HomeMy WebLinkAboutBLD2006-00212 •
• BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD06-00212 Received Date 04/26/2006
SITE ADDRESS: 113 HAROLDS HOLLOW Issue Date 08/15/2006
APPLICANT: JOSEPH A NUBER PHONE: 281-389-6760
APT 3062
1 HERMANN MUSEUM CIRCLE
HOUSTON TX 770047299
SUBDIVISION: MATS VIEW MEADOWS Block: Lot: 15+
PARCEL NUMBER: 970800015 Section: 5 Township: 28 N Range: 01 E
CONTRACTOR: TERHUNE CUSTOM HOMES INC PHONE: 360-681-8898
PO BOX 97
POULSBO WA 98370
Contractor's License: TERHUCH984MA Expires: 7/1/2008
PROJECT DESCRIPTION: NSFR WI ATT GARAGE &A/G 120 GAL PROP TANK
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: OBE' at/3/D6
UFFER: O/l' 9/3/a,
Footing: QK 403/
Foundation: OA q/9/a.f531
Stormwater FINAL Approval: DR 4/3ei
Underground Plumbing: [ f v
Underground Insulation: �/
Shear Wall : E r �✓NPAR PA,ti�tX #STRAPS OK.///141/0C y�
Sheathing: (((///��'
Framing: U/1 /1� �J COndd ibis IO/Ii f i G1C /274/041
Plumbing: OK / VAR
Propane Tank/ Lines: /Ayr . ii 9 O!L / l4,"
Insulation: 4'e I24/04 09 zi.),4 is Gk i /U6�
Sheetrock: Q /2/744, /BPs G1r/� r�z
Septic Sytem Final A {�roval MUST be obtained before final of stru ure can be attempted.
Road Approach Final Approval:
Zoning Final Approval: ,
Final/Occupancy Approval: 'Cfl.,+-V C,)3, (47:, eq-,7)/1 7
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION
THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED
BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
HOT LINE AVAILABLE 24 HOURS A DAY
SPECIAL CONDITIONS APPLY - SEE REVERSE
illik
• MLA06-00201
BUILDING PERMIT APPLICATION Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00212 Received Date: 4/26/2006
SITE ADDRESS: t (3 HAROLDS HOLLOW
OWNER: JOSEPH A NUBER PHONE: 281-389-6760
APT 3062
1 HERMANN MUSEUM CIRCLE
HOUSTON TX 770047299 MATS VIEW MEADOWS
SUBDIVISION: Block: Lot: 15+
PARCEL NUMBER: 970800015 Section: 5 Township: 28 N Range: 01 E
CONTRACTOR: TERHUNE CUSTOM HOMES INC PHONE: 360-681-8898
PO BOX 97
POULSBO WA 98370
Contractor's License TERHUCH984MA Expires 7/1/2006
REPRESENTATIVE: TERHUNE CUSTOM HOMES PHONE: (360)697-7000
PO BOX 97
POULSBO WA 98370
PROJECT DESCRIPTIOI NSFR W/ ATT GARAGE & A/G 120 GAL PROP TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,804
VALUATION 222,000.00 ADD'L: HEAT TYPE: HTP
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 504 SHORELINE:
CONST TYPE: DECK: 148 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: OTHER
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 2
Total: 3 Total: .2
Routin Dates�-yy0
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,682.55 LYK 04/26/06 8'1127
Plan Check $1,093.66 LYK 04/26/06 81127 APPROVED
State Building Code $4.50 LYK 04/26/06 81127
Potable Water Application $55.00 LYK 04/26/06 8'1127 AUG I5Q0p6
Total: $2,835.71 Jefferson County Planning
& Building Department
*
•
III
t� ��pp //
f 6 JEFFERSON COUNTY
\•. ... ,4 } DEPARTMENT OF COMMUNITY DEVECCIIIMENT tj LjvG
' `4f 621 Sheridan Street• Port Townsend•Washington 98368
\ . 360/379-4450. 360/379-4451 Fax
viww.co.jefferson.wa.us/com mdevelo pment
` Rhi -
Master Permit Application MLA: db-00 I
Project Description(include separate sheets as necessary): W/� /[��
;rm�tYurii a I 0 �-tz ( ;4 bec�lvoom - - ro v off,_. .cie,
Tax Parcel Property
Number. ��0 ('> Size: Z C[D :;.•"7 - (acres! e fee#))
Site Address and/or Directions to Property: _
Property Owner `
s)of Record: Inr"" ie JZV
Telephone2 i ' 3 t (0 7 tioD Fax: email:Mailing Address: l fl\4J n PAIAs et. en nit_ ttt4• 30 2. t.LS.itvt,_( -1 ()Li
Applicant/Agent(if different from owner):TelephTp�l
d: �t a'C). $ Fax: to J. p� �0
MailingAddress: .�. 7• �j —�'1/L�`ab�J, ���• _ �[, •.r
What kind of Permit?(Check each box that applies) .
