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HomeMy WebLinkAboutBLD2006-00228 BUILDING PERMIT APPLICATI(A MLA06-213 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00228 Received Date: 5/2/2006 SITE ADDRESS: 101 WATERHOUSE LN PORT LUDLOW, 98365 OWNER: JAMES TALLMAN PHONE: (360) 301-6336 MARY E TALLMAN PO BOX 65222 PORT LUDLOW WA 98365 LUDLOW COVE DIVISION 1 PHASE 1 SUBDIVISION: Block: Lot: 2+ PARCEL NUMBER: 968800002 Section: 17 Township: 28 N Range: 01 E CONTRACTOR: PORT LUDLOW ASSOCIATES LLC PHONE: (360)437-2101 70 BREAKER LN PORT LUDLOW WA 98365 Contractor's License PORTLAL994L8 Expires 05/02/2006 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW SFR W/ATTACHED GARAGE (COVERED ENTRY/PATIO 726 SQ FT) ALSO U/G 500 GAL PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,343 VALUATION 359,440.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: 1,084 HEAT TYPE: HTP OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: OTHER: 726 CONST TYPE: 5N GARAGE: 830 SHORELINE: CONST TYPE: DECK: 662 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: SEW WATER SYSTEM: LUDLOW BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 4 Total: 3 Total: 4 Routing Date 5/1 0(3 1v Mk Type Amount Paid By: Date: Receipt: - Ap.rove. Permit $2,449.75 KAS 05/02/06 81203/8125 JUN /i2006 Plan Check $1,592.34 KAS 05/02/06 81203/8125 State Building Code $4.50 KAS 05/02/06 81203/8125 Jefferson County Planning Potable Water Application $55.00 KAS 05/02/06 8'1203/8125 &Building Department Total: $4,101.59 CS (i-Q/ 4 BUILDING PERMIT• Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00228 Received Date 05/2/2006 SITE ADDRESS: 101 WATERHOUSE LN Issue Date 06/14/2006 PORT LUDLOW, 98365 APPLICANT: JAMES TALLMAN PHONE: (360) 301-6336 MARY E TALLMAN PO BOX 65222 PORT LUDLOW WA 98365 SUBDIVISION: LUDLOW COVE DIVISION 1 PHASE: 1 Block: Lot: 2+ PARCEL NUMBER: 968800002 Section: 17 Township: 28 N Range: 01 E CONTRACTOR: PORT LUDLOW ASSOCIATES LLC PHONE: (360)437-2101 70 BREAKER LN PORT LUDLOW WA 98365 360-437-2522 Contractor's License: PORTLAL994L8 Expires: 5/2/2008 5 PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE (COVERED ENTRY/PATIO 726 j#(l SQ FT) `( ALSO U/G 500 GAL PROPANE: TANK 1206 D ,?‘ CALL IN FOR THE REQUIRE INSP TIONS THAT APPLY TO YOUR PROJECT. 0t'6Q- al SETBACKS: Ofs 7//o(. (Pe VfiIGy!d go olf0D47Joa, OK-$12-la \� DY- U FF ER: .,(' 7f7/4Ib/1 l Footing: Qk /,D6 vI G1-1I'-e";6, F) 4*.`. Foundation: (SEE- jOTr AM,,) 0/rEe Scuevey ,9- PI 4 gfi/c,�# fik ►/ ,,,, Stormwater FINAL Approval: Faotnue 14T4a7-1-1ua- 1)E4I Ut O1< 0,G, Underground Plumbing: Underground Insulat? : _ �J b - Shear Wall : Ok J !l Q ; QE-C4►c.s/�� _/7l�' Sheathing: icy� Framing: C!(aIi26) / o Plumbing: �f ji(� / 3j 00 / Propane Tank/Lines: to-i-j ,uF„S a( 0//o* OIL /� Insulation: taus. CS< 2/7c? 1,/rn ii p.. •f r;l 7/j/6 � oti GI B �'� AC Sbec G,. 13'4' Owv- Sheetrock: 22o-b'1 (?-> �� 0 Septic Sytem Final Approval MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval:Final/Occupancy Approval: OK ar C/t, 6 f 7/tii 9/ HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED t3RIOR 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 I , r /9 f 7 GiG#/�.z/ Z SPECIAL CONDITIONS FOR CA, A BLD06-00228 • 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.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water quality degradation. The submitted proposal does not require additional aquifer protection measures. However, during construction the project shall follow the Best Management Practices (BMPs) and facility design standards as identified and defined in the Stormwater Management Manual for the Puget Sound Basin. 7.) 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. 8.) 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. 9.) 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. 10.) MANDATORY MEASURES Ft 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. 11.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 12.) 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. 13.) 