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HomeMy WebLinkAboutBLD2007-00227 MLA07-00247 Review Type: I MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00227 Received Date: 5/14/2007 SITE ADDRESS: NELSONS LANDING RD PORT TOWNSEND, 98368 APPLICANT: JOSEPH W CLOUSE PHONE: (360)301-1975 DARCI J CLOUSE/JUSTIN 352 NELSONS LANDING RD PORT TOWNSEND WA SUBDIVISION: g L9§A JRT PLAT Block: Lot: 1+ PARCEL NUMBER: 001173016 Section: 17 Township: 30 N Range: 01 W CONTRACTOR/ BUY RITE HOMES PHONE: (360)681-0871 DEALER: 259403 HWY 101 SEQUIM WA 98382 ((33ggpp)) Contractor's License BUYRIH`0840B Expires 598P2)0881 0780 Contractor's License WAINS0250 Expires 7/31/2007 INSTALLER: JAMES HOESEL WAINS0250 7/31/2007 (360)681-0871 640 PARISH RD SEQUIM WA 98382 REPRESENTATIVE: BUY-RITE HOMES PHONE: (360) 681 0780 259403 HWY 101 SEQUIM WA 98382 PROJECT DESCRIPTION: NEW MFH SERIAL NO. 28648/MODEL KMCK52865 TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE TYPE OF IMP NEW MAKE: KARSTEN SETBACK: VALUATION 130,000.00 YEAR: 2007 LABOR & INDUSTRIES APPROVAL? SIZE: 65.4 X 40 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: CITY BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date: 5 i I5,( 0-1 Type Amount Paid Bv: Date: Receipt: APPROVED Manufactured Homes $163.00 KAS 05/14/07 89898 Potable Water Application $58.00 KAS 05/14/07 89898 JUN {9 2007 Total: $221.00 Jefferson County Planning & Building Department • • MANUFACTURED/MOBILE HOME INSTALLATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD07-00227 Received Date: 5/14/2007 SITE ADDRESS: "10\"I'33 NELSONS LANDING RD Issue Date: 6/14/2007 APPLICANT: JOSEPH W CLOUSE DARCI J CLOUSE/JUSTIN 352 NELSONS LANDING RD PORT TOWNSEND WA 98368-9637 SUBDIVISION: STAHL SHORT PLAT Block: Lot: PARCEL#: 001173016 Section: 17 Township: 30 N Range: 01 W CONTRACTOR/ BUY RITE HOMES PHONE: (360)681-0871 DEALER 259403 HWY 101 SEQUIM WA 98382 (360) 381-0780 Contractor's License BUYRIH*0840B Expires 5/20/2008 INSTALLER: JAMES HOESEL WAINS0250 Expires: 7/31/200i 640 PARISH RD SEQUIM WA 98382 PROJECT DESCRIPTION: NEW MFH SERIAL NO. 28648/MODEL KMCK62866 MAKE: KARSTEN YEAR: 2007 SIZE: 65.4 X 40 THIS PERMIT IS VALID FOR ONE YEAR. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 6/14/2008. CALL IN FOR THE REQUIRED INSPECTIONS THATAPPJLY TQ YOUR PROJECT, Setbacks/Footing (CONTINUOUS FOOTIN SLAB_or PADS USED):: (o 2-C Stormwater FINAL Approval: CBlockingiPIumbing: '4, -tt.TscrPnenueeJ N01-rtt,5'IDZ. <9ruw1o<ara-lo^l tin Ti I P �Z.-(07 Propane Tank/Lines Zoning Final Approval: Septic System Final Approval (If not on sewer): Road Approach Final Approval: Final/Skirting/Vents/Porches/Steps: r c) cT GOJrLstroLel CI kt-c-c+ 1 in 4HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT-LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY- SEE REVERSE CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 PERMIT #: BLD07-00227 SITE ADDRESS: 73 WOODDUCK WAY Issue Date: 06/14/2007 PORT TOWNSEND, 98368 Final Date: 7/11/2008 APPLICANT: JOSEPH W CLOUSE PHONE: (360) 301-1975 DARCI J CLOUSE &JUSTIN CLOUSE 352 NELSONS LANDING RD PORT TOWNSEND WA 98368-9637 SUBDIVISION: STAHL SHORT PLAT Block: Lot: 1 PARCEL NUMBER: 001173016 Section: 17 Township: 30 N Range: 01 W PROJECT DESCRIPTION: NEW MFH SERIAL NO. 28648/MODEL KMCK52865 THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2003 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 7/11/2008 I:\F_BLD_Occupancy.rpt 10/29/19 • . SPECIAL CONDITIONS CASE # BLD07-00227 1.) REQUIRES PERMIT FOR SEWER TRANSPORT LINE BEFORE BUILDING FINAL AND OCCUPANCY. 