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HomeMy WebLinkAboutBLD2007-00194 MLA07-00221 OILDING PERMIT APPLICATI. Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00194 Received Date: 5/4/2007 SITE ADDRESS: 501 N BEACH DR PORT LUDLOW, 98365 OWNER: DALE K FLODIN PHONE: 206-542-3319 PO BOX 11293 BAINBRIDGE ISLAND WA 981105293 BRIDGEHAVEN DIV. 1 SUBDIVISION: Block: Lot: 12 PARCEL NUMBER: 933900014 Section: 9 Township: 27 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP FOUNDATION ONLY TO MOVE EXISTING HOME TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 836 VALUATION 21,736.00 ADD'L: HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: # OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 2 Exist: 1 Prop: 0 Prop: 0 Total: 0 Total: 1 Routing Date: � 11� sag CZ_ Type Amount Paid By: Date: Receipt: Approved/Date Permit $349.25 LYK 05/04/07 89745 APPROVED Plan Check $227.01 LYK 05/04/07 89745 State Building Code $4.50 LYK 05/04/07 89745 Total: $580.76 JUN 2001 Jefferson County Planting & Building Department • • CONDITIONS for Building Permit# :BLD07-00194 1.) The application was reviewed by the Jefferson County Department of Community Development staff on June 11, 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: suburban shoreline designation; seismic; SUSC aquifer recharge area; coastal SIPZ. 2.) 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. 3.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 4.) 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. 5.) 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. 6.) 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. 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.) 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. 9.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 10.) The applicant is proposing to create or add 836 square feet of impervious surface and 856 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require your proposal comply with Minimum Requirement#2 (Construction Stormwater Pollution Prevention) of the Department of Ecology Stormwater Management Manual for Western Washington 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. 11.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP) Elements#1 through #12 of the Department of Ecology's Stormwater Management Manual for Western Washington 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. 12.) A Stormwater Site Plan has been Onitted and approved by the Department s 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. 13.) 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). 14.) The site plan as submitted with the building permit application on May 4, 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 June 11, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 15.) This approval is for a foundation only to relocate existing house on parcel that is within 200 feet of OWHM. 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. 16.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 17.) 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. 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.) Residential developers and individual builders shall be required to preserve shoreline vegetation and reduce the associated risk of erosion during construction and any future activity which may impact the stability of the shoreline. 21.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 22.) The building height is not to exceed 35 feet. 23.) Minimum setback from North Beach Drive right-of-way shall be 20 feet. Minimum side yard setbacks shall be 5 feet. Minium rear(shoreline) setback shall be 30 feet from OHWM (existing bulkhead). 24.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 25.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 26.) An address of 501 North Beach Drive, Port Ludlow has been assigned to the parcel. North Beach Drive is private (P112). 27.) The lot was created through the Bridgehaven Division1 Subdivision on July 10, 1964 under AFN 180279. 28.) The site is served by Bridgehaven Community water. 29.) An EES of(SEP89-0183)was co ted on June 29, 2006. A septic permit (SEP07 0144)was issued on June 2, 2007. A SDP Exemption (SDP07-0047) will be issued with the building permit. Jefferson County Building Dillon Permit Numb. BLD07-00194 Applicant: FLODIN 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/:2/67 Foundation Footing 4/.%7 d� Footing Drains 7/3j 7 9L Foundation Stem Wall 4/2-1(i77 Insulation: Floors 9/ / (iv n!� FINAL INSPECTION I :ill 1' FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR AA 120 qmp .4411Q , OK of(4 (Di . 0/A .piClpA Z�� OK _ + U _ 1—,„s0.IV 0�� JEFFERSON0UNTY • ,\ DEPARTMENT OF COMMUNITY DEVELOPMENT 1-' ' `-4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax f' 'f - ,, , 0 www.co.jefferson.wa.us/commdevelopment Orl Master Permit Application MLA: ,\ ,-, , Project Description(include separate sheets as necessary): `•4OvIC KOk.