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HomeMy WebLinkAboutBLD2007-00008 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 #: BLD07-00008 SITE ADDRESS: 175 BLUE SKY DR Issue Date: 02/20/2007 PORT TOWNSEND, 98368 Final Date: 10/10/2007 APPLICANT: MICHAEL C BLANCHARD PHONE: 360-379-1301 CARISSA R BLANCHARD 175 BLUE SKY DR PORT TOWNSEND WA 98368 SUBDIVISION: DISCOVERY RIDGE DIV II Block: Lot: 11 PARCEL NUMBER: 001195011 Section: 19 Township: 30 N Range: 01 W 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 10/10/2007 K(,,,,k1) 2‘Akct"..) JiesAIL 0 liold7 Building Official Signature Date I:\F_B LD_Occu pancy.rpt 10/29/19 IDU ILDING PERMIT APPLICA ML 018 N Rev iew iew T Tyype: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00008 Received Date: 1/16/2007 SITE ADDRESS: 175 BLUE SKY DR PORT TOWNSEND, 98368 OWNER: MICHAEL C BLANCHARD PHONE: 360-379-1301 CARISSA R BLANCHARD 175 BLUE SKY DR PORT TOWNSEND WA 98368 DISCOVERY RIDGE DIV II SUBDIVISION: Block: Lot: 11 PARCEL NUMBER: 001195011 Section: 19 Township: 30 N Range: 01 W 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 DESCRIPTIOI NSFR W/ATT GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,484 VALUATION 268,895.00 ADD'L: 1,292 HEAT TYPE: HTP CODE EDITION: 2003 HEAT BASE: HEAT TYPE: EEE OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: 624 SETBACK: DECK: 228 BANK HEIGHT: SEWAGE DISPOSAL: CMY WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 3 Prop: 3 Total: 3 Total: 3 Routing Date: ___-_ - I I I(i) erl Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $1,940.15 LYK 01/16/07 87180 Plan Check $1,261.10 LYK 01/16/07 87180 APPROVED State Building Code $4.50 LYK 01/16/07 87180 Potable Water Application $58.00 LYK 01/16/07 87180 F :3 X 2007 a Total: $3,263.75 .1Rffwsnn r'rIuRtYl$ 19Partinent Jefferson County BuildingDelon Permit Nur. BLD07-00008 ,—� Applicant: BLANCHARD BUILDING PERMIT INSPECTION APPROVALS applicable 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 4 7 Oil Erosion Control Foundation Footing 31409 ),---f- 9 Footin Drains `I Foundation Stem Wall ''Il c.,)o7 Underground Plumbing Under Floor Framing Z1 t7`7 JAL {fvo Oft tit( '3 o,5=p ikr 1 ahy(314ct,( Yt-139 6Plf Straps(hold downs) Ext. Shear Wall Nailing ) tri _______ _:). v -t ( Ol-1 ciT3 /.T &A (knits co/t-tt.i` Rough-in Plumbing ; Framing G_ _o ? Blocking Airseal C,_2_7"_V7 v- Insulation:Walls -2_ v-7 9-- Insulation: Floors Insulation: Ceiling Int. Shear Wall Nailing 4 _ Wallboard Nailing Gas Line: Interior Gas Line: Exterior Propane Tank Heat/Chimney Clearance Drywell/Alt Drainage Address Posted FINAL INSPECTION ! /O 1 I FINAL INSPECTION MUST BE APPROVE[) PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD07-00008 1.) The application was reviewed by the Jefferson County Department of Community Development for the presence of Environmentally Sensitive Areas (ESAs). The Department conducted a review and has concluded that the property DOES NOT contain Environmentally Sensitive Areas. However, future proposals will be subject to a new ESA review and conditions may be added if new ESAs are found on the property. 2.) The applicant is proposing to create or add 2458 square feet of impervious surface and 3750 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. 3.) 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. 4.) 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). 5.) The site plan as submitted with the building permit application on January 16, 2007 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 16, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 6.) This approval is for a single family garage 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. 7.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 8.) 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. 9.) Minimum setback from Blue Sky Dr.right-of-way is 20 ft Minimum side and rear setbacks are 5 ft. 10.) 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. 