2.) A road approach permit (RAP07-0073)was cancelled on May 22, 2007 due to access is off of a private easement road. 3.) 10' SEPARATION REQUIRED BETWEEN A WATER LINE AND ALL PORTIONS OF THE ONSITE SEWAGE SYSTEM; EFFLUENT TRANSPORT LINE, TANKS, TREATMENT AND DISPOSAL COMPONENTS. 4.) 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: SARPA aquifer recharge area. 5.) 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. 6.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 7.) Critical Aquifer Recharge Areas are defined as Seawater Intrusion Areas, and Special Aquifer Recharge Protection Areas and the following land uses located within Susceptible Aquifer Recharge Areas (1)All Industrial Land Uses (2) All Commercial Uses (3)All Rural Residential Land Uses requiring a Discretionary Use or Conditional Use Permit(4) All Rural Residential Land Uses with nonconforming uses that would otherwise require a Discretionary Use or Conditional Use Permit (5) Unsewered Planned Rural Residential Developments (6) Unsewered residential development with gross densities greater than one unit per acre. All of the above listed uses shall be subject to the applicable requirements and standards of the Jefferson County Unified Development Code. 8.) 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. 9.) The applicant is proposing to create or add 2616 square feet of impervious surface and 2616 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. 10.) 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. 11.) 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. 12.) 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). 13.) The revised site plan dated Ma*, 2007 has been reviewed for consistencyl7'nder 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. 14.) This approval is for a manufactured home installation 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. 15.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 16.) 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. 17.) 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. 18.) 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. 19.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 20.) The building height is not to exceed 35 feet. 21.) Minimum setback from the private ingress/egress easement right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. 22.) A minimum of two (2) on-site parking spaces shall be provided for the manufactured home. 23.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28,1998. 24.) An address of 353 Nelsons Landing Road, Port Townsend has been assigned to the parcel. Nelsons Landing Road is a county local access (C618709). However, the parcel is accessed via a private road off of Nelsons Landing Road. 25.) The parcel is served by City of Port Townsend water. 26.) The lot was created through the Stahl Short Plat on May 18, 2003 under AFN 469785. A boundary line adjustment(SUB06-0034) to enlarge said parcel was finaled on December 13, 2006 under AFN 518516. „,,,,,,JACK WESTERMAN I Jefferson at,. Courthouse ASSESSOR PO Box 1220, 1' ' e nd, Wit(91t368 (:360)385-9105 API R pi ) MOBILE HOME INFORMATION FORM OWNER'S NAME/MAILING ADDRESS: - NAME: UlISTi� �u” p+; all +r,jt1 1 r VI %CvrlSEnrl_ 983�f3 ADDRESS: 35Z. AIl.�SO^1LS LAitidi4 PHONE NO. 360 --. 