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HomeMy WebLinkAboutBLD2007-00021 BtILDING PERMIIT APPLICATIO MLA07-00030 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00021 Received Date: 1/29/2007 SITE ADDRESS: BLUE RIDGE RD PORT TOWNS END, 98368 OWNER: KIM J SIMONELLI PHONE: 360-665-5114 JUDY L SIMONELLI PO BOX 725 OCEAN PARK WA 986400725 DISCOVERY BAY RIDGE DIV IV SUBDIVISION: Block: Lot: 31 PARCEL NUMBER: 001305031 Section: 30 Township: 30 N Range: 01 W CONTRACTOR: LITTLE & LITTLE CONSTRUCTION PHONE: (360)385-5606 2009 4TH STREET PORT TOWNSEND WA 98368 Contractor's License LITTLLC157C5 Expires 2/28/2007 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW SFR /ATTACHED 460 SQ FT HEATED SHOP TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,242 VALUATION 300,000.00 ADD'L: 764 HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: 460 CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 17u.D BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 3 Total: 3 Total: 3 Routing Date: l'a q/0/ ---- Type Amount Paid By: Date: Receipt: Approved/Date Permit $2,113.75 CJZ 01/29/07 86997 APPROVE ID Plan Check $1,373.94 CJZ 01/29/07 86997 State Building Code $4.50 CJZ 01/29/07 86997 MAR 2v 2007 Potable Water Application $58.00 CJZ 01/29/07 86997 Total: $3,550.19 Jefferson County Planning &Building Department II Jefferson Cc :ty Building DiMon Permit Num• BLD07-00021 Applicant: SIMONELLI BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2003 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:01)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 j �0,1 ,� V, tom CA1(2-P6qC9CJ-1I./-dQf? Footing Drains l Foundation Stem Wall Underground Plumbing `f /3\0 2 �U1 I Under Floor Framing ks10.7 Rl1SG u r f3E&Wt S ►Z , y E jWJEE& Straps(hold downs) ‘51/crtir Ext. Shear Wall Nailing I 5140P S//d7 ExT /vi4/LIw 6e Rough-in Plumbing 11/23/61 Framing -7/ fi CT� '7 i Blocking l Airseal Insulation:Walls ?Hal - Insulation: Floors &1( b Insulation: Ceiling G-18..C'1 - VAU+oT'I�os Int. Shear Wall Nailing ?IbL /Jr �LYLD ✓��f Ef4PjvJAtL5 _ Wallboard Nailing /5 �p Gas Line: Interior Gas Line: Exterior Propane Tank Heat/Chimney Clearance , , \ Drywell/Alt Drainage Address Posted -, �Gor'r c c sor3 I NS-pv-4,0 L��at�11r Arr w oc�uy � FINAL INSPECTION I - f:i �,+�_ 5 p.1Rs 1 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • A v„soN cOG JEFFERSON COUNTY W DEPARTMENT OF COMMUNITY DEVELOPMENT ~' `4 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment BINp Master Permit Application MLA: 0� -..30 Project Description(include separate sheets as necessary): LA) #1" VA,el Soo p 1,j e w Co kA,S+1rU C �i\1.1— -C-014, !y Tax Parcel Property Number: e'Do I, 3 05- ©3 l Size: G;UY45 (acres/square feet) Site Address and/or Directions to Property: L•.o4- .t 40.� B t e, 14 1 ,1, j2,.Oe , Property Owner(s)of Record: i v"L t May ��J Telephone: 360 C.C.S $((+-/ Fax: email: Mailing Address: ? $eX 7 Z 5 C,Ge.41,%. Pwv14., ( A q is(oLllt., Applicant/Agent(if different from owner): L •f- L.i444 L- LOWS 4-+^V Gk1 G C Al t x L 4 ,c_) Telephone: 3 Co 0 355 ss o i(o Fax: 3 6•c 3b5 7 33 email:of t% e h+fie - I;4'♦IG. tow Mailing Address: Z001 't# ... 5#- 'f�a r�- To w ti � , w,A qEs 36� What kind of Permit?(Check each box that applies) )<Duilding ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑Conditional Use[C(a), C(d),or C]** Single Family ❑ Discretionary"D"or Unnamed Use Classification Li Garage Attached/Detached L Special Use(Es`sential Public Facilities)'* ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑Short Plat** ❑ Commercial* ❑ Binding Site Plan** ❑ Change of Use ❑ Long Plat** ❑ Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Propane ❑ Plat Vacation/Alteration** ❑Allowed"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 ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetaion Request *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 -(Tit 4I171 C, Nit r i,A to ac#,as my agent in matters relating to this application for permit(s). � . OWNER SIGNATURE J; �,� ' � Date: tv By signing this application form,the owner/agent attests that the inf rmation 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 applic 'on that he or sh, a wants prior n ti e. Signature: 1•^,c' (1j Date: (7t 1 Z✓/b1 The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable resp n�ibiilit`y for a hering Ito and complying with the ESA. The Applicant has read this disclai er and igns and dates it below. Signature: J. '�1"2 Date: 01 disclaim tb7 -S t .b re c9t-►6 \) CG ` pc& -9\a -4v 5 K� l7 u — c oayoktpp-)c 2t x5p-cr — yaw .e \.40_4 • ` • • 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: L. i-i4'- + L.. ; 4-4-tt.. Gc,vtsf-b-u4 l-.b--. (3(uo) 313s -.Roo(o 0409)305-9733 