HomeMy WebLinkAboutBLD2006-00591 ILDING PERMIT APPLICATI!SJ ML vy 573
Review T Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00591 Received Date: 10/16/2006
SITE ADDRESS: S RHODODENDRON DR
PORT TOWNSEND, 98368
OWNER: KENNITH R CARTER PHONE: 360-379-9550
JANICE E CARTER
PO BOX 719
PORT TOWNSEND WA 98368 CAPE GEORGE COLONY DIV 3
SUBDIVISION: Block: 5 Lot: 28
PARCEL NUMBER: 938400527 Section: 12 Township: 30 N Range: 02 W
CONTRACTOR: LD RICHERT CONSTRUCTION PHONE: (360)301-0543
PO BOX 127
PORT TOWNSEND WA 98368
Contractor's License LDRICC*066L0 Expires 5/29/2007
REPRESENTATIVE: L D RICHERT PHONE: (360)379-0236
PO BOX 127
PORT TOWNSEND WA 98368
PROJECT DESCRIPTIOI NSFR W/ATT GARAGE & A/G 110 GAL PROP TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 2,134
VALUATION 400,000.00 ADD'L: 647 HEAT TYPE: EEE
CODE EDITION: 2003 HEAT BASE: HEAT TYPE: HTP
OCCUPANCY: R-3 UNHEATED: 981 # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 1,286 SHORELINE:
CONST TYPE: DECK: 350 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: CAPE GEO
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 2 Prop: 4
Total: 2 Total: 4
Routing Date:
Type Amount Paid Bv: Date: Receipt: ___Approved/Date
Permit $2,673.75 LYK 10/16/06 85095
Plan Check $1,737.94 LYK 10/16/06 85095 NOV i3 2006
State Building Code $4.50 LYK 10/16/06 85095
-
Potable Water Application $55.00 LYK 10/16/06 85095
Total: $4,471.19
• •
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 #: BLD06-00591
SITE ADDRESS: 206 S RHODODENDRON DR Issue Date: 11/13/2006
PORT TOWNSEND, 98368 Final Date: 2/4/2008
APPLICANT: KENNITH R CARTER PHONE: 360-385-9550
JANICE E CARTER
PO BOX 719
PORT TOWNSEND WA 98368
SUBDIVISION: CAPE GEORGE COLONY DIV 3 Block: 5 Lot: 28
PARCEL NUMBER: 938400527 Section: 12 Township: 30 N Range: 02 W
PROJECT DESCRIPTION: NSFR W/ATT GARAGE & A/G 110 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 2/4/2008
)_Occupa n cy.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 #: BLD06-00591 Received Date 10/16/2006
SITE ADDRESS: 206 S RHODODENDRON DR Issue Date 11/13/2006
PORT TOWNSEND, 98368
APPLICANT: KENNITH R CARTER PHONE: 360-385-9550
JANICE E CARTER
PO BOX 719
PORT TOWNSEND WA 98368
SUBDIVISION: CAPE GEORGE COLONY DIV 3 Block: 5 Lot: 28
PARCEL NUMBER: 938400527 Section: 12 Township: 30 N Range: 02 W
CONTRACTOR: LD RICHERT CONSTRUCTION PHONE: (360)301-0543
PO BOX 127
PORT TOWNSEND WA 98368
Id richert(a),waypoint.corn
Contractor's License: LDRICC`066L0 Expires: 5/29/2007
PROJECT DESCRIPTION: NSFR W/ATT GARAGE &A/G 110 GAL PROP TANK
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: i/
UFFER:
Footing: . -- .‘ - l e"U')
Foundation: i 1wt>L-3-or-A—{t,.,v) i D5 -
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation: ..l 4 i
Shear Wall : '
Sheathing:
Framing: v�'4/ 1-1 u 1 ;/ /i 713
Plumbing:7( l ¢-p_>
Propane Tank/ Lines:
Insulation:/1,4,N 7. )(PL)..-cJ,I<4 t G'pnr..—e--i.lt •7/�/0-7 }(kSro.l .7i-It 741
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: :),\I- /O` '- j'P I. . (( W.:)
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 CAS•BLD06-00591 •
1.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the
Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the
Landslide Hazard Area.
2.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated.