61- /975- Pg& J Do - /73-Oi, The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the previous ownership and location 4f a mobile home. This will help our office determine whether the mobile home is already on the tax rolls in Jefferson County or if it has been moved to this county from another area. 1)MO11ILE HOME DATA: (A) MAKE Jr/1452EAI (II) MODEL kill CK ,'j Z. 86 S (C) YEAR 200 7 (D) LENGTH 65 (E) WIDTH 7U 1 (F) SERIAL # �867`8 (G) YOUR PURCHASE PRICE (Do not include sales tax) 73.660. PURCHASE DATE, /I J07 2) PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE TO QUESTION 3) (A) FROM WHOM DID YOU PURCHASE MOBILE ADDRESS (B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? Yes (NO2) If Yes, Previous address of mobile. If No, What County was Mobile assessed in last year. 3)WHERE MOBILE HOME IS TO BE LOCATED: (A) WILL THE MOBILE HOME BE IN MOBILE HOME PARK? Yes No (B) IF LOCATED IN MOBILE HOME PARK: NAME & ADDRESS OF PARK Lot/Space # (C) IF NOT LOCATED IN MOBILE HOME PARK: NAME OF LAND OWNER: L'L,easC, ` Usri,J LOCATION ADDRESS 353 1IELSd tis L1 vc/i1 Aer & sc jd 98368 REAL PROPERTY PARCEL #/DESCRIPTION 06/- 173 - Q/ Le r -6-4.31----' ture of appscant THANK YOU FOR YOUR HELP! rr CJODIC, , \ S�Ss-F Q k. COSSELL, Property Technician a4/12i2E107 12: 12 5037E 2 KARSTEN HOMES EIV PAGE 05i05 ...si \ 40'-0' _ r I 124 . . 11 iI, I r‘47_ _09 g I pli., _'414 ll 1 I It 1['II A 1. '1. 1 - ,,,,,_„4„, ill mi - -.., \.,.. i p K,. 3 I I I l`o o s \ - it.... .t._ ° 6 I I A g t i ._,„._.:vli . r p • ,I . 1 i• ___.. . ._.i,‘ . , I N u> i� I ��J e4 t r .1 �� jj1 ,- �._4 - +eta 1 I • r . r a&x77H ei J. d6xT1H •oopp r` IREPIEWRID •--, :-.` „� � :i. :l .1 t. .'fib? N r ICfftff ftltf 1,1#1 Fr 1IF'i' nb — l o fr_om�as -to west 500.88 l 200.88' / A / 300.00 A A / I 7d free L-i,ne / , / 86.67' I I 96.67' APP O:1 :01: ,' 328.33' � shop/ if SITE P / ex�5t�,g 1 1 ex�stung 17rainfi�1 shop ` `" i 61.00' -� 3 / 2a 06 I 100% reserve area 6 1.00' —�" r-tuNi 19' enstt.ng DEPT. C UMT' '� shop20690'SIGNA %Es �� 36x36 1 / 1 �me to septl,Q2819' / / i 1 Z / Ewa — L _ _ _ _ _ _ tr.wort Ihne SkCI drweway 454' f,om house to septl,c Require = _-t- \1 T Water / sit1 l I N 4,0 489.I: Il fre Lime 1 free I-Lne 1 / 41 ,25.00' / / du,g / / / 3x3 landtn // .... Ill--- ---) Proposed I -4 g 4,0;0. e to pr6perty It,ne (not to scale home 1 actsurment -40 x 65.4' •1 ' -00.00' ow- / / o / I t- 1- / / AevLS619 l l CI22 .50' \ � ?I v::��E11 'V� R 1 / / 5x5 landuig ; I / 119.17' MAY 2 9 2OU7 / / / I sr l do415.42 ri. ! 400.00' V_ y 1 to-LA crofertl from east to west 815.42 Clouse, Justl,n 13uq— rI,te Homes L-ot I Nelsons I-anc ,ng port fownsenc1 98568 259405 Hwq 101 5equl,m 98582 parcel # 001- 17 — 016 Contact: 13Lrch, 560— 681— C:;777 scale I"-60' kev1sed as of' 5/16/07 JEFFERSON COUNTY JC ti�SON / 4'- 06 JEFFERSON OUNTY R `,'',, ��`��VI�''vt , ,..1 DEPARTMENT OF COMMUNITY DEVELOPMENT v ' `"4 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax 16, NG�O www.co.jefferson.wa.us/commdevelopment Master Permit Application If f rlig`:,"owlcj 'i` 1' -7 Project Description(include separate sheets as necessary): Zi/or,91/4rtmf Of /9,r/u7.9eru eE`d ,fr1C Tax Parcel Property Number: Q(j/- /75_ O/ , Size: 7 ,�l, (acres/square feet) Site Address and/or Directions to Property:n ,3jrZ• AkLsd-vss Lccui fn lv ,ller �I'/7�nd ,6'3 8 Property Owner(s)of Record: /f' /.exu,i `�f� _, ,v Telephone.i / -30/ - /' F x: email: Mailing Address: Z.- Ar, /� . � ./,. a-, - 4 / l Applicant/Agent(if different from owner): j d `�� Telephone: ,(00- (08/-077'7 Fax: 66 -4)8/_678o email: Mailing Address: 2 5 9 t0 3 i4 y 4>Q y693� What kind of Permit?