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HomeMy WebLinkAboutBLD2006-00576 • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00576 Received Date 10/4/2006 SITE ADDRESS: 1043 E MARROWSTONE RD Issue Date 11/16/2006 NORDLAND, 98358 APPLICANT: CYNTHIA J SCHNEIDER PHONE: (425) 347-5713 5622 108TH PL SW MUKILTEO WA 98275-4654 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 921043003 Section: 4 Township: 29 N Range: 01 E CONTRACTOR: SHOLD EXCAVATING PHONE: (36)385-0480 PO BOX 179 PORT HADLOCK WA 98339 Contractor's License: SHOLDI*224LT Expires: 6/30/2008 PROJECT DESCRIPTION: FOUNDATION FOR MODULAR HOME CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: i UFFER: /jo Footing: pH /1/67 2/4, Foundation:DK 3/2- el, Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathing: Framing: Plumbing: Propane Tank/ Lines: Insulation: Sheetrock: Septic Sytem Final Approval MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zo . final Approval: Final/O pancy Approval: C j0 / _ EALTH DEPARTMENT AND PUBL W rFKS 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 CAM BLD06-00576 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 East Marrowstone Road right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 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.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 14.) The building height is not to exceed 35 feet. 15.) A minimum of two (2) parking spaces shall be provided for the single family residence. 16.) THE ROAD APPROACH PERMIT (RAP06-0205) MUST BE INSPECTED AND FINALLED BY THE JEFFERSON COUNTY DEPARTMENT OF PUBLIC WORKS PRIOR TO THE FINAL INSPECTION/CERTIFICATE OF OCCUPANCY OF THIS RESIDENCE. CONTACT TERRY DUFF, DEPARTMENT OF PUBLIC WORKS AT 360-385-9159 FOR THE FINAL ROAD APPROACH INSPECTION. I:\F_BLD_Permit_Buildng.rpt 10/29/19 •JILDING PERMIT APPLICATJ MLA06-00558 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00576 Received Date: 10/4/2006 SITE ADDRESS: E MARROWSTONE RD NORDLAND, 98358 OWNER: CYNTHIA J SCHNEIDER PHONE: (425) 347-5713 5622 108TH PL SW MUKILTEO WA 98275-4654 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 921043003 Section: 4 Township: 29 N Range: 01 E CONTRACTOR: SHOLD EXCAVATING PHONE: (36)385-0480 PO BOX 179 PORT HADLOCK WA 98339 Contractor's License SHOLDI*224LT Expires 06/30/2008 REPRESENTATIVE: ROBERT DOWNING PHONE: (425) 343-3866 5707 PARKVIEW LANE (425) 740-0232 EVERETT WA 98203 PROJECT DESCRIPTION FOUNDATION FOR MODULAR HOME TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,886 VALUATION 77,220.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: GARA CONST TYPE: DECKLE 84 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 3 Total: 2 Total: 3 Routing Date: 10( 5 IN.C.1.5011) Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $839.75 KAS 10/04/06 85105 Plan Check $545.84 KAS 10/04/06 85105 State Building Code $4.50 KAS 10/04/06 85105 Potable Water Application $55.00 KAS 10/04/06 85105 NOV 1e 2006 Total: $1,445.09 Jefferson Ct3i!rf//v & t3tjilrlimr F • SIR E\� EIIVE '1 rkio. gg011T CO JEFFERSON COUNTY UU `` l DEPARTMENT OF COMMUNITY DEVELOPMENT i�+ i .t4'--,y s-. '� 621 Sheridan Street•Port Townsend•Washington 98368 � � 360/379-4450. 