dp,ild]ng , u Variance(Minor,Major or Reasonable Economic Use)
/ U Demolition Permit U Conditional Use[C(a),C(d),or C]'
U Single Family U Discretionary"D"or Unnamed Use Classification
. aragr Detached U Special Use(Essential Public Facilities)**
Manufactured Home u Boundary Line Adjustment
Li Modular U Short Plat*"
u Commercial* U Binding Site Plan**
U Change of Use u Long Plat**
, -Address �$oad Approach u Planned Rural Residential Development(PRRD)/Amendments**
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 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 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 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 req F inspections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours.
Sig : 'Jalp1i Date Z2.--E5)
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 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)• • •e u are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non .nsfe••bll r pop ility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Sign. • A____)
Date: —ZZ CiJ
C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc
�23/2006 16:58 3503794451 JEFF CO DCD PAGE 03
F' 'A "'�'• A TUNE CUSTOM HOMES . SEQUIN WA • No, 7910 P. 3/3
RECEIVED
I, • MBAR 2 3 2i 6
OWNER BUILDER STATEMMI r
i The:Jgner of Ws statement does hereby cat*that they are the Owners of th®parcel teforrnatd herein.(fiat they [[ It y,., P(d 1
r i �Qr� PT R�
1iey yAtl be accum oralbitty of the Contractor forth*Pere ect.
Signature' Dres-
' t G.FJZ'ALGONTRe rO PHONE: FAx
• 1 Maude ADDRESS: r d!�__ .�L'. M $
vv,a A 's LICE •--t- k li `A WAf NuRAI E
Alrtt.rNCtl PltoNE( ) FAX:( )
•1 MAILING ADDRESS: ) EMAIL -
r t'�Type: ,Frame Type: Bathrooms: r 1 Shorelir»: of Sewage Disposal:
?.-.F 'V:d I I q. . ,hp WOOQ 060: ' • ewer .
am Addition . u srooi- , , ' Proposed: 2, ' Bank Li Community System
J Alteration/Remodel u Concrete • , Totai: Height: •-u Individual System
Repair. •r 0 •Masonry SEP Pandit At
.CemofitIon r i 1 other Bedrooms: �• Setback: -Viater Supply: -
Existing u Private Wall u Two Party
-o•oe:of HeatProposed: �� kPubfe
1. -P - Total: me of System:
i lc by ej p, ,,,!.....p.ot:r.watarflu tntLwirx;:
Nu' gar �. •s: • .....iligr• .Pns,.• ' RI Or'a^ parkhn. .. 1 :
N • .-r of.IV •' (include . •:r :, .-e) Pro.-- _ •
I1C Oow •••V .•: :C Type of•• :-•I •. •• Will you••- - oaf Servicc7 i.•
•. a T k a do �I1}terns belOW thiumiK
•
I Underground Tank t'�ibove round Sim of Propane Tank: I M.."S ("7Q t
• • 1 Heat Stove 1 Cook Stove '1 W)odstave A lase 1 Hot Water Tank 1 Pallet Stove 1 Other
' ...it?nee bel . . ... led la a • I • .. '..! /
•
•
v
.seas. Jai •-:i.. arrd , .1 •, Cab+A• It to dll lines,
(fArr r Ah®lrlWV* ' _ �.. _ a�.fig
I�rr�+ i,. V o e z
L u9DB FOOfaQs•, •t';,4 y F ez. { i m im +�,' ;ili i"tizt� l •-
Gwent Proposed .Pro•osed ,, +.[„r.,Arti,a� ' r+!ors .�. °r ttiffi tried ,, 1�.•4,2 r' ;..��54-.19wa,' ai'
•
tvxira Aobt Viiii'.;74i,T4, EH Aid App Review:
. / �,�„'fir .0 f (" Consistency Review:
;S- F,00r, . , f c4 155-
• 4'��: .; �`"y,il;;. " Base fee:
1 4 I r nrl !-, i
• d,e<^-anine: +' i
1''W Additional Section:
Heated Basement wf1 . '. , a---��
unheated eaaemertt ' s t k Plan Check fee: DG./��}) (0(
C3her Unheated ), :, State Surcharge fee: r
i qn_;
s* a/Cerport • ZS r, ,t�,4 ,giA.., Pot Water Review fee: n 5 J"
