HomeMy WebLinkAboutBLD2006-00096 • I
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
PERMIT#: (360)379-4450 FAX (360)379-4451
SITE ADDRESS: BLD06-00096
330 COLMAN DR Received Date 03/6/2006
Issue Date 03/17/2006
PORT TOWNSEND, 98368
APPLICANT: CALVIN P COLE
LESLIE J COLE PHONE: 503-887-1932
804 NE PRESCOTT ST
PORTLAND OR 972114544
SUBDIVISION: CAPE GEORGE COLONY DIV 7
PARCEL NUMBER: 939601421 p: 30 N Range:
14
Section: 13 Township: Lot: 22
02 W
CONTRACTOR: TERHUNE CUSTOM HOMES INC
PO BOX 97 PHONE: 360-681-8898
POULSBO WA 98370
Contractor's License: TERHUCH984MA Expires: 7/1/2006
PROJECT DESCRIPTION: NSFR W ATT GARAGE&A/G 250 GAL PROP TANK
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: (,_ :0
UFFER:
Footing: -IS-
Foundation: a/-01i
Stormwate FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall :
Sheathing:
Framing: 1;1J,. •
Plumbing: - -0
i
Propane Tank/Line : L�L -�(
Insulation: r� �"l p
Sheetrock:
Septic Sytem Final Approval MUST be obtained before final
Road Approach Final Approval: of structure can be attempted.
Zoning Final Approval:
Final/Occupancy Approval: 12-2 -
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 SCHEDUL
Office Hours 9:00 a.m. -4:30 p.m. E INSPECTIONS.
HOT LINE AVAILABLE 24 HOURS A DAY
SPECIAL CONDITIONS APPLY SEE REVERSE
• •
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 #: BLD06-00096
SITE ADDRESS: 330 COLMAN DR Issue Date: 03/17/2006
PORT TOWNSEND, 98368 Final Date: 12/28/2006
APPLICANT: CALVIN P COLE PHONE: 503-887-1932
LESLIE J COLE
804 NE PRESCOTT ST
PORTLAND OR 972114544
SUBDIVISION: CAPE GEORGE COLONY DIV 7 Block: 14 Lot: 22
PARCEL NUMBER: 939601421 Section: 13 Township: 30 N Range: 02 W
PROJECT DESCRIPTION: NSFR W ATT GARAGE & A/G 250 GAL PROP TANK
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 ono
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON
12/28/2006
StOl 1 hPP t is ax c
Build4ng Official Signature Date
I:\F_BLD_Occupancy.rpt 10/29/19
I
UILDING PERMIT APPLICAtON MLA06-00095
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00096 Received Date: 3/6/2006
SITE ADDRESS: COLMAN DR
PORT TOWNSEND, 98368
OWNER: CALVIN P COLE PHONE: 503-887-1932
LESLIE J COLE
804 NE PRESCOTT ST
PORTLAND OR 972114544 CAPE GEORGE COLONY DIV 7
SUBDIVISION: Block: 14 Lot: 22
PARCEL NUMBER: 939601421 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: TERHUNE CUSTOM HOMES INC PHONE: 360-681-8898
PO BOX 97
POULSBO WA 98370
Contractor's License TERHUCH9B4MA Expires 7/1/2006
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP NSFR W ATT GARAGE & A/C; 250 GAL PROP TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,751
VALUATION 180,000.00 ADD'L: HEAT TYPE: HTP
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: # OF STORIES:
OCCUPANCY:
CONST TYPE: 5N OTHER: 44 SHORELINE:
CONST TYPE: GARAGE: 652 SETBACK:
DECK: 200 BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: CAPE GEO --
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 2
Total: 3 Total: 2
Routing Date:
Type Amount Paid Bv: Date: Receipt: A ®F e/E Permit $1,441.75 LYK 03/06/06 79262 �-1!! ����,J� ��//
Plan Check $937.14 LYK 03/06/06 79262 MAR 11 2006
State Building Code $4.50 LYK 03/06/06 79262