(Check each box that applies) wilding ❑Variance(Minor, Major or Reasonable Economic Use) o Demolition Permit 0 Conditional Use[C(a), C(d),or Cj** 0 Single Family ❑ Discretionary"D"or Unnamed Use Classification 0 Garage Attached/Detached ❑Special Use(Essential Public Facilities)** [tyManufactured Home ❑ Boundary Line Adjustment n Modular 0 Short Plat** ❑ Commercial* 0 Binding Site Plan** ❑ Change of Use 0 Long Plat** ❑Address ❑ Road Approach 0 Planned Rural Residential Development(PRRD)/Amehdments** ❑ Propane '„ 0 Plat Vacation/Alteration** 0 Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance O 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 *May require a Pre-Application Conference **Requires a Pre-Application Please identif any other local, state or federal permits required for this proposal, if known:Conference I herebydes'. DESIGNATION OF AGENT d d ' �.- 4r,yri, j t to act as my agent in matters relating to this application for OWNER SIGNATURE.— - t_' �/l �.� PP permit(s). Date: OV/:11/':' -7- By signing this applicatio form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attomey's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to vide access nd right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review a any quired later' s ctions.Access and right of entry to this property shall be requested and shall occur only during regular business ho . Sig \r / di J a Date: 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 lake"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' ued 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 i u are in com I nce with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual an no an able rpe„spon ' il. fo adhering and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Si natu . OJr/.(L • Date: /9 © 1 SEA i110eAca G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc • OWNER BUILDER STATEMENT • t The signer of this/-tement•••s ereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they wwilt b;-•ss ,r rig the r:-poi bility of the :neral Contractor for the proposed project. ,,° Sig ature 4 .i./._ e _ _IL_ A Date: GEN RAL CONTACTOR OR UFACTURED HOME INSTALLER: PHONE: FAX: (366 ) 68 l-0777 (36,0 ) 6'8l-o'c90 MAILINGADDRESS: 5Ct�-0 /6/, y/ , j EMAIL: CONTRACTORS LICENSE " �` WAINS NUMBER: 61A 1 A'X//4e.©8 t/6 NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) K�STF� �l�hlE MAILING ADDRESS: �c O� ku� Jo s``E'Cj21/,J7 98,382 EMAIL _ y I Pr,olect Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: V New LvWood Existing: 0 Sewer ❑ Addition ❑ Steel Proposed: P.. Bank 0 Community System Ll Alteration/Remodel 0 Concrete Total: L Height: tii4ndividual System ❑ Repair ❑ Masonry Nr11 SEP Permit# rl.c-/as ri Demolition ❑ Other: Bedrooms: Water Supply:. Existing: Setback: ❑ rivate well ❑ Two Party Type of Heat: Proposed: 3 VPublic LF e.r_,t'i[� Total: 3 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: ❑ Underground Tank ❑ Above ground Tank Size of Propane Tank: ❑ Heat Stove 0 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 For Office Use Only. I I CC Current Proposed E ) (YR cC k r V Amount Main Floor Consistency Review: ' �—r 2.6 )6 2""Floor Base fee: 1 tt 6 a 3r'Floor Additional Section: '__ (R IA' f \U'k" 11 Mezzanine: �,- Plan Check fee: Heated Basement State Surcharge fee: Unheated Basement Pot Water Review fee: { Other Unheated IfFI'I l�is i i s 911/Rd Approac Garage/Carport TOTAL: $ (p q. Cj Decks • Z 7 Receipt;Number: (. V� f'` x Cash/Check Number: t ° Other ESTIMATED COST(REQUIRED) Date: : 'Fair market value of all labor and materials foundation to finish 5/I /31,ono,00 Initials: G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc , 11. APPROVED STORM WATER PLAN � q�. gUNC JEFFERSON COUNTY JUN 1 3 2007 kiit 1 DEPARTMENT OF COMMUNITY DEVELOPME T _ _..� 621 Sheridan Street • Port Townsend • Washington 98:68 !EF 4 360/379-4450 . 360/379-4451 Fax DEPT.OF o,PL.' Y N ' .. EN http.