HomeMy WebLinkAboutBLD2006-00454 MLA06-00447
•UILDING PERMIT APPLICA'TJN Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00454 Received Date: 8/7/2006
SITE ADDRESS: MCCURDY LN
PORT LUDLOW, 98365
OWNER: PATRICK S HERBIG PHONE: (360) 437-8209
JENNIFER D HERBIG
71-3 HIGHLAND GREENS
PORT LUDLOW WA 98365 PORT LUDLOW NO. 2 AREA 3
SUBDIVISION: Block: Lot: 154
PARCEL NUMBER: 990603154 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI' NEW SFR W/ATTACHED GARAGE
ALSO A/G 120 GAL PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 2,070
VALUATION 234,157.00 ADD'L: HEAT TYPE: EEE
CODE EDITION: 2003 HEAT BASE: HEAT TYPE: HTP
OCCUPANCY: R-3 UNHEATED: 1,200 #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 625 SHORELINE:
CONST TYPE: DECK: 717 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: SEW
WATER SYSTEM: LUDLOW
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 3 Prop: 3
Total: 3 Total: 3
Routing Date: JJ
717 O &d)
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $1,749.75 KAS 08/07/0(3 83973 R .
Plan Check $1,137.34 KAS 08/07/06 83973 A` s I �,� r
State Building Code $4.50 KAS 08/07/06 83973 AUG 29 2006
Potable Water Application $55.00 KAS 08/07/0(3 83973
Total: $2,946.59 Jefferson County PIannir,n
& Buii<<:ne CeQa;tmeur
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 #: BLD06-00454
SITE ADDRESS: 131 MCCURDY LN Issue Date: 08/29/2006
PORT LUDLOW, 98365 Final Date: 5/24/2007
APPLICANT: PATRICK S HERBIG PHONE: (360) 437-8209
JENNIFER D HERBIG
71-3 HIGHLAND GREENS
PORT LUDLOW WA 98365
SUBDIVISION: PORT LUDLOW NO. 2 AREA 3 Block: Lot: 154
PARCEL NUMBER: 990603154 Section: 9 Township: 28 N Range: 01 E
PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING
CODE 2003 EDITION.
OCCUPANCY GROUP: R-3
TYPE OF CONSTRUCTION: 5N
SPRINKLER SYSTEM yes no�%
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 5/24/2007
(4.(:k 4,s; /(;)5. !ei-7
Building Official-Sign-a-
fficial Signature i� Date
I:\F_BLD_Occupancy.rpt 10/29/19
• 0
BUILDING PERMIT
Jeffe County pm
621rson Sheridan De Street art, Port
entof TownsendCommunity, WA 98368 Development
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD06-00454 Received Date 08/7/2006
SITE ADDRESS: 131 MCCURDY LN Issue Date 08/29/2006
PORT LUDLOW, 98365
APPLICANT: PATRICK S HERBIG PHONE: (360)437-8209
JENNIFER D HERBIG TAG(71-3 HIGHLAND GREENS ! _]
PORT LUDLOW WA 98365
SUBDIVISION: PORT LUDLOW NO. 2 AREA 3 Block: Lot: 154
PARCEL NUMBER: 990603154 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE
-ALSO A/G-12e GAL-PROPANE TANK- -p U eb ( i I -057 c. f
CALL IN FOR THE REQUIRE I ISP IONS THAT APPLY TO YOUR PROJECT.
SETBACKS: 4 / 3/O(,G,,i/
UFFER: OX /D/3/ jam'
Footing: OX /o�13/Oh ,
Foundation: Q'J /p/s fotfr
Stormwater FINAL Appr val:- IN4 c�`ai�s(3 sites CHJ1 )OK-to>'23 a -�o� haV mull'? VEW1,idi
Underground Plumbing: ( � -' s p s 1
CorESMT) 1
Underground Insulation:
Shear Wall : �x> SME z �u x Ok /if/I ' Arrli7 g' 618 SHE/diku 10Aic/pe 4//yvavus0�
Sheathing: Q'
Framing: e c'; -/,Zi, + ' Vrfielli
Plumbing: ,9 O1 i
Propane Tank/Lines: et-WAX l'ip e"k,s CW. kJ/«?Mdr efe,)5 VI 4-1�7 �' (�� — 20 07 � J S i1..6t�bcY
1� ,� / ‘/j�4
Sheetrock: L 07 / C
Septic Sytevi Fina Ap royal MUST be obtained before final of structure can be attempted.
