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HomeMy WebLinkAboutBLD2006-00122 SUILDING PERMIT APPLICAI'7!tiN ML v Reviewiew T Ty 121 ype: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00122 Received Date: 3/16/2006 SITE ADDRESS: WHEELER LN PORT LUDLOW, 98365 OWNER: NICHOLAS S VAN PHONE: 360-445-6023 PO BOX 1344 AUBURN WA 98071 PORT LUDLOW NO. 2 AREA 3 SUBDIVISION: Block: Lot: 22 PARCEL NUMBER: 990600322 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NSFR W/ATT GARAGE, PORCH, DECKS & A/G 400 GAL PROP TANK TYPE OF WORK RES SQUARE FOOTAGE: A .Vuiv l t, ` t-%,k .:vot GI TYPE OF IMP NEW MAIN: 1,650 VALUATION 323,£300.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: 1,448 HEAT TYPE: PRO OCCUPANCY: R-3 UNHEATED:Un}w�6hod 'IS OCCUPANCY: t ice, # OF STORIES: CONST TYPE: 5N OTHER: ?orc... - 08 GARAGE: 692 SHORELINE: CONST TYPE: DECK: - SETBACK: to`S BANK HEIGHT: SEWAGE DISPOSAL: SEW WATER SYSTEM: LUDLOW BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 1 Prop: 3 Total: 1 Total: 3 Routing Date: 1 1 r7 )6 (0 Type Amount Paid By: Date: Receipt: w �proy at �V Permit $2,248.15 LYK 03/16/06 80858 H EC Plan Check $1,461.30 LYK 03/16/06 80858 MAYa4, 2006 State Building Code $4.50 LYK 03/16/06 80858 Potable Water Application $55.00 LYK 03/16/06 80858 Jefferson County Planninc+ Total: $3,768.95 &Building Department lis)c- >-cV Sk\C`. 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 #: BLD06-00122 SITE ADDRESS: 122 WHEELER LN Issue Date: 05/26/2006 PORT LUDLOW, 98365 Final Date: 3/27/2008 APPLICANT: BRIAN VAN PHONE: 4225 CAKERIDGE DR E 2SUM3N3ERgWAA 98390 PORT SUBDIVISION: LUDLOW NO. 2 Block: Lot: 22 PARCEL NUMBER: 990600322 Section: 9 Township: 28 N Range: 01 E PROJECT DESCRIPTION: NSFR W/ATT GARAGE, PORCH, DECKS & A/G 400 GAL PROP TANK (1,599.75 sq ft of unheated/unfishished basement.) 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 3/27/2008 I:\F_BLD_Occupancy.rpt 10/29/19 • BUILDING • U LDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00122 Received Date 03/16/2006 SITE ADDRESS: 122 WHEELER LN Issue Date 05/26/2006 PORT LUDLOW, 98365 APPLICANT: BRIAN VAN PHONE: 253-334-6403 4225 CAKERIDGE DR E SUMNER WA 98390 SUBDIVISION: PORT LUDLOW NO. 2 Block: Lot: 22 PARCEL NUMBER: 990600322 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: NSFR W/ATT GARAGE, PORCH, DECKS &A/G 400 GAL PROP TANK CALL IN FOR THE REQUIRED INSPECDQNS THAT APPLY TO YOUR PROJECT. SETBACKS: Q,K UFFER: /1f4 Footing: Dkf3yl4/D4 f Foundation: ,Of 0/AG Stormwater FINAL Approval: - /oc1/M6 Dopus 01C )Gb3lcsZiictettiue OK t2/i2/0 Underground Plumbing: OK to f3/64/; Underground Insulation. a I 7 O6 ' Shear Wall : DX 6)/cam 1l/aM r /NS7AA< Z S?r2 z U1 Sheathing: Framing: 4k' /A,Ve.eppictrboA , i Qi Z Svte.Avs 7/2/1)7 (91 Plumbing: „le 6fr..5A7/ fr Propane Tank/ Lines: & 0 s �k t I?0- SA& e nh,iwas ,- , Fi�CE'I, r 4r' ���08 Insulation: I a L . - .� . _ /)747,M1110.�►/�/ / Sheetrock: 4e J�2? a7�I Septic Sytem Findl A pro al MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: Q - - Gf0 3/1,7,Og /, f HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL iREQUIRED 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 4110 SPECIAL CONDITIONS FOR CASE BLD06-00122 1.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 2.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC)Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 3.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 4.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 5.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 6.) 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. 7.) 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. 8.) 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. 9.) 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. 