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HomeMy WebLinkAboutBLD2007-00215 GILDING PERMIT APPLICA1N MLA07-00242 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00215 Received Date: 5/14/2007 SITE ADDRESS: 770 QUINAULT LOOP PORT TOWNSEND, 98368 OWNER: CAROL WOOD PHONE: 805-644-4312 JUDY DAHL 2371 HYLAND AVE VENTURA CA 930012403 CAPE GEORGE COLONY DIV 4 SUBDIVISION: Block: 11 Lot: 20 PARCEL NUMBER: 938701119 Section: 12 Township: 30 N Range: 02 W CONTRACTOR: SEVEN BRIDGES PROPERTIES LLC PHONE: (360) 379-4947 PO BOX 1953 PORT TOWNSEND WA 98368 Contractor's License SEVENBP983JD Expires 6/24/2008 REPRESENTATIVE: NEIL CAVETTE PHONE: 360-379-4947 PO BOX 1953 360-379-1750 PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOI NSFR W/ ATT GARAGE & (2) A/G 120 GAL PROP TANKS TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,564 VALUATION 342,160.00 ADD'L: HEAT TYPE: RAD CODE EDITION: 2003 HEAT BASE: 880 HEAT TYPE: OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: 576 SETBACK: DECK: 580 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: CAPE GEO BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 3 Prop: 3 Total: 3 Total: 3 Routing Date: Type Amount Paid Bv: Date: Receipt: APPrOVED Permit $2,354.55 LYK 05/14/07 89943 Plan Check $1,530.46 LYK 05/14/07 89943 JUN �� � State Building Code $4.50 LYK 05/14/07 89943 Potable Water Application $58.00 LYK 05/14/07 89943 Jefferson County Planning Total: $3,947.51 &Building Department Jefferson County Building Dijon Permit Numb" BLD07-00215 Applicant: WOOD BUILDING PERMIT INSPECTION APPROVALS kpplicable 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 "7/4 0" Erosion Control Foundation Footing -1/2/1-7"7 - - +uFc2 Footing Drains Foundation Stem Wall / 1-q I� r-�, C Jt' d,L Underground Plumbing 7 Zsley? 9`—' �I Under Floor Framing J Straps(hold downs) Ext. Shear Wall Nailing 1, 11 ;�� *� ;� i c'c. ✓'� Rough-in Plumbing --z 2_c-(f7J ✓%- fit -r.-rv4s sL.-A-12, Framing tO-1 om._`7.1 (� ' Airseal OZ", �,u)) I , -fir- [i7 � Insulation:Walls / Insulation: Floors 7(Zt c7 > - 31.-A ) Insulation: Ceiling Int. Shear Wall Nailing Wallboard Nailing I�,,Zq_07 Gas Line: Interior tt Gas Line: Exterior •%.i, .y — Propane Tank Heat/Chimney Clearance • Drywell/Alt Drainage Address Posted FINAL INSPECTION .5 'ty-t' FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD07-00215 1.) The application was reviewed by the Jefferson County Department of Community Development staff on June 13, 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 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.) 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. 5.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 6.) The applicant is proposing to create or add 2663 square feet of impervious surface and 10,400 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. 7.) 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. 8.) 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). 9.) The site plan as submitted with the building permt application on May 14, 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 13, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 10.) This approval is for a single family residence with attached garage and two 120 gallon above-ground propane tanks 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. 11.) fiOutdoorsafety residentialhealth storagesanitary shall b f aintained in an orderly manner and shall ote no re, , or 12.) 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. 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.) 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. 15.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 16.) The building height is not to exceed 35 feet. 17.) Minimum setback from Quinault Loop right-of-way shall be 20 feet. Minimum side and reary yard setbacks shall be 5 feet. 18.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 19.) The lot has been designated as RR1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 20.) An address of 70 Quinault Loop, Port Townsend has been assigned to the parcel. Quinault Loop is private (P138). 21.) The parcel is served by Cape George water. 22.) The lot was created through the Cape Geoege Colony Division 4 Subdivision on August 8, 1961 under AFN 169199. 23.) A wet-season evaluation (OTH03-0013) was finaled on April 19, 2004. A septic permit (SEP04-0187) was approved on August 30, 2004. • 35- i(qz al Qu ik-/), . ... APpROVE__ l Loo ' SITE PLAN _ -- A-rpF-ax JUN 1 3 2007 �—__ tis sue,_ P . GNT `% 4 C Sb t I JE ��+ 11));IiiimENT U. �. Fow&lzDEFT.OF 'r■�l ..SIGNA r_ jY /I' lr ,��` Wllll b �1,4 ' u(),MoNtT`( - . ( za l /1) Stormwat • c Require ' ;4.,-.-,'.....,'j•- \ • it$'1 6"`r 1, \ r /h� S` _ f / /V„ V 1 <2.