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: OX At- C/ S/i , 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
•
SPECIAL CONDITIONS FOR CASE BLD06-00454 •
1.) 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.
2.) A Stormwater 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.
Applicant proposed to use straw, mulch, silt fencing and landscaping to control sediments
and stabilize soils.
3.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
4.) Maximum lot coverage is not to exceed 45%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
5.) McCurdy Lane setback is 20 ft, rear setback is 5 ft, side setbacks should be no less than
5 ft.
6.) 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.
7.) All noise emitting machinery that cannot in any other way operate below the maximum
permitted noise level shall be housed in a sound-attenuating structure.
8.) Call Jefferson County Permit Center, Development Review Division for inspection of
erosion control measures. (360) 379-4463
9.) The building height is not to exceed 35 feet.
10.) Not more than 2 unlicensed vehicles shall be stored on any lot 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 Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor
vehicles is prohibited except in those districts where specified as an autormobile wrecking
yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter
18.18 JCC, and such storage shall meet the requriements of JCC 18.20.100, Automobile
wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor
vehicles be stored in a critical area.
11.) Per MPR Code Section 3.17, Accessory Dwelling Units (ADU's) shall not be allowed in the
MPR-SF zone.
12.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
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.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
if i
/:;oN °oG JEFFE)N COUNTY
471
Ir + 1 DEPARTMENT OF COMMUNITY DEVELOPMENT �1ftnC
•' ' 621 Sheridan Street• Port Townsend •Washington 98368 �� L uD
360/379-4450• 360/379-4451 Fax
p� www.co.jefferson.wa.us/commdevelopment
' mN� i
IfFfRcfl Cr,!�l,�, on
Master Permit Application MLA: 0 -`-1-4
Project —7 _
Description(include separate sheets as necessary):,,--) *'!'
P P rY)- l j i,� L+-
leAt(('�2 et 1 A. ttJt1 ri./e.1 i�, 6e4) y s-1-r ,L(- cite
Property
Tax Parcel Number: �/7'/0/' /j C� Size: / /)� ��3 (acres/square feet)
Site Address and/or Directions to Property: ` ci. M C�(,U (. l J(.�e 'iP-�F-ttl l,TJ
Property Owner(s)of Record: r� tC t .y ,iJtJ t'''v-, I'
Telephone: 2U U ' `t I ��`�j p�( /^ Fax: �1?r0' ' /" , " email: jet"vie-t^a 4?,;str11,.c ,' '.
Mailing Address: -7/ :3 f-I jh/a-d i- c� 7d'r+L�il!. U 0--' �,_;
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
i Building i Variance(Minor, Major or Reasonable Economic Use)
i Demolition Permit i Conditional Use[C(a),C(d),or C]**
:4 Single Family i Discretionary"D"or Unnamed Use Classification
A Garage -Attached/Detached i Special Use(Essential Public Facilities)**
i Manufactured Home i Boundary Line Adjustment
i Modular i Short Plat**
Commercial* i Binding Site Plan**
i Change of Use i Long Plat**
/iAddress i Road Approach i Planned Rural Residential Development(PRRD)/Amendments*"
'-'Propane i Plat Vacation/Alteration**
i Allowed"Yes"Use Consistency Analysis i Shoreline Master Program Exemption/Permit Revisions"*
i Stormwater Management i Shoreline Management Substantial Development**
i Site Plan Approval Advance Determination(SPAAD)* i Shoreline Management Variance
i Temporary Use i Comprehensive Plan/UDC/Land Use District Map Amendment
i Wireless Telecommunication* i Jefferson County Shoreline Master Program Amendment
i Forest Practices Act/Release of Six-Year Moratorium
*May require a Pre—Application Conference *"Requires a Pre-Application Conference
Please identify any other local,l statepor federal permits�reired for this proposal, if known:
(lAii •:J �,(/'l,l',(1�',t.-�,{/,�?;y' i;!),t ,i l'(,,,-/t ( :-_�." '_2i (--
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 z 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 rig of entry to this property shall be requested and shall occur only during regular business
hours. .—j" ! �1
Signature: �Ii �-'"�'( t �G)1,� :. �' . . Date: (97 (// )
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 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-
transferablejesponsibility for ad�'eririg to and complying with the ESA The Applicant has read this disclaimer and signs and dates it below.