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. 14.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 15.) 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). 16.) Maximum lot coverage is not to exceed 45%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 17.) Minimum setback from Waterhouse Lane right-of-way shall be 20 feet. Minimum side yard setbacks shall be 5 feet. Minimum rear(shoreline) setback shall be 45 feet as depicted on submitted site plan. 18.) 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. 19.) 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. 20.) The building height is not to exceed 35 feet. 21.) 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. 22.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 23.) Per MPR Code Section 3.17, Accessory dwelling units (ADU's) shall not be allowed in the MPR-SF zone. 24.) Motor vehicle parking between new structures and the Ordinary High Water Mark (OHWM) is prohibited. 25.) Motor vehicle parking between new structures and the Ordinary High Water Mark (OHWM) is prohibited. • 0 26.) No fence, wall, hedge or barrier greater than 42 inches in height shall be placed or enlarged nearer to the water than the building set back line (BSBL). No fence, wall or similar structure shall be placed water ward of the Ordinary High Water Mark (OHWM). 27.) Mechanical apparatus rather than chemicals shall be used for brush clearing maintenance wherever practicable. 28.) Herbicides used for maintenance along roads and drainage systems shall follow the performance standards outlined under"Chemical Application" of the "Forest Management" Section of the Jefferson County Shoreline Management Master Program". 29.) As delineated in the filed by orange painted 1"X 2" stakes, no earth disturbing activity shall be allowed in sensitive areas unless witnessed by Larson Anthropological/Archeological Services (LAAS). 30.) In the event archeological items are discovered during construction, builders and lot owners shall observe the following protocol: STOP WORK. DO NOT FURTHER DISTURBE THE AREA OR REMOVE ANY MATERIALS THERE FROM. NOTIFY IMMEDIATELY THE JEFFERSON COUNTY DIRECTOR OF COMMUNITY DEVELOPMENT (360) 379-4450. THE DIRECTOR OF COMMUNITY DEVELOPMENT WILL IMMEDIATELY NOTIFY THE WASHINGTON STATE OFFICE OF ARCHEOLOGY AND HISTORIC PRESERVATION ("OAHP"), (360) 407-0752. PROTECT THE AREA FROM VANDALS AND COLLECTORS. OBTAIN SERVICES OF A QUALIFIED ARCHEOLOGIST TO EVALUATE THE SITE AND MAKE RECOMMENDATIONS FOR FURTHER WORK IN THE AREA. IF FURTHER EXCAVATION OR DISTURBANCE OF THE SITE IS NECESSARY, OBTAIN THE APPROPRIATE PERMIT FROM THE OAHP. PROCEED ONLY IN COMPLIANCE WITH THE TERMS AND CONDITIONS OF SAID PERMIT. 31.) Construction of housing units within 10 feet of an adjacent housing unit on these residential lots shall be built with "one-hour"wall construction. 32.) Existing asbestos cement sanitary sewer pipe across Lois 1 and 5 and Tracts A and C have been pumped with grout and abandoned in place pursuant to Jefferson County Health District requirements. 33.) Lots 1 through 7 of said plat shall have an equal and undivided 1/7th ownership and maintenance responsibilities for the guard rail located within Tract"A". Refer to Declaration of Conditions, Covenant's and Restrictions for Ludlow Cove Division 1 Phase 1 for further information. 34.) APPLICANT AND/OR CONTRACTOR SHALL CONTACT JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT (DCD) AT 360-379-4457 TO SCHEDULE A SITE VISIT WITH THE PORT LUDLOW DRAINAGE DISTRICT, DEVELOPER/OWNER, AND DCD PRIOR TO ANY LAND DISTURBING ACTIVITY BUT AFTER FOUNDATION IS STAKED. I:\F_BLD_Permit_Buildng.rpt 10/29/1999 \ v - ---- ,----"" \ \ �� ;w V \ - REVISED S,�,� 'LAN ' , ' i`'� dated ffit / / W t Has been APPROVED (Ol ( �,o ', -- @Q 4 t by JEFFERSO , • (i, /� Q >�..of •� � � :, �T,��:, ai SIQNATU V ►ilii k.,. .40 4 Stormw., 47„;:pirda �� A. Re'. t fll\e!7!, ;'',► Ll' i Ld'T`` G,Q ,I 4rrJcJ ' 2;ir'0, \ 0 �.a 2 oU iI,-7i ,�T1 COLJ E owl d! ccAT Cr I - .v ri- �O PF iii. . ./# RD ''. - -, c--k • 1 2• : gti -°,Z a w 4 0228 - - --- ( � �, �F) , Ai RIUN COUNTY BC C3 ' - s ...,„ ' */ A7' --i.' \,„ \,/.7fiA( , I 1„ i _ _ M� F M. 60 Fq c_ Ire t� ni tINZ 1 ‘Lt. t%4T'f PrLL ,\ ilk / - .2,n L, , > --- : .4 (,„ A,c4. 