• ,r{ fs' T ire.S'r- . P---6Ut--x7z-\-r(c,J i�/-\,-1 (�A-� Tax Parcel Property Number: 1 S S 9 (9''2=:)i 4 Size: (-Po' x. I OrS C0' 00 11 (acres/square feet) Site Address and/or Directions to Property: trt?i H, G1-1 tPf2, Property Owner(s)of Record: \.-0 ' 1:7 h L Telephone: '20 cro 1Se- teG�2.-1 Fax: email: Mailing Address: P,o, x I/1 3 re,A-I+-te.cl rx, I> wrs. zi 1 Applicant/Agent(if different from owner): k 12►L ,i c,k i« Telephone: 3c'c� 5 S 4.,, 4c Fax: email: k2�c-i/-McT --,J,zroeS'T NLT Mailing Address: What kind of Permit?(Check each box that applies Zuilding ❑Variance(Minor,Major or Reasonable Economic Use) emolition Permit ❑ Conditional Use[C(a), C(d),or CI** Single Family 0 Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** 0 Propane 0 Planned Rural Residential Development(PRRD)/Amendments** 0 Sign 0 plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 2-Shoreline Master Program Exemption/Permit Revisions** 0 Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance ❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium 0 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 C,1 /C to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE e- j' s'-- - Date: 9 - 3 ' - c' 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 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 applicati that he or she wants prior notice. Signature: J, .r�� — 7. --e"-�--•, Date: `f _' - -2 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 ponsibility for a$lheri to and complyin with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: ���� /_�� `� Date: L/ ' �� `y ei -� G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2000.doc • BUILDER STATEMENT • The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming.tti si ility of the General Contractor for the proposed project. /. y Signature: ) Date: l% (\' (4-( 7 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: K 1 21G- eA(I4'- PHONE (1.'o ) 5 435 C,i 40 FAX: ( ) MAILING ADDRESS: ij-6cCDI M/1.2 CZ,a.1 �T , PT', ag3c,8 EMAIL F-2.0 -t I+,-c,,-r-(,?? c t.1r'-i3*7-c,,,7 NET Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New X Wood Existing: I ❑ Sewer ❑ Addition 0 Steel Proposed: O Bank Li Community System ❑ Alteration/Remodel ❑ Concrete Total: I Height: g Individual System �{� ❑ Repair El Masonry S' SEP Permit# C l/d-4' ❑ Demolition ❑ Other: Bedrooms: Water Supply: • tZEL oc.- r . Existing: 2 Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: U 0 Public Total: Z Se 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 / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: I Underground Tank Above ground TanP Size of Propane Tank: I Z- C4AL- (Zri_i_ X.4s,-trr__ C. I Heat Stove I Cook Stove 1 Woodstove I Fireplace Insert I Hot Water Tank 1 Pellet Stove 1 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 0 (..e, EH BId App Review: lS 2nd Floor Heated Consistency Review: 1 53 Other Heated Base fee: 3q 1 ab Mezzanine Additional Section: Heated Basement Plan Check fee: o I Unheated Basement State Surcharge fee: Other Unheated 20 o Pot Water Review fee: Garage/Carport SUBTOTAL Decks .e1�}ecl Co {Q(a� 911/Rd Approach fee: a)C C6'. Other t=c a ,��,� '3c' a�4�3�0 TOTAL: $ QO 1 n ca Receipt Number: S6t 1 c3 Cash/Check Number: ' taxi 6 ESTIMATED COST(REQUIRED) Date: 5 41 01 ' r 'Fair market yalue of all labor and materials foundation to finish Cz� Initials: `%i . MAY �� . u; G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc 0 • t JEFFERSON COUNTY _ MAY - 4 2007 Rom)' 4 DEPARTMENT OF COMMUNITY DEVELOPMENTTY _ I 621 Sheridan Street • Port Townsend • Washington 98368 :/cbriQpf,1ENl 360/379-4450 • 360/379-4451 Fax a' http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# I ZZ PROJECT/APPLICANT NAME: L.CO tZ) 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. Hove C E) 6,6ef1.-( < I S' Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. FLv r rf 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. GRessSS 4. Describe the existing soils. Indicate soil type on the site map. °e t rI t' 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. n'IJ VJtsT�f . - 1Z.4,OF - GtUTT J - OOLJ SW - Cft-A -t t CC)C.ICS - 61(2ASS- 4701 I — W/_�-vrc TA6c.-cC - 'E`1/ (7.Gx-r-roLi - YZ2P�T� APPROVED 6. Describe any excess levels of noise generated by the proposed use or activ-ty: STORMWATER PLAN Stormwater :� P JUN 1 1 2007 Require K ) JEFFER 4iENT DEPT.OF I stormwater site plan template—rev.10/1/2003 SIGN AP. E: 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. No 1- 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.). 14-- 12.