Signature:\.11- �i:gjLA .4 , ��{� ���� �1��c� Date: ��r��'(1�U2
C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\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 andittj () D
they will be a su ing the resrionsibility of thez9bneral Contractor for the proposed protect
t t,
Signaturez1-y.. 2..I:'-�(�,?4^ .�h� �� /� - Date: -
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: AVVLOSidS „ NUMBER
ARCHITECT/ENGINEER: 2,azi 141() E f' i '-'f,), k;n} ua c., PHONE (Z53)84, - p 32t FAX:( )
MAILING ADDRESS: EMAIL
P.oject Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
EV New Wood Existing: [B'Sewer
❑ Addition ❑ Steel Proposed: -�_ Bank Height: ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: A i� ❑ Individual System
❑ Repair ❑ Masonry J r SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat Proposed: N N Public
�1t 1�p Total Name of System: i 1\, . �.
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 Tar k and/or Appliance Installation permit,mark all items below that apply:`�� S /I / I/
U• nderground Tank 9ve undk".Tan Size of Propane Tank. n
I Heat Stove I Cook Stove VVoodstove I`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 ite 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 Current Proposed For Office Use Only Amount Revision
Main Floor Heated EH 7<+ D /0 t 531. io Bld App Review. or �JC )W
2na Floor Heated Consistency Review.
155-DO
Other Heated Base fee:
�.25315 7 IGt }-73. `-3-O L.°
Mezzanine Additional Section:
Heated Basement Plan Check fee:
I 61 �5c'° t�o‘k•qk{ ! 137. 3�- 3�V°
ated Basement ,`?( /1},ro � 0-9tate Surcharge fee: 5C
� ,(J I.0U
Other Unheated Pot Water Review fee: (�� �y��
-lc-W
Garage/Carport j t SUBTOTAL t C�
Decks , (.� 3 l���✓ l Co�� �
11/Rd Approach feet 4 )a.00
Other Col.t?rr j At,,j, 14-14.?0 TOTAL: $ 3 DEL, 6
Receipt Number: %29
3U� �_T5-2—
Cash/Check Number: 4D.5 C `
ESTIMATED COST(REQUIRED) ----- Date: 31 f 0 r `�_D�t ,�
. 0��
.Fair market value of all labor and materials foun on to finish tv "L
111' '25646 )9114I61-
�hitial�:
C:\Documents and Settings\carol\Local Settings\ orary Internet Ias\O}KSII\Master Pennit Application 12 30-05.doc
• •
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1 JEFFERSON COUNTY
f DEPARTMENT OF COMMUNITY DEVELOPMENT ``.` ''�a�
1-3 ;
_`Z'? ,may 621 Sheridan Street• Port Townsend •Washington 98368
360/31`s$INOO http:%7w ww co.jefferrs• /on w s/commdevelopmenU i Fax ti, .,
'4 lr. l ��
STORMWATER SITE PLAN SUBMITTAL TEMPLATE1.jl
MLA# PROJECT/APPLICANT NAME: ' `.... i i,:i rr. ltntic j,c's t r I t,li rf".1-€411 '`'' l• t-i-Yl
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 propoAe d developed conditions of the site. Indicate position and relative size of proposed improvements on the
site map. 4 I sc4r+1tI 4 e:onSf rrscf i'ddl PERMIT # BM
06 - 0454
Existing Conditions Summary JEFFERSON COUNTY DCD
2. Describefk
� r the existing topograph . Indicate contours on the site map.
lot veceai, 5i0 p -hr-o.ye. ?Ale-5Y 1-S �r
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
,,44 ; i1 b j rsK Lary cr rrrse 5 cicl jfe iaf2 &+')rir Te
4. Describe the existing soils. Indicate soil type on the site mp.
.)I=tcAN'c Sc:.iS , t —hexed Trli ' ciuC,�1 rill
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.
i:15n � eel AA ti W a ei rir � ` i L4/ {-C rite_ easi 'rsAA- r''ite i,t 5+
6. Describe any excess levels of noise generated by the proposed use or activity:
>)o M are #1 e t•at c f y pitied iie S,d eeit'l/ 6 A 5*-4:/iv/ 5)e
=APPROVED
STORMVATER PLAN
I
stormwater site plan template.doc—rev.10/12/2003 Al.► 2 5 2006 - 5
JEFFERSON COUNTY
DEPT.OF EVELOPIvE -
SIGNATUR / A®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.