Should buffer disturbance occur during construction, the Unified Development Code
(UDC)Administrator shall require replanting with native vegetation. No alterations shall be
made to the Landslide Hazard Area or its associated buffer without prior authorization by
the UDC Administrator.
3.) Prior to and during approved construction activities, the perimeter of the landslide hazard
area buffer shall be marked with a temporary sign. The sign shall be placed in such a
manner that it can be directly observed from the construction area. The sign shall contain
the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter
Existing Vegetation."
4.) All construction activities shall not encroach upon the landslide hazard area buffer. This
includes the storage or preparation of materials.
5.) The applicant shall permanently separate the boundary of the Landslide Hazard Area
Buffer from the remainder of the subject property through installing logs, trees, a hedge
row, or any other prominent physical marking approved by the UDC Administrator.
6.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water
quality degradation. The submitted proposal does not require additional aquifer
protection measures. However, during construction the project shall follow the Best
Management Practices (BMPs) and facility design standards as identified and defined in
the Stormwater Management Manual for the Puget Sound Basin.
7.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through#12 of the Department of Ecology's Stormwater Management
Manual for Western Washington 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 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.
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 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.) Minimum setback from South Rhododendron Drive right-of-way shall be 20 feet. Minimum
side and rear yard setbacks shall be 5 feet. Minimum setback from top of bank is
identified as portrayed on sheet 2 of 2 of revised site plan and letter dated November 1,
2006 from applicant and contractor.
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 designecTand hooded to prevent the light source fromSeing
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.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
15.) The building height is not to exceed 35 feet.
16.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
I:\F_BLD_Permit_Buildng.rpt 10/29/1999
• •
Jefferson County Department of Community Development "..t, `' 4".
Michelle Farfan
621 Sheridan Street
Port Townsend, WA 98368 NOV 0 1 2006
RE: Site Address: 206 S Rhododendron Dr
MLA#: MLA06-00573 Env { f{
Case #: BLDG06-00591
Dear Michelle:
As per your letter dated October 23, 2006 regarding my building permit and the
environmentally sensitive areas, I took the following steps:
• Met my contractor Larry Richert, owner of LD Richert Construction, at building
site on October 27, 2006 to assess the building site in reference to the landslide
hazard area and the required 30 foot setback for the septic components and
proposed structures.
• We measured from the leading edge of the nearest septic component to the ravine
and made the following measurements:
o Measuring SE, from the nearest septic component to a point at the top of
the ravine, the distance is 56 feet. The measurement is represented by line
"A" on the accompanying map.
o Measuring South, from the nearest septic component to a point at the top
of the ravine, the distance is 35 feet The measurement is represented by
line "B"on the accompanying map.
o Measuring SW, from the nearest septic component to a point at the top of
the ravine, the distance is 33 feet. The measurement is represented by line
"C" on the accompanying map.
o Measuring West, from the nearest septic component to a point at the top of
the ravine, the distance is over 100 feet. The measurement is represented
by the line "D" on the accompanying map.
o All parts of the proposed structure sit to the NE of the septic system and
do not come into play.
My attached signature attests to the accuracy of the measurements. Larry Ric '
signature is a corroboration of the measurements.
