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HomeMy WebLinkAboutBLD2006-00526 MLA06-0051 2 BUILDING PERMIT APPLICATION Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00526 Received Date: 9/13/2006 SITE ADDRESS: 765 GRIFFITH PT RD NORDLAND, 98358 OWNER: JOHN C SROUFE PHONE: 206-772-8322 JUDITH K SROUFE 10800 AUBURN AVE S SEATTLE WA 981783103 TRACT 18 SUBDIVISION: Block: Lot: T 21 PARCEL NUMBER: 021324021 Section: 32 Township: 30 N Range: 01 E CONTRACTOR: ARMSTRONG CONSTRUCTION CO INC PHONE: (253) 833-3355 2715 AUBURN WAY N AUBURN WA 98002 Contractor's License ARMSTC*373N0 Expires 5/7/2008 REPRESENTATIVE: WAYNE STEWART PHONE: 253-833-3355 108 AUBURN AVE S SEATTLE WA 98178 prDp .Cps Lus PROJECT DESCRIPTION NSFR l/C1 IZL) C pleb? ,1-L TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,824 VALUATION 246,000.00 ADD'L: 631 HEAT TYPE: HTP CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: 5N OTHER: SHORELINE: GARA CONST TYPE: DECKLE 720 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 3 Prop: 3 Total: 3 otal: Ro)4irlp Date: ul 15)CG? Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,811.35 LYK 09/13/06 84903 Plan Check $1,177.38 LYK 09/13/06 84903 f' t State Building Code $4.50 LYK 09/13/06 84903 OCT Potable Water Application $55.00 LYK 09/13/06 84903 Total: $3,048.23 Jefferson County Planning & Building Department 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 #: BLD06-00526 SITE ADDRESS: 765 GRIFFITH PT RD Issue Date: 10/16/2006 NORDLAND, 98358 Final Date: 12/11/2007 APPLICANT: JOHN C SROUFE PHONE: 206-772-8322 JUDITH K SROUFE 10800 AUBURN AVE S SEATTLE WA 981783103 SUBDIVISION: Block: Lot: TX21- PARCEL NUMBER: 021324021 Section: 32 Township: 30 N Range: 01 E PROJECT DESCRIPTION: NSFR & A/G 120 GAL PROP TANK 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 12/11/2007 I:\F_BLD_Occupancy.rpt 10/29/19 • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00526 Received Date 09/13/2006 SITE ADDRESS: 765 GRIFFITH PT RD Issue Date 10/16/2006 NORDLAND, 98358 APPLICANT: JOHN C SROUFE PHONE: 206-772-8322 JUDITH K SROUFE 10800 AUBURN AVE S SEATTLE WA 981783103 SUBDIVISION: Block: Lot: T 21+ PARCEL NUMBER: 021324021 Section: 32 Township: 30 N Range: 01 E CONTRACTOR: ARMSTRONG CONSTRUCTION CO INC PHONE: (253) 833-3355 2715 AUBURN WAY N AUBURN WA 98002 Contractor's License: ARMST�C*373N0 Eire .: 5/7/2008 ii-I-01 Ad - tti' IL i.►C -I-rk, 1' , PROJECT DESCRIPTION: NSFR � r t� lay r CALL IN FOR THE REQUIRED INSPECTIONS THAT A PL'Y � YOUR PROJECT. SETBACKS: V UFFER: AVR Footing: Z'K Z/z,G/o7 Foundation: Ok .5/5 07 Stormwater FINAL Approva: Underground Plumbing: Underground Insulation: -1 Shear Wall : i//d7 Sheathing: j ((G��� Framing: F O 07 _mi_ w ' D7 Plumbing: i o7 Propane ank/Lines: 1 ,-4 1),I ' c.I j.1e.c_((• )3- Insulation: AR. SE�IL GEC 5/t810 Q it2'4, t,u44 # Fuzes OK SA'" IA/ Sheetrock. Septic Sytem Final Approval MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: r„gor. Cib 1 07 HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRE IOR 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 A BLD06-00526 1.) 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. 2.) 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. 3.) 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. 4.) 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. 5.) MANDATORY MEASURES FOR 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. 6.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 7.) A Stormwater Site Plan has been submitted and approved by the Department of Community Development. Once the subject permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 8.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. • � 9.) Not more than 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. 10.) Minimum setback from Griffiths Point Road right-of-way shall be 20 feet. Minimum north property setback shall be 10 feet due to existing 10 foot wide easement on subject property. Minimum south yard setback shall be 5 feet. Minimum setback from OHWM (bank is less than 10 feet in height) shall be 30 feet. 11.) 