5;, 4t.k4.7?0,....r• lkt,6,11 3 �' �� ,.. ,,,...., ,.?- - kr _ „pp-- „,:,4.:ay.„.,w. .,;,_,_, ,,,..„, c o,-. a - . , - ' , 4 ,1- 09" V ...---"' ) ,/c01\ tj-/ - .‘ , 1 i 1 !kg ON" V--_-, i-0 & (N ,z„.i.0 'C' . ak,, 2_.= ' - A* , v ,,,,yij,v- ,, \Y_ id, JUN 0 8 7 Z00� 1 - �/ I JEFFERSON COUNTY DCD 0 • OWNER BUILDER STATEMENT V _ 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 propose roje Signature: Date: 2006 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: i Fax: 4'c -r- „oc,J jsFJ_AxAc 4 ,.1 l LC ( ao) Lt3-1- -101 ( ) 13-1 a. aa MAILING ADDRESS: `10 ec...1t.Y L.r11"pp,lk L iclicx,,,r WA c:fgj.,,S EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: 'PoR CL_t . "1`=1L-1k_.-g NUMBER ARCHITECT/ENGINEER: BGy pain t Coy.p PHONE ('1 5)4'37-gff2 3 FAX:(yzz )637_ 77/ MAILING ADDRESS: 5-15--H4'rj ,Yt NC, STE /NY &Ciiev'e , EMAIL 9 too y Prpject Type: Frpme Type: Bathrooms: Shoreline: Tye of Sewage Disposal: W. New Wood Existing: _0_ ewer ❑ Addition ❑ Steel Proposed: _'/S _ Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: —/ _ Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other. Bedrooms: Water Supply: Existing: _ _ Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: — _ I{Public e\�, \tea+Pus-tr„-,p Total: _ 3, Name of System: Du----,I If this is a Commercial Proiect 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 Above ground Tank A Size of Propane Tank: 500 1 I Heat Stove I Cook Stove i Woodstove Fireplace Insert i Hot Water Tank i Pellet Stove i 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. Square Footage For Office Use Only Current Proposed I Amount Main Floor 2 3`13 Consistency Review: 2RD Floor Base fee: t .IS 3`a Floor — _. Additional Section: �---r"' Mezzanine: Plan Check fee: 13`P Heated Basement /Ogy State Surcharge fee: ,Unheated Basement Pot Water Review fee: nth...I Inhcatart — 911/Rd Approach fee: Garage/Carport 93 O. TOTAL: $ iDyi Decks Coto Z, Receipt Number: i ' ao 3 lla 1 Other �,/ Cash/Check Number: / CoVered &If'y/pa y-i o 70t lf/ `i I 1 Q -1(�la I ESTIMATED COST(REQUIRED) ate: / �`�_ •Fair market value of all labor and materials ation to finish 5 I a 1 0 9/2_._____ a Fs, (000 „ Irials: C:\Documents and Settings\mochil\D ktop\Master Permit on 7-8-04.dd - ' 1 1)4%. j� ` • • 0 enio0,> JEFFERSON COUNTY VDEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450• 360/379-4451 Fax Owww.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: -a,3 Project Description(include separate sheets as necessary): af. ) -4Lt co r,rLl L r-e-skderic LoicLiicic.hca. r cue_ Tax Parcel Property Number: '(o$ - 2,00- CC) a. Size: 12, 0 2 Z I (acres6quare feet Site Address and/or Directions to Property: L`t a / 101 !( . ki >C LYl rt41 IQw , Loh cR.3(0S Property Owner(s)of Record:IG-' S \n t \ moo,- k CYlcr-v�J E V '..t v - c r Telephone: 340o-3o 1-(033(o Fax: _ email: Mailing Address: Po (3oi 6,5 Z Z Z ^?t oat Ludlow w A _ 98a�5 Applicant/Agent(if different from owner): Bdam+ ] t 3IOc,.3 f Y_T-,c,c-uOL-IcS, L_(✓G Telephone:(>tcb) -1-2101 Fax: C31.4))L13-1 -D-S2.2 email: Mailing Address:`10.-EXe.c...ksLv (may v-,Q.,—} ±I ,tdiou_., i —- cr:8- - What kind of Permit?(Check each box that applies) Building ❑ Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]** R:Single Family ❑ Discretionary"D"or Unnamed Use Classification RI/Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** ❑ Commercial* ❑ Binding Site Plan** ❑ Change of Use V ❑ Long Plat** E/Address Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** B'Propane ❑ Plat Vacation/Alteration** ❑ Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions-- ❑ Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑ Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑ Wireless Telecommunication* ❑ Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate P-.R0lo 6 Ba t'/-e e w to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE :::���tG40 /- " '�- Date: i 4- .b By signing this placation 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 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 application review and any requi later inspections.Access and ri ht of entry to this property shall be requested and shall occur only during regular business hours. �,, J /Signature: Date: � ?