10.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 11.) The project shall adhere to the�t 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. 12.) 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. 13.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 14.) 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). 15.) Maximum lot coverage is not to exceed 45%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 16.) The building height is not to exceed 35 feet. 17.) 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. 18.) 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. 19.) Minimum setback from Wheeler Lane right-of-way shall be 20 feet. Minimum setback from Oak Bay Road right-of-way shall be 30 feet. Minimum side and rear yard setbacks shall be 5 feet. 20.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 21.) Per MPR Code Section 3.107, Accessory Dwelling Units (ADU's) shall not be allowed within the MPR-SF zone. 22.) A CURTAIN DRAIN SHALL BE INSTALLED ALONG THE WEST LOT BOUNDARY LINE AND EXTENDING ALONG THE NORTH LOT BOUNDARY LINE AND THEN TO THE DISPERSAL TRENCH CATCH BASIN. I:\F_BLD_Permit_Buildng.rpt 10/29/1999 • • ray & Osbox-rie, L L . CONSULTING ENGINEERS March 19, 2008 Mr. Lee Amundson Chairman/Treasurer Port Ludlow Drainage District 121 Marine View Drive P.O. Box 65261 Port Ludlow, Washington 98365 SUBJECT: 122 WHEELER LANE DRAINAGE INSPECTION PORT LUDLOW DRAINAGE DISTRICT,JEFFERSON COUNTY, WASHINGTON G&O#08415.00 Dear Mr. Amundson: As requested by Jefferson County and directed by the District, we completed a drainage inspection for the above-referenced parcel(990600322). The subject lot(Port Ludlow No. 2,Area 3,Lot 22)lies on the northeast side of Wheeler Lane and slopes from the front of the property toward the greenbelt between the parcel and Oak Bay Road. The greenbelt slopes away from the parcel and toward Oak Bay Road. The project is a single-family residence with an attached garage. The following are our observations, comments, and recommendations: • The approved drainage plan shows a catch basin at the driveway to collect surface water. We did not observe this catch basin. • The approved drainage plan shows a dispersion trench at the east property line, immediately adjacent to the greenbelt. A dispersion trench was installed,but was immediately behind the house. It was unclear from the site visit whether footing drains were attached to the dispersion system. If footing drains are attached, they appear to be lower than the level spreader, and therefore will not freely discharge. The southern end of the flow dispersion trench is lower than the constructed level spreader, and therefore will direct water to this location. Either this area should be filled to allow the level spreader to function,or the level spreader should be moved lower on the property to provide adequate discharge. 701 Dexter Avenue N.,Suite 200 Seattle,Washington 98109 (206)284-0860 Fax (206)283-3206 1=i:i11 i: i;i'.IIi..111}'O 11.11,01 • Mr. Lee Amundson March 19, 2008 Page 2 I have enclosed several photographs from the site visit. Please contact me if you have any questions or need additional information. Very truly yours, GRAY& OSBORNE, INC. Barry Baker, BB/hhj Encl. 4, I SON c° JEFFERN COUNTY �, . 44,44 �.. � �, r ai a, 1 DEPARTMENT OF COMMUNITY DEVELOPMEIV'T ' \' .,„_ '� 621 Sheridan Street • Port Townserd•Washington 98368 & ,k 360/379-4450 • 360/379-4451 Fax �`S�YIN��O• www.co.Jefferson.wa.us/commdevelopmel AR 16 2006 Master Permit Application ��F��hpN �Y�(� � IIL.A: 0�-- 1 1 Project Description (include separate sheets as ne ssary): C?iL'SIPi•/c 7-- 1/et/ /Cle (-'/)--er- 'Sc-?- e--- C�/1771 ik1 " .