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HomeMy WebLinkAboutBLD2006-00117 MLA06-00119 ILDING PERMIT APPLICATON Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00117 Received Date: 3/15/2006 SITE ADDRESS: 672 TOTEM RIDGE RD PORT HADLOCK, 98339 OWNER: RICKY L GORE PHONE: 360-385-6883 LAURIE L GORE 62 RHODY CT CHIMACUM WA 983258723 W E SETON SHORT PLAT SUBDIVISION: Block: Lot: 4+ PARCEL NUMBER: 901114025 Section: 11 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: L 1& re,V 5G. L1ta /frg AI do tha tbcc -can PROJECT DESCRIPTIOr NSFR W/A/G 1000 GAL PROP TANK sue- Sty-t t ►ten, TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,566 VALUATION 555,623.00 ADD'L: 1,942 HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: 1,203 HEAT TYPE: PRO OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 1,856 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON _ WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 3 Prop: 3 Total: 3 Total: 3 Routing Date: , )� �a trc.-- Type Amount Paid By: Date: Receipt: Approved/Date Permit $3,499.75 LYK 03/15/06 80856 fri9 rF _-I' 0 ti _ State Building Code $4.50 LYK 03/15/06 80856 Potable Water Application $55.00 LYK 03/15/06 80856 APR IQ 2006 Plan Check $2,274.84 LYK 03/15/06 80856 jells;ma^EZIZMI7 P1annln}i Total: $5,834.09 Building Department C • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00117 Received Date 03/15/2006 SITE ADDRESS: 672 TOTEM RIDGE RD Issue Date 04/12/2006 PORT HADLOCK, 98339 APPLICANT: RICKY L GORE PHONE: 360-385-6883 LAURIE L GORE 62 RHODY CT CHIMACUM WA 983258723 SUBDIVISION: W E SETON SHORT PLAT Block: Lot: 4+ PARCEL NUMBER: 901114025 Section: 11 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: NSFR W/A,G 1000 GAL PROP TANK CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: 7A( dh3 06 PS r Fae r/AiG5 $ re4fcAMATIDA?��rJA Peek) UFFER: O,(k' 4//3/Av �)1< ///g/aj,L Footing: Di{ b/3/b (Diiij g -ro SUBMIT RE siOu eF i 1OR C-15146Jr £d1AL[ Td FMMED . Foundation: a 7 S/6t 9' AnA)Edo!) &rr Kt. ei2 OkL i/ii,/G� SNest a.- averQ eNzeS STARE'4' 541A-r'zza)A Stormwater FINAL Approval: Underground Plumbing:/7 4 .2 /c._"2/20/ce �,.l+,TFt,00,- (,1-vr as(-(, 3�{lg7 Underground Insulation: `7 r),„ I Shear Wall : ,g-' =i-cc_al �, 3j1"7.E)Jv Sheathing: I Framing: — �(- ))i- .4 Ok 4/5l07 Plumbing: AK 4/S/67 fr r L L _ �VPIWA 1 Propane Tank/ Lines: t 7 1 '�'` `t ► 0 7 f�67 7 a L /i� s/Af?I Insulation: /i 2 4 2t DX 4-# e7 ALLS #L'&7u v65 ,o_/C / G Sheetrock: Septic Sytem Final Approval MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: i•ei corvuzicvit-Go-25'C7 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. O*fice Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY - SEE REVERSE SPECIAL CONDITIONS FOR CS E t BLD06-00117 1.) A vegetative buffer of 30 feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. For this parcel the approximate location of the slight landslide hazard is the sloped areas located at the northeast and southwest corners of the parcel at the 300 foot contour elevation. All buffers shall be measured perpendicularlyirom 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 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 identified Fish and Wildlife Habitat Area (Type 5 Stream), shall maintain a vegetative buffer setback of 50 feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to the proposed residence, garage, and associated improvements. 8.) An additional setback of five (5) feet is required from the edge of the buffer area to the proposed house, garage, and associated improvements. 9.) 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. 10.) 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 con:act 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. 