• i Deslk't I b4 f q •ilr; SUBTOTAL r
QQ
or 1\iio•\� 1. ,: ,iirtt; 0o�0
cKvef �1 `{ 5{�0. ,i1 .,r ay r
_>r, ' -' 911/Rd Approach fee:
•• vpr air hbor arx!rnar2rla • mat‘ -fVivi P P 5a.op
\c '1.0 ;ao 1
nit 7�> ,,,, Receipt Number: g (I a-7
r.\Donn.,„,..„3 ain$SVnnchri\Daskyolr\M'+srrtPnr ni Ap t1 . �F c N.'i�3�%i ii:i* /
;d r :, liicf Ceeh/Check Number:
• r-• t 18:
•• Date:
Initials: `�
SPECIAL CONDITIONS FOR CAS• BLD06-00212 •
1.) 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
cX\N
marine shoreline shall be required to infiltrate all stormwater runoff onsite.
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.
3. 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.
4 MANDATORY MEASURES FOR AN AT RISK SIPZ:
1. For proof of potable water on a building permit application, applicant must utilize
DOH-approved public water system if available.
2. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water or an individual well may be used as proof of potable water subject to the
following requirements:
a. Chloride concentration of a laboratory-certified well water sample submitted with
building permit application.
b. Installation of a flow meter.
c. On-going well monitoring for chloride concentration.
d. Submittal of flow and chloride data to the County per monitoring program.
3. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water.
5.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
6.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater,
erosion and sediment during construction. BMPs shall address permanent measures to
stabilize soil exposed during construction, and in the design and operation of stormwater
and drainage control systems.
7.) A Stormwater 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.
8.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
9.) Not more than two (2) unlicensed or inoperable vehicles shall be stored on 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).
10.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
11.) Minimum setback from Harolds Hollow right-of-way shall be 20 feet. Minimum side and
rear yard setbacks shall be 5 feet.
12.) 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.
13.) 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.
14.) The building height is not to exceed 35 feet.
15.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
• S
d8 JEFFERSON COUNTY -- — ' _ ..__----
DEPARTMENT OF COMMUNITY DEVELOPMENT APR 2 6 2OO
• „0, 621 Sheridan Street • Port Townsend • Washington 98368
0 360/379-4450 • 360/379-4451 Fax
http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# ' PROJECT/APPUCANT NAME:
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.
V 4—
Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
-T")rv,i J u5h Fk.k-
4. Describe the existing soils. Indicate soil type on the site map.
QCLJ�
5. Describe the existing site hydrology(i.e.,drainage;behavior of water on the site—above,below,and on the ground). Indicate
existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if
applicable,and indicate acreage of each.
6. Describe any excess levels of noise generated by the proposed use or activity:
N APPROVED
s ATER-PLAN
(�1 MAY 1 7 2006
stormwater sae plan template—rev.10/1/2003 StnrMW4 rtt
Requiredak
JEFF p
0 N
DEPT.OF '�7P►� t
C'
# •
I .