360/379-4451 Fax (� j'(� ,.qS ' `"' www.co.jefferson.wa.us/commdevelopment t1 F ft '�, 'j' LII 111 Y U t,U Master Permit Application MLA: it-558 Project Description(include separate sheets as necessary): C - - LSLT16lLIPim11i �aM� Tax Parcelq Property Number: a+i O 3 43 OO Size: 4 �� (acre square feet) Site Address and/or Directions to Property: E. JJIAQROw,Si�t�s�'-) ,�• N0�0� VIA B 835R Property Owner(s)of Record: elle/7%/LO' .S[',v,v, x Telephone: - A ) 5113 Fax Mailing Address: .s2 /D�ii email: >".�� s�,yu�.zz�o �� 9aa75 Applicant/Agent(if different fr m owner): pawl• pav X/r¢ Telephone: 9/____.�... 66 Fax: 79 Oa73oq email /11/�i1/f�C,L'd Mailing Address: ]b7 A21�111' l 4w�F_ EVe1(2.E'T A What kind of Permit?(Check each box that applies) 111 Building Li Variance(Minor,Major or Reasonable Economic Use) u Demolition Permit U Conditional Use[C(a),C(d),or Cj** W.Single Family LI Discretionary"D"or Unnamed Use Classification •r Garage Attached/Detached U Special Use(Essential Public Facilities)** Manufactured Home U Boundary Line Adjustment `14/ Modular U Short Plat** U Commercial* U Binding Site Plan** U Change of Use U Long Plat** U Address 1 Road Approach Li Planned Rural Residential Development(PRRD)IAmendments** U Propane U Plat Vacation/Alteration'"' U Allowed"Yes"Use Consistency Analysis U Shoreline Master Program Exemption/Permit Revisions"* u Stormwater Management U Shoreline Management Substantial Development** LI Site Plan Approval Advance Determination(SPAAD)* U Shoreline Management Variance Li Temporary Use Li Comprehensive Plan/UDC/Land Use District Map Amendment Li Wireless Telecommunication* U Jefferson County Shoreline Master Program Amendment Li 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: S Lc Ti—z_ --, DESIGNATION OF AGENT I hereby designates f aJtir , to act as my agent in matters relating to this a lication for permit(s). ti OWNER SIGNATURE G7,L �I'' • /V 12 J�.r� �— Date: By signing this application form,the ow -r/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 acces.and .ht of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any requir later i spectio .Access an. i•- of e, ry , • .ert shall be requested and shall occ only-tiring regular business hours. _ ' / \ /Y//Y Q Signature: / i f. . �j�� .'(j__ ,T�✓�L �����Date: I v O�J Aliw The action or actions Applicant will undertake as,esult 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 -re in comp Q, ith the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transf-n•ere .. r ••:in to a • om I in with the ESA. The . 9 P Y 9 Applicant has read this di�cl 'L je d signs_/ and dates it below. Signature: / Art., �"-• 7 ?t7CJb Ly' " Date: C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc • • 7 _e� .'.. r RJE.i' E1R , OWNER 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. i Signature: - Date: JE . . I GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: S\b L.. -CCGPiN R Z�.+G- (3(r0 ) 3 g S-vy q0 ( ) MAILING ADDRESS: ' ) l�y LI' EMAIL: CONTRACTOR'S LICENSE (�QG WAINS �� NUMBER: -Pi Orr rn� :PN0etr NUMBER ARCHITECT/ENGINEER: QA� `L g��T� L�9$399 ( ) FAX:( ) *7 1'G} PHONE MAILING ADDRESS: a, M wA moo .r c•x1 (L EMAIL 4-:06tw4%t V� ' 7 ( S J Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: tx New yr Wood Existing: 0 ❑ Sewer Addition ❑ Steel Proposed: 3 Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: 3 Heig t- 1 Individual System ❑ Repair ❑ Masonry r/k SEP Permit#BFPO(-64� 0 Demolition Li Other: Bedrooms: 1111 Water Supply: Existing: ' Setback: ,g Private well I Two Party Type of Heat: Proposed: ❑ Public Total: Z Name of System: CLFt�(Li-z. If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed:_ Number of ADA Parking Spaces: Number of occupants(includes owners,tenants, employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: j Underground Tank 1 Above ground Tank Size of Propane Tank: i Heat Stove 1 Cook Stove I Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove i Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines,tank location and size, distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage For Office Use Only I Current Proposed �� C.- Qy 5 Main Floor h$g/ rj 503Consistency Review: 2NU Floor Base fee: o� �P Q1 391 3fd Floor Additional r Mezzanine: Plan Check fee: 5i5 (`t — \ Heated Basement State Surcharge _ Unheated Basement Pot Water Review fee: Other Unheated -, Approach I DN Garage/Carport TOTAL: $,"I g5 jA Decks t • - Receipt Number: _S 51 O 5 Other ,- ��O .ash/Check Number: �I ESTIMATED COST(REQUIRED) 1 9 ate: l O l Or 14) •Fair market value o l labor and materials foundatio - 50 / t46,4. Initials: I C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc I ECG .04F111‘, JEFFERSON COUNTY NOV 1 4 2005 j-2) FTT 4,1 DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 JEFFERSON COUNTY O' 360/379-4450 . 3erson 360/379-4451 Fax DEPL OF COMMUNITY DEVELOPMENT �D' httpJ/www.co.Jefferson.wa.us/comm(jevelopmerat/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# $ - Q 43- 0453 PROJECT/APPUCANT NAME: S C.W N Ex 0 Elk. 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. Sa-re .zs � . INav PEo ! s n'-..LG• acl.,S Coto re m A Lt, sr E ..\-2-a d . s 4 , TA Pteati Ahp =cr•pnbootenet,-r i \A At✓ L!E J q.v.- (1 t 1 (NLQE Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. S E P.0J tQ— o r.. S-am 4Z—)A1111) s'S I W' N E C 641 IS I IS' tN\ U., C.oLtPt'(L. rs MS' S W C-QQN(;:11_ 13r 0 U.rn4 A & TLe' SLaPE >)) C.e-J re[L Q S rS)' LJ.SlN Ea�v(r-rT..J 0% 1 3 0' 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. Q.u.s H ,"DE"L=D t.t.O%sS At.,C {a\10. "Z S , ; 411. it4I 4. Describe the existing soils. Indicate soil type on the site map. h 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. Soj...% L.od.S A t'tAt1 APPROVED 7' — 6. Describe any excess levels of noise generated by the proposed use or activity: STORM WATER PLAN NoTaE UV 1 4 2006 StorrY1Wa r .S JEFFERSO ell Require DEPT.OF EV m NT\ J, SIGNATUR : j,1_.__�i� _di' . storrnwater site plan template—rev.10/1/2003 5 • • _ 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. Nnt'E 8. Describe the general vicinity of the site, including adjacent land uses and strictures, utilities, roads,and sensitive/critical areas (streams,wetlands,lakes,steep slopes,etc.). ESL'C)GNc E S �l PA TV. INN CY 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. S Tb( y,- ., .oat~ioP D GyA.3:1••S 4-L1.c.. 3 E A 4L9w t~-0 TD Ft,ow PVA,ua.ALL' The v.ap4ve.b9tP' 2."►]"6 aQ 714. s Pry .6m2 5. 30 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. 11 A ,I-Pr` M'sV Fs2112A-T-ZaNa d* 12. Describe the flow control system. la otlE -44 �t4 • r iff stormwater site plan template—rev.1 W1/2003 6 f • • • 13. Describe the water quality system. R A-MtL{}L m11I .TR.Prizoc� 14. Describe the c nveyance system analysis and design. IA Pt 15. Describe the source of fill material,physical characteristick of fill material,and deposition of excess material. S-rQ.V.c-u9Ar . Eat., \1cr to LE A 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. .rl>t—Ac. t V a C .do Fite 2,A_INA AR' C-0x.maS A (30,4r i4 T\ 2 i Zr,tiTLltar� % k•NOEvt Ep AtttAs SZ4 S.Lll---"Cel-- S PI-TtlPrt_. 