11.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 12.) The building height is not to exceed 35 feet. 13.) The front setbback is 20 feet from the edge of the right-of-way of Totem Ridge Road. The side setback (east) is 20 feet from the edge of the right-of-way of 1st Street. There is a 5 foot side and rear setback from property lines. 14.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. I:\F_BLD_Permit_Buildng.rpt 10/29/1999 iOWNER BUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assunv the responsibility of the GeneralJ Contractor for the proposed project.. Signature: ,. 1 L LiL ✓--Le, l . ,.)C��11?, bate: `3'/, /o GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRFS.S: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: . New ❑ Wood Existing: Sewer ❑ Addition ❑ Steel Proposed: '43_ Bank ❑ Community System Cl Alteration/Remodel 0 Concrete Total: y Height: ❑ Individual System r /A ❑ Repair 0 Masonry NI f .�SEP Permit# (� -- I left ❑ Demolition T; Off: Bedrooms: Water Supply: L L, 4•- wr(r.) Existing: — Setback: ❑ Private well ❑ Two Party Type of Heat: :3 _ t/Public P cin+*.p ../E(,ez.tie,c- Total: _: "I/I Name of System: Pa I) # 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: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: [7 Underground Tank Iiit.Above ground Tank Size of Propane Tank: I i Cad 0 4 I to N '6 - Heat Stove I. Cook Stove ❑ Woodstove Li Fireplace Insert pf Hot V_V.4. er Tank ❑ Pellet 8tove ❑ Other Is this appliance being installed in a Manufactured/Mobile Home? Yes 4No 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 Fot't 'ks Only 'f4 v-` 0 Current Proposed Main Floor �`h7}G�/�j Cahsistenc�yReview *g* i s�.rR r b: f FK� J S 2`�'Floor ` h I'd r' 1I:.t r L , J��`/ Ii+ bl l4ee: Lt1�fr , 3f0 Floor =Ad�tional Sedioh: Mezzanine: ''Plan Check fee: ` - Heated Basement a 6 Mate Surcharge fee Unheated Basement Y; Other Unheated 9 R :•y lh lfe-4:i ]rP y ". a -• tC i lx yam; Garage/Carport - Decks -1' u - `� /^ L ` t.5 e .PtIs_ .---A, Other • Cash/Check Number ESTIMATED COST(REQUIRED) Date• •Fair market value of all labor and materials i tO i �t�t ..1.fce,-61-e7-o 00`' 555 (oaa.' 5 nWais: 6St� I i G:\PemutCenter\FORMS\ORD FORMS\Master I'ennit Application 7-8-04.doc III �,�,SON cab JEFFSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT i-' ` `4 621 Sheridan Street• Port Townsend•Washington 98368 360/379-4450 • 360/379-4451 Fax �q p� www.co.jefferson.wa.us/commdevelopment S,trING' Master Permit Application MLA: Ckf - i l _l Project Description(include separate sheets as necessary): N.e.: ,'+. 1 E !-Prevl, i y- A.t. -•ci t Nr-e I.,0E. 5e4oN 3he!`-t- elect-/ i_ef Li ,'ti St'c�i'Cu 11 / Tic�r.P.,WO .: e-t ��/iuefie 01 10e3 <-mWro Tax Parcel Property Number: U I I t{ -( �� Size: /U, ,+ 7 r= (acres/square feet) Site Address and/or Directions to Pr : �ci.7:� To f-�m �,'d r gd 1 P�1- / ((c 1� Property Owner(s)of Record: c--K. -+ L.,4 u2+' - 6,c,k< Telephone:�i;)(Z- 31;-0-3 S'S-(4 '!?3 Fax: 3C;0 . 3“: -0b y- email: GteDk6=(Oi y Ern/-('Or,) Mailing Address: !n a_ RhGc:t '�i u M + / C1,t ,'m.4Cu rvi / Li.?,'4 `i 8.3 J Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address:_ What kind of Permit?