11.) 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. 12.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 13.) The building height is not to exceed 35 feet. 14.) A minimum of two (2) on-site parlespaces is required for the single-family r•nce. 15.) Blue Sky Dr. (P278) is a private local access road. An address of 175 Blue Sky Dr. has been assigned to the parcel. 16.) This is a legal non-conforming parcel designated as Rural Residential 1:5 under the Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998. 17.) This parcel was created through Discovery Ridge Div. II under AFN , recorded April 4, 1989, Volume 10, page 57 with the Jefferson County Auditor's office. 18.) A septic permit (SEP07-00012) was approved February 15, 2007 for a capacity of 360 gallon per day. • • PLAN 2776 REVERSE 38'-0" IIiiii II 4) BEDROOM _ I, II j M 2 If I �� 11'x 13'8" :rn a � _�F �I II BONUS `, " . . ��� ROOM eriL 20'9"x n' ,��` WM, I", ,,„,,:iii.„,,,c,-, BATH i 3r at Ctou ,� a 31} * b )rtr Cy HOBBY BEDROOM DEN ROOM 3 12'7"x 10' 11'10"x 12'3" 12'x 13'5" 70.-0" MASTER II ICOUNTRY 1 6'x 13 II KITCHEN I 21'10"x 11'6" 010 f I ril71 - i (OPTIONAL) =�WIC GARAGE MSTR. BATH 9 x 7'6" 24'X 26' p _ r ABATH71 �� ® 1>< 1 �� UTILITY LIVING DINING n r T -1 1R00112' ENTRY 1 ROOM' I IL_______i_, 1 I COVERED PORCH I I 6'x38' I L i_ i r HiL ICE H OMES ©copyright 2005 HiLine Homes www.HiLine Homes.com • ri if O�� JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT ` `4 621 Sheridan Street• Port Townsend •Washington 98368 ��N 1 6 ��t 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment 'Hi 'ow? Master Permit Application MLA: 09— IS Project Description(include separate sheets as necessary): {; r e 4A G.( c Xk Tax Parcel p J Property Number: 00 I I�D I I Size: �cluGS (acres/square feet) Site Address and/or Directions to Property: ) 75 (Sloe_ skn �P. Poo TovonseA t t2A 9g56$ Property Owner(s)of Record: Mt c e._ CfAtVS.. Wo„nc\natJ Telephone: ,S(e,7- ,37q - I'O) Fax: -0-3'")`1-1-11'7/ email: Sion 0t,J,Ser's-+J/•com Mailing Address: I')S 61 Ve_ S k't tt'. ,l-- T,L &t 1,0A g$S6$ Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) I$(Building ❑Variance(Minor,Major or Reasonable Economic Use) Li Demolition Permit ❑Conditional Use[C(a),C(d),or C]*" Single Famil ❑Discretionary"D"or Unnamed Use Classification Garage ttach /Detached OSpecial Use(Essential Public Facilities)** Q Manufa ome °Boundary Line Adjustment d Modular °Short Plat** Q Commercial* °Binding Site Plan** El Change of Use °Long Plat** El Address i Road Approach °Planned Rural Residential Development(PRRD)/Amendments** R Propane ❑Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions*" lStormwater Management ❑Shoreline Management Substantial Development** OSite Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance OTemporary 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 attomey'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 Je rson County and its employees,representatives or agents for the sole purpose of application review and any required t in pection taff's s and right of entry will be assumed unless the applicant informs the County in writing at the time of the applica' h r prior Signature: I b ©'7 Date: The actio or c ions Applicant will undertake as a suit 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 i ividual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you a n plian with the Je on County development code.The Applicant acknowledges that he,she or it holds individual and non-transferab s s' i or ring d complying with the ESA. The Applicant has read this disclaim r and igns and dates it below. Date: Signature: / 9r t/0 (/ D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • 110 BUILDER STATEMENT The signer of this statement does hereby certify that t y are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assumint-!