.Streeti o &gild- :YVra. ° t
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360/379-4450 • 3 iA/37 -44 �"a) `—---• 68
$s�N00 www.co.jefferson.wa.us commdevelo ment
DEC 1 1005
Master Permit Application '
Project Description(include separate sheets as necessary): MLA: -
Tax Parcel LtZZ�GxA�, n ,/
Number: , ,:,, > Property /
�O. Size: . 2-1 (2 �
Site Address and/or Directions to Property:78 r P!,,. - (acres/square feet)
Property Owner(s)of Record: Le-1.-2. _ _ _ t-+ , y,1C., ,
Telephone:
Mailing ���` �g Address: tom,C� 1t x'i 'a a i ! email: yj< r
} > Sil _'sett ,r'
Applicant/Agent(if different from owner): C, i".$1e4
Telephone:
Fax: email:
Mailing Address:
Whet kind of Permit?(Check each box that applies)
building
0 Demolition: Permit 0 Variance(Minor,Major or Reasonable Economic Use)
Fa • 0 Conditional Use[C(a),C(d),or Cj**
lt3tn`
,l Gar le ttach .► Detached 0 Discretionary"D"or Unnamed Use Classification
0 Manufactur �ome 0 Special Use(Essential.Public'Facilities)**
❑Modular 0 Boundary Line Adjustment
❑Commercial* ❑Short Plat'
0 Change of Use 0 Binding Site Plan**
0 Address Approach 0 Long Plat**
.-Aro 0 Road 0 Planned Rural.Residential Development(PRRDyAmendments"*0 e "Yes'Use Consistency Analysis 0 Plat Vacation/Alteration**
❑Shoreline Master Program Exemption/Permit Revisions**
El StormwaterManagement
0 Site Plan ❑ Shoreline Management Substantial Development**
Approval Advance Determination(SPAAD)*
0 Temporary Use 0 Shoreline'Managementnt Variance
Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District MapAmendment
00 Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment
•Ma -.uire a Pre-A••lication Conference "R••ulres a Pre-A••lication Conference
Please identify any other local,state or federal permits required for this proposal, if known:
I hereby designate DESIGNATION OF AGENT
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 hue and correct to the
his,her or it's knowledge. by the owner/agent with Any material falsehood or any omission of a material fact maderespectbest of
may result inthispermit being null and void: to this appligtion.padcet
I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorneys 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 u
review and any required later inspections.Access and right of entry to this propertyshall be requested and shall occur onlyduring
hours. -. (-1 } purpose
�i ! !. q regular business
Signature: ,2ti' ^ .. /i i ,,
1t p ``e. Date: .. -.
The action or actions Applicant will undertake as a result of the issuance of this
permit mayendangered species and could lead to a potential"take"of an endangered species astho a termsvare defined in the federal lawlaw 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
action(s)even if you are in compliance with the Jefferson County development code.The
and non-tr ferable responsibil�r�adhenng to and com Iregarding your
Applicant ha acknowledges this
l mat h she s it holds individual
Signature: �L_,,� `�� ���c ,: � �, complying with ti}esFSA- The Applicant has read this disclaimer and signs and dates it below.
Date: l2- '7 - ,„ 01�� .
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
•
The signer of this statementOWNER BUILDER STATE�C ,
does hereby certify that they are the OOwmers of the . . .'' , f t tXt l
afthe -t ntractpr eneiit iat g
Signature: s.. ,. rFt
Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: F
F �" PHONE:
MAILING ADDRESS: .: FAX
FAX
( y: ) 5(.4.
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CONTRANUMBERCTORS LICENSE t'C,O l i l Q ,r y E IY EIUq�; $ ( �4` ( )
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ARCH �
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MAILING ADDRESS: j E f f E' pry ! tft4t 1ha t f PHONE (. )�� ;
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LI-'New of rie`T3Re :
❑ Addition Existing. - Type of sewage Disposal:
❑ Alteration/Remodel 0 Steel Proposed: -- Bank 0P4Ccon Sewer
C Concrete .K
❑ Repair Total: munity System
❑ Demolitipn
0 'Masonry -- - Height: a Individual System
0 Others_ : Bedrooms: Water rmitlf
Type et Heat: Ero -•• ,:IF
Water Supply;
Proposed: ' ❑ Private well ❑ T
Total: —'- 0 ',P.ublic Two Pa ty
-----
Name of$
If this is a'Commerctal Pro ect u must answer the..tohowin
Number of
., P,arktng Spaces: :Current:rrent -Pto ;
�pants.,(includes owners,tenants,employees,-etc)— — Number:ofA op Parking S
IBC
Occupancy; Current. n9 Spaces:
If this i c.a 1 nc .r, T o IBC TYpe of constnrctlon Proposed
Trance installation .Will you have q 17 ! rQU �k rm markall items beloww that aF
•ve. tlr5d a
,.- . Yes�No
Service?