��/0/ 6 The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one orlmore 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 permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-trans responsibility for adherin t emplying with the ESA. The Applicant has read this disclaim and sag and dates it below. Signature:? / .-�� Date: (/_Z v/� C ( C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc . i • 0 � -- jj EOWE IsON 3 0 2iO6 Li t •4%, JEFFERSON COUNTY MAY1 ►� DEPARTMENT OF COMMUNITY DEVELOPMENT ' ``. JEFFERSON COUNTY A. 621 Sheridan Street • Port Townsend • Washington 98368 DEPT OF COMMUNITY DEVELOPMENT s 4.O 360/379-4450 • 360/379-4451 Fax TIN http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# /.•"1 .. i 0co } 1 PROJECT/APPLICANT NAME: "Tr, - ;,,:,y.�',�`;4•.-, 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. {--- , t erri- 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. KL4 v el .�-T' _ T C- PERMIT # BID 4. Describe the existing soils. Indicate soil type on the site map. 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. "T L:k -_4tt' t_ "'----pe + a 7-0 7'0, Y4`\ �'`t'tt•5 -r ‘D 1 ''';a' APPROVED 6. Describe any excess levels of noise generated by the proposed use or activity: STORM W ATER PLAN JUN 1 3 2006 t Stormwat Require C NTH DEPT OF ' EL ENT stormwater site plan template—rev.10/1/2003 SIGN AT U RL/: • 111 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. t C),4:3"' LA 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.). t tom.. S c " i" L\.1''4eUn,Q 6 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. C `147:e0\ 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.] /1 / 11. Describe the performance goals and standards applicable to the project. c. 5raz-ny 4 .-•Describe the flow.control;;Y.g2/10,_ •.. Yf /. y l57 1'7 . • { } 7> 6 stormwater site plan template—rev.10/1/2003 • • 13. Describe the water quality system. 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 Appendix Chapter 33 of the Uniform Building Code. ,f 17. Describe the proposed surfacing material. 18. Describe methods for restoration of the s'e. • 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. /4//4 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 Clearing Limits. N/A- 2. Establish Construction Access. / I, 3. Control Flow Rates. r /A 4. Install Sediment Controls. 67-)ct9 0' 5. Stabilize Soils. 5 T,0uJ 6. Protect Slopes. /A-- 7. Protect Drain Inlets. 7A storrnwater site plan template—rev.10/1/2003 8 • • tl 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. y/�� 9. Control Pollutants. Tito e4,#41-toe 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). .- v/ T 12. Manage the Project. DB / G".�% r'�.,f 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). /,.,.,>'! ,� / "�tJ e S X G(J, tots b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). 6,)4 �� 1 ?rat rT" , - 6 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. (../A/,,,.- stormwater site plan template—rev.10/1/2003 9 • • • b. Description of special requirements for working in or near environmentally sensitive areas. F ;� 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 construction schedule. II. Wet Season Construction Activities. a. Proposed wet season construction activities.� / b. Proposed wet season construction activities for environmentally sensitive areas. 7. FinanciaVOwnership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. —r .u-.- v\-f n) 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. 0 /4- b. Diversions. / c. Waterways. /.4.- d. Runoff/Stormwater Detention Calculations AV A-~ 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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