17. Describe the proposed surfacing material. ( -M 18. Describe methods for restoration of the site. --Pc-f•-sr 642-O u•.►0 CooL41 F4.40 (--ANl; SGi'&s r 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. IA/ A 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. S& t-s L.0 6 s , S E)n2 C4c,-a..) 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. k-k..D., .b.%te .P.M.L.T" i k ,,' it RV: iI stormwater site plan template—rev.10/1/2003 7 f • • • 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[_sir QC,- f Q.0 Th "t£ w - ) C. Ft T a c Arta `-" R.oPosE.o A0. g fl..� � :�( A.►:► MA..oRJ osr S,TS 13E L y oasr►.aEo 2. Establish Construction Access. A LDS 3. Control Flow Rates. o&f ow L,,.) t1..L e c_..c.,a41.4LLCO k 51.E r OrsotiSMPrw 1d&"N Ntr-ftEZ-Pitii � L 4�Mi>1 S.30 4. Install Sediment Controls. S.ra--r Csb4o s ra. 5. Stabilize Soils. L,bV GA- \14 cbmga-, 6. Protect Slopes. rn r.. Pct_ S L a P SSTE 7. Protect Drain Inlets. 7 -,1 Eti I N stormwater site plan template—rev.10/1/2003 � 8 • • 12 Required Elements-Construction SWPPP(continued) 8. Stabilize Channels and Outlets. tJaw)E 6 H SAVE 9. Control Pollutants. S n..T F�,c.E_ \tc \-1).Ai5 I S P.iJ.. KIT a..+S.LTh' 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). F N f -eSsS MA w L.t. "1�t*'I., v.nn p tro C�-r , st ar a'.,SiSE s6 11. Maintain Best Management Practices(BMPs). \ 1 _.a rye 5 te.v Eo Pt-T Plz,c. T1 Av h V tILL'F b �� S c. .s t 5�.L V L L`� c>,`- �(Lo *-cr rf1(. , ! owtJ l Ern(Y T S,3d JiL.L gr R n 1. rzeo TT) 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). IA c E b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). w` 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. tt jEffiaiSON r0 111 C ' ruo r Ott TV DCG Jtrstormwater site plan template—rev.10/1/2003 9 __...__._: i • b. Description of s ecial requirements for working in or near environmentally sensitive areas. aN1rtS►�v..\ 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). tit 5. Construction Phasing. a. Construction sequence Ct~ Cot.as1t .cnbv RfLE"F.) ...t:NSrtal— StQ a. ►0 oci -x t2�mti..E�1`N P�,b t-. tMPt,1JV�4A[)ULL�O M � � 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. LNNC-t Si- o L•J V L CFr iw , __ON W tC s tt '�4QV.Jaui5n..,Cc_ ) - i 1' L Ptsr 'N O mt./LE TWIN 3a 0'M.S. II. Wet Season Construction Activities. a. Proposed wet season construction activities. t)c6.47L10.4 - b. Proposed wet season construction activities for environmentally sensitive areas. t a1,-►t 7. Financial/Ownership 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. Mt b. Diversions. tyQ c. Waterways. tJpwi~ d. Runoff/Stormwater Deten i rt Calcu{atio �4t4Ef ;Ni; #/� 0 Li j stonnwater site plan template—rev.1 d12 yq003 rv 'F f 10 cri? - • • 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 appliicantowner 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. 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I1V v ro Co ^v"a W N "x W fill Innis.Innis.In. ly a n �o � nH, WA ftLf 1-1F CYNTHIA S CHNE I DER fn in. 421.141.12i/ m H $a I-• in. 425.141.11211 •• Z trJ a'.'. o Parcel No. a921to e093 3 HNdoli.u• v 0 1.I'N�/ :`. East Marrowstone County Road 111111"'"'+++���"` • o N n Nordland, Washington The" o !H S 0 September 15, 2006 U•ICMlf tttUTAL DIS*SN i CONSULEIMS