� ,, Property r^ Tax Parcel Number: `n Z res/sq(--� Size: /G� Xila (acres/square fee Site Address and/or Directions to Property: (�•j ZZ 1GG 2- /% /} 3 (l�/rc,o - '€. Property Owne s)of Record: Al i Gg� t//1-.y Telephone: ' '( '- 1--/y s-_ Gl.s Fax: email: Mailing Address: asC• r ,)( Applicant/Agent(if different from owner): r'�/4,..,✓" t_' Telephone: �r-5, `.`5-5-/- yt , Fax: ✓ ., email: L�t` zr� ��% Lc,j Mailing Address: [�- ) L✓` �,�� %N -- oe C. '�i'. s�: .fit' �'. , th5,1 What kind of Permit?(Check each box that applies) cr ,Building ❑ Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or CI** A.Single Family ❑ Discretionary"D"or Unnamed Use Classification .Garage(tachedil.Detached ❑ Special Use (Essential Public Facilities)*" ❑ Manufact ewe ❑ Boundary Line Adjustment ❑ Modular 0 Short Plat** ❑ Commercial* 0 Binding Site Plan** ❑ Change of Use ❑ Long Plat** ❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments*'A Propane ❑ Plat Vacation/Alteration** ❑ Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development'`* ❑ Site Plan Approval Advance Determination (SPAAD)* ❑ Shoreline Management Variance ❑ Temporary Use 0 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: DESIGNr ATION OF AGENT I hereby designate ` vj4„4___ to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE IIC" Date: 3 - 7 "0 , By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet m; 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 t Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later inspections.Acces rightproperty shall be requested and shall occur only during regular business Pe d fen to this ro hours. " Signature: Date: J 2 - 7 „p 6 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 lake"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson Coun makes no assurances to the applicant that the actions that will be undertaken because this perry has been issued will not violate the ESA. Any indivi al,group or agency can file a lawsuit on behalf of an endangered species regarding your action(; even if you are in compliance with the Jefferso ty develo me t e.The Applicant acknowledges that he,she or it holds individual and non- transferable ronsibility fogada ri�o and ing W' T�Applicant has read this disclaimer and ' ns all,dates. below. Signature: 44 V —� Date: I.... 'e G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc 411mow- 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 assuming the responsibility.of the General Contractor for the proposed project. Signature: t?/-e,.. 4.) 1/6-1i _-- Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: :1, New P Wood Existing: ? Sewer ❑ Addition 0 Steel Proposed: -3 Bank Height: ❑ Community System Li Alteration/Remodel 0 Concrete Total: A ❑ Individual System ❑ Repair ❑ Masonry '` SEP Permit# ❑ Demolition 0 Other: Water Supply: ll f , kg i • _ Setback:{ B ms ❑ Private well ❑ Two Party T of He t• Proposed: _ / jfl' Public YP . F; > ' Total: _ '/ Name of System: If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Epp ; s(T + +1 Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,pripploy Welt6)"C r`ren 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: 0 Underground Tank $.Above ground Tank Size of Propane Tank: Lk'L 94 Zt c - Al. Heat Stove ❑ Cook Stove ❑ Woodstove k1 Fireplace Insert X Hot Water Tank 0 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. t k'+ Square Footage Current Propoaed r, .Ge '' - ' ,,�. ' It F. .,� . . Main Floor Heated / :, ° '`' s b, EH Bid App Review: _ W� 4i 2n0 Floor Heated , x'-< Consistency Review: 0 Other Heated 1 Base fee: a atl +t5( 1-5�j) 1,0/0 Mezzanine a ,.,.;:: Additional Section: 1 =� Heated Basement Plan Check fee: 6�A) fy�.1 c' Unheated Basement tt State Surcharge fee: 11 U•. on �•S -c1 ' ,7 g Oaf " -1 Other Unheated r�4„n,•.7ncc, I 'Y'''" ; Pot Water