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HomeMy WebLinkAboutBLD2006-00691 0 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00691 Received Date 12/7/2006 SITE ADDRESS: 42 BROOKSIDE ST Issue Date 01/18/2007 PORT HADLOCK, 98339 APPLICANT: CHARLES C SEIL PHONE: 360-732-4102 JAMES P/NORINE MC CARRON 26619 137TH AVE SE KENT WA 980428058 SUBDIVISION: BROOKSIDE ESTATES Block: Lot: 1 PARCEL NUMBER: 936500001 Section: 11 Township: 29 N Range: 01 W CONTRACTOR: BISHOP BROTHERS CONSTRUCTION PHONE: (360)301-1979 371 BISHOP HILL RD CHIMACUM WA 98325 Contractor's License: BISHOBC093D6 Expires: 1/11/2009 PROJECT DESCRIPTION: NSFR W/ATT GARGE & A/G 500 GAL PROP TANK CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: UFFER: Footing: , Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulati : Shear Wall : �� h"1 L, Sheathing: Framing: ii( tit,'? OK- 4-[5=07 Plumbing: J s l l -U 7 Propane Tank/ Lines: Insulation: ' ia_56),1-c.. 4-G4.l4U_ 6IL -(S -07t- b0 Sheetrock: 1=11.1151n, .�-R;,� o,J 1 -tn3,r)$ o;=C-,AvLaiget.„-fv wit-cL- ` 7-0,' Septic Sytem Final Approval MUST be obtained before final of structure can lie attempted. Road Approach Final Approval: Zoning Final Approval: 1Di Final/Occupancy Approva 119 j^ Tar- ['A 7/5 07 % (:/itriECT To aEAcT# D� APPR6Vi4HEALTH DEPARTMENT�ND PUBLIC WORKS APPROVAL R''QUIRD 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 CS t BLD06-00691 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.) The identified Fish and Wildlife Habitat Area (Type 2 Stream), shall maintain a vegetative buffer setback of 150 feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to the proposed single family residence. 3.) An additional setback of five (5) feet is required from the edge of the buffer area to the proposed single family residence. 4.) A permanent physical separation along the boundary of the 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. 5.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or every one hundred (100) feet, whichever is less. Signs shall be in place prior to and during construction activities. The signs shall contain the following statement: "Buffer- Do Not Remove or Alter Existing Vegetation." 6.) The project shall adhere to the Best Management Practices (BMPs) 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. 7.) A Stormwater Site Plan for a medium project 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 Brookside St right-of-way shall be 20 ft. Minimum side and rear setbacks shall be 5 ft. Environmentally Sensitive Areas further impact setbacks. 11.) 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. 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.) 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) on-site parking spaces are required for the single family residence. I:\F_BLD_Permit_Buildng.rpt 10/29/19 !UILDING PERMIT APPLICAT N ML 660 Revviewiew T Tyype: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00691 Received Date: 12/7/2006 SITE ADDRESS: AD-BROOKSIDE ST PORT HADLOCK, 98339 OWNER: CHARLES C SEIL PHONE: 360-732-4102 JAMES P/NORINE MC CARRON 26619 137TH AVE SE KENT WA 980428058 BROOKSIDE ESTATES TRACT A SUBDIVISION: Block: Lot: 1 PARCEL NUMBER: 936500001 Section: 11 Township: 29 N Range: 01 W CONTRACTOR: BISHOP BROTHERS CONSTRUCTION PHONE: (360)301-1979 371 BISHOP HILL RD CHIMACUM WA 98325 Contractor's License BISHOBC093D6 Expires 1/11/2007 REPRESENTATIVE: LOREN BISHOP PHONE: (360) 301-1979 371 BISHOP HILL RD CHIMACUM WA 98325 PROJECT DESCRIPTION NSFR W/ATT GARGE & A/G 500 GAL PROP TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,194 VALUATION 94,773.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 482 SHORELINE: CONST TYPE: DECK: 232 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: OTHER BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $958.75 LYK 12/07/06 87001 APPHOVEU Plan Check $623.19 LYK 12/07/06 87001 State Building Code $4.50 LYK 12/07/06 87001 JAN 13 2007 Potable Water Application $55.00 LYK 12/07/06 87001 JoffetsoaCounty Planes Total: $1,641.44 &Building Department 32-0 • •.. • „ 4 =,. .— SLIDER INIIIIMIlm, 2 g , 10'-5' cl (. , _.1. -77— -L. 0 el K WEN CLOSET < f\ ),. 