MAILING ADDRESS: Zob o` £iPh nf- 'Pr ctiA EMAIL: cif e c I!4+14 - I t +-R-Le .to CONTRACTOR'S LICENSE WAINS NUMBER: L.T1 rL.L.G.. 1S7 ,5 NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: XNew X Wood Existing: PC ❑ Sewer LI Addition Li Steel Proposed: 3 Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: 3 Height: 'Individual System ❑ Repair ❑ Masonry SE P Permit# No • OD 319 ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: 0 Setback: i, Private well I 1 Two Party Ty a of Heat: Proposed: 3 Public LtivEy;e., Total: _ 'ame of System:L 1)D'ts 3 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: ❑Underground Tank ❑Above ground Tank Size of Propane Tank: 0 Heat Stove ❑Cook Stove ❑Woodstove ❑Fireplace Insert ❑Hot Water Tank ❑Pellet Stove ❑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 .q , EH Bid App Review: V.K2- III Sao . toS 2nd Floor Heated Consistency Review: 153 Other Heated ��4� Base fee: S 4b0 91, , a). II31 Mezzanine Additional Section: 4-__-_ �{ Heated Basement Plan Check fee: I ( 313 .54 Unheated Basement State Surcharge fee: 5 O — Other Unheated Pot Water Review fee: oO Garage/Carport SUBTOTAL 30(e .1 °' Decks C 911/Rd Approach fee: o 0 Other TOTAL: $ 3158 2Z-17 O'„ Receipt Number: ^,g(D�-1--A -- !/ ` ¢ash/Check Number:— ,40 1 ES�A'rth COST(REQUIRED)'_, Date: ' a ,' of IH�� ` b Ztlli/ •F ' market value of all labor and materials undation to finish I I at4(Q1 A 3�C, I Initials: Crli • • CONDITIONS for Building Permit# :BLD07-00021 1.) H-PRIOR TO OCCUPANCY, FINAL APPROVAL OF SEPTIC SEP06-319 IS REQUIRED. 2.) a) 10' SEPARATION REQUIRED BETWEEN A WATER LINE AND ALL PORTIONS OF THE ONSITE SEWAGE SYSTEM; EFFLUENT TRANSPORT LINE, TANKS, TREATMENT AND DISPOSAL COMPONENTS. b) MUST COLLECT AND DIVERT ALL SOURCES OF DRAINAGE AWAY FROM SEPTIC TANK, RESERVE & DRAINFIELD. 3.) The application was reviewed by the Jefferson County Department of Community Development staff on February 20, 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: eagle; landslide hazard area 1; SUSC aquifer recharge area. 4.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 5.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 6.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. 7.) 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. 8.) The applicant is proposing to create or add 2362 square feet of impervious surface and 7900 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. 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.) A Stormwater Site Plan has been submitted and approved by the Department of Community Development. Once the subject permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 11.) 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). 12.) The site plan as submitted with the building permit application on January 26, 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 20, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 13.) This approval is for a single family lidence with attached shop only. Any futur•rmits 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. 14.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 15.) 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. 16.) 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. 17.) 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. 18.) Maximum lot coverage is not to exceed 25(Yo. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 19.) The building height is not to exceed 35 feet. 20.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 21.) The lot was created through the Discovery Bay Ridge Division IV Subdivision on December 19, 2002 under AFN 463697. 22.) An address of 453 Blue Ridge Road, Port Townsend has been assigned to the parcel. Blue Ridge Road is private (P575). 23.) A septic permit (SEP06-0319) was approved on November 9, 2006. 24.) The parcel is served by PUD #1 public water. 25.) The proposal was not sent to WDFW as the proposal is greater than 2000 feet east of the nest and is not shoreline property. 26.) Per letter dated October 10, 2002 from Ross Goodwin, DNR forester, the county typed streams are not considered typed waters under WAC 222-16-031(5), but are more likely considered draws with no connectivity with Type 1, 2, 3, or 4 waters down stream. 27.) The location of the proposed development is greater than 150 feet from the nearest slope. The location of development is approximately 105 feet east of the road and 16 feet from the southern property line, between the 340 and 330 foot contour lines. •gONO II 9 °� JEFFERSON COUNT`r tikip DEPARTMENT OF COMMUNITY DEVELOPMENT • 621 Sheridan Street• Port Townsend •Washington 98368 �� O� 360/379-4450 •360/379-4451 Fax _1s v LO`I_-N , kN� http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# PROJECT/APPLICANT NAME: 1 W1 •}' j c 45 1 IN O b$G 11 I j Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a separate stormwater site plan map. Project Overview 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site map. 1.a C+w Co tA,6{wsA"4b t". o c" t S i vl)lrc.. G 40r1:!y '-c s'tia N K- Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. .S:A-L. Utc.,s ti. �ntaty %l b i }�- Gev..