HomeMy WebLinkAboutBLD2006-00221 •BU BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD06-00221
SITE ADDRESS: 200 WILDWOOD SHORES Received Date 04/28/2006
BRINNON, 98320 Issue Date 07/25/2006
APPLICANT: DON L SKANCHY
KAYLENE SKANCHY PHONE: 253-631-9606
26248 129TH AVE SE
KENT WA 98030
SUBDIVISION: SEEDS & REHE SHORT PLAT
PARCEL NUMBER: 502142012 Section: 14 Township: 25 NBIock:Range: 02 Wt: 3+
CONTRACTOR: ARMSTRONG HMS
2709 AUBURN WAY N PHONE: 360-373-5061
AUBURN WA 98002
Contractor's License: ARMSTHT294KP Expires: 5/7/2007
PROJECT DESCRIPTION: NEW DETACHED GARAGE - NO HEAT, NO PLMB l et'hc ND Yie
CALL IN FOR THE EQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS.
UFFER:
Footing: I I i • / -Ztb
Foundaton: #_ etMS //
Stormwater FINAL Approval:
pproval:
eimaies
ediliiiiingliftShear Wall
Sheathing:
Framing:
Plumbing: -2'1-- 2 ,t
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�rr tJ v� G�a c5 �tJp ,n
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED 14 P PRIOR TO FINAL
THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED SPECTION
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
•
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 #: BLD06-00221
SITE ADDRESS: 200 WILDWOOD SHORES Issue Date: 07/25/2006
BRINNON, 98320 Final Date: 4/7/2008
APPLICANT: DON L SKANCHY PHONE: 253-631-9606
KAYLENE SKANCHY
26248 129TH AVE SE
KENT WA 98030
SUBDIVISION: SEEDS & REHE SHORT PLAT Block: Lot: 3+
PARCEL NUMBER: 502142012 Section: 14 Township: 25 N Range: 02 W
PROJECT DESCRIPTION: NEW DETACHED GARAGE -With 432 sq ft of Storage above& 1 bathroom
-NO HEAT
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING
CODE 2003 EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes ciio..,
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 4/7/2008
I:\F_BLD_Occupa ncy.rpt 10/29/19
Review T Ty•UILDING PERMIT APPLICA1 N ML y 210
pe: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00221 Received Date: 4/28/2006
SITE ADDRESS: 200 WILDWOOD SHORES
BRINNON, 98320
OWNER: DON L SKANCHY PHONE: 253-631-9606
KAYLENE SKANCHY
26248 129TH AVE SE
KENT WA 98030 SEEDS & REHE SHORT PLAT
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 502142012 Section: 14 Township: 25 N Range: 02 W
CONTRACTOR: ARMSTRONG HMS PHONE: 360-373-5061
2709 AUBURN WAY N
AUBURN WA 98002
Contractor's License ARMSTHT294KP Expires 5/7/2006
REPRESENTATIVE: ARMSTRONG HOMES PHONE: 253-531-7020
TOM MALLORY
2709 AUBURN WAY N
I l \coarY\
PROJECT DESCRIPTION NEW DETACHED GARAGE - NO HEAT, NO PLMB
)4r i1\o‘j.� am.) 1 udd t i r o -Natiea4 -
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION -27,453700 MAIN:
CODE EDITION: 2003 ADD'L: HEAT TYPE: UH
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: "1a # OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: 1,152 SETBACK: 139
DECK: BANK HEIGHT: 100
SEWAGE DISPOSAL: ALT
WATER SYSTEM: OTHER
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0 I
Total: 0 Total: 0
Routing Date v(
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $421.55 LYK 04/28/06 80998 i;
Plan Check $274.01 LYK 04/28/06 80998
State Building Code $4.50 LYK 04/28/06 80998 JUL
Total: $700.06 Jefferson County Planning
& Building Department
w•0. 1 Yr
0
4
APR 2 8 2006
,ENT
T
E"WIDE FOUNDATION WALL
IE,"xs"FOOTING TYPICAL
UNDER UNLESS OTNERIJIEE NOTED
2"Xt `EXTERIOR FRAME WALLS I
I0'-0"N HEIGIUT,FOUNDATION
BUILT TALLER TO ACCOMODATE ; I
CEILING NE!Gi1T
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%E______ 7 er_ rAa___
y 3 x 3ENSI 01' -.• INTERIOR
DR DIMENSIONS 4"T.CCNC.SLAB FLOOR I
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ROOF TRUSSES 24'ON CENTER \
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04, W-3"mcKOUT FCR ROLL UP DOCK
(BASED ON 1'x OODR WRAP) • Sig.