Kennith R Carter/ Larr D Rich
Property Owner General Contractor T
h�..BMI # BtP
REVISED SIT LAN 0 6 0 % c
dated I I I/O1 0
Has been APPROV D So( ( JEFFERSCN COUNTY OCb
by JEFFERSO►� 0,
DEPT.OF CO. 1r,1j '
SIGNATURE: �/�11.41.10.12r.416.4
0 i
4) cO � JEFFERSON COUNTY
aj A DEPARTMENT OF COMMUNITY DEVELOPMENT
'' ' `4` 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450• 360/379-4451 Fax
�q www.co.jefferson.wa.us/commdevelopment
Is,
�Master Permit Application MLA: Up -5(73
Project(D}e//�sscriptio.inn(inncicllaud}�e��separate ysheets
\as necessary): / ` w i
U eV) t WOi Da)t „Y A"ri n �t-�t) lf„JI\.YF stC + i i✓t;%,. 1-',,,( )1 i\-'.its i 1. '-J
Tax Parcel 7 -- Property 2l
Number: DC - '27, -- Size: (acres/square feet)
Site Address and/or Directions to Prrooppe�rty: L7UM'iIt — c )lDt i Di2 ,rf i)L- C-/ Pe '
Property Owner(s)of Record: % :Lj , ' �`
Telephone: ?l1 'I ' ) Fax: email:
Mailing Address: VU F'7X 1 ri Pr- L IA-- ' (if
Applicant/Agent(if differgpt from owner): L. b 2 i C 1.4- _--
Telephone: `) 1 • `'72,2/2.— Fax: ' 7q 5`Z27,-- r'
email: I� f'tC her- C.:itilt"li L- -Out
Mailing Adds: P O i 'VY 127 PI t.: r't- 9 Ssai is>
Wh nd of Permit?(Check each box that applies)
uilding OVariance(Minor,Major or Reasonable Economic Use)
°De olition Permit ❑Conditional Use[C(a),C(d),or C]**
Ingle Fami l °Discretionary"D"or Unnamed Use Classification
arage 5 bed Detached ❑Special Use(Essential Public Facilities)**
Q Manufactured Home °Boundary Line Adjustment
d Modular °Short Plat**
Q Commercial* °Binding Site Plan**
Q C ge of Use °Long Plat**
ddress I Road Approach °Planned Rural Residential Development(PRRD)/Amendments**
ropane ❑Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions*"
❑Stormwater Management ❑Shoreline Management Substantial Development**
OSite Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance
❑Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment
OWireless Telecommunication* °Jefferson County Shoreline Master Program Amendment
OForest 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:
y—DESIGNATION OF AGENT
I hereby designate L 6-4 ell— to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date: /c G6
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 a result of or in consequence of the granting of this permit.
I further agree to provide access and rigp, try to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any required late- nspecti Sta access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the appli lion that a ants '
Signature: 1 Date: -71C /&h
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 ou are in gom liance ith the erson County development code.The Applicant acknowledges that e,she it holds individual
and non-transfer a res r dhe• scmplyiaag with the ESA. The Applicant has read this disc aime and si s and f dates_ it below.
Signature: `\ Date: /C' /0 f�) k7
D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc
i •
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:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
L � etc4&-e- ` C '),,c-fi. i,C I -1- ( '79- ' 7777 )fin _
�_MAILING ADDRESS: 7(2 &7tTi i1:7 EMAIL: i�f l C her t 6,71 ( iM 1' c.. 41
CONTRACTOR'S LICENSE I ^ WAINS
CD NUMBER: a-I( 0(✓U NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Pro ect Type: Fra a Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New Wood Existing: / ❑Sewer
❑ Addition 0 Steel Proposed: �i{' Bank 4.4'❑Cmmuniry System
❑ Alteration/Remodel 0 Concrete Total: 1-� Height:///��� Individual System
❑ Repair 0 Masonry SEP Permit#y` - I -;
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: ...apvate well 0 Two Party
Type of H at: Proposed: '7. - ublic
Total: !
�t�- 1 �t;�-f ?i eve Total: of System ��
4
If this is a Commercial Project you must answer the followinq:
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:
C7 Underground Tankove ground Tank Size of Propane Tank: //LJ 6: .-
at Stove,j5Kook Stove 0 Woodstove ❑Fireplace Insert 0 Hot Water Tank ❑Pellet Stove p Other
Is this appliance being installed in a Manufactured/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 Proposed For Office Use Only Amount Revision
Main Floor Heated Z/ 7— Iq I a7O' Z EH Bid App Review: v
r-.,2nd Floor Heated 4� 5"1990 s 1 Consistency Review:
Other Heated Base fee:
acr73.`75
Mezzanine Additional Section:
Heated Basement Plan Check fee: 1 1 1. q
Lf
Unheated Basement cit., f 13gGb c , State Surcharge fee: �.3
41-)
Other UnheateA - - Pot Water Review fee: �
1 `I
Garage/Carport 3tD3110Z SUBTOTAL
iz 4f-rat- . iq
Decks,,,/-pac„,i.
0 $24 i st) OpRd Approach fee: 152.
