HomeMy WebLinkAboutBLD2006-00374 BUILDING PERMIT APPLICATION Review
Review Ty viewTy 363
pe: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00374 Received Date: 7/5/2006
SITE ADDRESS: 382 DISCOVERY RIDGE RD
PORT TOWNSEND, 98368
OWNER: ROBERT S FUKANO TRSTEE PHONE: 360-437-8237
ELIZABETH A FUKANO TRSTEE
PO BOX 65044
PORT LUDLOW WA 983650044
SUBDIVISION: Block: Lot: 19
PARCEL NUMBER: 001195139 Section: 19 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION ADU
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADU MAIN: 876
VALUATION 59,071.00 ADD'L: HEAT TYPE: EEE
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3
OCCUPANCY: UNHEATED: # OF STORIES:
CONST TYPE: 5N OTHER: SHORELINE:
GARA
CONST TYPE: DECKLE 80 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: OTHER
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 2 Prop: 1
Total: 2 Total: 1
Routing Date:
al (40 ,(0 C
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $713.75 LYK 07/05/06 83665
Plan Check $463.94 LYK 07/05/06 83665
State Building Code $4.50 LYK 07/05/06 83665 2
Total: $1,182.19 JUL 31 2006
Jefferson County Pdar►p4ig
& Building Depart a
0 a
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD06-00374 Received Date 07/5/2006
SITE ADDRESS: 382 DISCOVERY RIDGE RD Issue Date 07/31/2006
PORT TOWNSEND, 98368
APPLICANT: ROBERT S FUKANO TRSTEE PHONE: 360-437-8237
ELIZABETH A FUKANO TRSTEE
PO BOX 65044
PORT LUDLOW WA 983650044
SUBDIVISION: Block: Lot: 19
PARCEL NUMBER: 001195139 Section: 19 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: ADU - BLD06-00374
CALL IN FOR THE EQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS:
r
UFFER:�G
Footing: k._9,-22-at
Foundation: 4, 10 Q %4:'-
StormwateVFINAL Approval:
Underground Plumbing:
Underground Irn iullatio :
Shear Wall : / 1.4(1, ,)0, L\ \.),.‘16j vA 1 /1,{b-01 IrJi
Sheathing:
Framing: 1= _A-3c o1
Plumbing:
Propane Taink/ Lin s:
Insulation: ti JC1 c27
Sheetrock:. 5r/r17
Septic Syte Final pproval MUST be obtained before final of structure can be attempted.
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: O-- ( 2..-0*7
HEALTH DEPARTMENT ND 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
SPECIAL CONDITIONS FOR CAPA BLD06-00374 •
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 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.) 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.
8.) A stormwater plan for a medium project 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.
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 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).
11.) Minimum setback from the edge of Discovery Ridge Rd right-of-way is 20 ft. Minimum
side yard setbacks are 5 ft. Minimum setback from the top of the steep slope to the east
of the proposed building area is 30 ft. Environmentally Sensitive Areas further impact
setbacks.
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 four(4) parking spaces are required for the single family residence and
accessory dwelling unit(ADU).
I:\F_BLD_Perm it_Bu ildng.rpt 10/29/19
?Iv
c JEFFER•N COUNTY • b� ECHIVE�)
i DEPARTMENT OF COMMUNITY DEVELOPMENT
4 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax JUL D 5 306
.q O� www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA. AS II_
Project Description (include separate sheets as necessAv
Sin /e re;en; i��'t-J/;ny l
'r j Property
Tax Parcel Number: 00/ — /�'S—/37 Size: c c r r- 5 (acres/square fee
Site Address and/or Directions to Property:I 3 ! 2 D` c . r^
Property Owner(s)of Record: 1 d r=r-i- t be--
Telephone06())-¢37- ?2, 7 Fax:(' )-J--3.7-fs2,37 email:/ •• :l
L ' 4 �Coo.Mailing Address: T'0, j_3L,h (,67-)44- gri L v,.1 10,....) ) WA qe34 5 -
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
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 CI**
)(Single Family ❑ Discretionary"D"or Unnamed Use Classification
❑ Garage Attached/Detached ❑ Special Use (Essential Public Facilities)**
❑ Manufactured Home ❑ Boundary Line Adjustment
❑ Modular ❑ Short Plat**
❑ Commercial* ❑ Binding Site Plan**
❑ Change of Use ❑ long Plat**
❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments*'
-❑ 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 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 m
result in this permit being null and void.
