HomeMy WebLinkAboutBLD2006-00724 �•
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 #: BLD06-00724
SITE ADDRESS: 7351 OAK BAY RD Issue Date: 01/22/2007
PORT LUDLOW, 98365 Final Date: 7/11/2007
APPLICANT: CODY M PATTERSON PHONE: 360-437-7945
JENNIFER E PATTERSON
PO BOX 815
PORT HADLOCK WA 983390815
SUBDIVISION: OLYMPUS BEACH 62 Block: Lot:
PARCEL NUMBER: 978900058 Section: 4 Township: 28 N Range: 01 E
PROJECT DESCRIPTION: NSFR W/ATT GARAGE
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 7/11/2007
olBuilding Official Signature Date
I:\F_BLD_Occupancy.rpt 10/29/19E
ItUILDING PERMIT APPLICATION MLA06-00687
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00724 Received Date: 12/27/2006
SITE ADDRESS: 7351 OAK BAY RD
PORT LUDLOW, 98365
OWNER: CODY M PATTERSON PHONE: 360-437-7945
JENNIFER E PATTERSON
PO BOX 815
PORT HADLOCK WA 983390815 OLYMPUS BEACH 62
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 978900058 Section: 4 Township: 28 N Range: 01 E
CONTRACTOR: HI-LINE HOMES PHONE: 253-840-1849
11306 62ND AVE E
PUYALLUP WA 98373
Contractor's License HILINH*981BT 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 207,214.00
CODE EDITION: 2003 ADD'L: HEAT TYPE: EEE
OCCUPANCY: R_3 HEAT BASE: HEAT TYPE: HTP
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: 5N OTHER: SHORELINE:
CONST TYPE: GARAGE: 576 SETBACK:
DECK: 32 BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 2
Total: 3 Total:
Routing Date
14P-11.1
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $1,598.55 LYK 12/27/06 87033 }}
Plan Check $1,039.06 LYK 12/27/06 87033 iL
State Building Code $4.50 LYK 12/27/06 87033
Potable Water Application $55.00 LYK 12/27/06 87033 JAN
Total: $2,697.11 A'afa LL>)i,13a,y;
• •
CONDITIONS for Building Permit# :BLD06-00724
1.) PRIOR TO OCCUPANCY, DEMOLITION OF THE EXISTING RESIDENCE PER
BLD06-723 AND FINAL APPROVAL OF SEPTIC SEP06-268 ARE REQUIRED
2.) The application was reviewed by the Jefferson County Department of Community
Development staff on January 5, 2007 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:
Coastal Seawater Intrusion Protection Zone (SIPZ).
3.) Marine shorelines and islands are susceptible to a condition that is known as seawater
intrusion. Seawater intrusion is a condition in which the saltwater/freshwater interface in
an aquifer moves inland so that wells drilled on upland areas cannot obtain freshwater
suitable for public consumption without significant additional treatment and cost.
Maintaining a stable balance in the saltwater/freshwater interface is primarily a function of
the rate of aquifer recharge (primarily through rainfall) and the rate of groundwater
withdrawals (primarily through wells). The Washington Department of Ecology is the
agency with statutory authority to regulate groundwater withdrawal for individual wells in
Jefferson County. New development, redevelopment, and land use activities on islands
and in close proximity to marine shorelines in particular should be developed in such a
manner to maximize aquifer recharge and maintain the saltwater/freshwater balance to
the maximum extent possible by infiltrating stormwater runoff so that it recharges the
aquifer.
4.) The parcel is located within a coastal SIPZ (seawater intrusion protection zone) according
to the County GIS map. There are voluntary and mandatory measures identified in the
Jefferson County Seawater Intrusion Policy (Resolution 44-22, effective September 23,
2002) that apply to well drilling proposals and building permit applications on existing lots
of record.
A Coastal SIPZ is defined as: all islands and area within one-quarter mile of marine
shoreline, but no history of chloride concentration above 100 mg/L in groundwater sources
within 1000 feet.
5.) To help prevent seawater from intruding landward into underground aquifers, all new
development activity on Marrowstone Island, Indian Island and within 1/4 mile of any
marine shoreline shall be required to infiltrate all stormwater runoff onsite.
6.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ:
Water conservation measures:
1. Roof and other intercepted precipitation shall be routed to on-site detention ponds
and/or other approved means and allowed to be released to the soil slowly.
2. Water collected from Storm water and roof catchments may be used for watering
lawns and gardens. Unless catchment water has been treated to meet drinking water
standards, there shall be no cross connections allowed between the potable supply and
impounded water.
