Loading...
HomeMy WebLinkAboutBLD2006-00619• PILDING PERMIT APPLICAT•N MLLA0600600 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00619 Received Date: 10/27/2006 SITE ADDRESS: S JACOB MILLER RD PORT TOWNSEND, 98368 OWNER: CLARK B JENNISON PHONE: 360-379-8987 MIMI MICHELLE C JENNISON 310 S JACOB MILLER RD PORT TOWNSEND WA 983689096 SYNDICATE SUBDIVISION: Block: Lot: 17+ PARCEL NUMBER: 997600010 Section: 8 Township: 30 N Range: 01 W CONTRACTOR: HI-LINE HOMES PHONE: 253-804-1849 11306 62ND AVE E PUYALLUP WA 98373 Contractor's License HILINH*981E3T Expires 2/10/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NSFR W/ATT GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,152 VALUATION 206,460.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 576 SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: ` 0/a71 /0G Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,592.95 INT 10/27/06 85261 Plan Check $1,035.42 INT 10/27/06 85261 State Building Code $4.50 INT 10/27/06 85261 Potable Water Application $55.00 INT 10/27/06 85261 NCV Total: $2,687.87 1110 r BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00619 Received Date 10/27/2006 SITE ADDRESS: 360 S JACOB MILLER RD Issue Date 11/13/2006 PORT TOWNSEND, 98368 APPLICANT: CLARK B JENNISON PHONE: 360-379-8987 MIMI MICHELLE C JENNISON 310 S JACOB MILLER RD PORT TOWNSEND WA 983689096 SUBDIVISION: SYNDICATE Block: Lot: 17+ PARCEL NUMBER: 997600010 Section: 8 Township: 30 N Range: 01 W CONTRACTOR: HI-LINE HOMES PHONE: 253-81849 11306 62ND AVE E PUYALLUP WA 98373 Contractor's License: HILINH*981BT Expires: 2/10/2008 PROJECT DESCRIPTION: NSFR W/ATT GARAGE CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: UFFER: Footings L_--74_) : r Foundation: D ' 99/a, Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall21tAP-ra-07 Sheathin 1� Framing:• , LOI u-,-Kif3 11 CI? 94- 473/n9, Plumbing Propane Tank/ Lines: Insulation:ct.,t.ti'S c-)-( 41 ,tlp') A1,i- i�y-P131p --) Sheetrock�G 4 J 4 c,I 0-7 Septic Syte Final Approval MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: 0 -71/ 7 7. HEALTH DEPARTMENT ND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY -SEE REVERSE SPECIAL CONDITIONS FOR CASE A BLD06-00619 1.) The project is located in close proximity to an identified wetland and is subject to the delineation provisions of Section 3.6.9 of the Jefferson County Unified Development Code. Based upon the proposed location of the project in relation to the identified wetland, the applicant has agreed to maintain a buffer(setback) that exceeds the standard buffer requirements by fifty (50) percent. The applicant acknowledges the additional setback and agrees to maintain the extra 50 percent buffer, therefore, waiving the wetland delineation requirements of the Unified Development Code. 2.) 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. 3.) A permanent physical separation along the upland boundary of the wetland buffer area shall be installed and permanently maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC Administrator. 4.) 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. 5.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 6.) 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. 7.) Minimum setback from South Jacob Miller Road right-of-way shall be 20 feet. Minimum side yard setbacks shall be 5 feet. Minimum setback from edge of wetland shall be 225 feet (wetland delineation not submitted with the application). Site plan depicts a 427 foot setback from house to wetland. 8.) 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. 9.) 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. 10.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 11.) The building height is not to exceed 35 feet. 12.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 13.) THE ROAD APPROACH PERMIT (RAP06-0220) 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 (360-385-9159)AT THE DEPARTMENT OF PUBLIC WORKS FOR THE FINAL ROAD APPROACH INSPECTION. I:\F_BLD_Permit_Buildngspt 10/29/19 PLAN 2152 STANDARD t ;g°.