7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes,etc.)on the site. Indicate location on the site map.
ty / t
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.).
N/P\--
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.
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.]
4V (P5
11. Describe the performance goals and standards applicable to the project.
12. Describe the flow control system.
•
it V '.,11 S"
i
6
stoirnwater site plan template-rev.10/1/2003 --+
itI
• •
13. Describe the water quality system.
p7 2 U .UU
•
14. Describe the conveyance system analysis and design.
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 AppendixChapter
p 33 of the
Uniform Building Code. a
f � a I 11.4 I _I ,t' kC.A ,
rP (-3 (-LA cam.
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.
"large"projects only and only those for which facilities are required to control flow or treat runoff.] If included,list the required
M 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.
1\--\ / A
stomrnater 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.
A . A�- v p—Q-, k
2. Establish Construction Access.
3. Control Flow Rates.
Ct 14.)"al
4. Install Sediment Controls.
o_cet-ciA haksin ovthi r-c-- trzfsa.A-1 M34
5. Stabilize Soils.
hat rsC' -0—L J oY\ e*pc—) cl . I.
6. Protect Slopes. ,}
1 L;}" Cam... QY‘.1.t.� \ +rPAs 1X-adf1
7.protect Drain Inlets.
•
8
stormwater site plan template—rev.10/1/2003
•
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
9. Control Pollutants.
10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
11. Maintain Best Management Practices(BMPs).
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).
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
storrnwater site plan terrplate—rev.10/1/2003
9
•
b. Description of special requirements for working in or near environmentally sensitive areas.
l _ (Pr
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).
(pt
5. Construction Phasing.
a. Construction sequence -
1 C (" I I
i
b. Construction phasing(if proposed) /1\-
.
I v
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
�o4de a roposed construction schedule. k ✓1.t-.S
II. Wet Season Construction Activities.
a. Proposed wet season cons ructiorlactiv it��. � ��y��
9--)2<�e�`‘,6 v ' C CMC
b. Proposed wet season construction activities for environmentally sensitive areas.
7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for the initiation of bonds and/or other financial securities.
\ eV Nay
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. (PV
c. Waterways.
d. Runoff/Stormwater Detention Calculations
to
stormwater site plan template—rev.10/12003
III • ,
•
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 ected property.
(1�ND NERORAUTHORIZEDREPRESFMATIVESIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
•
12
stormwater site plan template—rev.'I 0/12003
PiFill„r----' 23'-s" ,
/yam a 2.-0" 12'-2"
00 - 3-0 3-4 / / ,
/
4 0 I
N \
a \ \ ,
cl
N N VN to 4'x3'xo \`!
^ E _
\ / 3 N IL-
30' 3'1" Ref. �.�- `I ....„..../
\ / n 0 W D Oven Clearance \ l i \
\ / IQ . SST I 3
O ^ o rp y_...\ / \WO co/ b = m fo / $\ I -' 3 v to .� s ^ x
N 01 \/ J T .3 m Al n OO $X ` 1 -O W �,
n rN ai OQ t'u" e
I \ P
ll
t:en U �aa- .b \tl
/ \ 0 6.
o O I 3IIn0 �a
�$
/ \ W w �d Oo O
\ m^ RtS
•
/ \ l� RIB _ m cl
: O
/ \ P 111 02 CD
N. 5 in
N
\I I/' OD Furnacle� m I \
O >1 V m t-t
•a •
•- . EO V
N N E Q \ 0�
O a
\ \ e` / g Q rem `. rn
N -, Cl I
a 7._6 _4" / 7� o
N o`'
tJ " T O' -1
tn'o W d i Q � 3'-2 l x
Entire Wall v O It
u
T r x 3 r Flat Ceding_ \
I i m la O Vaulted Ceding
I
D
o 1 II
E I a+ I
t. st II `0 -3 \J 11 w
w CD
{ �� E I I a • x
I 8'X I X QI trt
c "' (2)2'6" •.Lt. ' I I �'
o' I I ' i
\ co Lz- I = o \ o
rs
N T � 'jv _ rr
`' v (�A tl v a Q I I a 0 i �I
I
I T O 4 ! _ E Jr b .,,
to J 0 � ', g � Q �I Ic 2O Ei4oeed Bean I 1
i a .m 2i s1a- -8 _cr—
o\ a - �heetro-icc�rappe� °' 4
.. ( � n s 4.-0" o -8" 6`-2`i 4'-0:' bah 3�u n u n
to .. C) a f A 3 2 0 4-i T
/\\r n n 3 5
-4-� mv-nn
O �
11.
