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HomeMy WebLinkAboutBLD2006-00627 • BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00627 Received Date: 11/1/2006 SITE ADDRESS: 173 SPRING HILL RD Issue Date 2/13/2007 CHIMACUM, 98325 Expiration Date 2/13/2008 OWNER: JASON PURSER PHONE: 360-509-1679 ABIGAIL M PURSER 2965 PARADISE BAY RD PORT LUDLOW WA 98365 WINBERG'S BEAVER VALLEY TRACTS SUBDIVISION: Block: Lot: TR3A. PARCEL NUMBER: 901245005 Section: 24 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE, UNHEATED BASEMENT ALSO A/G 250 GAL PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,729 VALUATION 311,781.00 ADD'L: 1,242 HEAT TYPE EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: PRO OCCUPANCY. R-3 UNHEATED: 1,315 #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N SHORELINE: GARAGE: 840 CONST TYPE: SETBACK: DECK: 300 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 2WELL Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $2,180.95 KAS 11/01/06 86753 Exist: Exist: Plan Check $1,417.62 KAS 11/01/06 86753 Prop: 3 Prop: 4 State Building Code $4.50 KAS 11/01/06 86753 Total: 3 Total: 4 Potable Water Application $55.00 KAS 11/01/06 86753 Total: $3,658.07 Directions to Site: 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 ATTATCHED • • CONDITIONS for Building Permit# :BLD06-00627 1.) The application was reviewed by the Jefferson County Department of Community Development staff on November 10, 2006 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: landslide 1, 2, & 3; SUSC aquifer recharge area. 2.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 3.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 4.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. 5.) Jefferson County has determined that the use of real property for agriculture and forestry operations is a high priority and favored use in the county. The county will not consider to be a nuisance those inconveniences or discomforts arising from such operations, if such operations are consistent with commonly accepted best management practices in compliance with local, state, and federal laws. If your real property includes or is within five hundred (500) feet of real property designated as Rural Residential 1:10 or 1:20, Rural Industrial, Rural Commercial, Agriculture, or Forestry, you may be subject to inconveniences or discomforts arising from such farming and forestry operations, including but not limited to noise, tree removal, odors, flies, fumes, dust, smoke, the operation of farm and forestry machinery during any 24-hour period, the storage and disposal or manure, and the application of permitted fertilizers and permitted pesticides. One or more of these inconveniences may occur as a result of agricultural and forestry operations which are in conformance with existing laws and regulations. 6.) A Geotechnical Report dated December 26, 2006 prepared by NTI was submitted in conjunction with this application. The report addressed the stability of the geologic hazard area and stated "the subject property appears grossly stable...". The report addressed the drainfield location to be at least 20 feet back from the 20° to 22° (37% to 40%) slope that is located west of the drainfield area, which approximately corresponds with the 280' contour line. 7.) A vegetative buffer of 30-feet shall be permanently maintained from any top or edge of a Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 8.) 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. 9.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 10.) 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. 11.) 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. 12.) The applicant is proposing to creafar add 4963 square feet of impervious sur• and 9633 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require the project applicant submit a stormwater plan meeting Minimum Requirements#1 through #5 of the Department of Ecology Stormwater Management Manual for Western Washington. The stormwater plan shall address measures to control stormwater, erosion and sediment during construction and shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 13.) 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. 