Other TOTAL: $ ..21-Slo.19
Receipt Number: a55
Cash/Check Number:
30IO
ESTIMATED COST R RED)_ , 0j-1(3 Date:
.Fair market val rot'�andd atekials f dation to finish `r3 `(D
Initials: /
D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc
• •
1?j_ w^ /A
C
�� °��, JEFFERSON COUNTY
►`a43 DEPARTMENT OF COMMUNITY DEVELOPMENT ` "'621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 . 360/379-4451 Fax \
ige http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# CD(p r/ d�-s ��J�,
5 L PROJECT/APPLICANT NAME: ti-_)N f ( t'P
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. & (3 l+ Da)e
Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
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3. De cribe the existing vegetation. Indicate native vegetation areas on the site map.
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4. Describe the existing soils. Indicate soil type on the site map.
2 (.0-Ann
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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.
4-7-- 6-‘,p/-/ce-s.ti-i bu cc,r C 0-/— a-ii A i vel Qie \I/ 71°C
6. Descri e any excess levels of noise generated ty the pro P €L cO ED
to STORMWATER PLAN
.
Stormwa- r
NOV 1 3 2041
Required
1EFF C U T
stommeter site plan template—rev.10/1/2003 DEPT OF ' i IT V .L ENT 5
SIGNATU E.
• •
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.
Ail tipt a by C Cr4
8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads, and sensitive/critical areas
(streams wetlands,lakes,steep slopes,etc.).
t
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
withi the site. Locate these facilities on the site Ian and differentiate proposed facilities from existing facilities.
--)7 - i>'-r 1 t.."e--, , i 11/4-).rt rc44A"1 I c'
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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.]
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11. Describe the performance goals and standar applicable to the project.
, . ,2 2r-41 1.A:4-WUe.-- I%ki err 'ir-, it" 60 AA )1A- t I,14— . CL-Li--e_1"--
12. Describe the flow ontrol system.
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stormwater site plan template—rev.10/1/2003 6
• •
13. Describe the water quality system.
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14. Describe th conveyance system analysis and design.
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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 wilding Co
P
17. Describe the proposed surfacing mil:I. 4 ff
18. Describe methods for restoration of the site.
. ,,. 6�% 1 +�-P�Lw ���2C � � �
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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.
tik-)40c7e.------
20. List her and include any special reports or studies conducted to prepare the Stormwater Site Plan.
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. crric_ pitiii,t, pli,te, 120144...--r"
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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.
P Iev,2t.1 ( �. l�i•1�
2. Establish Construction Access.
3. tColntrooll Flow Rates.
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4. Install Sediment Controls.
Pai P( *
5. Stabilize Soils.
brirIP API) L-r
6. Protect Slopes.
7. Protect Drain Inlets.
stormwater site plan template—rev.10/1/2003 8
• •
12 Required Elements-Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
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9. C o trot Pollutants.
it)
10. /Control De-Watering(theact of pumping groundwater or stormwater away from an active construction site).
6 A✓ J7-}
11. Maintain Best Management Practices(BMPs).
1 1 :W";iiLisa
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
are s, 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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stormwater site plan template—rev.10/1/2003 9
I
b. Description of special requirements for working in or near environmentally sensitive areas.
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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).
Ati A.,�` '- , ' iZ`� fit' 11n+ �
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5. Construction Phasing.
a. Construction sequence
17 /-1 ---'-' N 5 ju ' /,t--
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.
' 7M1 " ,tor)
II. Wet Season Construction Activities.
a. Proposed wet sea on construction activities.
b. Proposed wet season construction activities for environmentally sensitive areas.
e5-3'7-0
7. FinanciaVOwnership Responsibilities.
a. Identify the propery own r responsible for the initiation of bonds and/or other financial securities.
-L—
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. t h'T
c. Waterways. �J
d. Runoff/Stormwater Detention Calculations
stormwater site plan template—rev.10/1/2003 10
• •
Stormwater Site Plan Changes
If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be
submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised
drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change.
Final Corrected Plan Submittal
If the project included construction of conveyance systems,treatment facilities,flow control facilities, or structural source control BMPs
(not standard on-site stormwater management BMPs),the applicant shall submit a final corrected plan ("as-builts")when the project is
completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as
constructed.
APPLICANT SIGNATURE
By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and
correct to 4he bes my knowledge. I also certify that this application is being made with the full knowledge and consent of all
owners o he a c(cte property
ki..)3.1 114 �1^
(LANDOWN@ri OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
stormwater site plan template-rev.10/1/2003 12
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