- }{OOt7 66-N6,L. 114 12Ss1D -.1T1Ai.. 1-IEIG1-I Zl-loop 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.] WIL 11. Describe the performance goals and standards applicable to the project. `-7 ITV- I P4c1" AS (-(T11-T- A5 1o55181z 1 7 Des-6 jibe the flow control systgm.""'- "' .;. ,: 'x l�fz 1—V`C t;`f, 8,-,/5' ) KJDT f=>✓C-C I"6 ( tz.•) ' c.otk) r s # Tk!-If".: .a" r. 10 1' 'fF sto nwater•siteplan template—rev,1 WV2003 . .« Y 41 6 • 13. Describe the water quality system. vfZY 4. JtL MAY - 4 200 . ,ln DF`.'FLOPMENT 14. Describe the conveyance system analysis and design. GtOrr t5 bo-3ws9oJrS -(o S scf �vc_�cs 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. WA 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. tso F r C 17. Describe the proposed surfacing material. Ca R.A55 18. Describe methods for restoration of the site. eee. C�20k,s1i `zo(7 4,EO? 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for large"projects only and only those for which facilities are required to control flow or treat runoff.] If included,list the Manuals here. 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 4 lA 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. Z2a.AIL k• P(0A143 storm water site plan template—rev.10/1/2003 7 • • CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP) The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential development. SECTION I—CONSTRUCTION SWPPP NARRATIVE 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual(beginning on page 2-15). 12 Required Elements—Construction SWPPP 1. Mark Clearing Limits. 2. Establish Construction Access. 3. Control Flow Rates. 4. Install Sediment Controls. t4 JA 5. Stabilize Soils. 6. Protect Slopes. 7. Protect Drain Inlets. 0/4 stomiwater site plan template—rev.10/1/2003 8 • • • _ 12 Required Elements-Construction SWPPP(continued) \-7....„)1 � 4 ` 'I � MAY 20iii } 8. Stabilize Channels and Outlets. ..� 1 1 WA- -J I )w!`l' �at�tEt�Y _�__i� 9. Control Pollutants. 1400-sE 14-1 )(ktArr( 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). NA- 11. Maintain Best Management Practices (BMPs). 1i0131-g„6,c,-rvrZ .-t , f.crs,3Oc,r,____ 12. Manage the Project. G76,ftt AS to 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). AP3tu is 'n 5t-tag.c. t.l Jt£. Mt ti+, I M PAct' Pd >; `rz: NATUi (9F L)ORk<- eaOP+oS2o 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. AD J . 10 S_.toot=> GrA L, stormwater site plan template—rev.10/1/2003 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility,settleability,permeability,depth,texture,soil structure). 5. Construction Phasing. a. Construction sequence /,-c-p.•s ATE- t R ►-3 c..w FoU c T(O1,1 , Mom 04451"-I-1-tD routooL t-tv�� b. Construction phasing(if proposed) S, 1 Mou-t-N 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. II. Wet Season Construction Activities. a. Proposed wet season construction activities. b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. 7,,t1L4. v ©pt tit 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 stormwater site plan template—rev.10/12003 10 I S Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan,the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems,treatment facilities,flow control facilities,or structural source control BMPs (not standard on-site stormwater management BMPs),the applicant shall submit a final corrected plan ("as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. 3 I.-(Ar 01 DOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED: D R., � I MAY - 4 2007 ' I JiTY . • DEVELOPMEN1 i stomiwater site plan template—rev.10/1/2003 12 [ i !.. •• •-Nlc:1 H-7‘,e-.z- cl ,•1-. V .._,,,• .,•,,,....:I, ‘•,,- •=,..) t ....... -;,..;;•y- t •, „...,, ,.. (, . L11 , _ C.? 59 ....---.) i o 7.--) p--- n i-A 1..)v,..4 eiii:.71".?-21--)-5 rf 0 !V -21-V vd -Pi_) 5 ac C) .1 ' -x lo-71-21.0 n 0 o pi ...6a sa-• t 1:•:1-1-- 1,,i 1;3.1. 71'..1 ('. ) 0 11 icii- aLT H 1 . Ili.A..... .....illamaimmemaa.....r... . \' ..• • i 1 1 ' ' tli \ • n () 1 1 ------- - ---- ---- --- , 1 i • I i ,2/ I 1-4 -6 --() i 1 i . , .111 0, . IV,\ 0 1 - r---1.-------t 11 ,.. I '1 1 ill 13 IP-- .-- Qi ,v. r , 11 _710 I r9 '5 `..1•N0?1A z, . 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T, 2 Co fp ❑ APPROVED AS SUBMITTED o __.I _51Ntt'SoN �G[� C2) �a, JOIST, APPROVED AS NOTED � CANT. _ - ❑ REJECTED Uj i'; T. 4�4 (MI�J,)=�aH7iNIJcxJS 2*-} 4J?LL_ W/ _ J 51Mp�o1l r,-r. 141- c< 4K} D.�4: Dates-I-01 Reviewer Wf P15 4 A JalsT W/ 51HP5014 PI3S4'f� LL, a �OJ� NOTICE. Plans are approved excepting ttJ any errors or omissions. All work must b D ➢ pass Inspection in conformance with ®2) # 5 GbFIT, .I': applicable codes and regulatiors. PEi2p _ - I Contact the prior BuildingDepartment PL® por at 379-4450 prior to making changes changes , Ili' . - __ 1.4" — IrD or revisions to the approved plans --- AS SHOWN �K Ir-1�rc c 71N64 �� �c�L�rz cyan =+ i�Ir�I�vN vT ING 22 APRIL 07