26.-0"x W'0"OPENING - V
L.-_ —�{}._ _ ._._._..,.�•ING BARN SiTLE C•
C" b7RJCTURE IdDGFLINE —•_._._._.�._._.—. �� ..J
STRAP 7'-1 I/1"
LOCATION
WRAP
LOCATION
18'-0"
32'-0'
FLOOR 4
FOUNDATION PLAN
1/4" = I -0"
•
b 'd 68E0 'ON ^
03�i 7Y1!� nivr QAIVN IAl II /1 7 n -
__________,................
SPECIAL CONDITIONS FOR CASE•LD06-00 221 •
1.) To help prevent seawater from intruding landward into underground
development activity on Marrowstone Island, Indian Island and within 1/4
marine shoreline shall be required to infiltrate all stormwater runoff aquifers, all new
2.) The applicant shall fully adhere to all conditions and requirements of mile of any
management plan. onsite.
3.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: the eagle habitat
Water conservation measures:
1. Roof and other intercepted precipitation shall be routed to on-site detention
and/or other approved means and allowed to be released to the soil slowly.
2. Water collected from Storm water and roof catchments maya ponds
lawns and gardens. Unless catchment water has been treated to meet drinking
standards, there shall be no cross connections allowed between be used for watering
impounded water. baking water
3. Water withdrawn from wells on each property shall not be used the potable supply and
and/or gardens. ed for watering of lawns
4. Ground water withdrawn from each property shall be restricted to a rate
gallons per minute.
ree
5. Installation of water conserving fixtures such as low flow toilets, faucets and shower
(3)r
restrictors and other water saving plumbing fixtures.
6. Landscaping plan (xerisca in shower
P g, native vegetation with minimal amounts of irrigation).
Please NOTE that the above listed measures are not intended to be exhaustive,
is intended to be illustrative of the types of water conserva
4.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ:tion measures. but rather
1. Installation of a flow meter.
2. On-going well monitoring for chloride concentration.
3. Submittal of monitoring data to County.
5.) MANDATORY MEASURES FOR COASTAL SIPZ:
1. For proof of potable water on a building
DOH-approved public water system if available it application, a
2. If public water is unavailable, a qualifying applicant must utilize
potable water or an individual well maybe 9 used alternative
proof of system may
following requirement: be used as proof thef
a. Chloride concentration of a laboratory-certifiedpotable water subject to
building permit application.3 well water sample submitted with
. If publicb water is unavailable, a qualifying alternative system may be used
potable water.
6.) The property owner shall comply as proof of
by the UDC Administrator). p y with Water Conservation Measures 7.) The project shall adhere to the Best Management Practices (BMPs) (per list maintained
erosion and sediment during construction. BMPs shall address permanent measures
stabilize soil exposed during construction, and in the design and to control stormwater,
and drainage control systems. to
8.) A stormwater Site Plan has been submitted and approvedoperation of stormwater
Community Development. Once the subject permit has been issued the applicant
by the Department of
fully implement the provisions of the submitted plan and contact the Jefferson
Department of Community Development to arrange a schedule to insect prop property
f
plan compliance. A Certificate of Occupancy will not be issued until the Department
County
verifies plan compliance. No clearing for roadways or utilities shall occur o the p projec for
site until clearing necessary for the installation of temporary partment
control measures have been completed. n project
P ry sedimentation and erosion
9.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
10.) Not more than two (2) unlicensed or inoperable vehicles shall11111
than one-half acre unless totally screened from viewneighboring
stored on dwellings any ld�less
rights-of-way. Such screening shall meet all applicable performance
and development
standards specific to the district in which the storage is kept, and shall be in keeping with
the character of the area. Screening shall meet the requirements of Unified Development
Code (UDC) Section 6. Outdoor storage of thirteen (13) or more unlicensed or inoperable
vehicles is prohibited except in those districts where specified as an automobile wrecking
yard or junk (or salvage) yard and allowed as a Permitted Use in Table 3-1 of the UDC,
and such storage shall meet the requirements of UDC Section 4.10. In no case, shall any
such unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area
(ESA).