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. 12.) 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. 13.) 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. 14.) The building height is not to exceed 35 feet. 15.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 16.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. I:\F_BLD_Perm it_Bu ildng.rpt 10/29/19 ao 1110 ��v N cO JEFFERSON COUNTY , �� DEPARTMENT OF COMMUNITY DEVELOPMENT ~' `� "C 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450• 360/379-4451 Fax 4riNe�rqS, O� www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: CJ`P—5 1 2 a st Prgj�ct .« ,r tee• a� +«': ) f t'v*,ra 4 O r n , es4Ototcr.- _Tax Parcel Aft •�'( Nuber! ©2 t `3 Z� '-T" (acres/square feet)• m Site Address andror Directions to Propert : .... t ` Property Ouvnerts)of Record: ••V Telephone:070e Fax: email:r—Mailing Addre'$s: tcP, r3• K�(� 0 ct9• o, aBCZ8 - Appiicant/A.�jent(if different from owner): 'r FQ Telephone`G SZ• j ocZ • .c.- Fax email: ► S �(Vq•�,. .Mailing Address: vvte.c . (T r 11l)it-kind of Permit?(Check each box that applies) INguilding ❑Variance(Minor,Major or Reasonable Economic Use) Ii De on Permit �-�� OConditional Use[C(a),C(d),or C]** .Single Famil �. °Discretionary"D"or Unnamed Use Classification •0-Garage D6,0.,,44 ❑Special Use(Essential Public Facilities)** ElManufactured Hom l Boundary Line Adjustment °Modular Short Plat** Q Commercial* OBinding Site Plan** El Change of Use °Long Plat** Address 1 Road Approach []Planned Rural Residential Development(PRRD)/Amendments** ropane OPlat Vacation/Alteration** gAliowed"Yes"Use Consistency Analysis OShoreline Master Program Exemption/Permit Revisions** L Stormwater Management ❑Shoreline Management Substantial Development** OSite Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance OTemporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment Wireless Telecommunication* OJefferson 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: bYtlesi9nat , L DESIGNATION OF AGENT to act as my agent in matters relating to this application for permit(s). flikt. SIGNATURE D «0 ? P By signing this application for no,the r/a nt attests that the information provided herein,and in any attachments,is—free and correct to the best of his,her or it's knowledge. Any rial fa ehood 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 acces n t of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later s ections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or wants ri otice. IF '. 7 c The action or actions Appli t ilVun e ak as a result of the issuance of this permit may negatively impact upon one o more threatened or endangered species and could le o a o ntial"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 co plih the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable responsi ili for adherin and complying with the ESA. The Applicant has read this disclaims and signs and' dates it below. Signature: I,, Date: O/�(s `f n / l0 f D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc 9 a c 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 of the General Contractor for the proposed project. Signature: Date: -ffae.�j R MANUFACTURED HOME INSTALLER: PHONE: FAx: F, ..v .'I O6 Co U 3• 55 It s)5t 6421 ..- sly; " F 5"4utFiAt N I Pe,14A of f&A r-CfceA A t' +"1 tip - TOR Sf.IIENSE A ` WAIN AR� 73 N NUMBER t�( C]1�(L,� j �e� ARCHITEC a�FFF.T���� ` It ry •' PHONE C .L /A i•�� f�^ �5 'O�J3 PONI-Nc3.�,• �`.i�g,.