HomeMy WebLinkAboutBLD2007-00269 ItILDING PERMIT APPLICATION ML vy 283
Reviewiew T Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD07-00269 Received Date: 5/29/2007
SITE ADDRESS: 1893 WILDWOOD RD
QUILCENE, 98376
OWNER: PHILIP G ROYER PHONE: 360-779-3955
KRISTYN E ROYER
20149 VIKING AVE NW
POULSBO WA 983709440 TRACT 12
SUBDIVISION: Block: Lot: T2
PARCEL NUMBER: 702101004 Section: 10 Township: 27 N Range: 02 W
CONTRACTOR: FIELDS CUSTOM CARPENTRY PHONE: (360) 697-8613
25871 CANYON RD NW
POULSBO WA 98370
Contractor's License FIELDCC093Q6 Expires 10/28/2008
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI' NEW DETACHED GARAGE - HEATED, NO PLMB
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 47,002.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: 720 SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 Total: _.__Il_1_
Roi llo Date
aq
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $619.05 LYK 05/29/07 91088 APPROVED
Plan Check $405.31 LYK 05/29/07 91088
State Building Code $4.50 LYK 05/29/07 91088
Total: $1,028.86 JUL I 2007
Jefferson County Planning
& Building Department
Jefferson County Building Dion Permit Nurrlr: BLD07-00269
Applicant: ROYER
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 Inspecto- prior to the County's Framing Inspection
Inspection Item Date Approval Sgnature Notes
Setbacks V
Erosion Control
Foundation Footing
0/07 OA:
Footing Drains
Foundation Stem Wall 15,7 �}
Straps(hold downs)
Ext. Shear Wall Nailing
Framing
Insulation:Walls C(. �� C
Insulation: Floors
Insulation: Ceiling
Wallboard Nailing
Gas Line: Interior
Gas Line: Exterior
Propane Tank
Drywell/Alt Drainage
Address Posted
' -ci 0` "c
FINAL INSPECTION i �L.•
FINAL IN TI N MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD07-00269
1.) No plumbing has been reviewed or approved for this project by Jefferson County Public
Health. Additional requirements may apply if plumbing is proposed.
2.) The application was reviewed by the Jefferson County Department of Community
Development staff on July 9, 2007 for the potential presence of Environmentally Sensitive
Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an
initial Geographic Information Systems mapping review and an investigative site
inspection, the following ESAs were confirmed to be present on the subject property: Type
5 stream; landslide hazard area 1 &2.
3.) 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.
4.) Jefferson County has determined that the use of real property for agriculture and forestry
operations is a high priority and favored use in the county. The county will not consider to
be a nuisance those inconveniences or discomforts arising from such operations, if such
operations are consistent with commonly accepted best management practices in
compliance with local, state, and federal laws. If your real property includes or is within
five hundred (500) feet of real property designated as Rural Residential 1:10 or 1:20,
Rural Industrial, Rural Commercial, Agriculture, or Forestry, you may be subject to
inconveniences or discomforts arising from such farming and forestry operations,
including but not limited to noise, tree removal, odors, flies, fumes, dust, smoke, the
operation of farm and forestry machinery during any 24-hour period, the storage and
disposal or manure, and the application of permitted fertilizers and permitted pesticides.
One or more of these inconveniences may occur as a result of agricultural and forestry
operations which are in conformance with existing laws and regulations.
5.) A Type 5 Stream (Fish and Wildlife Habitat Area) has been identified on the subject
property. The stream will require a setback of 50-feet. The setback shall be measured
horizontally from the Ordinary High Water Mark (OHWM). Fish and Wildlife Habitat Areas
shall also have Buffers and Building Setbacks established.
6.) Stream and landslide hazard area buffers are areas that shall be maintained in their
natural condition, however, minor pruning or alteration of vegetation may be permitted as
long as the function and character of the buffer are not diminished.