11.) Maximum lot coverage is not to exceed 25%. Lot coverage as defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
12.) Minium setback from Wildwood Shores right-of-way shall ibe 13 feet per approved
administrative front yard setback variance.. Minimum si4 yard setbacks shall be 5 feet.
Minimum setback from shoreline top of bank shall be 47 feet.
13.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the
finished grade, excepting when such lighting is an integral part of a building or structure.
Ground level lighting is encouraged.
14.) Lighting fixtures shall be designed and hooded to prevent the light source from being
directly visible from outside the boundaries of the property. The intensity or brightness of
all lighting, during construction and after project completion shall not adversely affect the
use of surrounding properties or adjoining rights-of-way.
15.) The building height is not to exceed 35 feet.
16.) 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.
I:1F_BLD_Perm it_Buildng,rpt
10/29/19
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Pt' G
IIIBUILDER 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: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
AWA`71120 n 60 Or--jtS -r (25-) '5 3I 7070 (Z53) 53/-762/
MAILING ADDRESS: I (0 Q ( 12A/1 I!,.I EMAIL:
CONTRACTOR'S LICENSE r WAINS
NUMBER: A A ,-r U • 9.4 IP NUMBER
ARCHITECT/ENGINEER: i-`k�/" i�-rh rjr 1 n/ -t-fT / f i PHONE ( ) FAX:( )
MAILING ADDRESS: 1.Qb1,r 1'v" `r(/ I t✓ 6 t EMAIL
Project Type: �'cV F9nie Type: Bathrooms: _- Shoreline: Type of Sewage Disposal:
New Wood Existing: _ 0 Sewer
❑ Addition 0 Steel Proposed: _ _ Bank Height: ❑ pommunity System
O Alteration/Remodel ❑ Concrete Total: l [IL/Individual System
❑ Repair ❑ Masonry /e -.*:
p Bedrooms: SEP Permit# r-�(.,
CI Demolition ❑ Other: Water Supply:
Existing: -
Setback: . 0 Private well 0 Two Pa
Type of Heat- Proposed: -
1 0 Public
t - - t Total. _ V/— �'�9 �Dla e of System:
f Le4R- JE,
If this is a Commercial Protect 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:
❑ Underground Tank 0 Above ground Tank Size of Propane Tank:
O Heat Stove 0 Cook Stove 0 Woodstove 0 Fireplace Insert 0 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 propel
lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components
including the reserve area. 4A r,,, t,, _ I. u • 10.10-0 - .A,1,
Square Footage [ rrent Propoaed ,
Main Floor Heated :-0,r, > 4 s, 4
C x. A EH Bld App Review: S V
na Ih-t, fi«. YW 1
2 Floor Heated i,g 1 Consistency Review: L.-14'ti3 Z _510 Q
ll
Other Heated '"°- . " :ase tea;
Mezzanine .-•4.< `:,; : Additional Section:
Heated Basement 'No ; ' 4..a; > P -n Check fee e:
Unheated Basement . . E : , 'F . State Surcharge fee: 13�
Other Unheated \O'\ '•, 44
� 4W
c7���� _ �� x������ .� Pot Water Review fee: _ �.