I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and
expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application
review and any required later inspections.Access and right of entry to this property shall be an requested
hours. q d shall occur only during regular business
� (Signature: _, r.414/7r y 3(OL
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 pent
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(:
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 responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
:' �Signature - � " /
e-,r� � . o�- �,I3- Date: -43(f)(a
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc
.
BUILDER STATEMENT
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the responsibility ofa the General Contractod I. o
: r for the proposed project.
Signature —� �- � ..-ri _ Date: 7F3!U(,..,.
i ,.-,.r
GENERAL CONTRAcToB QR MANUFACTURED HOME INSTALLER: PHONE: FAX:
itU it er— /Dui /fir m' ( ) ( )
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 X Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: J Bank Height: 0 Community System 3 4
�(
❑ Alteration/Remodel ❑ Concrete Total: I J►' Individual Systemp,Yci-cecl
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well 0 Two Party
Type of Heat: Proposed: 2 ,�( Public
Fie( 'ir i c_ Total: .z _ J Name of System: P1)n
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:
0 Underground Tank ❑ Above ground Tank Size of Propane Tank:
0 Heat Stove ❑ Cook Stove ❑ Woodstove ❑ Fireplace Insert ❑ Hot Wa er Tank ❑ Pellet Stove 0 Other
Is this appliance beinq installed in a Manufactured/Mobile Home? Yes / o
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. c
Square Footage Current Propoaed T, c�Js nl �� ► __ ,. ' i ._, .. ion' -- w.
Main Floor Heated ��! _ ,` EH Bid App Review:
2f0 Floor Heated (� `Pi*:: Consistency Review: I
3LA-iSFe.
Other Heated s ` Base fee: 9
l3 15
�,r
Mezzanine � Additional Section:
Heated Basement *.#011 Plan Check fee:
Unheated Basement j 4. Spwotate Surcharge fee: -4- so
Other Unheated si A Pot Water Review fee: 5FL
Garage/Carport ' r' SUBTOTAL Ll�� £pit l 12 .19
r -x
Decks / k g6' 911/Rd Approach fee:
Other p q
�Y E'r e Pc�t^c h ga I I TOTAL: $ 1 1(82. 1 y
"x"r' xa. Receipt Number:
p(tt6
�'(°'�- Cash/Check Number: S�I
t
ESTIMATED COST(REQUIRED) S-K51 I__-- Date: `-�`F�
.Fair market value of all labor and materials found `ation toh
(( Initials:
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Annlication 12-30-O5.(Inc
• •
eL t«
tenik%„ JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
, 621 Sheridan Street • Port Townsend •Washington 98368
m ,.c� 360/379-4450 • 360/379-4451 Fax ` ";�'' s Tr.;
iC`�'! http://ww .co.jefferson.wa.us/commdevelopment/ ,,t.
w
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# -its, PROJECT/APPLICANT NAME: R,^^4 G J `j ' /--. ,
yi
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 stomiwater 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.
{+
j !�* j
/r- C 7 I)K:;t t't f: 7; C i s l it- c t 4 r de-LF{'`t G� Y :
e X i S }"l i'Z‘f_, I Existing Conditions Summary
2. Describe the existing jjtopography. lndicata contours on the site map. J[
FL i l =z f �f7r1 r�/�fd7�cio- 1 Cl1Ltf :i if) rig dot.J/7 Ri.lc' i^c's27 7'c
3. Describe the existing vegetation./Indicate native vegetation areas on the site map.
DC I a C T-I r1 6-=1 9 - t^ S c, /c; /
•
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,TW indicate acreage of each.
, �Ct ;
� ,: , �� APPROVED 5 0
STORMWAT- R -PLAN
6. Describe any excess levels of noise generated by the proposed use or act ' JUL 3 1 2006
Al/t—
lEtr COUNTY
Kyr O C $4 UNITY DEY pNFt3
PERMIT # BED S1GSATUlt . �-
stomwater site plan template—rev.11:V1/2003 0 6 — 0 3 7 4 5
JEFFERSON COUNTY DCD
• • _
7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes,etc.)on the site. Indicate location on the site map.