4.. ,.... .. —1 4 il r, ... s o A rn —I .. tai 1 I 1 1 4a5 ABOVE '' 1-- \ in F A — 0 Z .. tn• AT Z ^: 1' 4 0. 0. t. - r--- . ;IC.C:0) 1 F,. p.,r1 WASNE t&DRYER Dw \ -_ V Z ... X T _ EF RANGE W/ / HOOD VEN A. 24' E T, ;5.i 0.•'4 ' A A , . . 3 4 4 01 • > 9W co M >< CA 0 c.? c't 0 111C0 Z: j I I.L 0 11,0* 42-0 411/ • ON C RECEIVEL W��4 OG JEFFERSON COUNTY ' , DEPARTMENT OF COMMUNITY DEVELOPMENT f1 ti ` `4 621 Sheridan Street• Port Townsend •Washington 98368 DEC 0 7 2006 360/379-4450 • 360/379-4451 Fax '2 www.co.jefferson.wa.us/commdevelopment S/INCI41,01,110 le ;1ri Master Permit Application MLA: 06, -LAD Project Description(include separate sheets as necessary): / SF�? t ,O', ifla,.' ^ , rn--a ( Tax Parcel Property J Number: 936, 500 )0 / Size: '/ 7` 3 16 .s -0 . i- (acres/square feet) Site Address and/or Directions to Property: Been/KS/0) C IPo,-f- Na d/0( +'- j,, 4, Property Owner(s)of Record: Ca,-,,c 5 A. 8,...5'ti`o) Telephone: 3 6 0- 7 3.2- Yi4 Fax: ! email: Mailing Address: 3)3 /3,,S.4n/a }/, !/ /f O e4,rna c .. , 4W,I, '. '.3z c Applicant/Agent(if different from owner): ,(n r Fn 3/_5.4273 Telephone:3 60- 30/- /9.79 Fax: email: Mailing Address: 3 7/ 3,_5f7",,? . "1;<_ //..�� „*,,,,f,,,,,*, '-A eft: `��j� �,?.-- What kind of Permit?(Check each box that applies) Atuilding ❑Variance(Minor,Major or Reasonable Economic Use) ❑Demolition Permit ❑Conditional Use[C(a),C(d),or C]** Single Family. "D"or Unnamed Use Classification Garage Attache Detached ❑Special Use(Essential Public Facilities)** El Manufacture ome °Boundary Line Adjustment CI El Commercialal* °Short Plat** °Binding Site Plan** Q Change of Use °Long Plat** Q Address i Road Approach °Planned Rural Residential Development(PRRD)/Amendments** KPropane ❑Plat Vacation/Alteration*'` DAllowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management ❑Shoreline Management Substantial Development** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance ❑Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless 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: / DESIGNATION OF AGENT I hereby designate /a r e n .Q/S�l ,/D to act as my agent in matters relating to this application for permit(s). i OWNER SIGNATURE • Date: / Z.- (' 0 6 By signing this ap cation 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 ap...t ion that he or she want ' r noti Signature:4 I%11� Date: / Z —1 V C The actio tactions 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 com with the on County development code.The Applicant acknowledges that he,she or it holds individual and non-tra rable respo ibili for adhering to and mplying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature g Date: / 2—t; ..c G ( — 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: /•.-s4 - 5 711 t,f c Ca,-1 s (36D)3 G?/ - 1 9 ( ) MAILING ADDRESS: 37/ J:S .,/, 17 // ,rr) C, ,r A,.+oss EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: 8 5 YO$C 09 W6 NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: a New IErWood Existing: 0 ❑Sewer ❑ Addition ❑ Steel Proposed: g Bank 0 Community System ❑ Alteration/Remodel 0 Concrete Total: Height' `Individual System El Repair 0 Masonry A/i� SEP Permit#.S°O..>— 7(s? ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: 0 Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: s rl 51Public ,e/c c Total: /t' , Name of System: /a/) 0 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: L1 Underground Tank WAbove ground Tank Size of Propane Tank: ,$?]') ✓4-/, d Heat Stove OCook Stove ❑Woodstove Fireplace Insert VHot Water Tank CI 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 17Ci44.3-2 EH Bid App Review: Il9y 2�" Floor Heated Consistency Review: (5500 Other Heated Base fee: t Mezzanine Additional Section: ---- Heated Heated Basement Plan Check fee: bZ. ig Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: ()b Garage/Carport slig i i 360.i-F SUBTOTAL I S9 ,4 Decks a �}fp8 .2 911/Rd Approach fee: ( vU Other TOTAL: $ aO41 4" Receipt Number: 001 Cash/Check Number: --1--7 ESTIMATED COST(REQUIRED) 94115 Date: .Fair market value of all labor and materials foundation to finish ig 000. Initials: D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • • tilf$141k\T co JEFFERSON()COUNTY PERMIT # BLA r *iii- '44 DEPARTMENT OF CMMUNITY DEVELOPMENT 0 6 -- 91 . ,. 