Review fee: . SUBTOTAL Garage/Carport ,_ �� � 1 , 3 Cr(O.CI5 Decks rI. , ft'=' 911/Rd Approach fee•T `c, O , Other ,eati_ S' t f, TOTAL: $ [ �� / 1 ),C _ 'J Receipt Number: N 5Y� 's Cash/Check Number: ((' ESTIMATED COST(REQUIRED) 5 y,C ;,l Date: i �1r., .Fair market value of all labor and materials founda t I V� l /fir Yo Initials: 1 2 G:\PermitCentcr\FORMS\DRD FORMS\Master Permit A .n t :3-0-05�.doc • 111 I00 (o 3aa. • 4esON c,,°% JEFFERSON COUNTY ��D`�I� # BIB t44: DEPARTMENT OF COMMUNITY DEVELOPMENT 0 0 621 Sheridan Street • Port Townsend •Washington 98368 Jf f Fria cow DCD DSO 360/379-4450 • 360/379-4451 Fax LINO http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# vlll 'a� PROJECT/APPLICANT NAME: it'IC/Cl t% _ 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 . l - E Conditions Summary 2. Describe the existing topography. Indicate contoo rs on the sit9f map. yitiezher 3. De ribe the existing vegetation. Indicate native vegetation areas on the site map. tot—ye r /Ge %l C; L-C7 f<4.S CC&q ' ' c- l0 { ' j /47c' 4. Describe the existing soils. Indicate soil type on the site map. tc7/4//t 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. , /O .��73-��:�i;�; & r am APPROVED 6. Describe any excess levels of noise generated by the proposed use or activity: STORM WATER PLAN /Cie — _ - MAR 26 2006 St0Wt at JEFFERS N C TY Requ»e DEPT.OF C' 1 Y E E P ENT stonnwater site plan template—me.10/1/2003 `1 SIGNAT!R . 5 • S 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 a 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.). G( ,iPPG g- 49GA7 3e?i' i-a✓il a121 / et C 4.01- CAI 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. 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.] '.5762E) 's if 'cn.,v 11. Describe the performance goals and standards applicable to the project. Te; flint:14-19i :et' ,a Xt..'t 7- 1,1-1 -71W A-2,4it---j---- wie- ' / 69i� Vie /cee / f i / Ay,(--(. /� ,12. Describe the flow control system. i stormwater site plan template—rev.10/1/2003 6 • • • 13. Describe the water quality system. !1//i- 14. Describe the conveyance system analysis and design. See pz3_,‘,44;-_e /tñ4/ 15. Desc be the source of fill material,physical characteristics of till 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. //lc cIJi. 17. Describe the proposed surfacing material. 18. Describe methods for restoration,of the site. !5 %VAC c c r%c ,f-(2 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 • • • 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 C,,Iearing Limits. 2. Establish Corn truct pnn Access. e 6:/(4-g2C/ yoc-i - 3. Control Flow Rates.{ 4. Install Sediment Controls. 5. Stabilize Soils. 6. Protect Slopes. LL 'u/ 7. Protect Drain Inlets. .. ice'/1A- stormwater site plan template-rev.10/1/2003 8 • • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. C/ /Jj'/C<7 9. Control Pollutants. /t// 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). 67/ S 1cf; LL 7)(-. 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 yards). C ti' 1 jl C-iv 1° 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. stormwater site plan template—rev.10/1/2003 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). 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). I. Provide a proposed uon schedule. t'_ (�, construction — /i: II. Wet Season Construction Activities. a. Proposed wet season construction activities. b. Proposed wet season construction activities for environmentally sensitive areas. 7. FinancialOwnership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable. a. Sediment Ponds/Traps. b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations stormwater 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. 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