•4;K u o5 5/c pt. R L.) 4- +.. �••e+5 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. L_ ` SS i 4'4-• I.$ C.C9 V G�'+�r _ 61415 Fs'-.) Ka �•1i C. S.L 7(.0V. -2%11100% 4. Describe the existing soils. Indicate soil type on the site map. 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. ©✓ -CIO ws c�v• •f 41 S v,7e_ ca .P 114-ue— rA n fNf © GVb3io 6. Describe any excess levels of noise generated by the proposed use or activity: APPROVED "Uu v khN,Ass 6�,,A54--yu44 4.� 4STORMWTER PLAN 11.1 F E B 2 0 2007 Stormwa r stormwater site plan template.doc—rev.10/12l2003 Require ../ JEFFERS OU Y 5 DEPT.OF C , I DE E P .NT SIGNATURE • . 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. 1.51 - 2s , S l na is o„ . r+6•. c46.+- 7/3 0 :G 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.). 11A, ►5 s i f` .1a e�. C..a....?o-•s..,{- e c- 4- t)s c.o vc,....J B..y -:ct 5 _ Stt 1644 it) i S►'e lotGL Dt1 A c4 •.,I- L 4 otot, �; tr S J LAN T'A( Gy'• T ✓ I4c 4 [I Ti•1l1-...es. /•A. Pl4GA- 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.] 1 ✓ ' 11. Describe the performance goals and standards applicable to the project. '-"rc C c �r o k�eL a t t ds t--- we..'- ,-- 4or,.,Apt 6,A;lei ;.441 OC /�^s► I✓A ! ✓ 401.01 Of 00t14pc b-S - 414+.I.v)1. (. w e .GW ,5 I.'rns arV vva I( o be `'o. pi t i-rA,4^r1hti 4-1,01.4%.aiN. 12. Describe the flow control system. L, S t�r C.cr L.A., ✓' CA,,"/( 17 .- r4%✓'�G .IL` A[ ,,,,e.e./..,hb..., 40444404.1 17.15 v•c" t.Uu. r w+ 1 l bee- c.-o I L c,k -( G.4.,[ u• --- S i / 62007 I stormwater site plan template.doc—rev.10/1212003 t j A N 'b�_.) 1 4 Ji_V 4.O iEnfj • 13. Describe the water quality system. 14. Describe the conveyance system analysis and design. 15. De be the source of fill materLahysical characteristics of fill material,and deposition of excess material'iV4 ci..-. Of''2 0441 l''‘.A I - 6 I.>;/t./,i? 7.4 i 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. 'Ai 4 G"oveart.t 18. Describe methods for restoration of the site. GLi44 to %.1 rc�4,rr vA--c.1 -4-t) 4-1.,m_ Czyvikok 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. PI A 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 1...741►1^,..4_.. 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. -�-- ---------- ---\,, 1 pk-‘h-4-4) 1- r ti JAN L 0 200i. ft ` stormwater site plan template.doc—rev.10/122003 i I 7 j ''tltl+)L.i NT.J • 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. 5-�►1�-c5 t �la�S 2. Establish Construction Access. 1 3. Control Flow Rates. w 154.% c.._ 45 V e,3 v I rt,4.4, 4. Install Sediment Controls. 5. Stabilize Soils. 6. Protect Slopes. -, S ✓e, v i vs,..( 7. Protect Drain Inlets. L 6 'OG i l stormwater sfte plan tempfate.doc—rev.10/12/2003 ._6 • • IIII 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. 9. Control Pollutants. 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 15iA 11. Maintain Best Management Practices(BMPs). 12. Manage the Project. 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). LL CA— b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. r ` i stormwater site plan template.doc—rev.10/12/2003 j 9 1 • • 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).L i `.l. T Y'V-1"C.CiT 51 oF-c._ e s wI %AA 1 -E- P't K 5. Construction Phasing. a. Construction sequence 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 proposedconstruction schedule. ter14 '" I..)OV svw ' JEltitr— II. Wet Season Construction Activities. a. Proposed wet season construction activities. /'+ s J+.' C.- l r✓jp I L- I"- ✓vb�+6�7+1 , "5t,�'�'t.t,... 7.'.?'ai PO4 /CL[ `v r•,�-k 644 I pi j vraw I G;(iS f?✓r16�K(*IL. J 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. b. Diversions. c. Waterways. _ d. Runoff/Stormwater Detention Calculations 1 l ut r i' JAI �. b �UU, !�_% { �. stormwater site plan template.doc—rev.10/12/2003 __' lo JC�h�I s...i I,',Cn� • • 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 inducie 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 R AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: ( I 'I 7 2 6 e:0u l i stormwater site plan template.doc—rev.10/122003 f "i2 T T: T" 'S.. \ l U \ z \ r�iQ \ 1114.. �� \ \ \ tr .....„.., N,\ \ ` \. — \ \ \)7% .,,,. o ` \ ` \ ,/ ....... '"*".....„, \ :*' • N * \ TvOl 11 ` a,-._,: CI ) • 1U.) 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