<<.,+;,s.w. ' , wry _ ..-----.. ,11171:111::I..., CD 1111111 rimle 1 omCNI ...z•;,.,z,— ) , CV �,� �k . , - 3 V cy..., ca V . st 1 58'-0" NOOK €— j KITCHEN BATH MASTER ^bl 15'6"x 13'11" II GREAT I* UITE ROOM 16'3"x 15'6" II 16'3"x 18'1" I 1 y._=L. • DINING VAULT LINE 4 .„,. ROOM 13'9"x 11' r---, BEDROOM �- 12'6"x11' o BATH �I UTIL., I ... ! In >. _... . l J MEDIA / ENTR --, BONUS ROOM 13'9"x 15'6" DEN 13'1"x 11'3" GARAGE 24'X 24' r i i HiL ICE 1 HOMES I. ©copyright 2005 HiLine Homes www.HiLine Homes.com .1 w 1E( P AIR, i D �9--„Ls c% JEFFERSON COUNTY 7 n ,1, DEPARTMENT OF COMMUNITY DEVELOPMENT OCTU 2 ZUUo ` 1.4 621 Sheridan Street• Port Townsend •Washington 98368 � 360/379-4450 •• 360/379-4451 Fax Aff ili IA1110 0 Ci 1 q SING www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: a0-(ca) Project Description(inc a separ to sheets as ne ssary): T x Parcel Property �j Number: } l Size: 1' ( q Q C raj (acres/square feet) Site Address and/or Directions to Property: _ 3/0 S Jk Cob mill r , pod- 7u1,fiXu „) Property Owner(s)of Record: Mirk i :' C.IGL..rIZ �2 ,tj Jc Telephone: 33 clg d'7 Fa : email: b ysi�ac '/( 0 cct,-,._/ • Mailing Address: 3w _S ;�Q (t)k, mil L i-C1 poi- TCLji?�c.4 Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) relBuilding ❑Variance(Minor,Major or Reasonable Economic Use) El Demolition Permit ❑Conditional Use[C(a),C(d),or C]** Single Fa °Discretionary"D"or Unnamed Use Classification Garag Attache /Detached OSpecial Use(Essential Public Facilities)** El Manufactured ome ClBoundary Line Adjustment C]Modular OShort Plat** ❑Commercial* ❑Binding Site Plan** El Change of Use 0 Long Plat** .'i$Address I Road Approach [Planned Rural Residential Development(PRRD)/Amendments** Q Propane ❑Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis OShoreline Master Program Exemption/Permit Revisions*" 18Stormwater Management ❑Shoreline Management Substantial Development*" ❑Site 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 ❑Forest Practices Act/Release of Six-Year Moratorium *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet 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 right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appli ti t a e wants prior notice.Signature: Date: // a/23/0(r The action o ac ions 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-transf able res I ility for adhering to and complying with the ESA. The Applicant has read this disclaimer and sig s and dates it below. Signature: Date: /0�13C CO D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • • BUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: 'V-t- 1 itr� e ()me CH LA S Orle i Pr.. ( ) 379- 3600 ( ') 3 1 -Q/7/ MAILING ADDRESS: ' f fie„t'-Z r it .rs , I ";.•..r , EMAIL: CONTRACTORS LICENSE "a'vs ro Ir . ./P`-'• t; WAINS NUMBER: %`Lf 'v w (rt q 34-13-4-- NUMBER ARCHITECT/ENGINEER: +1� PHONE ( ) FAx:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: Vf:New Vi Wood Existing: 0 Sewer ❑ Addition ❑ Steel Proposed: 2 Bank ❑Community System ❑ Alteration/Remodel 0 Concrete Total: 2 Height: JA Individual System ❑ Repair ❑ Masonry SEP Permit# sf Ns",-602 3 ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: IS Private well 0 Two Party Typ'�e�ryf Heat; Proposed: �_ ❑Public LA?LyL Total: Name of System: 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: []Underground Tank 0 Above ground Tank Size of Propane Tank: ❑Heat Stove ❑Cook Stove ❑Woodstove ❑Fireplace Insert 0 Hot Water Tank 0 Pellet Stove p 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 Current Proposed For Office Use Only Amount Revision Main Floor Heated 2,52 laa 1IPEH Bid App Review: �S i 2nd Floor Heated O Consistency Review: r 53 Other Heated Base fee: i 5 S- aa Mezzanine © Additional Section: `o--- Heated Basement Plan Check fee: O 3c). Unheated Basement State Surcharge fee: O I. Other Unheated V Pot Water Review fee: 0 Garage/Carport 3? SUBTOTAL (A40 c6-1 Decks r.._ -- -8. 