Garage/Carport IA SUBTOTAL bS•
33
Decks ' 43-, 911/Rd Approach fee: St
,
Other A. �� . ` _...__.TOTAL: $
l4ri-• xs '
fi- x�^' Receipt Number:
u, , �,` a 3 $� qi1 y 9�y
,, aJf h'. , Number:Ft 4,11, g 4 ( -loots-
ESTIMATED COST(REQUIRED) q7- Date: �i ilaartaA /
.Fair market value of all labor and material 31� i to
� (, Initials: ' /�^2-
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc
Corr c o 64" I c�
6 JEFFERON COUNTY Fr----,------ __—•
rilillik
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43 DEPARTMENT OF COMMUNITY DEVELOPMENT
f ' -;•• '4 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-44v1 Fax E�pppp 2 6 2006
.q�, NO�p www.coJefferson.wa.us/commdevelopf�fellit
__..!
Master Permit Application ,.,.l.cpt,i MLA: b62 -RIO
Project Description (include separate sheets as necessary:y
,c Property Q
Tax Parcel Number. .>0z -/4Z -0/2 Size: ii 71-• (•\7� cres/square f
•
Site Address and/or Directions to Property: e.3-O) VJ I L.b Q •
Property Owner(s)of Record: `I fit, 9Len�. lj Y\Ce{-
Telephone: 6753) &'31 - yh o� Fa : I email:
Mailing Address: 21,I yg /.2! rti AxyE" S. ' 'i )7 1,414, d/t C)
Applicant/Agent(if different from owner): ,---r'p(Y\ I"lA U OW.
Telephone: - 02-0 Fax: - 0 2 e ail. M
Mailing Add ss: C j A- - n'74.
What kind of Permit?(Check each box that applies)
O Building ❑Variance(Minor, Major or Reasonable Economic Use)
0 Demolition Permit 0 Conditional Use[C(a),C(d),or C]"*
❑ Single Family ,, 0 Discretionary"D"or Unnamed Use Classification
Garage Attach Detache 0 Special Use(Essential Public Facilities)*"
❑ anufactured Hom 0 Boundary Line Adjustment
O Modular 0 Short Plat'"
❑ Commercial* 0 Binding Site Plan**
O Change of Use 0 Long Plat'*
❑Address 0 Road Approach ❑ Planned Rural Residential Development(PRRD)Amendmentf
•❑ Propane 0 Plat Vacation/Alteration*"
❑ Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions*"
❑ Stormwater Management 0 Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
❑ Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendmen
❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
0 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:
J DESIGNATION OF AGENT
I hereby designate /DM /44i10(-✓ 4f)t1,Q1 •f //o,,w►SS to act as my agent in matters relating to this application for permit(s).
�
OWNER SIGNATUR % `/ Date: 2-6 p 4,
�- i
By signing this application form,t er/agent attests that the information provided herein,and in any attachments,is true and correct to the best
his,her or it's knowledge. Any meal falsehood or any omission of a material fact made by the owner/agent with respect to this application packet
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 attomey'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 applicati
review and any required I r spections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours.
Signature: 3- L --C9 4
Date:
7
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"take"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 pi
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 actio
even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-
transferable,sponsibilityfor a ring to and:com ) t4 p ` ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: h..— 6 /-
Date: —
f
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc
• sub- 24 2006 4: 13PM I1110LASERJET FAX
— — • P- 2
PERMIT # BED
Dv;c \ JEFFEOIJCOUNTY 0 6 0 2 2
i.� •`-. ;. DEPARTME TOF DOMMUNITY DEVELOPMENT JEFfERSON UItl COUNTY DCD
4 ! =* 621 Sheridan 'treet• Port Townsend•Washington 98368
11`s-iIt'NG .0 360/379-4450 360/3 "Si-1 151 Fax
http:/lwww.co.'-fferso l.wa.us/comrndevelopment/
STORMWA =R S ITE PLAN SUBMITTAL TEMPLATE
MLA* D(a-.2,1 0 PROJECT/APPucANT NAME �J l �. -
Please answer all of the following quest)ins to t is best of your ability. Where (the question calls for depiction on a site map, the
applicant may choose to either incorpora the ek orients 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 '••nditioi s of the site. Indicate position and relative size of proposed improvements on the
site p.
Existing Conditions Summary
2. Describe the existing t••.,raphy. I •icate :..i •urs on the site map. do
ctiel-rLe, P• `,• NO , `ate- c c ."
3. Describe the existing vegetation. I •icate 1 olive vegetation areas on the site map.
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Describe the existingsoils. Indicat: soil tYiF on the site map.
