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HomeMy WebLinkAboutBLD2007-00010 •UILDING PERMIT APPLICAN MLA06-00016ReviewType: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00010 Received Date: 1/16/2007 SITE ADDRESS: BALDWIN LN PORT LUDLOW, 98365 OWNER: FREDRICK D DAVIS PHONE: 360-437-0490 PAULA S DAVIS PO BOX 65454 PORT LUDLOW WA 98365 PORT LUDLOW NO. 2 SUBDIVISION: Block: Lot: LT 7 PARCEL NUMBER: 990600107 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOF NSFR W/ ATT GARAGE & AJG 120 GAL PROP TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,530 VALUATION 269,623.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: HTP OCCUPANCY: R 3 UNHEATED: 500 # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 1,054 SHORELINE: CONST TYPE: SETBACK: DECK: 464 BANK HEIGHT: SEWAGE DISPOSAL: SEW WATER SYSTEM: LUDLOW BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 3 Prop: 3 Total: 3 Total: 3 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,945.75 LYK 01/16/07 87174 APPRJ\JEID Plan Check $1,264.74 LYK 01/16/07 87174 State Building Code $4.50 LYK 01/16/07 87174 'FEB 2007 Potable Water Application $58.00 LYK 01/16/07 87174 FEB Total: $3,272.99 Jefferson County Planning &Building Department Jefferson County Building Division Permit Number: BLD07-00010 Applicant: DAVIS 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 3// 67 q/ Erosion Control 05/07 0 &emus D,e»,a, favivx PizAti) 41 4truac Foundation Footing / 3/1167 d� G.)/Co0�r�1N(eFG�utREs �,usQ - 3/� '( J Footing Drains it D Foundation Stem Wall 14)/47 A' o Underground Plumbing qIs/ / 40K Straps(hold downs) ?ri IA 4/13167 1 Ext. Shear Wall Nailing .5// 1U7 /�.tF,!? v hE IJAiL,bC. .d ® �;u SIDES 1�6F 45°WAL Rough-in Plumbing bb/O7gi ABS .04 5 7.3 c; 1Dc es�,c rJ ; = � �- Dru z Framing G/3 el a`' pivddenditiais 4/r /el •W GGon .oce Airseal 03/0 I d Insulation:Walls G/i 4/0 aK Insulation: Floors 404 0 ff 41( Insulation: Ceiling I a 1/AaLr8D 6k a9/47 p Int. Shear Wall Nailing Ogfr A/ Ote Wallboard Nailing /0 6k Gas Line: Interior Gas Line: Exterior A/A Propane Tank Q/�/07it Ok Heat/Chimney Clearance 7 Address Posted /Ze/7 , ae FINAL INSPECTION Oat fr 4K FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR - JEFFERS�.OUNTY • w \. DEPARTME F COMMUNITY 1EG,d it •DEVELOPMENT '' '4 `.4 621 Sheridan Street • Port Townsend Washington 98368 Jr 1 6 � 360/379-4450 • 360/379-4451 Fax 4' p' www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: (- i rCij Project Description(include separate sheets as necessary): A-Trt"tk ti / ;, j - k v1 t- a\,e ',i:t h r.�) / A,ucl AA-- ?0 924p P1' 1M.k Tax Parcel �, Property Number: (0 00 1 o Size: (acres/square feet) Site Address and/or Directions to Property: 8 A laud,Al /,.-(A N e. R., + Lu.d.t n L4 i:•JA `1C 3&.s Property Owner(s)of Record: FR -AR.it1( C. •• •�r {' kt [A S �fiy�'r c, Telephone: 1'_1(<,c" (-1.37- `4 96 Fax: - email: R•ay+t-c 'ictofmA- i,c< , Mailing Address: e..c^ , A'r.x 1451-9 PC ad- ',A,:.1 t c.j r iA fi- 13(.1 S Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) 1 Building I Variance(Minor, Major or Reasonable Economic Use) 1 Demolition Permit 1 Conditional Use[C(a), C(d), or C]** 5kSingle Family 1 Discretionary"D"or Unnamed Use Classification XGarage(ached)/Detached 1 Special Use(Essential Public Facilities)** 1 Manufactured Home i Boundary Line Adjustment 1 Modular 1 Short Plat** 1 Commercial* 1 Binding Site Plan" 1 Change of Use 1 Long Plat** \tAddress I Road Approach 1 Planned Rural Residential Development(PRRD)/Amendments** x Propane 1 Plat Vacation/Alteration** 1 Allowed"Yes"Use Consistency Analysis i Shoreline Master Program Exemption/Permit Revisions** I Stormwater Management 1 Shoreline Management Substantial Development** 1 Site Plan Approval Advance Determination(SPAAD)* 1 Shoreline Management Variance 1 Temporary Use 1 Comprehensive Plan/UDC/Land Use District Map Amendment 1 Wireless Telecommunication* 1 Jefferson County Shoreline Master Program Amendment 1 Forest Practices Act/Release of Six-Year Moratorium *Ma r uire a Pre-A