7.) Among the native conifer species which may be used in buffers or for re-vegetation
include, but are not limited to: Grand Fir(Aibes grandis), Sitka Spruce (Picea sitchensis),
Shore Pine (Pinus contorta), Douglas Fir(Pseudotsuga menziesii), Western Red Cedar
(Thuja plicata), and Western Hemlock (Tsuga heterophylla).
Among native tree species which may be used includes: Vine Maple (Acer circinatum),
Big-Leaf Maple (Acer macrophyllum), Red Alder(Alnus rubra), Pacific Madrone (Arbutus
menziesii), Quaking Aspen (Populus tremula), Black Cottonwood (Populus trichocarpa),
Bitter Cherry(Prunus emarginata), Oregon White Oak (Quercus garryana), Cascara
(Rhamnus purshiana), Pacific Willow (Salix lasiandra), and Scouler's Willow (Salix
scouleriana).
Among the native shrub species which may be used are: Sevice-Berry(Amalanchier
alnifolia), Red Osier Dogwood (Cornus stolonifera) Salal (Gaultheria shallon), Ocean
Spray(Holodiscus discolor), Indian Plum (Oemlaria cerasiformis), Pacific Ninebark
(Physocarpus capitus), Red Flowering Currant (Ribes sanguineum), Wild Rose (Rosa
nutkana), Swamp Rose (Rosa pisocarpa), Willows (Salix ssp.), Red Elderberry
(Sam bucus racemosa), Snowberry (Symphoricarpos albus), Evergreen Huckleberry
(Vaccinium ovatum), Red Huckleberry(Vaccinium parvifolium).
8.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the
Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the
Landslide Hazard Area.
9.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated.
Should buffer disturbance occur during construction, the Unified Development Code
(UDC)Administrator shall require replanting with native vegetation. No alterations shall be
made to the Landslide Hazard Area or its associated buffer without prior authorization by
the UDC Administrator.
10.) Prior to and during approved cor fiction activities, the perimeter of the lands hazard
area buffer shall be marked with a temporary sign. The sign shall be placed in such a
manner that it can be directly observed from the construction area. The sign shall contain
the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter
Existing Vegetation."
11.) All construction activities shall not encroach upon the landslide hazard area or stream
buffers. This includes the storage or preparation of materials.
12.) The applicant shall permanently separate the boundary of the Landslide Hazard Area
Buffer from the remainder of the subject property through installing logs, trees, a hedge
row, or any other prominent physical marking approved by the UDC Administrator.
13.) The identified Fish and Wildlife Habitat Area (Type 5 Stream), shall maintain a vegetative
buffer setback of 50 feet. The setback shall be measured horizontally from the Ordinary
High Water Mark (OHWM) to the proposed detached garage, pool, and pool
house/cabana.
14.) An additional setback of five (5) feet is required from the edge of the stream buffer area to
the proposed detached garage, pool, and pool house/cabana.
15.) A permanent physical separation along the boundary of the stream buffer area shall be
installed and permanently maintained. Such separation can include installing logs, trees,
a hedgerow, or any other prominent physical marking approved by the UDC Administrator.
16.) Stream buffer perimeters shall be marked with temporary signs at an interval of one per
parcel or every one hundred (100) feet, whichever is less. Signs shall be in place prior to
and during construction activities. The signs shall contain the following statement: "Buffer
- Do Not Remove or Alter Existing Vegetation."
17.) 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.
18.) The applicant is proposing to create or add 2138 square feet of impervious surface and
3449 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.
19.) 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.
20.) 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).
21.) The site plan as submitted with the building permit applications on May 29, 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 July 12, 2007 shall be resubmitted for review and
approval by Jefferson County Department of Community Development.
22.) This approval is for a detached garage, pool, and pool house/cabana 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.
23.) The parcel has been designated as commercial forest (CF 1:80) under the Jefferson
County Comprehensive Land Use Map effective August 28, 1998.
24.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
25.) Not more than 2 unlicensed vehill shall be stored on any lot unless totally sened
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.
26.) The building height is not to exceed 35 feet.
27.) Maximum lot coverage is not to exceed 10%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
28.) 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.
29.) 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.