Nk
8. Describe the general vicinity of the site,including adjacent land uses and structures, utilities, roads,and sensitive/critical areas
(streams wetlands,lakes,steep slopes,etc.).
)4\i
A_
Permanent Stormwater Control Plan
This portion of the Stormwater Site Plan consists of the selection and installation.of the appropriate stormwater control BMPs
and facilities to remain in place after construction of the project is completed.
"Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious
surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control
facilities are not exceeded.
g. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed(i.e., per BMP T5.30
in the Manual)or, if not,what types of stormwater flow control will be utilized for the site or specmclhreshold discharge areas
within the site. Locate these facilities on the site plan and differentiate proposed ffacilities from existing facilities.
Al WI t)i i I rP'1z .4 M4 ur i ve �i"ic' 4"
ff
g i Iyi ),'rr7 4r/4r i-r.-- CI r1eer s 0 7
C.-1,4 i r r,Ii s (54,I.I e��r eirr,r'fr2 i,..,,,6 1`Fie,$.
10. If the project requires the use of stormwater treatment facilities,describe the types of stormwater treatmt 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.]
AI %
11. Describe the performance goals and standards applicable to the project.
/T^�/_ l / 1 1 l
1 l,"'P r f �j7f�r,ri L1JC1 t Pr",_jo ,,c / 'reii/ �I'P'LfQ/G"t.Tl rl i-1
12 Describe the flow control system;
- — + j"S L/i�^ee/- 4-e, %'jii 7 vi'ct I IiC`yel cG17
.. .,.,.<...__ �.._, 3 /
6
stormwater site plan template—rev.1011/2003
• •
13. Describe the water quality system.
/7/ j A
14. Describe the conveyance system analysis and design.
/V / /i/
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.
try
17. Describe the prop ed surfacing material.
)--iv '
18. Divribi met to restorat nn of the site.
-*Mina e' la 4
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. /i/
>/ e
20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
4////..1.-/
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.
/111/71-
PERMIT # BED
stormwater site plan template—rev.10/1/2003 0 6 - 0 3 7 4
JEFFERSON COUNTY DCD
•
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. I� /Mark Clearing Limits.
lt/ / /A/id r K l✓i f 1. Seer v ego, 5 -faf N
2. Establish Construction Access.
lam/; // /) .
3. Control Flow Rates.
4. Install Sediment Controls.
ti-
5. Stabilize Soils.
�,,l /► C4.74.'11 R,. le- 5
6. Protect Slopes.
gg // II
Oa Pit le ctn�l lr,v H
7. Protect Drain Inlets.
N/44,11
stormwater site plan template—rev.10/1/2003
•
REC.'EJIVED
12 Required Elements—Construction SWPPP(continued) JULf 5 2606
8. Stabilize Channels and Outlets.
/1/1//i Jf-FfERSOA CIIIJ 1 {tRl ___
9. Control Pollutants.
10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
Az/ :4-
11. Maintain Best Management Pra ice$(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).
lib
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
r� i
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
tr
r
P
PERMIT # BLD
stormwater site plan template—rev.10/1/2003 0 6 - 0 3 7 4 9
JEFFERSON COUNTY DCO
• • .
b. Description of special requirements for working in or near environmentally sensitive areas.
4
i /4
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. FinanciaVOwnershlp Responsibilities.
a. Identify the property owner responsible for the initiation of bonds and/or other financial securities.
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable.
a. Sediment Ponds/Traps. /
b. Diversions. 1
i /
c. Waterways. '
d. Runoff/Stormwater Detention Calculations
stowater site plan template-rev.10/1/2003 10
mt
a •
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 affected property.