` \4a, < RIS 5' Bi(dd <O �'0. nNo a
$
I9._ RIS s
5' BI(dd rn g to
I I
a 6._0" g•-0" 2'-2"1 4'-0" o. w
NVr rn tJ ` : /
I CO i W •;
:. / r,
U\J -1-�. tit )_L <O Ep }- I! •_( 1 \ \
•
I N , a ti / \
rr.
O W t o W A j O ! -WI
Q »f I '3 0 -
Entire Wall 'w� N 3 �k.6? v!
n u (1!i,)
J
An N N .6" Bif. Ci)-d (l /-a-' \
fi
\ti
•
co e; 1 3'-4" 9'-10" ,
\ \ ^ RES kr_Afl1 nn(lm A .I
-� Cl ✓ e tX.1 O <O Enure Wall o 1
to i]3 iL �1 m a < I g
m
• N (.� • (A o N c N I
3 m co =
3
f rt \ i A d x co
V I �� \
('I� O N E I -3
O
�. II 3 n _1O (1 to
N 0 u
f0 3 O A (1) tee I
te O
Curb u
o_
<--
-Pt a Bir. n 0
3'e` 'O / \ q'x5'Plc Io
o_ Ir—
k In Sh Linen �
\ \
q'x2'x Temp 1
3.-6" 3.-4" 3.-2" 14'-0" , ,
I
i
Sheet:
.--- -----, \
Date: 3/
t,\-t�-ob New Residence For:
1P Enry Nod but bean mad*bavoid
plan,home.,the dosifino,Moot
/(�"/-'j��-\\\ `� t a,_j; . w+,+nw against human WO,It
custom homes cn.,aymtnyena and debivae I
C
ems'9 -
a.
Vi \
C"`" i k 0
= C7 71*
-c
C. . 3, \ _,3",
c-3 80\ I
6 0 CP \ ZO 0
\\°\ ,. 3
.-.(::; ....______. ›,. ..
\- \/ '
pl._ cA )-cs 2,\ \\
-\\ , = ,....4
_ ►-3 \' -
t �
(\ ri
%- N
� . a
1 CD o� Z tt
db
\ \
\oNI ( II
_Li 1 1 \_0s--
O P`PP,0\.°- oO
� OF I I n
\ 5 N s _i`C& 0A N AA z J ,
Ipup 5 Or���� P O�G p' CN
i
lC p'c'yc> +rry • ' Co w
�,- S- M, aN — C\
w' o z /.
/ ' ck_
4-
P IV Quo S
pp -�\O y
G�` �sp' C PN l\ Q OS I�8 Op
I �1
p��p p�N� I { I s�o �O�o �y��1 L 1
p :M Z2 +- �C 3 1q
a 44 SS
UI r g\ i
al
�� b` I
T
UTILIT
' 115 ql N 64 -- ........,_____
�_�— 5E17EN —
1
0 3 / / 2 // H i \- Ni '
: 1 1 A
L,u
,v IIIoo:, AOLDS
Ro
{ ri a erlaco\d
5 \
.__. „x•'ON P'\ \*
, � 5 oe oad a \ � �rf ke\�'
goe\o� c \_otr a dca see \--
lb
be ae�9raot, \ ,O"
,ire f or \' 1 r• �� 20 ,0\�
e ag
aSePt�e de p,\,�' ` \A G oO,00�5
j05G� 0 �' `1�5
Pp.`,5 \ , 5�&\� NA N0