30.) Minimum setback from Wildwoods Road right-of-way shall be 20 feet. Minimum side and
rear yard setbacks shall be 5 feet. If an ESA is present, then the more stricter setbacks
shall apply.
31.) An address of 1893 Wildwood Road, Quilcene has been assigned to the parcel.
Wildwood Road is a county local access (C340409).
32.) A building permit(BLD06-0276) for a single family residence was finaled on February 16,
2007. A road approach permit(RAP05-0328) was cancelled on December 30, 2005. A
septic permit(SEP06-0160)was finaled on January 16, 2007. A well review
(USR05-0101) was finaled on May 31, 2006.
33.) The proposed detached gaeage, pool, and pool house/cabana are located greater than 75
feet to the steep hillside located to the east of the proposed structures.
34.) The proposed structures are located greater than 125 feet north of the mapped Type 5
stream.
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. ON cam JEFFERSOWUNTY •
rx7'x ,� ,..3 DEPARTMENT c7F COMMUNITY�D E • " ENT
~' `` , `� 621 Sheridan Stre:�! •t.�4�ow �,,1" i':.. ington 98368
�y 360/379 4450 • 3�..- =�451' Fax
1,9
4INO‘CO www.co.jefferson.wa.us/commdevelopment
Master Permit Application MAY Z $ at-
MLA:MLA:
Project Description (include separate sheets as MO
6
Tax Parcel „70 02 i p/ Q v Y
Property U� l � �
Number: Size: (acres/square feet)
Site Address and/or Directions to Property:
1813 frl Zb6vc/ 4 dc,7ce e,t-n. elb-37C.
Property Owner(s)of Record: ?ki t i P 6 AA-0 rL(i_ -rt. AJ E Ra Y e t
Telephone: 360-77/J^35 Fax: .3(o- 779-66FG email: �}Qlii'�A►Ce6fZt I0C-. ,
Mailing Address: do//I fr IGi.-faj 44,e AA.) .WOK/S iv, fro_ yir370
Applicant/Agent(if different from owner): N I t4
Telephone: Fax:
email:
Mailing Address:
What kind of Permit?(Check each box that applies
Building )(Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit 0 Conditional Use[C(a),C(d),or C]**
❑ Single Family Garage Attachedeache) 0 Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home IIIS Modular ❑ Special Use(Essential Public Facilities)**
❑ Commercial* 0 Boundary Line Adjustment
❑ Change of Use 0 Short Plat**
❑ Address 0 Road Approach ❑ Binding Site Plan**
❑ Home Business 0 Cottagelndustry 0 Long Plat**
❑ Propane ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑ Sign ❑ Plat Vacation/Alteration**
❑Allowed"Yes" Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
El Stormwater Management El 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
❑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 M`4S rK" ��S to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE 4)�iCl1 ^--- Date: S-ZZ 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 accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agre i •• •e a ess a right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application
review and a d later insp ctions. Staffs access and right of entry will be assumed unless the applicant informs the County ions
n writing at the
time of the ap•,w r.on that he o she wants prior notice.
Signature: �— Date: ��22•G 7
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 "Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this
permit has '-e . will t viol to the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)e -n if S. in c mpli ce with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-tra sfe . •onsibif for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: / Date: S--27-c 7
G:\PermitCenter\###FORMS###\DRD FORbLS\Master Permit Application 12-19-2006.doc
• BUILDER STATEMENT •
The signer of thi Arig7 ent d es h reby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be asi
.the reselon ' 'lily of the General Contractor for the proposed project.