(LANDOWNER OR AUTHORIZED REPRESENTATIYE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED:
12
stormwater site plan template—rev.10/12003
1
W �_ '1:' — _ _ _ _ _ -- 1
_ 1
f.
t-' — —i �� — l v F --,105 C�7 iv Z �7
• ..,,, , „ o ,,,,, , 0 v.,, , ,L ,, ., , ,,„
„ _, , ,, ,,_ , , „, , ,, 6 ',
;l O J J
:S -- iJ (I` (l 5 1
4a -
o
Ul 1' 1' 9 N c+ - E. c+ (D •
'I,, 1 i c4, V o ,, n �, S �;
IIII 6 a cr n fl (D c+ '
Ncb Sit ., �. Sn,
I`i 0 N n _ C SLE, p
i l 'J 1, 0 '.'I 1 p _ ce Ce �G — Z ce
II�'I 1, O C.Ii, 1 w __ 0 cS+ fD C 5
►�� L a- cD S1 S Z
I"
-___:-- - I ii^,"
..,, ),tr,v(x X,, _IJ
J CA
S
M 1
I
® -"• I /17-4' „ (>1
s
il)
i —\ I -
II i ,
1 r� `1 1 v h ,
I
'I"Z 0
N , cat o c o '
1 F c z `i2-4
S (l z I I_ t__._
4J
0 I — / r— N
— — �1 n i l n' N / �, v N �� O
- - ��. .7; 4- - - (o — 2-41/Z"�" m X
1 �, �,i �1 > g z I c� i
�� co O_ v
L.,'- \-- A i :
J
•
n T
' s 111 1
• 0
I
___.
_ I 1 __ c
l m a c'
.:
II
...2 ED 7, , „ Iv
.,_
1
0 , _
z ^,
X I,
-
Liri 1/2'Xa1 5' 1" iT�D1 v
� I
L _ _,c) P.-
y I
I i jr
p , . mn N I1 I j O
I D
� �_1 I , 8 �l 1 t I �
0 ,
1 ,
.,,\ 1 —
®I 01 Ill _11-= �J 0
I �`
1I \ I
� �� ; Ctelk L
_ .
4x8 p.t. I�� 4x8 p.t.' n
Sm 5)
5) 1 x
1'-4" - 7'-9"- - - - 13'-7' -----g J-o
A {' �'
4B1
cn
24'O" cSi _ -r --,r m 0 y
CO`-'
29june 2006 --- J' 3" ¢' 1r' z
4 0 1 Fukano P t., ROSS CHAPINAIZCH ITECTS �.
���ee
!b�1 �"p s1„y- Post Office Box 23o••195 Second Street•• Langley,Washington 9826o
Guest I-I o u 5e �,' r�`� Ph:(36o)221 2373 • Fx:(36o)221 8603 • Em: inquiry@rosschapin.com �y
PLAN ``\ t. RTM17 ♦w HP+Ztry
m o
\m m
u
_-
3
r ,
420'-0--
5999
m
/
/
/
/
PARCEL 10
0
Property Line N 89'15'48" E 552.47'
_ _--
_ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _
Line
------ --
'
Mtn. Setback
Proposed
Guest House
12
s}
,
Proposed
,
Garage
N
o
N
328s
, N
to
1
9
o \
/
PAKCEL 19
1820 s{
I 1
I '�
67—
ropo5ed
n
\
Y6'
I�
f 1 ouse
existing drain to daylight
1
'
5 \
existing curtain drain
0)
588' to east lot line
�-
'�
water underground/
' line
' V I I 1 1
II/I 1
/W/
E
Water '
q) Meter'i
VO !. E_Wi
! underground power &
\, communication lines
---- -
/ Power
Transformer
,i Telephone
d Riser
rical metJr/f V If
un house
rground �/A
eut
,
,
S-----_- — -
Min. Setback LILT _ —
_ - - P or pertY Line
926.02'
N 82'
All septic system information indicated on this plan is conceptual and is Included here for reference only,
Refer to drawings by soils Application Inc. for the septic system design.
The location of certain site features ac shown on this plan are approximate only;
no site survey was performed by the Architect.
Property lines, contours and other survey information shown hereon are based on a survey performed by
Northwestern Territories, Inc. as recorded in Volume 1 ,Page 102 in the public records of Jefferson County.
PARCEL 20
PERMIT # OLD
06-0374
AFFERSON COUNTY DCIO
5ite flan
0 25' 50":00'
APPROVED
SITE PLAN
JUL 3 1 2006
IEFFERSON COUNTY
DEPT. OF COMMUNITY DF�Op