3. Water withdrawn from wells on each property shall not be used for watering of lawns
and/or gardens.
4. Ground water withdrawn from each property shall be restricted to a rate of three (3)
gallons per minute.
5. Installation of water conserving fixtures such as low flow toilets, faucets and shower
restrictors and other water saving plumbing fixtures.
6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation).
Please NOTE that the above listed measures are not intended to be exhaustive, but rather
is intended to be illustrative of the types of water conservation measures.
7.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ:
1. Installation of a flow meter.
2. On-going well monitoring for chloride concentration.
3. Submittal of monitoring data to County.
8.) MANDATORY MEASURES FOR•ASTAL SIPZ: •
1. For proof of potable water on a building permit application, applicant must utilize
DOH-approved public water system if available.
2. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water or an individual well may be used as proof of potable water subject to the
following requirement:
a. Chloride concentration of a laboratory-certified well water sample submitted with
building permit application.
3. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water.
9.) 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.
10.) The applicant is proposing to create or add 2152 square feet of impervious surface and
3700 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.
11.) A Stormwater Site Plan for 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.
12.) 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).
13.) The site plan as submitted with the building permit application on December 29, 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 January 19, 2007 shall be resubmitted
for review and approval by Jefferson County Department of Community Development.
14.) This approval is for a demolition permit to demolish the existing single family residence
and shed and a building permit for a new single family residence with attached garage
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.
15.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
16.) 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.
17.) Minimum setback from Oak Bay Rd right-of-way is 20 ft. Minimum side and rear setbacks
are 5 ft.
18.) 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.
19.) 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.
20.) Maximum lot coverage is not to eed 25%. Lot coverage is defined as amoof
impervious surface which includes roof tops, driveways, concrete, etc.
21.) The building height is not to exceed 35 feet.
22.) This parcel has been designated as Rural Residential 1:5 under the Jefferson County
Comprehensive Plan Land Use Map effective August 28, 1998.
23.) A septic permit (SEP06-00268) was approved on November 27, 2006 for a system of 360
gallons per day.
24.) Oak Bay Rd (C569908) is a minor collector road. The road approach is existing and an
address of 7351 Oak Bay Rd has been assigned to the parcel.
25.) This parcel was created through the Olympus Beach subdivision, filed of record in Volume
3 of Long Plat at Page 19 with Jefferson County Auditor's office.
26.) A minimum of two (2) on-site parking spaces are required for the single family residence.
Jefferson County Building Division Permit Numc.+: BLD06-00724
Applicant: PATTERSON
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
Erosion Control
Foundation Footing 5/47 ,� /�
Footing Drains
r/�Yy' uFrEie iN.srAt,cEo
Foundation Stem Wall gNiq
ifir
Underground Plumbing
Under Floor Framing �J
U:.TTU_�'0g-Lietf/'CEcut _t fin ./ve- .�[2lCites(� (r
Ext. Shear Wall Nailing
4/q/o 7
Rough-in Plumbing
Framing �y
Blocking
Airseal
4/7.4/4 7
Insulation:Walls ,,Q
Insulation: Floors
Insulation:Ceiling
7/0107
Int. Shear Wall Nailing ., ✓y
2gnl�
Wallboard Nailing �
Gas Line: Interior
/0/A
Gas Line: Exterior
N/A
Propane Tank N/a
Heat/Chimney Clearance w,�q
Drywell/Alt Drainage /v
7/0%7
Address Posted 7////67
FINAL INSPECTION 7////p7 12/ vk rat C 6
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
��.�,SoN woe, JEFFERSOiv •
DEPARTMENT OF COMMUNITY DEVELOPMENT
P' `\ Q `4 621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax
le`�t37NG, p www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: )(�-CcSrl
Project Description(include separate sheets as necessary):
r
Tax Parcel ? �// �
Proz
Number: ./ r / Property
/2G�� �LJ
2Q5-f/Cjacres/square feet)
Site Address and/or Directions to Property: 73 .5/ c % / / Rdf� L/��,���(tic-, �3 363—
Property Owner(s)of Record:,.Teg�iy/�.�' uh� /cr `'J-"fe,j�
Telephone: S' e) - '"3 7-?71.5 Fax: . iT'2' email: 5� ,' ijc*/ai?��
Mailing Address: Pc". /3 OK .-'/S� i"o79L y�i4 * ./,,. y ?, r�
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
XBuilding i Variance(Minor, Major or Reasonable Economic Use)
i Demolition Permit i Conditional Use[C(a), C(d),or C]**
1 Single Family I Discretionary"D"or Unnamed Use Classification
1 Garage Attached/Detached i Special Use(Essential Public Facilities)**
Manufactured Home i Boundary Line Adjustment
I Modular i Short Plat**
i Commercial* i Binding Site Plan**
1 Change of Use I Long Plat**
I Address i Road Approach i Planned Rural Residential Development(PRRD)/Amendments**
i Propane I Plat Vacation/Alteration**
Allowed"Yes"Use Consistency Analysis i Shoreline Master Program Exemption/Permit Revisions**
1 Stormwater Management i Shoreline Management Substantial Development**
I Site Plan Approval Advance Determination(SPAAD)* I Shoreline Management Variance
i Temporary Use I Comprehensive Plan/UDC/Land Use District Map Amendment
I Wireless Telecommunication* I Jefferson County Shoreline Master Program Amendment
I 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 a ss and right of ent o Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any requi a er inspections. Staff ss and right of entry will_ge..assumed unless the applicant informs the County in writing at the
time of the appli i that he or she w ----
Signature: Date: (/'
The i actions A icant 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 no violate the ESA ' ' idual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you a " ompliance-with the Jeffers unty develo meat code.The Applicant acknowledges that he,she or it holds individual
and non-transfers esponsibilit r adherin with the ESA. The Applicant has read this disclaimer nd igns tes it below.