Signature: Date: 5—""ZZ 7
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: 7O/i 7 7-7I C,( FAX:
,goB Reld3 - @eld5 Cefs72>A1 7itY 3PU - )657- -(,/3 360- 497-Lf 77 3
MAILING ADDRESS: '7/ ` ,,yryt, I2c(. NG-' EMAIL:
CONTRACTOR'S LICENSE Yo(A(519Or 10-'4 - c/ir37 d WAINS
NUMBER: Fr t.L4 C 'O f3 C 0 NUMBER
ARCHITECT/ENGINEER: IKNOX De,s j 5,J PHONE 360-47,--6.6(3 FAX: (, )
MAILING ADDRESS: ug(g ae eA,CiY'CtL PE btei►1cr-TOvi t tttEMAIL R$3(I
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
XNew X Wood - Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System N k
❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
❑ Repair ❑ Masonry 6'75 ree--r SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: X Private well CI Two Party
Type of Heat: PfOP�e- Proposed: ❑ Public
leggilAINager—IktiCrerTotal: Name of System:
EX;sii Nq LQ TA4,311.
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 ground Tank Size of Propane Tank: /tom CA'L/ lSTi
I Heat Stove I Cook Stove I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove I Other Gii1+1i l r er(Lp)
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 ' W EH Bld App Review: COS c71;)
2na Floor Heated Consistency Review: ' °°
Other Heated Base fee:
k I.C1,- -05
Mezzanine Additional Section:
Heated Basement Plan Check fee: `j�\
Unheated Basement State Surcharge fee:
Other Unheated Pot Water Review fee:
NO i--i P)
Garage/ arpoocriwjAcok Q SUBTOTAL
Decks 11/Rd Approach fee: elC
VSn
Other TOTAL: $ 1 a Licit,
Receipt Number: CI l(DM
Cash/Check Number: 1520
ESTIMATED COST(REQUIRED)_,..�---'�� ~ter b: r�
.Fair market value of all labor a materials foundation to finish ) :21rml
--initials:
GAPermitcenter\###FORMS###-WRDTORKSMaster Permit Application 12-19-2006.doc
•
RECEIj
terflii%, JEFFERSON COUNTY
%140. .1 DEPARTMENT OF COMMUNITY DEVELOPMENT It;; , q h,10
tk: � f
j) �„�, 621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax I:r a
�O http://www.co.jefferson.wa.us/commdevelopment/ � �r� .
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# 017 a PROJECT/APPLICANT NAME: 1 tip C 4- V R t r('^I E y
Cie
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.
l 9 w
Project Overview
ilinigrelm !limp
1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the
site map. / '_
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Existing Conditions Summary f '''f
2. Describe the existing topography. Indicate contours on the site map.
675 'rc/e44}7-7 v'?, A n/ eg i 5 77)1' LeLGL y Ve IvO. :5 A hti-a s,arc DBE
S774rn /9ppcox /soy— Lc ' ;� O'roi , p L is A✓/17i"4L 47—
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3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
ravNO ir'4 2e Sc?T .. V ZWe.. Mtaple e-+L.bE1. Ate) F'r Tie ikq ry n,cA
cci i S d r a r
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4. Describe the existing soils. Indicate soil type on the site map. C tCJ'e-('s _have— B-at,..)
s;re r S 7vto so.Z . bc,)/cG.,ocys 9r t-ve.e cie 4r�/_ Wry SoC W 4A
j.,,cGte-/..c.exr377 A•!� ,�o rRi,c ve rt'S !j/ s 4'-'0 , A C4' h 5/Arse•
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.
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6. Describe any excess levels of noise generated by the proposed use or activity: LJNola lJ�
Aie txccy0; in y AleAv sTt.-cam ![:l/c2 ' _ATiatyWAriEB.J3LAN
JUL 1 2 2007
Stormwater .
111�Require. � � . . e4,01\J JEFFERSO ouN
storrnwater site plan template—rev.10/1l2003 ` J DEPT.OF C OEV O pME 1 5
SIGNvAT.°Fl �//
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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. /� ,�
7D ' sct.�24,A) eopei1-z U , -/G- AL IT f} sree p s, wr+sti
7 or�'�f
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et/`GA 771A-T. 1447/ tf,Lot vr,-)ry SGutet-/Z,w+
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.).