Heat Stove $ ' ' ilk SO cif Propane Tank:_ 1"�.E? . ,1 Z
>7 ° oS►e..ri w slove 0 f,i
Is this a liahce: eon Installed in oo st facia P� sert 0 Hot
r Tank ❑ Pellet Stove .Q ,Other
INh�n�ap�Yrlt ��/�Mobtle Nome'T y
/r�es, antraycrm1to Install a:proPne tank oumust akoo
<lncladin.. tem•theU _plan
Ltd size,ddistances' ¢Itt..;:.l r showing all of the yste n mp
,reserve area. Prnpahe,tanir.M$!t lin
e bu!d
S,uareFpo �.pae %ra pe n m l e t . ... ..
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mct value of all labor t_ ▪W � � ti * (f o(�
and mafefials formara ,x, ` W `"
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��� � �'� JEFFERSONDEC
COUNTY 1 3 2005
4 • _y:b R DEPARTMENT OF COMMUNITY DEVELOPMENT ._
621 Sheridan Street•Port Townsend•Washington 98368
orcpY 360/379-4450-360/379-4451 Fax
http:Ifwww.colefferson.wa.us/commdevelopmenti Pfkkiiii # RI II
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
1 MLA# 0C, -Ivo\ PROJEGT/APPUCMITNAME: 1" h,� t`-i
Lit{� "5�j ty«- . /
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
f_ Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the
` site map.
r.)i'.4 ,.d�k:.t l,.-0-7 i +.-0 t ..,•,.
Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
�- `r'1 C.A C ch?..t. 7,1- .) -,....4.', 'I
t "Z l f.' 1 i ''
4. Describe the existing soils. Indicate soil type on the site map.
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.
•
6. Describe any excess levels of noise generated by the proposed use or activity:
,.d A APPROVED
STORMWATER PLAN '
JAN 2 0 2006
slorrmeter site plan template.doc—.rev-10/12/2003
k 5
JEFFERSON COUNTY
INEPT OFC . MUNITYD VELD i
SIGNATURE. v d��E� �i �1� ; i
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.
IA
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.).
VJ 1 1. -r��'�; ►mot:t G , '°' `,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.
.., .i..},. ; y,, r.
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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.'
11. Describe the performance goals and standards applicable to the project.
I t -1`
12. Describe the flow control system.
DEC 1 3 2005
stormwater see plan temptatecbc—rev-10/12/2003
6
13. Describe the water quality system. Cr
T}‹..., : C c : c t t.} � D FC 1 3 '005
14. Describe the conveyance system analysis and design.
15. Descnle thee source of fill material,physical characteristics of fill material,and deposition of excess material
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code_
17. Describe the proposed surfacing material.
18. Describe methods for restoration of the site.
V \t i t•
9. 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.j If included,list the Manuals
here.
•
20. List here and include any special reports or studies conducted to prepare the Stonnwater 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.
storm, ter site plan templat doe—rev.10/12/2003
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 2.52 of the Manual(beginning on page
2-15).
12 Required Elements—Construction SWPPP
1. Mark Clearing Limits.
2_ Establish Construction Access,
}} CC
4
3. Control Flow Rates.
4. Install Sediment Controls.
5. Stabilize Soils.
j I (D r • a
6. Protect Slopes.
7. Protect Drain Inlets.
stormwater site plan template.doc_rev.10/12/2003
a
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
9. Control Pollutants.
10. Control DealVatering(the act of pumping groundwater or stormwater away from an active construction site).
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).
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
y3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
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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).
5. Construction Phasing.
a. Construction sequence
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.
�`
IL Wet Season Construction Activities. DE s I
a. Proposed wet season construction activities. t- 2005
b. Proposed wet season construction activities for environmentally sensitive areas.
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7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for the initiation of ponds andlor other financial securities.
„
b. Describe bonds and/or other evidence of financial res
impacts. possibility for liability associated with erosion and sedimentation
8_ Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable.,
a_ Sediment Ponds/Traps.
b. Diversions.
c_ Waterways.
d. RunotfIStormwater Detention Calculations
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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 al( 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, l 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 affect roperty_
?
2/
(LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
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DEC 1 3 2005
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