lication Conference **Requires a Pre-Application Conference I Please identify any other local, state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I herby designate to act as my agent in matters relating to this application for permit(s). OWNI R SIGNATURE Date: By sigi,ing 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 acre stand right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later ins sections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appli - 'on t•a h o she wants prior notice. Signature: A Date: ) d -.2 Y:- OC 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"ES . gefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not v. lat 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 i ,com lian ' with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-trans r le re o fib ity f r adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: /a.- 2.,g -66 G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.doc • BUILDER STATEMENT • The signer of this state nt d s hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be ass ing t e s o 'ability of the General Contractor for the proposed project. Signature: Date: i= ,t:t..g,'/6j1, GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: j�t R K PsO i k-{ PHONE (40)ges_(0/410 FAX:( ) MAILING ADDRESS: y t 0 j MA$C^f , 1) f twat,enf, EMAIL F}/2sh iLfec < r .d Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: I6/New X Wood Existing: .'Sewer ❑ Addition ❑ Steel Proposed: ,a)-2. Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: 2 %z _ Height: Li Individual System 0 Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: ._'- Setback: n Private well ❑ Two Party Type of Heat: Proposed: ), 1 .Public ?-�r:..,.{-Q ' e c:(tc i Total: ; Name of System: Ci;,,itA c_ ice -f esiu 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 Ta►rk audio! Appliance Installation permit, mark all items below that apply: i Underground Tank )Above ground Tank Size of Propane Tank: f rh C} i Heat Stove j4Cook Stove i Woodstove A Fireplace Insert i Hot Water Tank i Pellet Stove i Other Is this appliance being installed in a Manufactured/Mobile Home? Yes /(N6', 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 1(P34D EH BId App Review:2.5 2"F oor Heated Consistency Review: �.53. O I Other Heated Base fee: J 4 CI' 4-5= r15 Mezzanine Additional Section: ,. Heated Basement Plan Check fee: Unheated Basement ��� SOO �( State Surcharge fee: t Other Unheated Pot Water Review fee: Garage/Carport i c�`1 .y$ya`18 SUBTOTAL (q Decks `7`j4Z 4© 911/Rd Approach fee: �C•LJ 326 45 . o Other a1 �t "II :��+� ` -- TOTAL: $ �P Ia Receipt Number: 'r/ i 94 Cash/Check Number: aco I ESTIMATED COST(REQUIRED) 44 (p t'`j Date: �., 'Fair market value of all labor and materials foundation to finish j 1(p I 0 .5;o�-." Initials: _ � P G:\PemutCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.doc • • CONDITIONS for Building Permit# :BLD07-00010 1.) The application was reviewed by the Jefferson County Department of Community Development staff on February 9, 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 Zones (SIPZ). 2.) 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. 3.) 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. 4.) The applicant is proposing to create or add 3654 square feet of impervious surface and 4954 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. 5.) A Stormwater Slte 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. 6.) 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). 7.) The revised site plan as submitted on February 13, 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 26, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 8.) This approval is for a single family residence with attcahed 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. 9.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 10.) Not more than 2 unlicensed vehic•hall be stored on any lot unless totally seed 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. 