-- --, I Vet os(r O '-1 r ' ' t .. ,,.1 .: A.,Li' 'si-Lri ;„,,,, ,-,:, .,., ,. . -s. . N ';'•e"- ' - ,- 4, 141,11:.:': ::.!,.:1,4'.'.''': ' : - -': 'rlf. , s' ...____,... „...„,..,.., . \ �, S p� ,_ -_. F y L ry I _ t KA1E 14"! � E �tha iI PO' ~ �. , ga rv• Pr °a 5k' �# kx ,,, • 4tf•tt,rl/-ti, t-1 Et i ,.- �� Jtl-t-tKSUN N I T (W� '410DEPARTMENT OF MUNITY DEVELOPMENT ti `� 621 Sheridan Street•• Port Townsend ••Washington 98368 lo 4,, ,� _ 360/379-4450 • 360/379-4451 Fax. 1 p� www.co-jefferson.wa.us/commdevelotent bTIN� Master Permit Application MLA: cr? ��,/ D Project Description (include sep rate sheets as neces ): `f t�C�C� � a � Tax Parcel 2 ,r1 Property Number: 1 J R 7(/ i 1 I q Size: ' R)MD (acresuare feet) Site Address and! r Directions to P operty: 7 NV- 1 it ili (1- .0-1 Cato, Iv,* Property Owner(s)of Rec'brd: C.. 4. 4- Si # 6dA (q Telephone: — D I Fa : .3 / 3 4 . ` 3 / email:/�S11/f la CcI/r1 ✓CA`s?1 Mailing Address: 6 . / iv, F l 4¢G' ---� Tf/l4 Cam '. 13a,5 Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: Wh and of Permit?(Check each box that applies oreBuilding 0 Variance(Minor, Major or Reasonable Economic Use) 0,,Demolition Permit / 0 Conditional Use[C(a), C(d),or C)** E/AiSingle Family f(j Garage - • /Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use (Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment O Change of Use 0 Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** ❑ Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign 0 Plat Vacation/Alteration** 0 Allowed"Yes" Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance ❑ Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment 0 Wireless Telecommunication * 0 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: 0.4 _i DESIGNATION OF AGENT I hereby designate 1f/L�•ZL 64 f✓ to ct as my agent in matters relating to this application for perrnit(s). OWNER SIGNATURE 4 _ Date: 57(///e 7 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 Jeffers() County as a result of or in consequence of the granting of this permit. I further agree to provide access -nd rig •f e. • to Jeff •• •• its employees,representatives or agents for the sole purpose of application review and an required later- spec taff's acc-- -nd right of -ntry 'II be assumed unless the applicant informs the County in writing at the time of the .•plication . a or /rooj - is pr•. no' - AC. Signature: /J • - _ Date: The action or-actions A.• '.•=fit will un•= ake 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 ES s. - y individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are,i.•complia • the J- = on Coun •- elopment code.The Applicant acknowledges that he,she or it holds individual and non-tra sferabl- - -ponslbi:,�o -dherin• a d comp w'. the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: � Date: /� .• D 7 / l/' !p or/7—fr — G:\permitcenter\###FORMS'###\DRD FORMS\Master Permit Application 12-19-2006.doc •d neir_gin_ngr_ T ao<q.aneo IT au d6S :L0 LO 0I ReW • 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: GE RAL CONTRACTOR O�ANUFACTUf��OINE����� � �� PHONE:) ^, (F�' ) ���_�� r/� .. /6 T J _ �/ Y/v/l 3 7G� L(4 t7 3W 50 MAILING ADDRESS: �q 5_3 f 7- 1 � ws„,ml.i EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: S6 Ube 1\ i CJ 35,6 NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Fr a Type: Bathrooms: O Shoreline: Type of Sewage Disposal: ki New Wood Existing: II Sewer ❑ Addition ❑ Steel Proposed: Bank 0 Community System IIIAlteration/Remodel ❑ Concrete Total: a, I Height: individual System ❑ Repair ❑ Masonry SEP Permit# 04(-00/47 Li Demolition ❑ Other: Bedrooms: Water Supply: Existing: 'U Setback: ❑ iDrivate well ❑ Two Party Proposed: B'Public Typg of t>1eI 4._ Total: 3 Name of SystemC9(\.O 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 i Above around Tank• Size of Propane Tank i/o� i Heat Stove i Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes /l./ When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size, distances from the propane tank to all property lines, buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated I SO I4t i8159 EH Bld App Review: , c 1 Consistency Review: 2nQ Floor Heated I Other Heated Base fee: a 51. Mezzanine Additional Section: ..---- Heated Basement U ° IQ '214g6Ian Check fee: i i5" •� o Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: /3 Garage/Carport 5-.�r '�S1( SUBTOTAL l e)1 Decks ,(�- O `3 Al0(QP 911/Rd Approach fee: Other TOTAL: $ 41.355,9 14/ 30a(4. eceipt Number: 1q-45 Cash/Check Number: //l __ ESTIMATED COST �}— ► Date: 1,i l .Fair market of all labor and materials fot7► ation to finish '1 3 jA 1 I j O a9 Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc • • _ .; ici ti I 1 it gel JEFFERSON COUNTY al '` � +a1 DEPARTMENT . ., o ►� OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Washington 98368 �l t a O 360/379-4450 . 