621 Sheridan Street • Port Townsend • Washington 98368 LLp n ,S, �O 360/379-4450 • 360/379-4451 Fax - r r L rl S U N COUNTY Q�D �37N�' http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# 06-l000O PROJECT/APPLf CANT NAME: 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. Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. 6 rod,.(, f ,570,,?l 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. 4. Describe the existing soils. Indicate soil type on the site map. 6 cc 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. / : f'< r' f .. APPROVED 6. Describe any excess levels of noise generated by the proposed use or activi SjTORMW ATER PLAN Ai DEC 922Q06 JEFFERSON COUNTY` DEPT.OF.0 MMUNITY DE FLO SIGNATUR . �' -•*' 5 stormwater site plan template—rev.10/1/2003 • • 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. 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.). 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. 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. /1 7 `f �. �..�...�. .2. Describe the flow control system. HERMIT # -ate to _ -- 691- rf u1S0N LOWY )� 4 t:K':fe4 :Y.? stormwater stormwater side pT3i1`template--rev.10/1/2003 6 • • 13. Describe the water quality system. 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. > u per.; . 17. Describe the proposed surfacing material. 18. Describe methods for restoration of the site. ,—e, : jez„ , , 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for "large"projects only and only those for which facilities are required to control flow or treat runoff.] If included, list the Manuals here. 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. /1.' 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. PERMIT # HD 06 - 6- 9 I it tEBSON COUNTY OCD 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. 2. Establish Construction Access. 3. Control Flow Rates. ff . 4. Install Sediment Controls. �c 4- t-fcj s 5. Stabilize Soils. ` 6. Protect Slopes. / _f 7. Protect Drain Inlets. f: c., , . r # BED • - -S9I .JttfERSON COUNTY DCD stormwater site plan template—rev.10/1/2003 8 • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. 9. Control Pollutants. i 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). f4a/ c GIrt :4 l'� -Ar '7/Ai' 5 i 11. Maintain Best Management Practices(BMPs). , _so i elc. -a / • - t C 12. Manage the Project. iri r 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). C , r , r I 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. 7-1 re-'r k PERMIT # BED 0 6 --- t G , . iERSON COUNTY DCE. stormwater site plan template-rev.10/1/2003 9 • . b. Description of special requirements for working in or near environmentally sensitive areas. 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility,settleability,permeability,depth,texture,soil structure). • 5. Construction Phasing. a. Construction sequence L.p: _ 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. II. Wet Season Construction Activities. a. Proposed wet season construction activities. b. Proposed wet season construction activities for environmentally sensitive areas. 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. P�� 1T b. Diversions. c. Waterways. — d. Runoff/Stormwater Detention Calculations ,ittEntat GuunuI U�L 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 property. ."/_ (LANDOWNER OR AUTHORIZED REPRESENT 4VE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: ?IMO # BID f, - 6 9 1 JEFFERSON COUNIY KO stormwater site plan template-rev.10/1/2003 12 r'a) ;1 • C., rn VI 0 • Z > : rI, r -r- '1". , "'"?'•, rr-i "CZ .., —.... ---.__,„.._ —..,,,, CP•1 C: i cr) q,,, "D •• ••• 0 i 42 .., — = ---., r• -.. , -.•..„ .....4= a) co (1.3 u -..... 12 0.53, -•.c.....„ = e . ......... .\ , ..........„, _,..... 0,3. „... _ 74 .74) 8 -4..... 1 •33' M r ..-t:.,, > Qg .•"\--,. t ct, 0\ A 71 (3 ?•1.,., .--.---- 60' — — \---c\ --1.-- mil CY1 0) Z 0 (-1-12 • ....,-,••• 1 ›m , , c,.., ° --.„..-- •.\ 1 o o - i•-• - , ,4,.....,, 0 _ • ci, . A, il X 0 P —I m co 0 14 rm --6f=.— i .. ,. ...11111•••OEM GO , Z ' .." CA ....) - 0 4 c. 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