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.).
16�'� Sc See- '7'JrZ f
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.
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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.]
11. Describe the performance goals and standards applicable to the project.
12. Describe the,flow control system.
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,,
stormwater site plan template.doc—rev.10/12/2003 6
•
13. Describe the water quality system•.
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14. Describe the conveyance system analysis and design.
' l4
15. Describe the source of fill material,Pi
characteristics of fill material, and deposition of excess material.
41 v,1,1 C ,,A., .1 C i i . �y-G vet �Y R c v k ,w„ 'th ,.,:...5, ._,,,,l
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
l xA k h �iL k or V b t fin h'2ri i Co f{c�ur
17. Describe the proposed surfacing material.
18. Describe methods for restoration of the site. i
I)(ant iN H. ,,Vdz ; v- lcartd5 to IA 6 4f /►t !cit
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. 1
20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
Ai IA
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. 11 ,11 I /�
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co no e 4 5 . litrV9VS
PERMIT # BED E ,_., ' �� ,_t '`�`>
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sexmwabr site plan tempate.doc—rev.10/122003 . • A i- 7
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• •
CONSTRUCTION STORM WATER 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.
de r+pi 1; it 7 ellaYie6 tZy z pj- reisc:e ckt1lr(e k' ; (2tiila e /jail
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lIkfl !is, „vt 'd fJo, ,v .r ���, 1 ��. lY' i l«• ; nz weir!'.
2. Establish Construction Access. /.
-h-Ol9t fl((.(4dr-1 ('"ISr i �!lc �"%i 3,a
'tomV1ti1' ,e- eiti, de 61i- .e— \derx b'av,rtc aeceNs wirvt
p te. ;rvii 4 5:
3. Control Flow Rates.
`'.74 l„i ,A4 t V/';— rt/�flUr( 6< �Lr +'l:�}'.
4. Install Sediment Controls.
(r14` 01. .eU5f_ eiN,1 eI, `j i tc // 5ee / 1` UIt �Fl�cir
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5. Stabilize Soils.
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flakL (Net- it 1 CCI z 1
6. Protect Slopes.
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7. Protect Drain Inlets
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stormwater site plan template.doc-rev.10/12/2003 8
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12 Required Elements—Construction SWPPP(continued)
8. Stabilize Ch nnels and Outlets.
A 11
9. Control Pollutants.
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10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
A;,lA
11. Maintain Best Management Practices(BMPs).
riiii-
12. Manage the Project.
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2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas, roads).
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b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards). , [[
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3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
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PERMIT # BID
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stormwater site plan template.doc-rev.10/12/2003 9
0 6 - 0454 V
li
JEFFERSON COUNTY Ord
• • •
b. Description of special requirements for working in or near environmentally sensitive areas.
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).
Ai One- .Pereceet� aT- !A r M.*
5. Construction Phasing.
a. Construction sequence r
b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
Provide a proposed construction schedule.
co-'r r I F4 I sk Acirett t 5 2 vv
II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
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b. Proposed wet season construction activities for environmentally sensitive areas.
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7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for the initiation of bonds and/or other financial securities.
1 Q w`i*:'K sa ,-two • n 1)
�i+ice Z.
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. ,.)IA
b. Diversions. /U M
c. Waterways. '"1/}
d. Runoff/Stormwater Detention Calculations
sinrmwater site plan template.doc—rev.10/12/2003
• • •
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.
/f
LANDOWNER
ANDOR OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
• .. i.ati
stormwater site plan template.doc-rev 10/12/2003 U I C J ZJ c 11 �a Y i.r;} 12
• •
w,
r ' G JEFFERSON COUNTY
, :,
A
. DEPARTMENT OF COMMUNITY DEVELOPMENT
(-1 .A: .c,3
:^D',, . / 621 Sheridan Street• Port Townsend •Washington 98368
�y O 360/379-4450 • 360/379-4451 Fax
RING ' http://www.co.jefferson.wa.us/comrndevelopment/
Stormwater Calculation Worksheet
MLA# CAV` LI 7 PROJECT/APPLICANT NAME Ii��h' ) 1 ';:tn`'e I '�1-v Jt 4-7S-'ifl fe"'�e' y
t /
DETERMINING STORMWATER MANAGEMENT REQUIREMENTS: This stormwater calculation worksheet should be completed first
to classify the proposal as"small,""medium,"or"large." The size determines whether a Stormwater Site Plan is required in conjunction
with a stand-alone stormwater management permit application, building permit application, or other land use approval application that
involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan, if required.