1/Rd Approach fee: 50. Other %•4 O TOTAL: $ 3 t( a Y 1 eo--- Receipt Number: 81Sca(Vit Cash/Check Number: 00 3 i ESTIMATED COST(REQUIRED) Date: lO a-1 1" Fair market value of all labor and materials foundation to finish $ /21'320 , c'v Initials: a76/ _ D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • • gsoN e REC e :E terIV JEFFERSON COUNTY OT 2006 � DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Washington 98368 ;, t11.01Nlitt , ill, 1911INC(f360/379-4450 • 360/379-4451 Fax N�` http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# lam PROJECT/APPLICANT NAME: 3 en -s on hLla-4e 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. l - WaJ (k ;� s tk t i()e4tC' 0 hcy Ccc- i4uI )) • f-tC, iv 1' a , c 4c4e , i1 Ol.J j u - b;,u - h; r�P>i<irr '�;:; - lieuae cevirit Self Existing Conditions Summary 2. Desc be the existing topography. Indicate contours on tbp site Tap. 4-- ky`, S(vP'S 5/0 US oar) iV's - a `n4 3. Describe the existing vegetation. Indicate native vegetatio9 areas on the site map. 4. Describe the existing soils. Indicate soil type on the site map. Clay 54/6 - 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. 5/r� i CS'2 714 r s Lt _pa,s -e e "d e II /.S r�?So r-i'C) LV 3i S n r ; l S 1v &re APPROVED 6. Describe any excess levels of noise generated by the proposed use or activity: STORMWATER PLAN I - 9 2006 StormWa 's J 1 Require JEFF= , O T DEPT.OF O , DE PMEN SIGNATUR : 5 stormwater site plan template—rev.10/1/2003 S • 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. 77.;1 ` S z. LtYC � 1 are0, etc," 11)4 C.ii:v'j ` .4 nCY71-6(1 1` i 3y.1-10r' ,fix r.,. :) ,17,-f) P a1,. - A *+'ki2c'3• a ,- 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.). LM S✓k tNc.t.p u! >" -/a-e2 / fra-L-01 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 th i site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. (h Fl&4 - �'5 i rr a d e ivy-1-ed ate d i. S7Z►�=pni.L' .f-r- rta 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. 6 stormwater site plan template—rev.10/1/2003 • • b. Descri tion of special requirements for workingin or near environmentally sensitive areas. Sty,,; e It C �4,-e.; 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 d fry .'u'(tI ) h,�e i +i A? ' z kJ 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. j 0..-- I lz-- - 7/ a ') 7 (12 d II. Wet Season Construction Activities. a. Proposed wet season construction activities. 'b. Proposed wet sea n con liruction a ti ities for environmentally,sensitive areas. .` Ca t o a..l l a,,,(;) . l S L�.�-C=4,v di,(A t 6`i C rr 4rtec.,A of Cs,� r s ow-r Lj z 7' a-w`ti 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. b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations stormwater site plan template—rev.10/1/2003 10 • . I, 12 Required Elements-Construction SWPPP(continued) 8. Stabilize Channels and Outlets. 9. Control Pollut nts. , w A n -f hp e ha? a—d t .. -^,c�:, -e,��.�S sle��:z�� CL!- *& - •t c !_ZYrk C c,vSt r e j`in, 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). MK 11. M intain Best Management Practices(BMPs). 50 = J 4(1 6 1 a tud, vk i r1 -6-.A le C� u t, O t.t.A ni u v�'r (24..ii rtv, ' 12. Manage the,Project. �. live On O ,d'i /5i--- nip "1 a-,v) r .raj 'ft, d?t - �� ,rr '„ aft L (( r • c�ti rc• z /a-(,% . y A c-1 • �;i�'. 4 yy - ' v rfic- -fvt_i,//.� S �rl �C t'� �' �' �s,h0 r 2. Adjacent Areas. iNi ,/-� C Lai a, 4( a' d +C- "Lt /1 a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). /' T /�, 10,�,r / /LCY\ II &.h€-_() 4- iy lam'1. ' 1 " 61, _ ' e c b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). uw:►�/Ado I[rl'i/ter/lgri/IilA/L'�'�r 2r.lJ�� \VIC 4 3. Environmentally Sensitive Areas. a. Description oc environmentally sensitive areas that are on or adjacent to the site.45 hc,* �uJ‘t ( S a j , 0y) C�45 S,1Z' �7--7..