5. Describe the existing site hydrolog (i.e.,d singe;behavior of water on the site—above, below,and on the ground). Indicate
existing stormwater drainage to a,d from the site on the site map. Depict separate drainage basins on the site map, if
applicable,and Intl' to acreage of each.
06 5- (-)44
ft. (moon, , � "
e LA, _ r n tp Ie-- Yat ri
Q
6. Describe any excess I Is of noise generr_ea by.the Zroposed use or activity:
`-t-d..--- , APPROVED
STORM WATER PLAN
\ JUL 2 5 2006
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Require i
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Jul. i'4 '2UU6 4: 13PM LRSERJET FAX •
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7. Describe significant geographic features a id critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes,etc. on the site. Indicate I lion on he site map.
NiFtzolc,
)
8. Delefei.scribe the general vicinity of the site,inc tiding adjacent land uses and structures,utilities, roads,and sensitive/critical areas
streams,wetlands,lakes,s slopes,etc ).
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Permanent Stormwater Control Plan
This portion of the Storrnwater Site Plan ci nsisis of the selection and installation of the appropriate stormwater control BMPs
and facilities to remain in place after constn crtion of the project is completed.
`Medium'size projects are required to ha' e the totals calculated of all impervious surfaces, pollution-generating impervious
surfaces, and pollution-generating pervior s surfaces to verify that the thresholds for treatment facilities and flow control
facilities are not exceeded.
g. Describe the developed site hydrology, as )roposed. Indicate whether stormwater will be fully dispersed(i.e., per BMP T5.30
In the Manual)or, if not,what types of stor rowater flow control will be utilized for the site or
specific within the site. Locate these facilities on th. ,site plan and differentiateproposedg threshold discharge areas
�if `rh6„? , ni,,gyp ! y ii O-. -to facilities xistin facilities.44- (Dirt 'Lop
as
10. If the project requires the use of stocmwatr treatment facilities,describe the types for use on the site. Locate these facilities in the site plan and differentiate of stormwaterffrom
facilities proposed
normally for'large"projects or projects that involve the posed facilities from existing facilities. [This Is
potential for dispersion of contaminants.]
it\ki
11. Describe the performance goals and stand, rds applicable to the project
tV Ibsc
12. Describe the flow control system.
itarmwster sits plan Iemplate.doc-rev.10112/20W
6
Jul. 24 2006 4: 14PM LASE •
RJET FAX
p. 4
13. Describe the water quality system.
gig anommin
14. Describe the conveyance system alysis a id design.
15. Describe the source of fill material, , ysical characteristics of fill material,and deposition of excess material.
16. Proposed methods of placement : d corn a action consistent with the a
Uniform c Ming Code. applicable standards on Appendix Chapter 33 of the
11111.1..1
17. Describe the p ..,:.
• / • surfacing •lariat.
_
18. Describe methods for restoration of
/
,I
_ Li,.
L.a.
19. An Operation and Maintenance Ma is r:wined for each flow control and treatment facility.
Ceres"projects only and only those whir facilities are required to control flow or treat runofftf inductelist the iManfor
uals
here.
.]
20. List here and include any special re..rts or studies conducted to are re the Stormwater Pa Site Plan.
21. List other necessary
drainage� -
conditions that permits
and a'•royals as required by other regulatory agencies. If those permits or
rage n or c mtairt more restrictive drainage related approvals include
dui .describe those conditions or
res ' ions here.
et:mwvater she plan lenplete-doc—rev.10/12/2009
7
• Jul 24 2006 4: 14PM
LASERJET FAX
CONSTR • STO IMWATER POLLUTION PR
The Construction SWPPP PLAN(SWPPP)
Ste' addresses sedi ent ar I erosion control during
template that follows must be Installed on • = gro .nd during all construction construction.
on. The ect. indicated by the applicant inthe
p
development�Iment and y � erosion iBestmpacts a rat Practices (BMPs) Packetand off-eke areas. Consult the Construtoh Possible for
Pollution Pre (SWPP) impacts
•n mental of Prol Proponent is responsible
guidance, particularly with rural residential
sideritlal
�- TION I- .•..STRUCTIOM : •PP N -.- .i yA
1' Construction 9tonrkvaterPoll • Plan
laments. Describe each of the Construction
will be the addressed.d justify Identify �: d loc lion of BMPs used to satisfy the wired element. If n el ment e�s�has been or
to2-te writing. '�PtIo is of the 12 Elements are found at section 2.5.2 of the Manualis not
applicable
page
t ,/ ^ (beginning�page
12 wife(!Santo es- ..,�1� F -• S WF)
1. Mark :r 'ng Limits.
Mark • 'Ili ;-1
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2. Establish Construction .---
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3. Control Flow Rates_
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4. Instal Sedime Controls /
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5. Stabilize Soils. y-.