11.) Minimum setback from Baldwin Lane right-of-way shall be 20 feet. Minimum side and rear setbacks shall be 5 feet. 12.) 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. 13.) 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. 14.) Maximum lot coverage is not to exceed 45%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 15.) The building height is not to exceed 35 feet. 16.) The lot is subject to the Port Ludlow sewer and water therefore the SIPZ requirements do not apply. 17.) The lot was created through the Port Luldow No. 2 Area 1 subdivision, filed of record May 19, 1969 under AFN 200294. 18.) Baldwin Lane (C544109) is a county local access road. The road approach was reviewed under RAP07-00004 and an address of 143 Baldwin Ln has been assigned to the parcel. 19.) This parcel has been designated as MPR SF4:1 under the Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998. 20.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 21.) Per MPR Code Section 3.107, Accessory dwelling units (ADU's) shall not be allowed in the MPR-SF zone. 22.) The road approach permit (RAP07-00004) must be inspected and finaled by the Jefferson County Department of Public Works prior to the final inspection/certificate of occupancy of this residence. Contact Terry Duff at (360) 385-9159 for the road approach inspection. 23.) This parcel is served by public water and a well will not be utilized. If a well is required for potable water the applicant shall meet all of the Aquifer Recharge and SIPZ conditions. 411III .. JEFFERSON COUNTY ,cam soisz .. 7 -4 r, ,S)410, DEPARTMENT OF COMMUNITY DEVELOPMENT A L 621 Sheridan Street • Port Townsend •Washington 98368 `.. 360/379-4450 • 360/379-4451 Fax 461 ,; il-NO' http://www.co.jefferson.wa.us/comrndevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# 0'7— I( PROJECT/APPLICANT NAME: Free -D f}V iS 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. e.-a/r. c4- A- Alew s 12 , Cow iv. .�-eI 4-rt Extrfin.J WAh,e .►. Sewe& nI0..ic_-f- 5T I2JY 1 4A4-t2. ORA-cma.ga + 0i1-c.k .f'(oINN, 6A /clr,J'nr 1.141116. Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. T S lope (2,.rllc s adt.,o.i y -Mr)nek 6,44-/dw,'nv A-10/0,e, Ad r 3. Describe the existing vegetation. Indicate native vegetation areas on the site malAPr RO v Fill rkt si-tt t4A3 f4 S.vvr.!( t'}m-I-• 041 TRees evAriroaftwAilte.plhAW ifr cis 4- 1-• .e t t tQ--1- L°j#c K n-4 L6-4- ftir ; 1 t .,3, pKP tc/e 1 4. Describe the existing soils. Indicate soil type on the site map. FE8 2 6 2007 tJ 4A-;W c 11 t( IFFFEPSON COUNTY L. DEPT.OF OM. UNIT' D `I. PM i 5. Describe the existingsite hydrology SI�,�n'�r F. y gy(i.e.,drainage;behavior of water ors�„-��,ta—a nv�:a Indicate existing stormwater drainage to and from the site on the site map. Depict separate drainage b ins on the site map, if applicable,and indicate acreagea of each. w a I /n e..�r 1 C �1�.Y�K-e Ar�V IU A r �1r 4 0 OiV �1,-‘ R 4 i nr p4.11 a r 2t.c-1-1.( ; nt-1-a -f-k. 5 Ie.&.A10k 6. Describe any excess levels of noise generated by the proposed use or activity: Th-e ...,e 1A.1 ; I( 6-e -I-yp1e....( coMS-f7Zu e floor Al e i s-e dok.2inrJ -+ . c nw 5-1120 c 41 o A.1 . 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 slopes,etc.)on the site. Indicate location on the site map. Ti,,fa '2 RA- /lid S i yfi•icA4-e -Fe kvice c o N {-h-t- S i+ 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.). 11\-"t' L.o-t 1 s b 6 c tr eel >3 y ft $ P R.. Ar7Jd A- 110.c/a-A14-- Leer AC ft..aXs 8 rMldto;ri LAN- +t-tit. eliZ ceitf Ca.&t s-IC/� . pt-T -I-I've.. 8fft- 04- -I-hle Lam-{- th-erzt i s 4 G-2eerkf13e-1+Y 7he.lue 4►2-e Nd rrsi'41ifc/( ilftc. ( aAPet s 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. S T 0A.At 1Jorkg. Witt 6-e. <Itspiseel. 40 eXrS+invA Qi-4-ck u • 10. If the prc6jecfrequites the use of stormwater1treatment facilities, describe the types of stormwater treatment facilities proposed for usp pn the site. ;Locate these-faciF�ties the site plan and differentiate proposed facilities from existing facilities. [This is norm'allSrrfor�iarge"projects or projects that i evolve the potential for dispersion of contaminants.] s h:tatt.'ltL 3 . .. 