--. Gin 1//C44_ 471-- ( or Or , 4tC-ee -J L''1 LS 0f� 9 S- �2_.,(1 `' -) cr C,11(ol , [N j -7-k c.y Yj. stormwater site plan template—rev.10/1/2003 9 • • 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 Clean g Limits. / ) �� i d`' l c c Co)if rbL-�j/ 2. Establish Construction Access. Wm-a k 11 (, Ci.c Ails:�•- y wit 0 At'S`) ,t(i c • 3. Control Flow Rates. 4. Install Sedime Co trols. ` JU /fit" � 45' yC �G_-•�✓ Mat: hit.; i - "Y.e c/F'C) 5. Stabilize Soils. • �� 1'l7f Gr rTj�E `y= ct,d t LOC 11 14' fli/-a:'(kd/ 6. Protect Slopes. Pr/ '1- 7. Protect Drain Inlets. stormwater site plan template—rev.10/1/2003 8 • • 13. Describe the water quality system. kiJuiv t#1i�i' 14. Describe the conveyance system analysis and design. 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 17. Describe the proposed surfacing material. )1 �� C-1 fcc�' ( cw' �:),n1r / �Sti c `�r a�€( 0 ft,4; 4�t, S"hkt' ; (.)6 'S - CLtJ,j ...,r, 7 18. Describe methods for restoration of the site. c.126i- 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. l 20. List here 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. _ stormwater site plan template—rev.10/1/2003 7 • • . 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 )..)k owner of th affected property. ./..-1'''''''' /0/2 IVO& (LAN NE EPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: 12 stormwater site plan template-rev.10/1/2003 1. ...... V.") ) ..N , ..... -7-7- --- 77 ti A k ' m ,:,,,,, 4,., --r. ‘.. ..... --...._ •• --' •, K, _. ......t__ ......... __. _ 57> ... . . .,. , ,, „ • oz- ..---- • , - _ ---t---t„ m ,...• . 1 .. 0,..... c' - 5",sN 9 . . ti, cr S' v 1,1 1-s‘' rt--. ."1"1 , ••• lbw. -AD -4.-1 r•ri 'TS e......, et, ems (11 I '1 t 7....F.• =1 C=, r4-1 F • ... 3, V"' ,-•- I C) 4 ,b vl ) 1 cl =4 0 .. .. ---) , ..,. 1 , • . -,• -r-...,..,,,el-, c, .......... .4:1 G--2 .1. .4t. ........ , --•1 x , (i. • -4, '11 1 tso cr.z .. .. • NN ----... ..,... ..,, -......-. .." c= 0 . : 0 .1..,... 4 r•—• '4... „ . ........ 0... sr. , .I ......:71 N,.. . M . • , > . c--- i 2.?' --> . .. 20. • 4 , . • 0 , . ,,. - ' ie-„,:y , 4, 44,4,,.. t., I -, ..., , .,, ,,•,, i . M , i CO .--- •,..-- --' ; i 4rt . . .....) • i ' V) ..• .47. 1 I . i , . . :g V\ I ,. . ..4'.., .• \ ..C;;':‘> (74 I . . . , . C' ''....-",-- - .,! ,...&o..„,,,,--70,s,• ..; ..43 C., ,1 ' ,,,,S. G--- ,., N. ' 4 , ,,, 0 , f • I . , F I' kr* . •t ; ! -)......). r- I • o.... :71 •- ( c 3 , A , • 1 ! t.„..„ a -..-- • ) 5" ,.... .., . I ''t .... e"" \Ali - r...77.4› Cl) • 2 -(_ 1.\ ‘\ 1 i , . . 4....•_. '. g . . . . ,. ,.... •. , 7 <pc, • . . ... z . • . --,i,a •. „,- / Ft ,,,,- • C' /•'''''''---------- \ 1 ! .....-• M 0 V 47:4A14- tlit • ''.. - .ti • t I/1\' ' ' \.\ - NI ictg, ':: '. .f%rf. * ' 1 . 4"'"''' ' .-... .-1>:1 . (.. 4‘,„„e„,), '.1 7.144*i - e --- • watici, ' '' -- --- , X • ni CA 011::,, . 44.. !!'", „r„,,, A ,, ,,o, c_.....1 cn v, _ ..c.. c4 ..,. i .. ..„ — 90 i tri PI:i 47 rai "'"C-.9ro .. ..., 4, -7:1; "13 ""16 t , f --47, co 1 1 n t 'k4 •.1 0 !,..)c›,4---).,„ rc?, -,.. ,ISt, 1_... _.. ii,_ \ (..f ,.. ,,:\ITz, a, - . P•c, c c.— trs:/ LI L P ''' 4"-i• I ---$7.7-', IS • , . , . ,-•.-.....) Ci (1-/ s • N 9 Lcg-- (.. , - •, , r-t......" C' M . .' 40' ' '‘.>>.... °6 • ''‹''' ''-' . 1 7.:',‘, 0 .,.„ 'r •,t1-'t., ,./,,., , ;!,p ' 1 - :::, '(..° ,,, i Z • • .4. >r- • . Pr"'T -: -• -4 .- - f.----.‘-''". - ' , . , ., ,. "t7 sr '41 , ,r7 ' i \n -V.),.-';' I r 14.. • ' ' A : 230 cck, i - - 7ci ..--- • ,...- - - - : ._. -,..titt. r.,.....- . +0 p , ion ......, _ .t ( Va.4 vi / ). ' 'rir--k, . ..40. - ,4:*:-10,-1'‘cr 4.-•,... / * .. . .1 , ..,.. • v , ry.. . • * ci . . --,ti .4 , 4';.•4„ -2) z "" '"%a. "*"*"'""")) ---• . -.4 . ,V . , z. 1- • - ,, -,... / .., 1 • ...-, N -0 cr. . (7,-- . i , .... ,....c, • -,:,..r. .-- ...,...„ . 0 rAir f i . .-.' /2/Co' C ' It: II! .1 „ (-N. •--1. CZ) s. -1,-.1 ,• 1 / i ,,, „ *P 1 , tr .I <----- 3 : 0 0 --...>. 3 ' . I ‘' ....t...., .„4,_I • --- I' i