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HomeMy WebLinkAboutBLD2006-00204 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#: (BLD06-00204 SITE ADDRESS: 1461 GRIFFITH POINT RD Issue Date: 06/21/2006 NORDLAND, 98358 Final Date: 9/5/2007 APPLICANT: ANTONIO SALGUERO PHONE: 360-385-4703 1461 GRIFFITH POINT RD NORDLAND WA 983589500 SUBDIVISION: Block: Lot: T 69+ PARCEL NUMBER: 021321045 Section: 32 Township: 30 N Range: 01 E PROJECT DESCRIPTION: NSFR 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 9/5/2007 q. t:ccol Building Official Signature C\ � Date I:\F_BLD_Occupancy.rpt 10/29/19E -0 06 GILDING PERMIT APPLICATON MRL viewTy 1p 9I 5 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00204 Received Date: 4/25/2006 SITE ADDRESS: 1461 GRIFFITH POINT RD NORDLAND, 98358 OWNER: ANTONIO SALGUERO PHONE: 360-385-4703 1461 GRIFFITH POINT RD NORDLAND WA 983589500 SUBDIVISION: Block: Lot: PARCEL NUMBER: 021321045 Section: 32 Township: 30 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NSFR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 786 VALUATION 176,000.00 ADD'L: 996 HEAT TYPE: PRO CODE EDITION: 2003 HEAT BASE: HEAT TYPE: WOD OCCUPANCY: R-3 UNHEATED: 900 #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 150 SETBACK: 40 BANK HEIGHT: 10 SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: 9125/0(0 Type Amount Paid By: Date: Receipt: ,'d-`. Approved/Date P h W Permit $1,424.95 LYK 04/25/06 80987 Plan Check $926.22 LYK 04/25/06 80987 JUN al 2006 State Building Code $4.50 LYK 04/25/06 80987 Jefferson County Planning Potable Water Application $55.00 LYK 04/25/06 80987 &Building Department Total: $2,410.67 � d02-fh-'"-N 0 0 OWNER BUILDER STATEMENT The signer of this state nt d reby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming t e res ility of the General Contractor for the proposed project. Signature: Date: J Z—W66, 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: New <Wood Existing: Ll Sewer J Addition U Steel Proposed: / ; Bank Li Community System J Alteration/Remodel Li Concrete Total: /.5' Height. l 'Individual System J Repair Li Masonry -� SEP Permit# E/9696 /5"-- __IDemolition LiOther: Bedrooms: Water Supply: Existing: Setback: X Private well i i Two Party Type of Het: Proposed: '� `'If�I Li Public INt`� ' � � Total: 2— Name of System: 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: i Underground Tank ove ground Te?iit) Size of Propane Tank: i Heat Stove i Cook Stove I Woodstove Fireplace i Hot Water Tank i Pellet Stove i Other Is this appliance being installed in a Manufactured obile Home? Yes ' 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 For Office Use Only E { ,, Current Proposed �� ` �-knl° LQ, Main Floor d,. �O j Consistency Review:ill L '3' 2Nu Floor l'161 I �ap gC a/ 1Iase fee: ' Y 3f°Floor Additional Section: Mezzanine: Plan Check fee: Gam/ a a• Heated Basement State Surcharge fee: _A SO Unheated Basement /)DO �g(� l`-� Pot Water Review fee: CM �" Other Unheated gee) ` 911/Rd Approach fee: Garage/Carport TOTAL: $ a4f (_43c 1 Decks / 1 J e • umber: c b t7®S.— - Other `,� t Cas /Check Number: i ESTIMATED COST(REQUIRED) ate: ,_.___.._-------- -/ •Fair market value of all labor and materials faun (�',—'._�. - '/a��� 7U`w I Initials: tl .. C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc APR 2 5 2005 .?;::-.ONr.trt- • j ,IgON Cp6, JEFFERSO•OUNTY • -I �w \8� A DEPARTMENT OF COMMUNITY DEVELOPMENT 2 `"4 621 Sheridan Street- Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax � �p� www.co.jefferson.wa.us/commdevelopment �IIN Master Permit Application MLA: Q(S1 — (ci 3 Project Description(include separate sheets as necessary): Sn/bL FiWU-Y ►' rPP.JCE Tax Parcel Z/ G`�7 Property "7s7 .y/ 7 et Number: ��1- Size: (acres/square feet) Site Address and/or Directions to Property: MO(( &f-/FCtT2 js . Property Owner(s)of Record: /41Vib 4--- -IUD Telephone: g4,0- .