70 %ke- ,5 / Ko Ac'-7t C ✓M • 7z2 M°r i75 AA} 6-43 rgce,cliCee
Setia r3 A- 5 r t/2�•� foh ii1 Ar s eIsoi.rt. c-c. R f .7v ;7,.c_ is k
sro -puce, X.3644. 4pprox 3 /►tirIcs £Asi it 2-t- e_ir/te_4(41ce,/'e- (2-+`vek, Alo111 hUy
/0( . % t c 4 r''G i..0 c7
s7)Zv =d 1 C "Yi A�y A0J""C a✓7 d/o it e-S �.t�tC Gam- 7O6,r1
-r goeMs rb4?( Pr/l y�..c. iD yr p w;ld w000t 1t-01 tilTle Q.ui - (44.
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
�Jand differentiate�y ` proposed/ facilitiest fromr existing facilities.
�z t3 n .L,'n�s I Y"�/l(/ice-L �^� //w A7/(ot'i C,3Ttic" %7l f}1- /2eroo,dsAu%
JZcc P2.-veal6 Fro.n .aa' Rcs;c4 c . Also, ,Z.e ,►t4.M1'Me cr rc,o-;rr rc ;h+- Fruws
ArrivA-0474._ t f Suvik SrZec. 9c pip 'se e / col/cc. / `jt�l sr err -i7. ,t./sa A-il
$ 3f/ril444-7112 wil( tic //1y o ,S/Cfsea ( AIS ;repe.•vlovs Ow64teC 4-' -F Sdcc✓ .n,✓1:44.4,4445
A-vv,J 7ta t.C_ x S7c. o?S'4 ,ni.,,Nt .'l ltvw 171/7v'- #1 Nit 7710.e_ N-elf19770✓1 j 'A-1 f Zi%`W7dllS,
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.]
)tV IUQ, iZeris ovL cd/t.7i 4.cc_4K.. 7Z4- ) t X r3 7?Ni fr avZ,' 44 eve
11. Describe the performance goals and standards applicable to the project.
prof o se..- %. srernl 1.,4-7'eYz. ;ZJN[ / Q rcf o s-e l -x.)-w,+1 vet r�7 7,cvt
r1.c 7��+/P a'✓I! p r o fi o ye_ 4/I419 t'S c.4t eArr Dv5 i C o Cy /765-e_
?�-s Pet�7'0►2 a•+�d �0.1.,�rt aG ( ccvt.sr�c7v�s .n s,T vs-5 ocid-
r�1^2. Describelthe flow control syegl
E - r;vtdi.e;►-I t=(""'.sp,1.e_4-0 7V v .cJ eh ..v y qn Covorrry a7?N1_ 4 -C/fis %Z7 440-A471,10`
y
77t fs{ ►� Ci 7Y 1 . '&'j sire- L/'i>+S N�},7 ' ct l y To ir's
{ �s .N ... o _- 0 / 14.44 Nf►-T+ v
7c es
s f
�tortr�AteV'���p1�rf`t4mplal}�� id'trzod3 .. 6
• •
13. Describe the water quality system.
Gat/ tsLi,q 5 L -+i((Y 1310-uxo�: I ow.e,-eiC 2 trN //fs.7a T41£*i'2-?2.
F(owr ,Avrra u47.27z-'Fo v�G" Gui7l 6 c ','L7 72reu / sy5 rENS
aY27-els 1....L1., 6 te-e.41,0 1.4d ri e..l r-,3 ,cm,r1 5cc114.-w,ti. Gt-c.47, sp..c.Poo n w k-4 _
/ r Pitre,s, Art4 1,1i7l 1.Sc.. s,27- Aces IF ceSArey. ,Q-CSor /gyp
,'v rve. A+^c/ /!. -yi ti ii,C 16,/ vt7 Wi 6l b c 4-ccGH+fJ/i s kecl.
14. Describe the conveyance system analysis and design.
We 4t471 (,Lco, ,Q-(/ A.--oh-VI Gold If-eyes/cc I>' T "L% as •-vtvctx 9s 19'cs112lC.