Potable Water Application $55.00 LYK 03/06/06 79262 Jefferson County Planning
& Building Department
Total: $2,438.39
a
< C �-L
OWNER BUILDER STATEMENT
ility of the Ge Contra
The signer of this state does reby certify that the a or the ers ofpropott>es
parcel re ced rein,that they are n nsed contractors and that
they will be assu ' g the respo
Signatur . S Date:
GENERAL.CONTRACTOR PHONE: FAX:
—1. --V\NW/1,2_ L E b IM (3(x))(�('-1=)0ce, ( , O)1 .-1 .'15c"O
MAILING ADDRESS: Pc, . x ck--/ W ,15rDD -IiilotelL7 t ADU,, a�3-70
CONTRACTOR'S LIC SE WA1NS
NUMBER: —Txkl eJil -8L{ rirk4 NUMBER
ARCHITECT/ENGIN _ PHONE ( ) FAX: ( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: I Type of Sewage Disposal:
New jg Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: 2' Ba ❑ Community System
❑ Alteration/Remodel 0 Concrete Total: I- Hei t: Alndividual System
Cl Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other. Bedrooms: /, Water Supply:
Existing: Setba : ❑ Private well ❑ Two Party
Type of Heat: Proposed: D<Public
Total: _ /Name of System:
,sir f''-i17,
If this is a Commercial Project you must answer the following:
Number of ing paces: Curren - Pr ed: umb of ADA Pa ' paces:
Numb of occupy is(includes ners,t ants,em ees, tc) Curren sed r--
IB ccupancy: IBC Typ f struction: Will you have Food Servi . s / No
If this is a Propan ank and/or Appliance Installation permit,mark all items below that apply:
❑ Underground Tank pC Above ground Tank Size of Propane Tank: Z50
❑ Heat Stove A Cook Stove ❑ Woodstove K Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove ❑ 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 h;x
,, : ,
FOr if i sY,
Current Proposed r �2► : t �
Main Floor -2Ccr sistency Review ' r� ri. • *71 l it � ' a a'4
--no Base fee: ; ,r� . '-'+ �� ar2 Floor �
3n°Floor Additional Section: '"' , '
Mezzanine: Plan Check fee: /1'
Heated Basement State Surcharge fee: : ,
„,,,,,, 4.--.1..:-:, :'
Unheated Basement Pot Water Review fee: ; .,, `_
Other Unheated 911'Rd Approach fee: 1t :gig r,
Garage/Carport 661. 6 1 A ," TOTAL: $ - • ,,
Decks ;
'�� (�. T _
�� Receipt.Number-
Other 2,1 n� h/ eck Number•
Cis Lid W'
ESTIMATED COST(REQUIRED) Date: ' y�
•Fair market value of all labor and materials foundation to finish 3 I 0'rN K
OQO Initials:
�I1 is
G:\PernitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
( ell/1r)/2006 16:52 36037944 i JEFF CO DCD PAGE 04
' 5. : 2006! 4: 30PM TeliPle Custom Homes • 8 _� wi Jr1 • '
. . "
. 7=f;:vx1,,,,,.:,-7: co,.' JEFFERSON COUNTY JAN — 5 2006 i,-
_:.. ;f�' DEPARTMENT OF COMMUNITY DEVELOPMENT
Washington 98365 -- --- �-
t, ' ,a a B21 Sheridan Street•Port Townsend•Washin '
s •
'' is .r,,, , + T,.•ri'�
7 ., .,, 360/379-4450. 360/379-4451 Ft c
%' www.co•jefferson.vwa.us/commdevelopment ."
4t LOFl.1ENT
•
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Ff a i Pe &Ap licatlor . , .
_ _
i. 4 Oes np6on:(include separate sheets As s nacessary):- ; , •-a - ` . , , • ..
ex Parcel 10)
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ropartY
? t�lslbPr, :`7..c "6'19/'^42-1 _ P Size: t -OU.` . ___ (eoresl are fat
'S re Addret a end/or Dlreclons to Property:e W C2pay°ve •,2V 7 e/ Zio7" �
a O'^ep °+a heels)of 'Record�• ` Y1rf[� G o a .