11. escribe the.performance goali and standards applicable to the project. 12. Describe the flow control system. N/Y� stormwater site plan template—rev.10/1/2003 6 . • • 13. Describe the water quality system. AU/4 -, 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. CA-}— M Y4-4-"CIL.t oL( W (,I. C b� 12-e. 1N a wvd pn-o-+pee.1y !' i t flap poi QP . 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. 18. Describe methods for restoration of the site. Pt-f-t-e 2 e cr mi jrec,-1-1 6 A( {I- Co A 1-k-2+A-t_i^,0 r.i (A!e w i I i Aittiveh co.e °L CenAts ;5f w . -f-G. +k 4. (11C-15(nips)A A0-4 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. NM-. 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 04 o N 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. NDN- 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. CJt'a/Unt L1tV4 ,z (Ai rl( Ie 44'he e24f1ri L..jAi-p. 4 .5 LiArn tAt r !( -b-e ; Ars+celled 40 exisfi�j S k'CVe7 in4-141<e;CA 2. Establish Construction Access. (i( p &J 1/( C ..4 iG h 02(Vf w,4y A-ad i OU3/-i4-i"i /larr k Al veiittc .1- gn -. h.c. li i ( ,b ►9i(cult U( i'rc—C- 0-P 0RtveIk/ y 3. Control F ow Rates. PI 4. Install Sediment Controls. ki e (ni j i( (rJS /( �i l + -Pej <.c As AI eCIp0( . 5. Stabilize Soils. Al/14 6. Protect Slopes. AJ/l4 7. Protect Drain Inlets. nVa stormwater site plan template—rev.10/1/2003 8 • b. Description f special requirements for working in or near environmentally sensitive areas. /U f}- 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). P N y p d 4- i4-t tt_ 1 e &o s tow ta t(2o bfe»vs I.t- CotV-42a(l tea( i'l ( g i I 4 �.vc�e 5. Construction Phasing. a. Construction sequence \l e/Len al. I S F Seq t&,enrc i n[� try ;'i I s' b. Construction hasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. IAA Pc c.-h -14 k 14v s-t II. Wet Season Construction Activities. a. Proposed wet season construction activities. A.1A b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify le 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. Af 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. /l/A b. Diversions. f/4- c. Waterways. Alp=4- d. Runoff/Stormwater Detention Calculations AVA- stormwater site plan template—rev.10/1/2003 10 • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. lU/A 9. Control Pollutants. tJA 10. Control[ae-Watering(the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). et-it 4r \/ 's 14 , tI .6.c. a6,'twd 12. Manage the Project. tJ e. LAI i i( -{-ek 1.4 c Ca a.•e fo. eht z bvg..e Ft-0 12/i Y"'s 14-R e -4a t(yew e d b y I-1 I s cab is 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). NON e— b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). N,/A- 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. Ai tici— stormwater site plan template—rev.10/1/2003 9 • • 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 C tfuction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the b t of Imy knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of th a ecte property. I&./a..8145 c; (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: stormwater site plan template—rev.10/1/2003 12 II •J 1 4N ' (n i >-c 8 ma., X I mry � o, N ; . , : • � .o _ . r I � I - ---T iI ' 3,5"A II..B'15"Vl.oR pl. I I I — 1 1,. I. " \' ' I I I I I II I l I I I II ii I I I I i I I ; I i I --- --- I i I ( H I irI � c • 0 s ,' I (� iS: I --- - --19" T.L1 .012 �GI II'�StLMF412... i I4111111) —� __ f"1 1II.II .,..(r. .:• ,.iY.LN 4er�$ SY11Y k — I I iIII II I I :11L_J I I I I III II I I N\ F m` I Z.m. -- i a I ''.�— I „ !0 a. 1 \ •'& rts , ,f I J ' Ii — — — — �u�c „ ; I. IL 1 I --� Xi i II I i, I:• I 1 :3 u".aw1lr II I 1 • I' I I t. I I :.II � • I 1 I 1I I ! / I 1I�u, I i N-1 !s I 6'h i r u C �(a Ifl I I/ n` N I I SI ���' P � r I I 1 I ) J rA 1 - x11) QL I I1 F I � I, i. �I ' i AV0 w s ICI if II B I r � I I Al r as I. r I I J_ 14n TJI ore f3U 1?�I2 1-1FCi12, I i I i 0 I ( . 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