Signature: �, /�
i '
Date:
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.doc
• BUILDER STATEMENT •
The signer of this statement does hereby�ce that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assurpih the re_spons' iH General Contractor for the proposed project.
... �-Y., 7
Signature/ ---- — ~- Date:
GENERk[CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
177 /4e- //eW"-5 ,( )379- W)37y -y/7/
MAILING ADDRESS: �;"4�l��G Gw!'(/ACL Po' -%C y ."4 EMAIL:
CONTRACTOR'S LICENSE _ WAINS
NUMBER: 74,///3/ '// / NUMBER
ARCHITECT/ENGINEER: r-Y/‘,/, j L" c-'/�-1 �e' ' PHONE ( ) FAX:( )
MAILING ADDRESS: •� EMAIL
Project Type: Frame Type: Bathrooms: Sh reline: Type of Sewage Disposal:
' New 4Y Wood Existing: pi Sewer
❑ Addition ❑ Steel Proposed: Q Ban ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: a Hei ht: 0 Individual System
Ii Repair ❑ Masonry SEP Permit#
CI Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setb ck: X Private well LI Two Party
Type of Heat;: Proposed: . ' ri Public
L''./,, �4(r�✓ � Total: 3 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 I No
If this is a Propane Tank and/or Appliance Installation permit, mark all items below that apply:
i Underground Tank i Above ground Tank Size of Propane Tank:
i Heat Stove i Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove i Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No
When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property
lines,tank location and size,distances from the propane tank to all property lines, buildings and septic system components,
including the reserve area.
Square Footage Current Proposed For Office Use Only Amount Revision
Main Floor Heated - i 1C1 Ts "' ; .- EH Bld App Review:
2"d Floor Heated ,... / Consistency Review: 1 _DCc
Other Heated -_ /„...e....------ Base fee: ' 44 33
Mezzanine /_ ---/ Additional Section:
Heated Basement ,,� Plan Check fee: C'
---' IbC)
Unheated Basement �. � - State Surcharge fee: A
Other Unheated _ __------ Pot Water Review fee: ( CD
IC
Garage/Carport F - ) SUBTOTAL
i
Decks 3 d `7'3:1 ,_j' 911/Rd Approach fee:
Other TOTAL: $;` CeA+`5('' 1 [
Receipt Number: ,,„---,,
,_- -70,33
Cash/Check Number: ':� ,
ESTIMATED COST(REQUIRED) `, Date:
'Fair market value of all labor and materials foundation to-iinish / 0 fl
/,3 FOCI Initials:
G:\PemtitCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.doc
• •
a 1RECEVED
d ° , JEFFERSON COUNTY
DEC 292006
,: A DEPARTMENT OF COMMUNITY DEVELOPMENT
Alp.er' 4 621 Sheridan Street • Port Townsend •Washington 98368 EEELINti ±': 1IiN °co
360/379-4450 • 360/379-4451 Fax el r1 L J!,
http://www.cojefferson.wa.uskommdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# Dlo- s r PROJECT/APPLICANT NAME: L_ 'j .+ Gd �J(
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 �lL/ /�/"l�Fl /a, i,,-/f %�/i -i /' �/��4 / �� ��//a ✓/°iGa'/l �i OI�f/'/riG�pis
. r>Ov ,0// 'dl! �`- `7aril r '> ,b<'q dr,./ e�rf Q'��t ,N► �d�"'4 ,'aloe/ 49'"0*
�-i?,;�1'al•I� �.�°�f,F,-fir. 4,--p 'rpeoo **
Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map. 1
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
4. De cribe the existing soils. Indicate soil type on the site map. 0 (; "' 7 ? 4
EP"It �1d 1Y DCb
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
ap licable,and indicate acreage of each.