. + :�?leOlone::5D 't5e3/ ! 93 a Farr • _ email:
Malirig Address: i/'/lc -C/✓/la2C-,0§tt MI_ 3 g
• Applacan/ nt(If different from owner):.�.J ..0e,/, el&LS7_�7 4'/
TF;Iep>ene_ '77z-37 Feoc: ai3 1'''7So G email:
Moir g Add s:e,2 '77 ga4i4 � (4'4 - `99,37
' Vh.:lair d of Permit?(Check each box that applies)
P(S:i�.,r-rg. d Variance(Minor,Major or Reasonable Economic Use)
'. ❑Demolition Permit ❑Conditional Use[C(a),C(c ,or CI"
Engle Famr ❑Discretionary'"D' or Unnamed Uea Classification
Garage ( aa Detached ❑Special Use(Essential PubliC Facll'itiea)••` " '' '
' , , i 0 ManufaduredTTome 0 Boundary Line Adjustment
rC Modular 0 Short Plat".
l❑ Commercial• • r CI Binding Site Plan'" V
0 Change of Use ❑Long Plat'{
0 Address 0 Road Approach D Planned Rural Residential Development(PRRD)/Amendments"
0 P ropcine • ' ' ❑Flat VacatIon/Alteration'
w r?ihw Od."Yes'.Use Consistency Analysis 0 Shoreline Master,ProUram Exemption/Permit Revisions"
$1n Manaaotnent 0 Shoreline Management Substantial Development"'
0 Site Plea Approval Advance Determination(SPAN))• 0 Shoreline Management Variance
' '..-1%7Tiporri,cy Use, ❑Comprehensive Pien/UDCILand Use District Map Amendment
:117eie ;el colt tT uhkatfon• 0 Jefferson County Shoreline Master Program Amendment
":y,,e?m. c;cgs Ad/Release of S!x Year Moratorium
'a,f`roverea Pm-Application Cont'N.'rao. *'--•ul =. aProAv,ficationConferwco
"Kea! Identify any other local,state or federal parinits required for this proposal,if known:
—E i RAGENT
I hereby deal to act my agent In matt ring to this appliostion for permit(s).
-' tr
-= ' t rs spplloatfon foan,the owner/agent attests that the Information prodded herein,and In any attachments,is true and correct to the best of
Nis,her or ire lv+owladge. My Material falsehood or any orniseton of a material fact made by the owner/agent with respect to this application packet
ey 743u3A.In this permit being null and void.
;v' 1.7:agree to asva,Indemnify and hold harmless Jefferson County against eV Imbibes,judgments,court costs,reasonable attorney's fees and'
ar,vemkaa Which May in any way accrue against-letiersen County as a result of or in consequence of the grunting of this permit
F tither agree to provide access and ngnt of entry to Jefferson County and Its employees,representatives or agents for the sole purpose of application
review and any required letar inspections.Access end right of en to this property&half be requested and shall occur only during regular business
' hours. ® `)/
`lQr+aa - - Cato: 2 •
": The aeon of actions Applicant will undertake as a result of the Issuance of this permit may negatively impact upon one or•morc threatened or
cpda- shad species And could lead to a potential•take of an endangered species as tnoea terms are deemed In the federal law known as the
7.1....13:7114Fed aesAcri-or'ESA.•Jefferson County maker)rio assurances to The applicant that the actions that will be undertaken because this
• i Rerrr+,r s»L9*rr tee*will not violate the ESA. Any Individual,group or agency can file a lawsuit on behalf of an endangered species regarding your..
• i ct on;s)even if you are In compliance with the Jefferson County development code.The Applicant adv owledges that he,she or it holds individual
• ! u.rc! r.-'ha.r� a r'epponstbttltyfor and p ng wittl the ESA. The Applicant has read this IS er anddsigns and QeOas It below.
. ,r.sn�w, Data: '
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COLA \ DRIVI
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• •
SPECIAL CONDITIONS FOR CASE # BLD06-00096
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 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.
6.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
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 Colman Drive right-of-way shall be 20 feet. Minimum side and
rear yard setbacks shall be 5 feet.