`,0'�` + wA, 18— `�t EMAIL if�IJ• Y I f h� , ` �; Q ifPe-"�' Bathrooms: ' for lime: C a.re Disposal - I' ew ood Existing: ❑ Addition 0 Steel Proposed: Bank ❑C unity System ❑ Alteration/Remodel 0 Concrete Total: ', Height:/ Individual System ❑ Repair 0 Masonry � SEP Permit# ❑ Demolition 0 Other: +Bedrooms: , •' m— I E.OAStikaply: Existing: Setback: ND PrIVie well IE TwoParty ;:'# Proposed: ' / ❑Public P .4_. # I Total: r Name of System: ef�f. Al� • AID 0 If this is a Commercial Protect you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane ank and/or Appliance Installation permit,mark all items below that apply: °Underground Tank Above •r. . Tank Size of Propane Tank: Ir °Heat Stove ❑Cook S ve 1"% t s'',s bve ireplace Insert 0 Hot Water Ta 0 Pellet Sto e p Other Is this appliance being installed in a Manuf ctu ed/Mobile Home? Yes 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 Current _ / For Office Use Only Amount Revision Main Floor Heated x' ,IZ EH Bld App Review: // CD �)� g2 to lLD i2i-VI.?ICAL. II-I-0-7 2"°Floor Heated63 , Consistency Review: 153q3 Ac1Cu pa ko-a'/ ()ns I.LIs+ Other Heated Base fee: l ' 95 I Mezzanine Additional Section: Heated Basement Plan Check fee: 11 2 c Unheated Basement State Surcharge fee: •50 Other Unheated Pot Water Review fee: no Garage/ea SUBTOTAL 3301 O + 1 C) i Decks 30 I L, 10.410 911/Rd Approach fee: Eja3n Othe TOTAL: �' 53 II Receipt Number: %(PO "153 lb Cash/Check Number: `53—kp b6Zf'-J ESYiIMdT D... o3"p tZ'o5 Date: it va , _ rrAfs `n ifnish CD11.L (_ I 0", 2 T( QQ -, Initials: �� D:\PemritCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • • • "�,, ON Co A k%. JEFFERSON COUNTY ti DEPARTMENT OF COMMUNITY DEVELOPMENT ., , 621 Sheridan Street • Port Townsend • Washington 98368 ►, , .NO-)" 360/379-4450 . 360/379-4451 Fax http://wwvv.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE IMLA# — 1 a PROJECT/APPLICANT NAME: 'SRCOr ---a-...--- -) . Please answer all of the following questions to the best of yo t�iljj�I�yy W e uestion calls for depiction on a site map, the applicant may choose to either incorporate the elements into the Kent IO ar> he Master Land Use Application or to submit a separate stormwater site plan map. 06 - 0526 Project Overview r.1. Describe the proposed developed conditions of the sI{FfRoONs� iYelfi€'4";size of proposed improvements on the site map. c� 14 2":,cLirrl A 2`60 3 . ,,r.- .., ltkt,, , �` ,� (QCtit(t\ ..' c)b 3j2• )2. )• S( oS r ,?t � k� ? c.c v�5 faAt,,.s t�k u v, cNc-"32 `''':` •Z- cW L wed ct-t&� syP'c ' S tLeAc(t ! 5 c5 V Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. -as by -�� ct..1;v.t 4tv-w o-A c- �C 4k- te•.skt beet L C_'KC,A<.; 0-,0 t r./ - it , 3. Describe the existing veg tation.. Indicate native vegetation areas on/ the site map. L S=�i \ c`cetrcL vC t!'c'r�S ' E-'Kr-�L t lam, k \ Skv,O G��`]1A� "j rr- U �: c (A i i k- b9-r1,f-,�S:�kr'S, .Y c S`t`t -I r t'S c, r c- Vi -wt ko Ot.-) b c,N1 b�Y F•d-, e"?e l(t c..vAMca., �KiSr►,A- !. A. c cN e( J ., 5`A k t c~ .5 5 c', ='v 5�x,--i 4. Describe the existing soils. Indicate soil type on the site map. • < t c) „::;(.::,...,,,,,-"A: p.,N6,cY ac: '"Zc 4 0 v,w4.t�:l.•k �+ \•tK& ate4 .'V-� ot9 5_ a-v..1 a� ( r•.y'kv?. 't), Scsc\ct�.S 0..., y K. 611,7,.'<tt:.c t k L-►.. 11,.s 5a...,&013x z JIv &w,1\i . i-k `LA Vic) iY,6-,:.S &.e.p}ct , 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. !+"G. 3 ,t 3 CyetW-A ll eA ek S ,1/ e:c%-4,S 'no t tr e,.S C'-(`» e::P{ n t• ; c. vx - 4 e. �o.Pi' „ t•s\-:A- ,{,( A v--(=C,.,„ _ k:i r e c., -`(‘Y,N< C.- - C S� � ict) L; ....1,e 4,k 43,:s13 tc4v' C:;(- eq v Or�,� 1, ...,',-1',- 11jj <cz}z :�to 6. Describe any excess levels of noise generated by the proposed use or activity: 11 iZOVED tV e� 4l iiNowt. .. c` S .w CVtJ:r►� :,.J-r‘� 0 �NA. ES �P .. STORM-WATER PLAN Storrv�a r OCT - 9 2006 stormwater site plan template—rev.10/12003 Required JEFFE �_T S OLINTy ; 5 DEPT.OF(' M ' Y :VEL ENT SIGNATURE: • • 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>`.+✓t 3 -I' &`'F<.'_2(1� ''S LE,..' tf.kitit 8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads, and sensitive/critical areas (streams,wetlands, . ,ste ep slopes,etc.) Pe es ;� �. �m , &r � . � ,� 7 tASL��� �� lL� +<5o t -ey \5 t-r",; `,ea t c- Lc --zi ,k4 e %.5e L& qA—2 r1 v'4Cc tn.t. b 425 -(1.,e s, ot.t4 c4K r-bt S cam' Vst itu.&"> -'- 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 sitet plan and differentiate proposed facilities from existing facilities. (3\i_ yv‘ '11c�:tl�� Lii�\` �(,>. i.,�'"'�i'��.t\,"CLS.. \W�ti, (\,(1 k..C.