•_r i '' e G er Contractor for the proposed project. Signature: ,/ Date: ///,/©7 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: V►L`►ne kkt'imcs (moo) six 371_8 0(30 379-yl71 MAILING ADDRESS: lai3 Lon \/�/'/',,,,�„_,,QlwA pi$�I EMAIL: CONTRACTOR'S LICENSE LV VS �� �m`1 WAINS NUMBER: N=l f)N Q a 1 RT NUMBER ARCHITECT/ENGINEER: tole_QP_P,1� L,110��a�F ► t r 'PHONE (�)SI-17-Clan FAX:( ) MAILING ADDRESS: 1C it U�Fii IL �b5 SO ne� La� Pasco) A qp l Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: 'RI New 181 Wood Existing: 0 Sewer ❑ Addition 0 Steel Proposed: .?•S Bank ECommunity System ❑ Alteration/Remodel 0 Concrete Total: a.. Height: Individual System ❑ Repair 0 Masonry SEP Permit# ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: 3 JEl.Public \\ Pi,r(1 2r_F air Total: 3 Name of System:QI,.)M-1_ 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: C]Underground Tank 0 Above ground Tank Size of Propane Tank: ❑Heat Stove 0 Cook Stove 0 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 14$y I73otrj.q EH Bid App Review: c; w 2"'Floor Heated 1 aqa l 15301 % Consistency Review: r- ,,�j e Other Heated Base fee: l r, ,^(JJ 1 I� Mezzanine Additional Section: "(L{ Heated Basement Plan Check fee: t to Unheated Basement State Surcharge fee: c Other Unheated Pot Water Review fee: 95' Garage/Carport 141v1.l4 SUBTOTAL Gall DO .5 Decks 5315.95- 911/Rd Approach fee: 9,0 .— ASr1►�Y� Other TOTAL: $ "( '1� Receipt Number: Q I la) Cash/Check Number: v I cq _ ,ESTIMATED COST(REQUIRED) SSC/5 Date: �O .Fair market value of all labor and materials foundation to finish I ���� I 9G'co Initials: 7 D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • • e-0. JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT jr i 16 200/ ,, , 621 Sheridan Street • Port Townsend •Washington 98368 , /11Ne(a http:/3/7www co.jefferson wa4 �q s/omrndevelopment/51 FaxS STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# V9— I PROJECT/APPLICANT NAME: IAInJryke` lax taC 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. (� (A)04- \WP_-\ (pcnWAVP bt2�0?\11`tk a ,1 Cec keve (•)n a sac. peel cQ�'a4e\cQ :S a\ N a ft, e� a+� \�^a�c� o��sile. (PC��Ss`�o1e ,AANXiek ' 2`r _ be_ \oc ri ce-i44.\\, 1/47 •\- e si Comer Nate. CAPixislktyreVree0, Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. {A\e-- v\cc\Ah\ CA- AM st,0 C osn& ex-e. t � 4 4)E, Comer, .4 Corner a4- ,Sol? / ) J1194 Cor ner- a 7,5'. 1A1a jor;1 4 rD aD sb�e_. 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. n\ (� T _ ere\-\11' u c s Qn ©N?( ,V6��`'C4\ c'C��Q,w� . � !"pedvs1V5 A \t 1��d(eI M'X (ma A ceitr P. 'no,J' (-Av.& -We 6. 4. Describe the existing soils. Indicate soil type on the site map. 50,4).eb , 0b01A- a' Ora ,% 1 ;\ . 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. L3C v Ca„ cQ�a.�.S A\wok Pke, Sit\�. Colt'ei t' ec- ex is-V o 4 k�f rA t u c\ r�ve,\ e �p rn.1 \n Jp. il?a- ral ff Ps- ale #c,i n t`nG�Dr;� a\ taa\-el`. APPROVED STORM WATER PLAN 6. Describe any excess levels of noise generated by the proposed use or activity: Alcor__ FEB 1 6 2007 JEFFERSON COUNTY DEPT.O UNITY E ME c....\) SIGNATURE: stormwater site plan template—rev.1 0✓112 0 03 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. 8. Describe the general vicinity of the site,including adjacent land uses and structures, utilities, roads,and sensitive/critical areas (streams,wetlands,lakes,steep slopes,etc.). £ t'c\ acCA * yC% C ronirk 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. ( c 5 ) \a1\A) C Ay\%\0\ MC\C )%\ovJe- to AfeeS p `c•P Oart\-CrQ can Li11 cks-svcloel 1te 1cr\fAecto.\r,\ -,,,)m-,yas \\e sec- �it\cQtt�c� gibe. 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 app��able to the project.I ►•Ai c \ to e I`P iMf A cPesi reek , J0a4,,cal nniscyi 64);11 ) sp 3 h k) m r n r►^ire 12. If ©Sgcrtper�tI a flow.control system. • • y yy"f vtt1 A'3. "'slomiwater i`e an template-rev.1712003 — 6 • • 13. Describe the water quality system. v . • -tl 4..,_ • () 9E 7 rtr 14. Describe the conveyance system analysis and design. Ct//ver}-) to e`,�/'ii,r..Aa.