C MA^^Lc-i,' A-(1 12� ,?eci WS 7-15 A -rq a/ f c E semi/ co c(cc • ,h`6
,4M'J I'S 1 e ad 'co( �!.ea�S e$1e 44,r-A•7ll. 2- t -n7 n e.► ,�
L FCB-7V,`c. c-(fec75
GfL-W5 j AO k eep_S Q 14,AsvD w21/ to S-Qu t,P,2 e Q,,•l f?,'r,, ev �.'
(Vr-rililV 1c ..1v$ c.tiZ( 5<_ f/ 77) eit(y-e.cl- /t1KV( 7a e_ NA-� ,-4-6.Dcitc)Ir}/rc 4v'e4.
15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material.
[•,,2 c..il( rye) ,w Fi v( # a,-er•, 1 ,+5 s•'i-C i3' A-4ca. 's42.y Ge4/CL .
egeh✓Air D,rr cwi Pool w'vt be crsccj h-g La -Sc4pc._ NtAre.-i -C.
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code. No P LJt le.ccM .r, or comp or; ,,on orS c 43 CS r g.,cr oh MICA (s �e, .Q,4td.
Alt VbeeA Ftwa,0 ihi o✓1s iiDirok .t..n Ll b.e c.ur�p Ac.-1 FD t-) Ft 27S-lb.vttloi"A"r i
ply con A-c�,2 - 34sw Ce.rnr;i� A C, Ft rtC r or y
?cthL s;-rc u tit 6 - cor,np�rc..i 9 I b !bell S�,cc..'�;cA-ri4745 AS eess
17. Describe the proposedbA surfacing material.
MZY
O/Q'& iovfo0 Oda( mvt.c14e-01 rt-S ruts ess ,b u c Ce,As r tics? \ , ilnro
Low4s( 41tc( A p(4M A A�1' . Ryc-5rnrss 1, 7-. CIovc.rS, 7,5,. 4 RkkcWes
18. Describe methods for restoration of the site.
l si i l wl gspn".r k.k4-Svs rem -Tv �Nvwc e_. Atil (girt() Ape4s
'fie.p l w 1 , ,,,A-;i"e. phu) "-oiv A. )1W p(*viS . MA/t c,L.,. TO Reclvice..
Dust 1w1() Intlek isto 37-1)d`Q . (VI i/v iMR'(.. S i fC Pe -i?nn. ,-3 f>
We µ ilriL( A-S S i rC.
is ex;s-r W La..4- C... e . 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.
NCO--
20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
LPL t-% I-L
iA Not k -cai A-6. - Svvav€ .j 1 olo p.N 1./1444gAiroulvC
Wid r o Strr tt 41 f l„2"41 t ocrh°t"6—D r 1.4._ MO s 'io n^.S !,5 S i 1`C C-D r' 1�4._
1 r;kA.,, Pb a ux_ t,•-e,P - --
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. Al
///
•
stormwater site plan template-rev.10/1/2003
7
• •
CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP)
The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the
template that follows must be installed on the ground during all construction phases of the project. The.proponent is responsible for
preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater
Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential
development.
SECTION I—CONSTRUCTION SWPPP NARRATIVE
1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or
will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable
to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual(beginning on page
2-15).
12 Required Elements—Construction SWPPP
1. Mark Clearing Limits.
proposed 5vt/ 4 C ge,fclY
2. Establish Construction Access.
COAs7rtic 7)r.� �A'T.erA-fie, i s e c i sT►v,-1 -C-Ce-cS Ad--cy( el v1- art
n . ii k�5. efive.t.+o.9 wn ly Aivriti't' is c(e A- -ly m4r12-
3. Control Flow Rates.
r Pre_ V..exllm oR6-S pe..rSeok we_ Gtave_.. non-re", 0rc,7L.4-e_ F 144-s
rK Nance i 7?rT1 r l tt/G A Gl vse.- .MciC Gal S 02.4 w,3A-/cs
,91 AK-ct'csRit-y Ft.-711 - Scd,ne', c„ft,cis -'z Cam+- c ST7(S-0 Oc )