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6. Protect Slopes.
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starnsgler eats Wan IemWsee.doc—rev.10/122003
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12 Required Elements—Con '. :'WPPP(continued)
8. Stabilize Channels and 0 ,lets.
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9. Control Pollutants.
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10. Control De-Watering(the .
of Pu nping groundwater or slormwater away from an active construction site).
11. Maintain Best Manage - P chi, es(BMPs). --------- ----- _ 4 _
12. Manage the Project.
2. Adjacent Areas.
a. Description of the adjacent a - the I may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas,roads).
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b. Description of the downstream drainaf s path leading from the site to the receiving body of water(minimum distance of 40t1
yards).
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3. Environmentally Sensitive Areas.
a Description of environruen ,ty ser Alive areas that are on or adjacent to the site.
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b. Description of special requiremeni ;for working in or near environmentally sensitive areas.
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4. Erosion Problem Areas. Description of G ytentiai erosion problems on site In the context of the characteristics of the on-site
soils(e.g.,erodibility,settleability,permeab•illy,depth,texture,sod structure).
5- Construction Phasing.
a. Construction sequence
tf I-tOnc� /i) OttI ((_
. Construction tion phasing(if proposed [
6. Construction Schedule. Wet season is )ctober 1 through April 30(page 2-21 of the Manual).
1. Provide a proposed construct fn�hedu(r�
Ii. Wet Season COI!ski -on vines. —
a. Proposed wet se son co ct uction activites.
ltAre 'fro n
b. Proposed wet se son co struction activities for environmentally sensitive areas.
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7. Financial/Ownership Responsibi ties.
a. Identify the property owne respor Bible for the initiation of bonds and/or other financial securities.
b. Describe bonds and/or o er evid once of financial responsibility for liability associated with erosion and sedimentation
impacts.
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8. Engineering Calculations. Provid- Desig r Calculation on a separate sheet for the following,if applicable.
a. Sediment Ponds/Traps.
b. Diversions.
c. Waterways.
d. RunofffStor-mwaterDetenti.nCak Alations
etormweter site Was tmlpiete.doc-rev.10112R003
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Stormwater Site Plan Changes
If the designer wishes to make changes a-revisk is to the originally approved Stonnwater Site Plan,the proposed revisions shall be
submitted to DCD prior to construction. The sc Gmittal 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 Btu Ps),the applicant shall submit a final corrected plan eas-buitts')when the project is
completed. These should be engineering drawir is (stamped by a I.censed civil engineer) that accurately represent the project as
constructed.
IPPLICANT SIGNATURE
By signing the Construction SWPPP wcrksheet t as the applicant/owner attest that the information provided herein is true and
correct
to the best of my knowledge. I also car iiy th this application is being made with the full knowledge and consent of all
ofhd Property r�
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ifOld
(LANOOYYI�R dlt O REPRESENTATi1fE 81 r ;) (p)
THIS SPACE MAY BE USED FOR ADDITIONAL I IOJTES,IF NEEDED:
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"S APPLICATION, �. ..,.1.
•. :. PLAN SAIL .. . . ..•...�
• - _- 1 ON-SITE WASTEWATERCL. # 502-142-012 CARLSBORG ROAD S�11T r': " . '1
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ri TAX P .. 863SEQUIN, WA 98382 1 � , c---
1 N • INT. SAND FILTER do•SHALLOW PRESSURIZED' .
PH (360) 603-6300 FAX (360) GA \ ;"'�, '
8 SYSTEM FOR. DON Sc KAyLENE SKANCHY I