14.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act(SEPA) pursuant to WAC 197-11-800(1)(b)(i). 15.) The site plan as submitted with the building permit application on November 1, 2006 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated February 12, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 16.) This approval is for a single family residence with attached garage and unheated basement with 250 gallon above-ground propane tank only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 17.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 18.) 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. 19.) Minimum setback from Spring Hill Road right-of-way shall be 20 feet. Minimum north property boundary setback (adjacent commercial forest lands) shall be 40 feet. Minimum side yard setbacks shall be 5 feet. If an ESA is ppresent, then the more stricter setbacks shall apply. 20.) 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. 21.) Exterior flashing, moving, or blinking lighting is prohibited, except as required by local, state, or federal standards. 22.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 23.) The building height is not to exceed 35 feet. 24.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 25.) The parcel has been designated as RR 1:10 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 26.) An address of 173 Spring Hill Road, Chimacum has been assigned to the parcel. Spring Hill Road is private (P392). 27.) The lot was created through the Veerg's Beaver Valley Tracts Subdivision or y 29, 1993 under AFN 362614. A boundary line adjustment (EXM00-0049) was finaled on December 19, 2000 that changed the common boundary between Tract 1 &Tract 3A that resulted in Tract 1 becoming 3.44 acres and Tract 3A becoming 3.56 acres. 28.) The site is served by an individual on-site well. 29.) A boundary line adjustment (EXM00-0049) was finaled on December 19, 2000. A septic permit was issued on February 9, 2007. 30.) The proponent submitted a written letter dated November 22, 2006 requesting a reduction from the adjacent commercial forest lands from 250 feet to 40 feet. On January 9, 2007, the Development Services Manager, Stacie Hoskins granted the reduction to the requested 40 feet. 31.) A Declaration of Restrictive Covenant was recorded on November 22, 2006 under AFN 517837 due to limited capacity of the septic system to 4 becrooms. 32.) THE DRAINFIELD LINES SHALL BE AT LEAST 20 FEET BACK FROM THE 20° TO 22° (37% to 40%) SLOPE THAT IS LOCATED WEST OF THE DRAINFIELD AREA, WHICH APPROXIMATELY CORRESPONDS WITH THE 280' CONTOUR LINE. 33.) TREES WILL NEED TO BE REMOVED IN THE HOME SITE AREA TO ACCOMMODATE THE HOUSE, DRIVEWEAY AND YARD AREA. ONCE THIS SITE WORK HAS BEEN COMPLETED, SOME FORM OF GROUND COVER SHOULD BE UTILIZED TO REDUCE THE EROSION POTENTIAL OF BARE SOIL. 34.) HEAVY IRRIGATION OR OTHER ACTIVITES THAT WOULD CONTRIBUTE LARGE QUANTITIES OF WATER TO THE SOIL SHOULD BE AVOIDED. 35.) SURFACE RUNOFF FROM HARD SURFACES SUCH AS ROOFS, DRIVEWAYS, WALKWAYS AND PATIOS SHOULD BE CONTROLLED AND ROUTED TO A DRAINAGE CONTROL DEVICE SUCH THAT SURFACE WATER DISCHARGE TO ADJACENT PROPERTIES DOES NOT SIGNIFICANTLY EXCEED PREDEVELOPMENT CONDITIONS. IT MAY BE FEASIBLE TO RELEASE THIS CONROLLED WATER TO THE EXISTING NATURAL DRAINAGE CORRIDORS WITH QUARRY SPALLS OR PERFORATED PIPE. 36.) SILT FENCES OR OTHER SEDIMENT CONTROL DEVICES MAY BE NEEDED DURING CONSTRUCTION SO THAT SEDIMENTATION TO ADJACENT PROPERTIES DOES NOT SIGNIFICANTLY EXCEED PREDEVELOPMENT CONDITIONS. 37.) DRAINAGE CONTROL DEVICES SHOULD BE MAINTAINED IN GOOD WORKING ORDER AND INSPECTED AT LEAST ONCE A YEAR. 38.) ALL DRAINAGE CONTROL FEATURES SHOULD CONFORM TO THE CURRENT REGULATIONS THAT APPLY TO THE DEVELOPMENT OF THIS PROPERTY AND BE CONSTRUCTED IN ACCORDANCE WITH STANDARD ENGINEERING PRACTICE IN ORDER TO INSURE THAT SURFACE WATER DISCHARGE OR SEDIMENTATION TO ADJACENT PROPERTIES DOES NOT EXCEED PREDEVELOPMENT CONDITIONS. 