1'G ccr/!d c,Yt c-i W 7P N ,Woc(S q S ,2t04..r,>t 4cGr'12e1 E5
4. Install Sediment Controls.
NO ✓ c,teetrisrl wit( GAL do-r 1 ,also u,-e-c✓rle usr: S��iAc,�gAfc�
5. Stabilize Soils.
k r?,( C/Set S 70-4.64/ 90/4 "ALA I w e It a--( A- U-i9 7 .Pz .I7c r
t?n Si TC- Fr Jvs j Covi i►-eL • tt e_ law_ (1-ye geons A. C/oecg
/3l„c.col Y / k�;cGt kv-5 l ce,Ttac/ , of
6. Protect Slopes.
ie..-><J Slop. %5 IrcS� /h9 3%(, I- . '�/ h
,-,v0 D11. ;ai p'rW;ii ( A7� .5c
r9zz ,>//A14c
erv5,osl 4-rA0 /wNei v✓N w �nZy et - 1 _ e-- "a
VS Nr ,4
7. Protect Drain Inlets.
Sr o ii (l G 14. Crc$c, 471.1 tA-holy-vvc-(i /to e![. ,
• 13 -s atevtZ Mc,.ec 7V foCvre—c-' 77 2vw�j�, /t .1
'7764�aGj/ Q isi dvr2 .Si rC__ No oil-es c -1141 ,5"rt�r� /t`✓�.
stormwater site plan template—rev.10/1/2003 8
• 0
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets._ .-
-rem, c ")Nets wrG( be (,A/`C01/
4,177, Sp-,9'e.) s/' /$14/LG4,
9. Control Pollutants. /� %/"
SdUrc�Lr i -nG✓ICOWCO be- �Or4r.7 c'fc . C4115f/C-7)-evi. deb/
rig !rlil ivG
1irvT s0 pi-Ay/kid ,¢a,Fy /i3 met essmy. Cn►c. C c.le.+-si, - wit/ 6-e.
,1-. jN il.e- /tg,ei ' r..ric.ol Area " Or A-,— Lc4ST o►' 14 siTe- / 44 wi II
s 7;41 AA. i2-c.- si-re .
10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
The-%h/J S;r-S Ave._ v� t qc 'O w4•i 7Z, t c Aaa.c..i 7 ,p) fZ�.-44 .
F4otve_ve-A-) tF geow�0 3 e 'C4vA-j70A 77- 4441 5e., exeal/ i7 lb
a,'e -`77•n ll el-Ssw,. toe e_scv M .
11. Maintain Best Management P.actices(BMPs).
Ova-- 3 AP.; tA.' l( 5 e.. ivts},'kaTtct;Mtc) d u-r14 t 1 Aµ.O R-F-t cr2 Cons rL-t?i61.
(.v i u 6 e_ Qe stat&e.ol w i l,. o(c `�
i 30 S Cv.tap lc 11'o'vl,
12. Manage the Project.
`vvlL SLID cc Q ;S a?-3 rt.t%cs b 1 To cle-T ota s,i?r 1 so aet.do vsc
i X ; 2 ()e.r- AS #-'c ce .5 61-ay 7 pY /t.r TIZ0rs1a�,'ci serf"
Ai ( ova. (A.oiV. u C.I b.e comp p leta d.t,,r? Ilse- s✓yrt 4'-& s-c4rael
-r L CC' S an ''L st o k'l be._ Lest Ai fwg 60 .c s - a6( (L
cira,"-i' s ,ct•-C. r)Q PlicC , Gvc a97/ /y1,j,1, L eat 1-444. Plod 4,- egyaretws
2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas, roads).