PARCEL SIZE(I.E.,SITE)
Size of parcel <�_1 acres An acre contains 43,560 square feet. Multiply the acreage by this figure.
Size of parcel in square feet 0 `��% v sq/ft
Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover(both vegetative and
non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling,
excavation,and compaction associated with stabilization of structures and road construction.
Native vegetation is vegetation comprised on plant species,other than noxious weeds,that are indigenous to the coastal region of the
Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as
Douglas fir,western hemlock,western red cedar,alder, big-leaf maple,and vine maple; shrubs such as willow,elderberry,salmonberry,
and salal; herbaceous plants such as sword fern,foam flower,and fireweed.
LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL
Calculate the total area to be cleared, graded,filled, Answer the following two questions related to
excavated,and/or compacted for proposed development conversion of native vegetation:
project Include in this calculation the area to be cleared for:
�1 Does the project convert'/4 acres or more of
Construction site for structures '2.)6'6' sq/ft native vegetation to lawn or landscaped areas?
Drainfield,septic tank,etc. :, sq/ft Circle: Yes ENo,.-'
Well, utilities,etc. #"- sq/ft Does the project convert 2'A acres or more of
,1 native vegetation to pasture?
Driveway, parking, etc. sq/ft
Circle: Yes No
".,
Lawn,landscaping,etc. sq/ft
Other compacted surface, etc. Li eq/ft Indicate Total Volumes of Proposed:
Total Land Disturbance Lk.
l/ I L l sq/ft Cut Fill (cu/yd)
[over] RiO
06 . 0454
stormwater talc worksheet doc—REV.10/12/2003 JEFFERSON COUNTY 10 -
• •
Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions
prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow
from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof
tops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving, gravel roads, packed earthen materials,
and oiled, macadam or other surfaces which similarly impede the natural infiltration of stormwater.
STORMWATER CALULATIONS—IMPERVIOUS SURFACE
NEW EXISTING
Structures(all roof area) 2 599 sq/ft Structures(all roof area) sq/ft
Sidewalks sq/ft Sidewalks sq/ft
Patios sq/ft Patios sq/ft
Solid Decks sq/ft Solid Decks sq/ft
(without infiltration below) (without infiltration below)
Driveway `t1jS d sq/ft Driveway sq/ft
Other sq/ft Other sq/ft
Total New 1 sq/ft Total Existing sq/ft
TOTAL NEW+TOTAL EXISTING* yt I sq/ft "This amount will be used to check total lot coverage.
The following questions will help determine whether the proposed project is considered development or redevelopment.
DEVELOPMENT v. REDEVELOPMENT
Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: L..' %
Does the site have 35%or more of existing impervious surface? Circle: Yes C No
FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be
used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the
attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum
Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements.
For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution
Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and
prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction
Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet. Proponents of"medium" projects—those
that must meet only Minimum Requirements #1 through #5—and for "large" projects—those that must meet all 10 Minimum
Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan,
principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or
prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual.
APPLICANT SIGNATURE
By signing the Stormwater Calculation 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 the affected property.
" -ill
(LANDOWNER OR AUTJ-1dRIZED REPRESENTATIVE SIGNATURE) {{`?!11M! r�{{ d,' „Tv ,.1' f (DATE
uelrri
FOR OFFICE USE ONLY
SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No
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McCURDY LANE N
R =45 NN
No � S--ITE P�FF General Notes
�N
22,78
,,,2�
OJ
CPO (y)
\�\� 9� POWER 135,00
N
PROPOSED
WATER RESIDENCE
` SEWED
(SEE
74,3' T
PHONE
VCABLE
LZ-3 ;6Q Ilo�
A�h20 Ca a , 3
PROPANE'
TANK L
J,
169,00/ N87*18/00 //
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3 T3EDROOM
S H E E T 7
ROOF PM
GAS".