39.) PRIOR TO FINAL BUILDING OCCUPANCY, PROPONENT SHALL SUBMIT A WRITTEN LETTER FROM NTI ENGINEERING & SURVEYING, INC. (GEOLOGIST WHO PREPARED THE GEOTECHNICAL REPORT) DATED DECEMBER 26, 2006 STATING THAT THE STRUCTURE AND/OR FACILITIES HAVE BEEN CONSTRUCTED IN CONFORMANCE WITH THE REQUIREMENTS OF THE "GEOTECHNICAL REPORT." THE LETTER SHALL BE WET-STAMPED BY THE LICENSED GEOLOGIST/ENGINEER. • Jefferson County Building Division Permit NumbcTr. BLD06-00627 Applicant: PURSER BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2003 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks 3/3D/0? Erosion Control Foundation Footing 3/3%7 /} i-LLER Footing Drains Foundation Stem Wall 04)7 044/ Underground Plumbing #25,17 p AR Straps(hold downs) 7/07 # a( Ext. Shear Wall Nailing 1f �. 4°4?tg fi Rough-in Plumbing 544M Ps 014) OK #67,41 F/29/d1 SL�BQ k)AsrE 4s(AKILY) bigTF.? Ole I*/ R'514141 Framing7/f9/� j I 60") gaD INS BASEIfivr4)ToP aArf—a(7/4 Airseal t / e09 / B, - 7 /4 Cif H/�P J��/�l BE,I//Nt Insulation:Walls l_ -GM Insulation: Floors Ø,/ 7Gcie Insulation: Ceiling /f/1/,7 p Int. Shear Wall Nailing , /� Wallboard Nailing /3// 7 Gas Line: Interior 7/7/&7 Gas Line: Exterior N/,Q Propane Tank /) Db Heat/Chimney Clearance `1/ /c' Dy 6RoPA J 1 Drywell/Alt Drainage f\ r 1/Z3/G7 f' ExI'N—TD (.,A7t#BA Si o✓ Address Posted F FINAL INSPECTION //i/p7 �K CA . FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR /U,Qi)AC.g '� ./7uc`TwoRL 64 7 A IV' (at& Az410401 P -n".ir WWI te_ 02_ HoorD .Pe---V) °*---` t4141M w(ct-t4149 06- IIC ILDING PERMIT APPLICATTN MRL Review Ty 608 ype Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00627 Received Date: 11/1/2006 SITE ADDRESS: SPRING HILL RD CHIMACUM, 98325 OWNER: JASON PURSER PHONE: 360-509-1679 ABIGAIL M PURSER 20488 MILLER BAY RD POULSBO WA 98370 WINBERG'S BEAVER VALLEY TRACTS SUBDIVISION: Block: Lot: T 33 PARCEL NUMBER: 901245005 Section: 24 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI NEW SFR W/ATTACHED GARAGE, UNHEATED BASEMENT ALSO A/G 250 GAL PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,729 VALUATION 311,781.00 ADD'L: 1,242 HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: PRO OCCUPANCY: R-3 UNHEATED: 1,315 #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 840 SHORELINE: CONST TYPE: DECK: 300 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 2WELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 4 Total: 3 Total: 4 Routing Date: `/ // )D (0 �, Type Amount Paid By: Date: Receipt: Approved/Date Permit $2,180.95 KAS 11/01/06 86753 APPROVED Plan Check $1,417.62 KAS 11/01/06 86753 State Building Code $4.50 KAS 11/01/06 86753 FEB 13 2007 Potable Water Application $55.00 KAS 11/01/06 86753 Total: $3,658.07 Jefferson County Planning & Building Department • Ilk 1� C 1vE ) ON CO �,��i � �� JEFFERSON COUNTY • y DEPARTMENT OF COMMUNITY DEVELOPMENT '' `4 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450• 360/379-4451 Fax j'�gsiliNo�p� www.co.jefferson.wa.us/commdevelopment JEf U5(I1+, gIIUNIt djl Master Permit Application MLA: D(p — o.O Project Description(include separa sheets as necessary): 1'n,,..., S' r I . 1 `'✓ Y_.il�-L s'i.-— i ,{ , 'L1 4 Ct,l,( 1 4 -c .�Tax Parcel _ Property _ Number: '-l ( j D J`1 , 6i i.' Size: .-S t./'.C! ' ? (acres/square feet) ,.,QeSE3'eJ i 1,'I IC Site Address and/or Directions to Property: I ►itc t- 3/i Bet-AL(- VA,(Li"' 12,:1' e lit t rill cci.viA Vet Property Owner(s)of Record: .1-016 1 f IA bt;)<2 C / VIA-(-S Z r Telephone: 31+''c SO)I 111 71 Fax: 3lp0 011 aCo(e(, email: 6 bi9/e C!ft.)SIn.nS►1 •atS Mailing Address: LC-y46Qr fil t Litt- {it,) 174. Pcfrt, S be jtiy-, `j f3 3 3- ' Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: Mat kind of Permit?(Check each box that applies) reguilding ❑Variance(Minor,Major or Reasonable Economic Use) (i Demolition Permit ❑Conditional Use[C(a),C(d),or C]-- Li'S�ngle Fa o ❑Discretionary"D"or Unnamed Use Classification 'Garage ttach /Detached ❑Special Use(Essential Public Facilities)** Q Manufa ome [Boundary Line Adjustment d Modular [lShort Plat** O Commercial* OBinding Site Plan-- Q_ Change of Use °Long Plat** dress I Road Approach [Planned Rural Residential Development(PRRD)IAmendments** Propane ❑Plat Vacation/Alteration** DAllowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions*" ❑Stormwater Management ❑Shoreline Management Substantial Development** Mite Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance ['Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* C1Jefferson 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 .rr/1 - _7) Date: ,i -/- z E- __ By signing this applio tji n-f rm,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 rd later inspections._,Staffs access and right of entry will be assumed unless the applicant informs the County in wilting at the time of the appli tion hat he or she wants pyior notice. • Signature: — r,:, _ ____ f•--' Date: / J' // 6c C., — 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 yo re in compliance wit the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferzible r ponsibility for adhering to and complying with the ESA. The Applicant has read this disclai er and signs and dates it below. Signature: .. — Date: /P/ '//Or D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc 0 • 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: D�T&s Y. r VVa_L- Date: !L- l-C'4 RE( if-, li k -IF if GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER rL rp i ARCHITECT/ENGINEER: PHONE ( ;!F !( ap MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: J New g Wood Existing: 0 Sewer ❑ Addition ❑ Steel Proposed: ii 4-1 Bank 0 Community System ❑ Alteration/Remodel 0 Concrete Total: ,;`;, H g t: N Individual System ❑ Repairy 0 Masonry �� SEP Permit# ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: Ij Private well k Two Party Type of Heat: Proposed: 2 ElPublic Jam,..., �,_i 41,_ Total: 3 Name of System: 0 If this is a Commercial Project you must answer the following: 1 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: ED Underground Tank 19 Above ground Tank Size of Propane Tank: �.1`(=.' (.-,i/: .-, ,Heat Stove N Cook Stove ❑Woodstove Fireplace Insert 0 Hot Water Tank ❑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 EH Bld App Review: -72-Ci 1514 Q-c (c5.CO 2nd Floor Heated I nsistency Review: 1ZLf2, 1113a).� 15� -cO Other Heated I Base fee: ai $o.°L5 Mezzanine Additional Section: Heated Basement Plan Check fee: 141 -1. fpa Unheated Basement T I �r�,4 State Surcharge fee: , 1pPv 4' () Other Unheated ) • Pot Water Review fee: ^ 0.00 Garage/Carport SUBTOTAL `'� Decks 3p° q 0-1I .�b d Approach fee: c 1_ ' ..DO Other TOTAL: $ 40(o3.b7 Receipt Number: $ -,1 53 / Cash/Check Number: t3 l ESTIMATED COST(REQUIRED) .gate: ff .Fair marke value of all labor and materials fo a�tion to finish \ 1 1 , 1 G I, Oo l .mil i qc,q3 Initiails: D:\PemritCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • I R ECEI EI) eo JEFFERSON COUNTY ' `ski DEPARTMENT OF COMMUNITY DEVELOPMENT Sheridan 360/379 4450 • 360/3 9-4 51 Fax Townsend • Washington 98368 Jau.0 !fowl•., 1 u d� Q" O w 0 C� INQ' http://ww.co.jefferson.wa.us/commdevelopment/ !�`� STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# DO LiQS PROJECT/APPLICANT NAME: ,SeM) HfrS- r 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. SEE .5(TE , f)P .r Existing Conditions Summary J[frERSRN COUNTY L. 2. Describe the existing topography. Indicate contours on the site map. sE� 5(,12vE 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. 6/7E /S U/✓o6/Q..aeD , kerwii4L of v£6,--7R77o4 Aar) 7kCFJ /// yobn FooiPR-10 . Co.w ars or Fies, ALDers AufNE:s 4. Describe the existing soils. Indicate soil type on the site map. 1yPE /S Zahm 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. 3/7-C- /S SLOPE) f4N hi4j//f 70VEE�f S i Sav7L/ T?I/Ov(it/ D/TCNrES APPROVED 6. Describe any excess levels of noise generated by the proposed use or activirj: STORM WATER PLAN keep i dO4Arrizve,7700 zvoisc F E 6 1 2 2007 Stormwater B lEFF C U DEPT.OF C T EVE ENTstommwatersiteplantemplate—rev.I0/1l200.3 Required SIGNATURE. 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. //o wE7M'uJi S 4 S7R /}MS - SEE Sv,,4I Sf1EET 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.). k1/ (4) "6. rc:u7 S lC7v/Z sod likvAy 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 thel site plan and differentiate proposed facilities from existing� ng facilities./y �i� �p� (�!1Lf Pt� lAtA l ( �tV n11�1k(I YIa `„r rrj( (�t0(.}e 1. f 2 1 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.] vA 14- • 11. Describe the performance goals and standards applicable to the project. i o __,./ er- t*/0 ; I ( -c ( 00 . r �•! 