360/379-4451 Fax t *P . `d. ,r j,_ N http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# - (94a PROJECT/APPLICANT NAME: D/Cid k I ("Jac( Oc( 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. ON S FdZ o-y\• 12 aV � Xd/ i Existing Conditions Summary 2. Describe theAstin raphy. I i to contours on the site_Qap. n .ts /---7tali-.. N z...._ -7;,, 0 3. Describe the existing vegetat' n. Indicate native vegetation areas on the site map. o�YUtl 4. Describe the. xisting soils. Indi to 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. IV f 5 ND rl-a'vva APPROVED 6. Describe any excess levels of noise generated by the proposed use or activity: STORMWA 1 ER PLAN NDivy JUN 1 3 2007 Stormw• - : ts, DEPT.OFC., Alkk t V • ►I;V, ►PME T Requir-d 1II�r SIGNATURE 2131".�. •/ _ stormwater site plan template—rev.10/1/2003 L.,. -_ : 5 • 41 • • 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. A/©/1/6 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.). , PVs f �� 4l 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. f'W S FeY> uitJd I( 6-e ' ) t S4ifiztAl2 ( c),A lrapPivf-`-f 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 applicable to the project. tS tra-i\idAT d 12. Describe the flow control system. -47Y + 7 .1 stohnwater site plan'templat9=rev.10712003 .... 6 • • RECEW1it �� 13. Describe the water quality system. ru 6 IfIc to o JETIEHS1P, MIND Kb 14. Describe the conveyance sys m ana ysis and design. Gulfr 8 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. Allirg 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building'Code. il /4 17. Describe the proposed surfacing material. U 4 5 p tt4( 18. Describe methods for restoration of the site. AWM) (L6 1 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 prep e the Stormwater Site Plan. fl 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. /V- stormwater site plan template—rev.1011/2003 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. !V /-1416 // ‘0441 2. Establish Construction Access. • / / O �51 L.! 3. Control Flow Rates. /1/4 4. Install Sediment Controls. 7/0 5. Stabilize Soils. 6. Protect Slopes. 7. Protect Drain Inlets. /4//4 stormwater site plan template—rev.10/1/2003 8 • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. /1/A7 9. Control Pollutants. N/4 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 7111/1 11. Maintain Best Management Practices(BMPs). Cjl 12. Manage the Project. 7 mil/ OU, , ay- f eft 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance ( •g•, stre ms, lakes, wetlands, residential areas,roads). / /26a1 / / b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). V 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. 7N 6 stormwater site plan template—rev.10/1/2003 9 • • . b. Description of special requirements for working in or near environmentally sensitive areas. /.11/ 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). W ( 5. Construction Phasing. / a. Construction sequence .,.:�? /` 5() y b. Construction phasing(if proposed) r 61-- oc_4olpek 4 ) 7 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construct n schedule. A IM.shet II. Wet Season Construction Activities. a. Proposed wet season construction activities. /0 A' L b. Proposed wet season construction activities for environmentally sensitive areas. , AleN ,6. 7. Financial/Ownership Responsibilities. a. Identify he pr perty owne responsible for the initiation of bonds a and/ r other financial securities. NV 4_ b. Describ bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. cl Cff\ ra I 4. 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 All 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. : o ertify that this application is being made with the full knowledge and consent of all owners of the aff- ted prop--of tr, lam'.— 7 (LAN :,/rE- •' • J- ZED EPRESENTATIV SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: stormwater site plan template—rev.10/1/2003 12 s s 1 ri; i • :3m i _ t D ° 1�`" 'N ' SG -o" I z.4-0" 3L-o` r� i • _ , - sr 0 . i . 4-0- / " gd0 cZ ' a4 � p v ;IL 8L.°O� HIGH CURVGO - i IN 6Abrc � ____G•Z• Pw 1 �' t ���;s -4- .�...?..2v u5 S',r4• 4.3•x0 _ : .. • T I 15 mY - e® - C� P*� o c I£e`IP % / 3b.�� ry. r I% _ , t �,, w Z ��. npc•ti.C. $ 111 ` is IT P I o I• -..__� }{ - I s ^Iti ` 2" O* S IS ois_u N-\' I. w • I,t�I, 7L~ I . `1 I a II I --- _Tt_l.tc 1 S t } ' c�'i.x -. r N -1.3 i ' w 2, cz'v• r=o" r j'1SSi':cr �--c 1 6` •� d L-2 9 gym£ c o c I r'_ c� e G i -0\ c '� - I \ 4,1 cid Q. �'C y G I 2 'a @ ry vhv f I«r i O "' ®.. m• tr !t,.tz onz I`^TMixt ;21Ii ;-. •F S s`o ,. 0-,AO. \ T4'S°xdl t, ,;£� �i r La I r Ire FY a s 1'' •N\\ O - Fs • s - i- -yam --< ;.vz- --' o.�--r - -rc-- t`�;... 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