{ _ Cids,A-01 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. 0ilk 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. ( Moto\� a�racS) ��+-at.O t ccv‘ck rno\c\A 18. Describe methods for restoration of the site. \\ pcec -‘v,\+ &\r c-\t\ S.19 cr LA (1�-Ve bu‘\cQ S‘�e loth be_ \a+Arei 04-1A, Ac O`S tt--eS) \ vSkC_.S)--i ct,‘\& m J\c [ . 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. _it1/4- 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. ti/di 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. mot' . 2. Establish Construction Access. EY:\S'Nt\ -`` itAxkctosck-\\veki"welA-Nsk oNtecaSim Y;\-\ r J 3. Control Flow Rates. 4. Install Sediment Controls. (� A.�x r tc\ c eS o & Ncc\ion C'`,lM�waNeS A-Ve I\eC& 5. Stabilize Soils.kcezS S�64AD5 ) c vQ m v\^\,\ be P1Aik CQ r r cQ s4otbek Was. 6. Protect Slopes. l�cr\ C_Vck 5\o . 7. Protect Drain Inlets. /Q stormwater site plan template—rev.10/1/2003 8 JAN1b2007 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. Jr j k4 II,IL l 9. Control Pollutants. ((�� \\sdtZ ck 19�95 cy eila\s ( - eX Qd�ek Q\- S‘ &v t'\'n C'E%YS�.rt)e-ADn, 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 4")4 11. Maintain Best Management Practices(BMPs). 12. Manage the Project. t\A'Ne oe_N._ o 4, .baN 0490s ax(S C.Y_S A-S\c,NeS Cans tut4c-ex 1,00‘ ev e_ _AAAese_ me asures C*ke `‘r1ANe C1t ei). 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). A.) 14 3. Environmentally Sensitive Areas. a. Description of envijonmentally sensitive areas that are on or adjacent to the site. du A stormwater site plan template—rev.10/1/2003 9 • • • b. Description of special reqgirements for working in or near environmentally sensitive areas. A1/✓ 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erggdibility,settleability,permeability,` depth,texture,soil structure). • ���',lcX S,Ne L ( r �'1Yt a1-0-0.4. , t,r(c )erf25roit 46+ an jSSvrr 5. Construction Phasing. a. Construction sequ nce Sl1�' PCP Q ) 170il /1.7�s f XW �rq i �C�✓J)ht( 3715 tt'i^f) LA 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 c edule. Cpri4io - pee/c es 3 k ) e. cd ,Po ed/eit o-t- II. Wet Season Construction Activities. Y a. Proposed,wet season construction activities. /044 b. Proposed wet season construction activities for environmentally sensitive areas. 7. FinancialOwnership Responsibilities.I a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. V\ate A.lgvtcikar b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation imp cts. t St�`aI t icoSli ia 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. b. Diversions. c. Waterways. 7)/1/1 d. Runoff/Stormwater Detention Calculations stormwater site plan template—rev.10/1/2003 10 • • Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan,the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems,treatment facilities,flow control facilities, or structural source control BMPs (not standard on-site stormwater management BMPs),the applicant shall submit a final corrected plan ("as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I als certify that this application is being made with the full knowledge and consent of all owners of the ffected roperty. 1,/b/v 7 ni EPRES 1 E SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: stormwater site plan template—rev.10/1/2003 12 —'4111111111111111111111 4 cm z >44 lil • rrs"n V ),i_- 1 . 8 a) tv, 0 r) V 41) X§ • m 1 If° \ , -• l' , 13 II V ' N > .04 ,.. 4_,_ , , u le 9) , 0 , , - :.. i,,, 0 , . i ' ' 1. t.1 , 0 0, w 3 cn cn t ; Z tt1 t 1 - ,„ 10 P_ c5 ,._.i.c , a) 51 1 il' t:rN ...- •!_. ". I r 1 o . Jo a ,I, u) , i, . so I c 1:;.'1' < • c s < < < c < ;- --. Al----1-- -t` ' 7 \,,S.,3',. /\ 4—/ .;' 4..... \1____ 4--.d---' e.—. e''' <. • i '.'• ) \St• C, C -----e..._ .,7• 4.` e--. • -5),, s c ss,:. ,•(' -.,-..ci, ,, <_ < <, e., c c4 (t) c c . 4_ • -Ss- ' ,____ c- --? I s c w \ s c Alp;;.„; __ . , c s' i < s c \-- .. 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