'c I p r i(J t r11 0 In �, u Ycr1 C,,.'#e • 12:~ Describe The flow control system:--} RECOVE'D LO t vxC ra-elic. eyrs I1,tn - 1a RR iF S(I' +:IIIItl11Y 1 1 i 1w S TV r . Tq:11 �ormwater 09p(n template-rev t0/12003 : 6 • • 13. Describe the water quality system. / _ LAC P r `CC t w1 5 '� �. (1 c 1.l rail 0 ejkliciF' * 14. Describe the conveyance system analysis and design. t°P Ste tY- - Q lAcdt4r / • 4- 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. u/M 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. k/A 17. Describe the proposed urfacing material. C(`1,( PC/ 3/ym u S (Oc,k \&Cr cf r , Co (ci Say\ci ` - crivIrrioir t 18. Describe methods for restoration of the site. eX 1 C ,( d — `nP(,c-) om+ C l)PUJV cwv1 eo# sideG. 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. M/A iR ECEI \�rEI) y"i tl 20. List here and includey special reports or studies conducted to prepare the Stormwater Site Plan." t.:- S111, ;L.N 21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals in clude conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or restrictions here. storrnwater 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 Limit+s. \_1 , c e)V\\L C`eC32 litA:)0\c,I '' S - S ' iG_ �CCC'`� T ei ./Yy1 95 6.(.1 e 4 `C r W c fit.�°"c.^' . V ! 2. Establish Construction Access. A C P 55 ' 'a � � -/ > 1 Y ef:" ,6 tad r`I Oe a y 3. Control Flow Rates. `f 0 '�3,�1 41 -5 -A'0 � 1 if, t�(Qc .ET7 Yl 4. Install`Sediment Controls. RECE1VED ct,/ b't cn..te M 1V x.. 4. 5. Stabilize Soils. �CIQw/ C" XfSf\ Y! 0,01 _ RNA LUUNTY 6. Protect Slopes. v.. t- l°ari 1Co II j tK; 5'irS 7. Protect Drain Inlets. Q r', (t \rn t n e s°thy?' t stormwater site plan template—rev.10/1/2003 8 • 12 Required Elements-Construction SWPPP(continued) 8. Stabilize Channels and Outlets. Nr\ l 9. Control Pollutants. 10. Control De-Watering(the a t of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Manage ent Practices(BMPs). pe:,.ejae r Ont,c i�cl Pr Q C -F' rrl EA)E E b Ere Vd 1-1 citktm(."5_ 12. Manage the Project. S ��Q r"" iult r tor_) Lc i 1 1o, . // - i ale-S . - 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). A/UNc b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). / r`1, 1 c 1 S +0 114►-t rm. ?Pled ; Arlp 3. Environmentally Sensitive Areas. f' QI a. Description of environmentally sensitive areas that are on or adjacent to the site jEffL((,, f j f �U UIV I Y gal �l/a�lE (JIV Ll1 stomiwater 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.,eroydiibili settleability,il permeability,depth,{� texture,� so Ii structure). 1( !Ol 1 re t I j{J//�j'/ ( k f'� I11 4.Y rC 1' u.)07,� 5. Construction Phasing. a. Construction sequence ).--\01Arrie-vi fOr‘ ,-"C fool(ley (4)e-1cl)1-0' el""kt 0 iftri ey-ez b. Construction phd'sing(if osed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. �Oci - (dv. goo? II. Wet Season Construction Activities. a. Proposed wets,g ason construction activities. 5 'f� ,� (' -cL vl q/!z.7�Gi'l �p�l�d r V? 4r;(zj b. Proposed wet season construct' activities for env' n entally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identity the property owner responsible for the initiation of bonds and/or other financial securities. JfJso ' Ar it Pvgtsc"g b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. r wi‘-‘ \R Ec 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicalAe,.;, a. Sediment Ponds/Traps. �n`� I.L' b. Diversions. X// c. Waterways. i t I 1 o U� d. Runoff/Stormwater Detention Calculations A.K �r`�`U1 t� 6 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 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 pro erty. -o G ( ER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: \REcEIVED ^`t nf!nl• *HOED OCO stormwater site plan template—rev.10/1/2003 12 \ • . . 40I-04 I 4 \ \ \'' wtosi \ L i , . \ +a a& , 1 , t"qP '-•-.- rolb W11,!, k,,r , ' - -oit 1-P1-zcz'iTLF"' )ii - `1,5'.,."• . — - cl.i.ri \ i t6 .4=B4r_=‘_, - -.. I -.'it; \ is:1 lilt': -V-, j!I 0 1 -,<• \ 'SI ti..4. '''.; ' ' ,osiSk UT.iJiT3.- — 1 ,i, i ;7 -t• ''' 4 i'' . , 11, :, "' • - ;1',3N ' % '.' 1'1'f ' 4*f -- ... 711r - . ., ` - .... 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