/,
APPROVED
6. Describe any excess levels of noise generated by the proposed use or activity: STORMWATER PLAN
LAN 1 9 2007
JEFFERSON COUNTY •
DEPT.OF UN T LOiiT
SIGNATUR Y v,
stormwater site plan template—rev.10/1/2003 5
• •
7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep'slloopeessr,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
(strea ,wetlands,lakes,steep slopes,etc.).
���c
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 prop sed facilities from existing facilities.
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
non a yy f ge"projects or projects that involve the potential for dispersion of contaminants.]
11. Des ri eerfonnance goals and standards applicable to the project.
i 12.e Descb flow.control system.
itritimptirmarmempiete
irt:itd'it}.1:iY:iti Y11.1 t,'.t.. ,'r rrV 11441
as ar!'/,at2 6
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13. Describe e quality system. tz ''!r1!?_
tr U4
jail; ellON t i: '
14. Describe the nve system analysis and design.
15. D scribe 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. Des the proposed surfacing material.
- ',lf' + )
18. Describe me hods for restoration of the site.
/—�c' 40,
', 2 if'' 'tPw , ,, •, . ,, 0i !o, '� r
e/
19. An Operation and Maintenance Manual is required for each flaw 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. jr762 ,
20. List h re and include any special reports or studies conducted to prepare the Stormwater Site Plan.
RLa
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 restriclive drainage-related requirements,describe those conditions or
restrictions hgrg . ` L+r a ji L O U NTY D��
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 learin Limits. /� �pr`t r, �
'fir ='v - .Fes''? (� �ir^') /
dee--ydr?Cie �/ /'"""'-,yr ����'� �" 'r'� � fir""�''r°a�i.?
2. Estabf h Construction A.. ess r ,p
01,
3. Control Flow Rates. 1 r v%-ey5
4. Install Sediment Controls.
I t'"✓r l- �'�"; Gd �'d� .r" 1 ✓„ s.•m�'"r'or Ill
-c'- /4), ,pl y d? :c 4!,//' Cam'.a7..f/i0.4 ' i. J
5. Stabilize Soils.
6. Protect Slopes. _
.
7. Prot-ct Drain Inlets. w -
.+-�iirAfi+�t
eeiere .
8
stormwater site plan template—rev.10/1/2003
• •
EIV
12 Required Elements—Construction SWPPP(continued)
8. Zilizie Channels and Outlets.
> feO9:09 ` •'Y'tr' ' '°two?
9. Control Pollutan s.
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o ^ [I'/f Cb.sie C,E (�/ter tip Sl/
10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
11. Maintain Best Management Practices(BMPs).
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12. Manage the Project.
as A.ir- r�;:�-•.-T�c c -��s� / � , ;�y cv , , —4-4/ }'�'b /� e, may) G
,/Je,L'7# �i'�v�y� �'Y`,Y" ?Y.�r� . sw ..order /
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).
r
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
72 4
Lfl UN COUNTY 9Ci
stormwater site plan template—rev.10/1/2003
9
•
b. Description of special requirements for working in or near environmentally sensitive areas.
Ott
ifirdP
4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site
soils(e abili ,settleability,permeability,depth,texture,soil structure).
5. Construction Phasing.
a. nstruction s.quence ' �� r� � .- e,
F ry e /;/-
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. -,w
II. Wet Season Construction Activities.
a. Pro Proposed wet season construction activities.0,r
b. Proposed wet season construction activities for environmentally sensitive areas.
Sri r
7. Financial/Ownership Responsibilities.
��enti the Arty ow er 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
10
stormwater site plan template—rev.10/1/2003
. •
•
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
cc* tructed.
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 be t of my . I also certify that this application is being made with the full knowledge and consent of all
owners of th ect d,property.
/aP
( NER ORI REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED:
12
stormwater site plan template—rev.10/12003
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> o,c�zm FLOOR PATTERSON
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=zPLAN PORTHADLOCK, WA 98339 m
� ~ ,--,A, H O M E S
ccoo '- p rn� (360)437 7945
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