§i- '(703 Fax: 6Q --*RJ `17O4/ email: .�f-d426i i2(() tC4Cr L, 4J -Cc' '1 Mailing Address: %`'1Iv/ lPF/''S PT p-i• it ,2 tvV i tv4- QQ`'-1r—' Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) )(Building U Variance(Minor,Major or Reasonable Economic Use) U Demolition Permit U Conditional Use[C(a),C(d),or C]** Single Family U Discretionary"D°or Unnamed Use Classification U Garage Attached/Detached U Special Use(Essential Public Facilities)** U Manufactured Home U Boundary Line Adjustment U Modular U Short Plat** U Commercial* U Binding Site Plan** U Change of Use U Long Plat** ❑ Address i Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** U Propane U Plat Vacation/Alteration** U Allowed"Yes"Use Consistency Analysis U Shoreline Master Program Exemption/Permit Revisions** U Stormwater Management U Shoreline Management Substantial Development** U Site Plan Approval Advance Determination(SPAAD)* U Shoreline Management Variance U Temporary Use U Comprehensive Plan/UDC/Land Use District Map Amendment U Wireless Telecommunication* U Jefferson County Shoreline Master Program Amendment U 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 designateOf- � _to act as my agent in matters relating to this application forfo permit(s). OWNER SIGNATURE - _ Date: 3/ (/Utv 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 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-jinst Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access . d g . f entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later in •e o Access and right of entry to this property shall be requested and shall occur only during r gular business 04( hours. 1 '/ 06' Signature: NI _ Date:RI 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 lea•to a potential"take"of an endan red•species-as-those-terms fin are.deed in the federal law known as the "Endangered Species Ac or"ES "Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issue• ill i ��.late the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you - e in•• lance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable res..• `i. Ii for adhering to and complying with the ESA. The Applicant has read this disclaimer• nd si s and dates it below. Signature: L. APR 2 2006e: Ze/ i C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc i W- - '� !ENT • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX. (360)379-4451 PERMIT #: BLD06-00204 Received Date 04/25/2006 SITE ADDRESS: 1461 GRIFFITH POINT RD Issue Date 06/21/2006 NORDLAND, 98358 APPLICANT: ANTONIO SALGUERO PHONE: 360-385-4703 1461 GRIFFITH POINT RD NORDLAND WA 983589500 SUBDIVISION. Block: Lot: PARCEL NUMBER: 021321045 Section: 32 Township: 30 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: NSFR CALL IN FOR THE REQUIRED IN PECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: 8 /7GK 0,474 UFFER: OK 7/D,L Footing: /( #7/44 Foundation. - Stormwater FINAL Approval: Underground Plumbing: lj 6147-'MIA,s Pool-A+r �` o.�.1�{►S►Z� -,g '(o - Underground Insulation: —t 0 �'-' Shear Wall : �XT / .P�v,�1tz 0 s o7 Sheathing: Framing: ✓t,f — S(I4 "7 Plumbing: L) e} ° J ' / A r 4 l 7 r 6ie- 5 /A7 Propane Tank Lines: -250 E — Lt x ,Uj -tM;'s 8k ,2_7-07 Insulation: di< Sheetrock: L - ,/ ✓ 7 � Septic Sytem Final Approval MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: cupancy Approval: G,� t47 EALTH DEPARTMENT AND PUBLIC WORKS APPROVAL1 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 SPECIAL CONDITIONS FOR CASE # BLD06-00204 • 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.) MANDATORY MEASURES OF HIGH 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.) MANDATORY MEASURES FOR HIGH 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. Variance from Chapter 173 WAC standards granted by Ecology per WAC 173-160-106 for a new groundwater well within 100 feet of a sea-salt water intrusion area per WAC 173-160-171 (i.e., within 100 feet of a groundwater source showing chloride concentrations above 200mg/L or within 100 feet of the marine shoreline); or for an existing or proposed groundwater well not subject to an Ecology variance, applicant must provide evidence through a hydrogeologic assessment (relevant components of an Aquifer Recharge Area Report per UDC 3.6.10.e) of a reasonable probability that the subject aquifer will not be degraded by the proposed use of well. 