//www,co.jefferson.wa.us/commdevelo ment/ SIGNATUKE: �j ; IIIIP' lib STORMWATER SITE PLAN SUBMITTAL TEMPLATE IMLA# lJ 1 - OO a \eiPROJECT/APPLICANT NAME: 7/&)/2_, 914:2-te,4L-, / I 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. - t/D'X ln3 2oa7 /yCc,te, /,i l — . tke.,;(J 7. 3 t1 �' / U Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. 4. Describe the existing soils. Indicate soil type on the site map. �te'4tl• 711i 1<" X4-ii.,(_.., '((1t�V!! 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/A 6. Describe any excess levels of noise generated by the proposed use or activity: lt `�r)1 Stnft7]W 1 1,'/`,` Requir ,, .i , stormwater site plan template—rev.10/1/2003 5 , 0 • j 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(1/A 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.). 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. i) /..0 0 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.] Ayg 11. De ribe the performance goals and standards applicable to the project. i/M-z20-lir-er� 12. Describe the flow control system. k ifi stormwater site plan template—rev.10/1/2003 • . 13. Describe the water quality system. /4 E v S , d8 _ C7 c1 S 1a b(OGtS 14. Describe the conveyance system analysis and design. A)/i 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. N!A 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. 4v/19 18. De cribe methods for restorapon of the site. A ate it' 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. A// 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. A1/2A 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. /U/'ti stomiwater 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. th 2. Establish Construction Access. r.a„. 3. Control Flow Rates. Nf4 4. Install Sediment Controls. 5. Stabilize Soils. 6. Protect Slopes. .,V/n 7. Protect Drain Inlets. M 8 stormwatersite plan template—rev.10/1/2003 i 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. A//A 9. Control Pollutants. A/,/ 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). N!A 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). J4 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 cn or adjacent to the site. 11 \u )) HAY 292087 stormwater site plan template—rev.10/1/2003 " 111 IN(NO/ 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. N/A 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). NYA 5. Construction Phasing. a Construction sequence ' <<2ki At b. Construction phasing(if proposed) Nib 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction schedule. D 2 � Set o 7 lrh.��.zL /Q2, `i ���-cam�y�✓u�oL' d?, II. Wet Season Construction Activities. a. Proposed wet season construction activities. /(///9" b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the property own r responsible for the initiation of bonds and/or other financial securities. J. financial res onsibility for liability associated with erosion and sedimentation b. Describe bonds and/or other evidence of impacts. , / 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. 1 b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations 10 storrnwater site plan template—rev.10/12003 • • 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 Bysigning thethebestnof my knowledge.IV also hcertify that this applicationeet, I as the isr being made attest that hwith the full knowledge and consent of e information provided herein is true all 1 co correc owner the affecte roperty. / ,%'W)& (DATE) DOWNER OR RIZED REPRF/FrATIVE SIGNATURE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED: ‘ ' 14 A \‘ lk.\A ) t�r,Y 2.ti1 ail 12 stormwater site plan template—rev.10/12003