O
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t' DRAINAGE
EASEMENT
LOT 162
4
LBT LINE
— - ��.. .. —----------
LOT 163
co
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CD
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2 4'
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O
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PERMIT
# BLB
06-0454
JEFFERSON COUNTY BCD
APPROVED
SrM PLAN
2=5
O tinww
5R:
O �, } f T
.[ Vi'
m > ,,°� � .
EXISTING TOPOGRAPHY
SHOWN, FOR PROPOSED
TOPOGRAPHY SEE DRAINAGE
PLAN
MAIN FLOOR ELEVATION =
314'
BASEMENT FLOOR
ELEVATION = 304.5'
ROOF PEAK ELEVATION =
336'
GARAGE FLOOR ELEVATION=
312'-3'
ALL ELEVATIONS
REFERENCED TO
BRASS DISK IN MONUMENT
CASE
IN THE CENTER OF THE
McCURDY
LANE CUL DE SAC (SEE
SURVEY SHEET)
SEE SURVEY SHEET FOR
TREE REMOVAL PLAN
(ALL TREES TO BE
REMOVED, AS THEY
INTERFERE WITH BUILDING
AND/OR BUILDING
FOUNDATION PLANS)
No. I Revision/Issue I Date
N"mWAft in
PI,efcarrc: bp6irick HeV- nt_
NmwwWAdch
HERBIG RESIDENCE
PORT LUDLOW, WA, LOT 154
AREA 3, PL i2
PARCEL • 990603154
FA
BIG RESIDENCE9/06
sods
co
m
d-
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In
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0
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d-
d-
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McCURDY LANE
R =45
22,78'
74,3
169,00'
DRAIN
4-INCH
PERFORAT
PIPE (FOOT
DRAINAGE PLAN
scale1 = 10
Patrick & Jennifer Herb'ig
Port Lud!ow Lot 154,
Area 3,
Parcel #
V-
35,00'
PL !k2
990603154
o FILTER BARRIER
�
CD co�0 d 0i
O Cr O O
N 8�018'0
6'NSVOUT
II PREP❑SED 3 DEDF1OOMj
ESIDENCE z�
NEE SHEET 7- I� MIN
� F R❑�F LAN)
G DRAIN)
7°18'00"
D❑WNSPNT �P❑UT
❑WNSP❑UT
IIII
4-INCH
PIPE CTIGHTLINEp�pWhS ❑UT
DOWNSPOUTS & IIII �
DRIVEWAY DRAIN I U
Illlq
Ip�
5
0
e- 4
m
v
OqT
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lO
W
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(SEE DETAIL)
4' DRAINAGE EASEMENT
162 6-INCH DRAIN
TO HARMS LANE
CT GHTLINE)
LOT 163
CLEAN❑�
4"X6" REDUCER
& 4" Y-FITTIN
PERMIT # BID
0 6 - 0 4 5 4
JEfFEBSON COUNTY BCD
• 1
��+ y
r ..
General Notes
ALL DOWNSPOUTS AND DRAIN
TIE INT❑ 4—INCH TIGHTLINE
PIPE
4' PERFORATED FOOTING DRAIN
SHALL BE WRAPPED IN FILTER
FABRIC & FREE DRAIN GRAVEL,
BACKFILL FREEDRAINING MATERIAL
TO FINISHED GRADE ABOVE ALL
PERFORATED PIPES
PROPOSED TOPOGRAPHY
SHOWN, FOR EXISTING
TOPOGRAPHY SEE SITE
PLAN
MAIN FLOOR ELEVATION =
314'
BASEMENT FLOOR
ELEVATION = 304.5'
ROOF PEAK ELEVATION =
336'
GARAGE FLOOR ELEVATION=
312'-3'
ALL ELEVATIONS
REFERENCED TO
BRASS DISK IN MONUMENT
CASE
IN THE CENTER OF THE
McCURDY
LANE CUL DE SAC (SEE
SURVEY SHEET)
No. I Revision/Issue I Date
Flrm Name and Mdreee
DRAWINGS PREPARED BY
PATRICK HERBIG, P.E.
360-437-8209
Project Noma and Addreea
PATRICK & JENNIFER HERBIG
PORT LUDLOW LOT 154,
AREA 3, PL #2
PARCEL # 990603154
Project Sheet
Date
Seale