�C:.\\S` L- LTv li2 rue i-, 4t, G.ruAkk ostvs e LJ( c.t`t� �•+!c1L -4 v4 cc t t ��`l.� �-t to.S,at e. t.a e,l r� .t 10. If the project requires the use of stormwater treatment facilities, describe the types of stomiwater 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. t ►. c)CX c u�� ( _w..& °c� s15 �. cell o.��v c p�SS � ta ' cL�s��c,,5, tx:" ``^ �t "lL rLti �Z:��,-. �`� w� 'LAN lL2A i S` cs.f vuc vrki,c5 , 12. Describe the flow control system. :44,-T- okt-5 t vt5-t-c.lk ('` {t (�ti,��w\ \\\t5:�t 't�t•l -`r� stormwater site plan template—rev.10/1/2003 • • 13. Describe the water quality system. j .e1 O eif , CC-gel CA e, t:c <a ,' 14. Describe the conveyance system analysis and design. _ 6 �4 e�.,4S t: r1� b USGe43 Pi"\ 15. Describe the source of fill material,physical characteristics of fill material, and CliAhon ofe c ssPmaterial. o G a n R!!'r'r/ .IFFFFRSP : ' PFP 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. +. 1r r1sZk9ci 1 L..)c\` k�:o�C� �`4.. M J4)S B�`K scL oc1e C �iW (�+�l dam,,. �� e Alit. <<- � Sl cos t t.�t kk be. J t' r is (-4 ecC L�-ultic��`, 17. Describe the proposed surfacing material. hi l ct�t'�' 1 ,`( �i�jrt`� r v - {� V� L�.f Z Flax ��'J �.. CU �j�? `7 18. Describe methods for restoration of the site. { cd- k;-% be- r<CS:•lC .A'- '3AA. y�%or Oct i � Z�tr �M l v l 1.1 lot, LJ C& 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. L 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. \ '{� S- �cz \�vC7 0.1-CxrA. (foe t} t " k1�\C- e O C�c)cen Ld' 4/ z.V r>4'k t5 A hc..Li(. r,•� i\wt�c�� �a4�Ne\'-\ti A Ca c& 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. (\�c� C-\.e y-vv% . eCt.•v- .'C-t<C k -( kLc� `L e C"\p- 2. Establish Construction Access. f Ck����v�� C��t�G-:�•�, C�� `�lor� G•r��C i S 12-1-. Izc�� s-' 6c. L? `� P G�3 C� 5� CZ'ti-• c eySS , 3. Control Flow Rates. \ 4>rkk'S LA-5 c.\K t?C'_ ?`c:c rcC �, (.s�r�+�`sL\\ v'\SV` �1 , 4. Install Sediment Controls. • . :,Zvt c-su-•cam�\ c _ -c w.(� :'l.Sk4lt��cr C..)-vn. eLATN 5. Stabilize Soils. (( /� k 4'0 i.=1 S`' L�\ \o e-- )V l�.t te-i- \)r3 \h ,r Acr--; 1c dot/ 6. Protect Slopes. 7. Protect Drain Inlets. a stormwater site plan template—rev.10/1/2003 • • PERMIT # RED 12 Required Elements-Construction SWPPP(continued) 0 6 (� 8. Stabilize Channels and Outlets. 0 6 JEFFERSON COUNTY DCD 9. Control Pollutants. 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). c ce �a.�S 11. Maintain Best Management Practices (BMPs). C�v C�P�j . Cr.i1.s.JlA=ay � �- \V\ � L�'' �V�rcv�' ILA apt:. 12. Manage the Project. Ch tort l( �� `vr- s-Ac C�.r(.� 5 e u a� � &�/ 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). b"e- l LA-1 f Sl b 42 ti to ' t/'lr6.4 t✓c`- >1C= Ci �u C :' uoh='C S K[ f� c b. Description of the donstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). b .vs e c,-t 40 �o�,S,c t 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. stormwater site plan template-rev.10/1/2003 - 9 • • 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). 5. Construction Phasing. a. Construction sequence ! r 5 r... �Ic 0e s ssw^ i-N Lie+C)--M Li_ec3, 1C l tATV. Q, �(� Lull [C �`�. 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. e:�t•i.�i�SVi i�1 C. 4C�� 6..(uV 5, II. Wet Season Construction Activities. a. Proposed wet season construction activities. , ts).Jli— c •s->c< Lir.-,eik AA t 5 c b. Proposed wet season construction activities for environmentally sensitive areas. - ,'>'- 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible forf the initiation of bonds and/or other financial securities. cuN( r 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. c. Waterways. d. Runoff/Stormwater Detention Calculations 10 stormwater site plan template—rev.10/1/2003 • I 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 m owledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected operty. t ,1,4 --t)(1-1 (--' )1; ��.�r �r t ( , 2 q.— (LANDO R OR AUTHOR! 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