(Check each box that applies) E'Building ❑Variance(Minor,Major or Reasonable Economic Use) ❑Demolition Permit ❑Conditional Use[C(a),C(d),or C)** OrSingle Famil ❑ Discretionary"D"or Unnamed Use Classification e d ❑Special Use(Essential Public Facilities)** ❑Manufactured Home ❑Boundary Line Adjustment ❑Modular ❑Short Plat** ❑Commercial* ❑Binding Site Plan** ❑Change of Use: ❑Long Plat** ❑Address CI Road Approach ❑ Planned Rural Residential Development(PRRDXAmendments-- ikePropane ❑ Plat Vacation/Alteration** ❑Mowed'Yes'Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions'"` ❑Stormwater Management ❑Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* Cl Shoreline Management Variance Cl Temporary Use El Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium *May require a Pre-Application Conference **Requires a Pre Application Conference Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fad 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. , t- ,hST- Date: •�//510 ' Signature: L.d�c �/C` 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"hake 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-tran fere e responsibility for ad 'ng to complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: ,��-�)(� (�L(¢ Z_ Date: _j//S70(d — G:\PemiitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc e ' JEFRSON COUNTY s...J F � DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend -Washington 98368 'S'' 360/379-4450 •360/379-4451 Fax i r t t http://www.co.jefferson.wa.us/commdeve$opment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# \J VD — \.�� PROJECT/APPLICANT NAME: Ra 1 JQ L{ l �i ( C1 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. 5U i tei ktA9 , - L'-Pjd `II*" I)L-' n 1 i z'eA Cc, //io n€.. Lp2z.,:. t 5 k)i`-vvl e.t:;` -Y, ,.(1-t v?`[ A-a Li r 06-6 ), Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. F I✓-t-+, L . . h o✓14 i`S 4c r ,-i l i.t:i i't"tri e.?NI 1 GA r=}loe t:t'i-- °} Y/O ci-R Gt_c2�ic:( Lr.i 5 top,`, z 1 S :s 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. 1;-;calclr-c.df QA-vJ I Pr+tiA 5[,c�i2Cc.r_i..d4,` 3(.. 116W S•_ *-T - Allvt- tt -I C1..d.P1-i,Z i- A-t d -1-r2 <; . 4. Describe/the existing soils. Indicate sod type on the site map. 1 E st os --:N-I cA �7©1 I `7 i A.�'_ `5 N-i•l Ci. 1,t,)/ L A✓4-'- (Y.i 5C -i-c.l.;Z.E_ - ^�O c t i S n i1 C , ! l�ortAP L+ - NLi +f't.1)��,`Oi'i 0k iE_^j'r /9-C--i—`e I L_i i<. (4-T�-1N_6z- i t .A '` C� - 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 sae map, if i — aooIrahw rtrl indicate acreage of each. N i-44u&- - -s i o p C - - - A' I ci m v4-k L)L 'i-b_:_. c 'n-1 t•S i' 4-0 1-k L J P-1,1 h. -6,`, J i'14'(1..`Coo 'e aC cg lJ vvt14 p . 6. Describe any excess levels of noise generated by the proposed use or activity: ---"— i\-),, APPU i LD STORMWATER PLAN _ LAPR 1 2 cnn 74eA)'-(5)--i) s stormneter site p:anterrflat9-rev.1011/2003 )EF RSON COUNTY OEPT.OF COMMUNITY DEVELOPMF\T SIGNATURE. • 7. i Describe significant steep sc e g,eic geographic features and critical areas (i.e., environmentally sensitive areas such as w on the site. Indicate location on the site map. cJ ! !q 8. Describe the general vicinity of the site, including adjacent land uses and structures,utilities,roads,and sensitive/critical wetlands,lakes,steep slopes,etc.). areas Permanent Stormrwater Control Plan This of the er Site Plan consists and facilitiieies to remain in plaice after construction of of ththe pro project is completed. and installation of the 1appropriate stormwater control BMPs `Medium'size projects are required to have the totals calculated of aD impervious surfacesng impervious surta�s, and pollution-generating , pollution- facilities are not exceeded. pervious surfaces to verify that the thresholds for treatment facilitiesr and flo control 9. Describe the developed site hydrology, as in the if not,whatproposed. Indicate whether stormwater will be fullydispersed within Manual)a site. Locate these facilities of the s e plan and er flow control tr l will llabe utilized for the site or specific c (i.e.,per BMP areas yproposed facilities from a ting facilities.discharge areas 10. If the project requires the use of stormwater treatment facilities,describe the for use on the site. Locate these facilities on the site plan types of stormwatersfromtreatment facilities proposed normafy for large'projects or projects that involve the and for dispersi proposed f inilities existing facilities. [This is potential for dispersion of contaminants.] 