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. 5.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 6.) A flow meter shall be installed prior to final sign off of the building permit. 7.) On-going well monitoring for chloride concentration is required. The property owner shall allow access to Jefferson County PUD or approved contractor to take samples as required. 8.) 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. • 9.) A Stormwater Site Plan has been submitted and approved by the Departmen 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. 10.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 11.) 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). 12.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 13.) Minimum setback from Griffiths Point Road right-of-way shall be 20 feet. Minimum side yard setbacks shall be 5 feet. Minimum shoreline setback shall be 30 feet. Submitted site plan identifies a 45 foot setback from OHWM. 14.) 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. 15.) 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. 16.) The building height is not to exceed 35 feet. 17.) Residential developers and individual builders shall be required to preserve shoreline vegetation and reduce the associated risk of erosion during construction and any future activity which may impact the stability of the shoreline. 18.) 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 • • —n E C E.' W7 E [FY Ito �°� JEFFERSON COUNTY �a � le� ' MAY 2 2 2006 til -44 74 DEPARTMENT OF COMMUNITY DEVE LOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 •I FEt'SON COUPaTY NO�Q 360/379-4450 • 360/379-4451 Fax DEPT. OF COMMUNITY GEVEtOPt�lEhf http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# l i 1, PROJECT/APPLICANT NAME: " 1 ' v" l / O Ue r O Please answer all of the following questions to the best of your ability. Where the question calls for depiction 6n Pita 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 91"��jy AC) 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site map. -i f N 5 J72t it1 /I-- 5iAV et-e_ T71t41,v1' fry'/Ded e f- Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. 1711 zer Ls. 'PreleX- tot) /oo` Lim se '.. LG-a41/3/ 1 is it- ba' :.-APE PLtii.ii ni fzl/z._ /i-rtiff_ _ 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. _711, - _IS Xi XR49 i/ge c;Ai/ 6NClr f .ICJ) ,Sj+-LitLl ;Ai i/ - q j,t 4.4 rf, ( 1>. 7Vh - l 1U . /i ice, ivi1 t Jr'-`- f'lv2; f-6'9-O/us4- 4. Describe the existing soils. Indicate soil type on the site map. C4t1/II/ /.,1 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 site map, if applicable,and indicate acreage of each. ..>7' Cjt1W,17)i# Dath,414 Eet1A 5(:47PE/" """ � 412 /Y4' if'z 4 /2 ,-/-f//Jb '1I'1/2_ lm1 5 APPROVED 6. Describe any exces levels of noise generated by the proposed use or activity: STORM WATER PLAN JUN 1 9 2006 Storrriwate :A S , JEFF U TY Required ��� _�-,'�' DEPT.OF(' , 1 Y . PMEN stormwater site ante template Re ` SIGNATURE: i 5 • • 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. /71F..1 ;� /ca i rP //e ,m j-v/�rizre P' i`0- (is' e4-tc4a-) ,. Haw Weft t- Goilir6 i '-2` li7 j71C- 0A. ML.. 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.). 1 r t 5 AT Vic t l i1V r',, i14 1 it OM' `r_N'Ii+ i4-ri►) Ar r t,i 1M /3 /?,a- Pr�rn - 1. I.-or /L, 01/� c l-Y V 'i 6if4Fr%lf'S ,j T.. 120. 