A-Or/Cur s 1peorex.:,CO PLA€ ;b 7 c s,�e
g'x e.ie.. ot� S peds;ovx ex r s. 41( A-+O� p re p_r e s A-re(cz v .
iia - I ct)ge.nes GN.rNkq b1re.A I mesz.Fer,*i-3,
'fie. C i T7l e_. Aoacetie_ fZ,1ve.R i s 3 MACS i,
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
�A-i` YG0 yes, .r crv(,�d s�l/ �c o'T ,pv,2 P f er ( t,�ev� P i
/hR-T drs7 ce, tro.s1"q a c„o urn arc. --a i 1lo/c•'octo( Roac.( 0}isT
s%ram, Rt €.17, woc.� N s Avr_,P/L uQ trer3
t d%vc.riix 'Tl_C
Flaw ilvvi- %Iu {z,e-si 5.4 .E vciatiPr l ty i it nA-i s inT" P co cxa-c( Tb
LITnc_.tl,ti,;lces-e- ,Z;vc12- Ph- lO t t eryrox 3 A- P"ile s otocA.o-s;y. �eA
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
n✓o X 7c 7 lice: µe -coy-. e/ 5;it_ i3 fn !.«e7ZAr✓D 4,,e_ '/ 4.a—%Vf -(. ')✓'mow �R7 Hi(G�s G,sri-an. Dv✓'ty Sev+e -e_wa,i‘le-r- 5-7PeAl-C.
A-pi")4 /3 reed- AfA e_ stiv-
Irli 0# 72e- sr)t. is ?lam si En s litre
Pre---4- a.7 1l c ;A/Ps R C �/c✓ .
NO lZ 0 or•Sea.;,,,.«, 14441 �� it 41,.e9 s.
stormwater site plan template—rev.10/1/2003
9
• •
b. Description of special requirements for working in or near environmentally sensitive areas.
57--4.y A-t-u-y Grog �Ij„��,� ;s-
,tee c�cs a.2 y c- Apt yore ' Je Peg. 1 .
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).
tt,t & 'C Mo i W A— po i -'7'A-C ex-0 s, p c)le"t. Fh
c i. S zrcs. . . oC) (5 ark TV P So Aid So.M S 4+ _ S' i�'
LeA4X._ A o SdLI cat (.../!'S G(t 12 t(G S o Afs.re^_ tc- S
►.Jr) eros i 0✓L tSS ve S ma iV02- V'esi.i it ar; tl CjCits-aes
c4t(-`erri t-c 'Dot_ c efoMJGt$
5. Construction Phasing.foot_ Desk--t-y-C- ' 0 % C' 7V cK R
a. Constructionr sequence '-�� vG 04 t l CCMS 7T t t-T/oo L 0J Ada q ' `tc ITV 2,
SM►'t� M
rot/ri f-5 m kcal h r N �G.£' d/ pl.446, . oe M Nt �rra6 vcl r Fi�i?� G-v✓�C ��''l
5;01-679 r �Q LENT^^'j LA.��-Sche, ✓5-
b. Construction phasing(if proposed)
i/f-
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a proposed construction schedule.
Mfj Sv iYe-- 240 7 / rivaiV1 6-14 A-uS aecr I S I ZC O 7
II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
Alt f°1--
b. Proposed wet season construction activities for environmentally sensitive areas.
il/f
•
7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for the initiation of bonds and/or other financial securities.
Ph;tip 6. AivO krz.,3-gl J
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
/v('A` •
8. Engineering Calculations. Provide Design Calc lations on a separate sheet for the following,if applicable.
a. Sediment Ponds/Traps. /V��'
b. Diversions. "f1t+.
c. Waterways. Al
d. Runoff/Stormwater Detention Calculations /✓�/�-
to
stormwater site plan template—rev.10/12003
i • .
Stormwater Site Plan Changes
If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan,the proposed revisions shall be
submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised
drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change.
Final Corrected Plan Submittal
If the project included construction of conveyance systems,treatment facilities,flow control facilities,or structural source control BMPs
(not standard on-site stormwater management BMPs), the applicant shall submit a final corrected plan ("as-builts")when the project is
completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as
constructed.
APPLICANT SIGNATURE
By signing the C ru tion SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and
co • the b t of y knowledge. I also certify that this application is being made with the full knowledge and consent of all
o f the a ected roperty.
5-22-07
(LANDOWNER OR •UTHORIZ REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
12
stormwater site pan template—rev.10/12003
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