11. Describe the performance goals and standards applicable to the project. 12. Describe the flow control system. • • stor matersibplan:errplate—rev.1d12003 escribe the water quality sym. # ,l if 1 l� 14. Describe the conveyance system analysis and design. r+ ^; 15. Describe the 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 Bung Code. • • 17. Describe the proposed surfacing material. 18. Describe methods for restoration of the site. 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. stormwater site plan.template-rev.10/1/2003 7 )410 CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP) The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the k. template that follows must be installed on the ground during all construction phases of the project. The proponent is a. preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural . development. SECTION I—CONSTRUCTION SWPPP NARRATIVE -Q't\ 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or wil,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. • L;lv�.t��2t'vr 1.,V A—j aar�,& i.U.4-LA pk.Y.vt Lu > S1-r). -vt LLM-44aL 2. Establish Construction Access. . U r.1 /JL ;'0 tz iA.3. - (1.3P.L`v c_i t2:'I.. . h 5 I,��4v nis tl d tA) i-tit 3. Control Flow Rates. (( '' • 4. Install Sediment Controls. 1 �}{ 14)Q .)`ti. t^�V `�'I- `}t t ?r Iv 5. Stabilize Soils. 0,0 w x L '\ Dt) t . 6. Protect Slopes. tkiA-}-ur,;a- vjj eRz t 1-1/ s (0re 7. Protect Drain Inlets. D R - bk. w l h Nf>f- -lead iitj c, ,s F 1 i ., )_' ;l ! i stormwater site pan template—rev.10E112003 t 8 11111 12 Required Elements-onstruction SWPPP(continued) 8. Stabilize Channels and Outlets. v rj �� 4 ( jt 9. Control Pollutants. N.()F.l '!, itji It b pI. a3 � . 'a 10.4opg De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). 1, e t( . -A i i1-N P' 1 . 12. Manage the Project. i ll 1A)r i ;EL �i �j kvielAi £� P �',� FQ6 1( 5r�;.i. L 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). 72i a2 vt- k o ru' b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards).!f !/�� yr i le i ti'�0i-L i Ate- `f 1 (J„j [/Ai J, i-`� a — /'tC%+ i-Ad r1�ij ( -fh) $ ! Vl+ Lit �e _ Vr 7J7 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. st-2* en) 5,941-k uYe-511 L u 6=I pkbp fc�. s s s u icev1 S, ? stommater site plan template-rev.10/12003 9 4111/ lb 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). ONE 5. Construction Phasing. a. r�Construction sequence [_'':LA tCi C +��ti�'at /} i( kiso i.i In `<- b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction schedule. Alp, ;.l ,! .-.11)o 5 t,4p f e Ice.*✓04-1-i'o counid 4-1-.br.l 11/O(v II. Wet Season Construction Activities. a. Proposed wet season construction activities. b. Proposed wet season construction activities for environmentally sensitive areas. 7. FinanciaVOwnership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. LAK�2,' cr l2-.'t=K. Ufa b. Die bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. ittiA, Is' 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. b. Diversions. r c. Waterways. d. Runoff/Stormwater Detention Calculations stormwater site plan template—rev.10/1/2003 10 0 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. APPUCANT 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. •3//.S o (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED: am' If Y 'i.,. . t17... '..'�:3. . ; stomrxater site plan template—rev_10/112003 12 ., .... . . 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