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. lie-gi,. '.9m4 W i4 - 0r .17Is'& i 2 7 Atfrn V - V>647:r -nci;.J 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 normalty for large"projects or projects that involve the potential for dispersion of contaminants.] . A I r\ 11. Describe the performance goals and standards applicable to the project. .1 a.... Descri a the flow control system. rT� ' L. ,stormwater site plan template—rev.10/1/2003 6 • • 13. Describe the water quality system. 0 If 14. Descr y tt conveyance system analysis and design. 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. i=1 eMails-- Wvu.- O FAX c Frkts4 i,Jp, t ! / wz-02:_ 412? &t(s Wu4.. 0E- f fey) eirr 41 M./ (,� � i�,.�r u... },r- u 4i42 n a,Fe'a-,n7 i4rAJO 771P, /-i.61//i 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. a.- _ 17. Describe the proposed surfacing material. 18. Describe methods for restoration of the site. ti V'�z- i i 1 , t ci ,HMOS / W, ri.4)0/6414 _ 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._, ti'F 20. List`, rF) re and include any special reports or studies conducted to prepare the Stormwater Site Plan. N` 21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or restrictions here. HID! ,moo:-DbtZ- ��S Mil"4j" - !�4�E:'1 FI-ta'lriJ 7 5t°afu i.TTvo 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 Clearing Limits. 2. Establish Construction Access. flee i r 1i�'f',5-LA?6 Palik J/?4f 77J �t . 3. Control Flow Rates. -s �f7 4. Install Sediment Controls. > � fWc uL 19/47r4140K71 - 5. Stabilize Soils. W11& './4/L. t BEd (' Iiz/lAJ 02 6. Protect Slopes. f f\y 7. Protect Drain Inlets. Oh stormwater site plan template—rev.10/1/2003 8 S • 12 Required Elements—Construction SWPPP(continued) 8. `Sze Channels and Outlets. 9x). tCtrol Pollutants. 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). Hi Z-- 9MP yjic t' � i a� fray iriett4frk9 12. Manage the Project. , '5A' tQe-fi �i L -A1.4/.414 � 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas roads). 26,`''n/k"`_ A-K IA)/ A;'5> ,14' b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). -,,,,,{, , Tr-Wit' /3o_t i... 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. rflysti r stormwater site plan template—rev.10/1/2003 9 • b. Description of special requirements for working in or near environmentally sensitive areas. W Ao✓?✓° - 7‘._,,-,,,, ,„ (4.1 i, i/,� ,,iI.i�[. _ Af 6 fl-a,& ,;7'✓71'14,Y -. , 17 02._ 4fl&7fc 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 _ � C: �/ . �ifivof�-4-�Zc"'`, , l ti✓viL , ,;mod NI-:a-i.. 7i"` v�v. l.,Or /9t.ZY. 1 ,L. i 1, r',.LF/ffi -i 7�t, r-t, g3i� t/ pc;/v$"_. 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. N1I// J II. Wet Season Construction Activities. a. Proposed wet season construction activities./p A yy b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Iden' 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 /0/ impacts. Py 8. Engineering Calculations. Provide Desi r�Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. i11- b. Diversions. c. Waterways. l r t / d. Runoff/Stormwater Detention Calculations /(3 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 ,) rr By signing the Conaructiorn PPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the bey/of yfkn wledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected rod , r t Lam_ —7,---71 L (LANDOWNER OR A ORIZE PRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: stormwater site plan template—rev.10/1/2003 12 ios'ik rn J I rn co I •(j' � g. k I A t„ b I <m Z , ,;, i1 . 1 ri k—cs N $ N % NO $ i N �N A N ZS 4 ( % *I 7 z t CP - _ _ - 1 )11-z- 1 N a _ _ _ _ _ _ _ , .. I = <. 0 0 ► ,ss y 8 , o ) ` I CM 0 1--- ' \� \\ ,91 x,'Ls ' -- o I �cr�e b \\\\ < 0 w 11 �‹ L. 1 \ I__ +.I T7 0 1 5> ____, ______ I T�' I ► 1 I ` Atak Af. ••• 27]_ _ _ _ _ _ , mryi , . 4 — — i _ ____. — _Z 0 N ���` „ 1 1 : 1 OI i '11 j�_ ' a) I `,...„ —1 ri 1. i t \\\\ ----t- o1 =- c� Zr .Z \ Z �p1�c cP 1 .I \r I g oo o d lei z3, I 8 03 4 -0 0 .N P. 1 , w I "OOP N. 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