16.) 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
II
0,-- % - JEFFERSON COUNTY ! �.
DEPARTMENT OF COMMUNITY DEVELOPMENT (o
621 Sheridan Street • Port Townsend • Washington 98368 MAR -IS 2006 3
.elsiu,, 64
Cf 360/379-4450 • 360/379-4451 Fax
i
http://www.co.jefferson.wa.us/commdevelopment/ - i j
,. 'rLo:-.SEN 1
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
IMLA# PROJECT/APPLICANT NAME: �j9`L kiet7 C SG/ C' _ -
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.
•
Existing Conditions Summary
•
2. Describe the existing topography. Indicate contours on the site map.
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3. Describe the existing vegetatio . Indicate native v getation areas on the site map.
/ , 7 Cal' 0-6(XL_ / . - -.--
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.
/U 'Gle Si c--lx?a., "v 4,-,,ems,
6. Describe any excess levels of noise generated by the proposed use or activity:
APPROVED
/tf/ _ STORMWA I ER PLAN
MAR 1 7 2006
stoteineter site plan template—rev.10/1,2003 Stormwa ( lEFFERSO OU T
r DEPT.OF .; •I D• L P ENT
Require tIGNATUR:
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7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes, etc.)on the site. Indicate location on the site map. ?"
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8. Describe the general vicinity of the site,including adjacent land uses and structures, utilities, roads,and sensitive/critical areas
(streams,wetlands,lakes,steep slopes,etc.).
/V/Ai
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., per BMP T5.30
in the Manual)or, if not,what types of stormwater flow control will be utilized for the site or specific threshold discharge areas
within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities.
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10. If the project requires the use of stormwater treatment facilities,describe the types of stormwater treatment facilities proposed
for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is
normally for large"projects or projects that involve the potential for dispersion of contaminants.]
//
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11. Describe the performance goals and standards applicable to the project.
12. Describe the flow control system.
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• •
13. Describe the water quality system.
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14. Describe the conveyance system analysis and design.
M _ __—_---
15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material.
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•
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
.,--e-A4(140,- 6,--7-6--e, Oei . fre( Aft
17. Describe the proposed surfacing material.
18. Describe methods for restoration of the site.
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19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for
large"projects only and only those for which facilities are required to control flow or treat runoff.) If included,list the Manuals
here. A(
`
20. List here and include any special reports or studies conducted to prepare the Stonnwater Site Plan.
xJ /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.
/v //
etorrewater 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.
4 p
2. Establish Construction Access.
3. Control Flow Rates.
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4. Install Sediment Controls. G
5. Stabilize Soils.
6. Protect Slopes.
7. Protect Drain Inlets.
A//4 -17 77r-- 2:i
Stc-avatar stta plan tanclate—ray.1 V 12003
• •
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets. '+
9. Control Pollutants.
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•
10. Control De-Waterin (the act of umping groundwater or stormwater away from an active construction site).
11. Maintain Best Management Practices(BMPs).
12. Manage the Project.
671 4-
2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas,roads).
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•
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
• 2086 .
stonnwater site pan template—rev.fief V2003
iic' itil 9
40
b. Description of special requirements for working in or near environmentally sensitive areas.
Ai/.4
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).
/i4
5. Construction Phasing.
a. Construction sequence 7
4-4. -1-, .. :-,-.4-1-,,--1.--1 ---
b. Construction phasing(if proposed)
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6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a proposed construction schedule.
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II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
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b. Proposed wet season construction activities for environmentally sensitive areas.
. Al.,41 .
7. Financial/Ownership Responsibilities.
a. Identify the prgperty owner responsible for the init�iOion of bonds and/or other financial securities.
(ji f- ,,`c p C:.€s lip 6c2eI-
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. j A
c. Waterways. V
d. Runoff/Stormwater Detention Calculations /
stormwater site plan template—rev.10/12003 10
41
•
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.
(LANDOWNER ORAUUTHORIZED REPRESENTATI SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
t o -- 5 2.006
•
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•
•
•
•
stormwater site plan template—rev.101112003 12
•
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