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HomeMy WebLinkAboutBLD2007-00357 •UILDING PERMIT APPLICAN MLeview Type: IA07-00375 R Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: SITE ADDRESS: BLD07-00357 411 MONTGOMERY LN Received Date: 7/2/2007 OWNER: GARY S KAVANAGH PHONE: NANCY K KAVANAGH 17888 LAKE FOREST DR PENN VALLEY CA 959469454 PORT LUDLOW NO 1 AREA 2 SUBDIVISION: Block: Lot: 7 PARCEL NUMBER: 990400207 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: BISHOP BROTHERS CONSTRUCTION PHONE: (360)301-1979 371 BISHOP HILL RD CHIMACUM WA 98325 Contractor's License BISHOBC093D6 Expires 1/11/2009 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NSFR W/ATT GARAGE &A/G 250 GAL PROP TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,120 VALUATION 220,114.00 ADD'L: HEAT TYPE: PRO CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 645 SHORELINE: CONST TYPE: DECK: 632 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: SEW WATER SYSTEM: LUDLOW BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 3 Prop: 4 Total: 3 Total: 4 Routing Date: C. j r-l "a-CY-L_`----- Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $1,671.35 LYK 07/02/07 91364 APPROVED Plan Check $1,086.34 LYK 07/02/07 91364 State Building Code $4.50 LYK 07/02/07 91364 Potable Water Application $58.00 LYK 07/02/07 91364 SEP 12 2007 Total: $2,820.19 Jefferson County Planning &Building Department Jefferson County Building Dillon Permit Num.'. BLD07-00357 Applicant: KAVANAGH BUILDING PERMIT INSPECTION APPROVALS \pplicable 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 02 /49 Erosion Control 31i3/ - 1 Foundation Footing /o ff bk lFfia. MrAaq Footing Drains C 0 14- Foundation Stem Wall A J__/47 # de Underground Plumbing �"rJ M , Under Floor Framing I°I3dla 0..._ Straps(hold downs) ,/oi, ir Ext. Shear Wall Nailing , . r :J r Rough-in Plumbing / J g .i, / I Framing Vii Blocking /41/ir ru Airseal 1 i G g Insulation:Walls ` Q/Dt P i/ ' zti /Ø,jI Insulation: Floors 3/,2/a g Insulation: Ceiling 3//L/44 F VlotrAD Zeu..4 v6-5 /Sly. V9Aiep Int. Shear Wall Nailing //21/1 Al Wallboard Nailing i/z3/c 2 W Gas Line: Interior ' J M / 0 Gas Line: Exterior 3/2/0 g ;f Propane Tank 3�i 2/e9 Heat/Chimney Clearance y.2_ of1 11/ Drywell/Alt Drainage Cu-+coop aC 10✓3*0 -A1EEPs DgAwrcF DUST Apti -liCitat146 GK /0/3%7IiF Address Posted g RA Z,f� Qhxh W114111ES terrtt OF Argo/it BY PLOD re -ro cue APR WcL nx 4.2- 7 �0 IR°• • 6� Nen: £EGtR1eAL f&) 1L 1E&4(,,RP D 3ti%.k FINAL INSPECTION 3//31pt # 4W( -i2r er/ FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR CONDITIONS for Building Permit# :BLD07-00357 1.) The application was reviewed by the Jefferson County Department of Community Development staff on July 3, 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, the following ESAs were confirmed to be present on the subject property: Coastal Seawater Intrusion Protection Zone (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.) This parcel is served by a public water system (Olympic Water and Sewer). 4.) The development will be serviced by public water and a well will not be utilized. If a well is required for potable water the applicant shall meet all of the Aquifer Recharge and SIPZ conditions. 5.) The applicant is proposing to create or add 4,060 square feet of impervious surface and 4,325 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. 6.) A Medium Stormwater 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. 7.) 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). 8.) The submitted on July 2, 2007 and revised on September 11, 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 September 11, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 9.) This approval is for a single-family residence with attached garage 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. 10.) The parcel has been designated as MPR SF-4 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 11.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 12.) Not more than 2 unlicensed vehi!shall be stored on any lot unless totally sSned 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.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 14.) The road approach permit (RAP07-0057) must be inspected and finaled by the Jefferson County Department of Public Works prior to the final inspection/certificate of occupancy of this residence. Contact Terry Duff, Department of Public Works at 360-385-9159 for the final road approach inspection. 15.) Per MPR Code Section 3.17, accessory dwelling units (ADUs) shall not be allowed in the MPR-SF zone. 16.) The building height is not to exceed 35 feet. 17.) Maximum lot coverage is not to exceed 45%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 18.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 19.) Setback from Montgomery Lane right-of-way is no less than 20 ft., side and rear setbacks are no less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 20.) This parcel was created through Port Ludlow#1 under AFN 19620, recorded June 3, 1968, Volume 5, pages 26-32 with the Jefferson County Auditor's office. 21.) Montgomery Lane (C542109) is a county local access road. A road approach (RAP07-00057)will be approved in conjunction with this building permit. An address of 411 Montgomery Lane has been assigned to the parcel. 22.) An easement was recorded on September 10, 2007 under AFN 527176 with the Jefferson County Auditor to allow the stormwater tightline for this parcel to run across parcel 990400264 in order to connect to the existing drainage system. ,SON c . w,,4� o�r i � JEFFERSON UNTY .. - -, , x,. ,. DEPARTMENT OF COMMUNITY DEVELOPMENT `-' '' 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax kqS 0 www.co.jefferson.wa.us/commdevA,Qpn rat Master Permit Application r rlr� , pp ����:� D�� , � t•kr}0, ,, ,: MLA: �:`� ���� Project Description(inclu separate sheets as necessary): ' � "' J tf6ii ti 1 c /1/S f IC W .4-#. yar 0 ,,/ ro one Tax Parcel roperty Number: 9 9 O di 00 07 07 size: /3 o yo (acres/square feet) Site Address and/or Directions to Property: , 4/f/ /VOn�30rile, v /A!� !D , ©,- 7 141 ch/0 Lt/ lv/2 Property Owner(s)of Record: ' Gok r y Ka raat n a r� A Telephone: Fax: `l email: Mailing Address: 2/ 8i,s4v0 ek, - ,,' if'J) CS(i eri 44«44 ev f 0-- '' 9I74' .. Applicant/Agent(if different from owner): lot .x.+.;a Telephone:36 U- 347/'- / 25' Fax: email: Mailing Address: What kind of Permit?(Check each box that applies 33uilding 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]** Single Family ji t Garage<AttachejDetached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** XPropane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign 0 F'lat Vacation/Alteration** ❑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 ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium 0 Tree Vegetaion Request *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: / DESIGNATION OF AGENT I hereby designate (c y,- •7 y.5 40 to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: LI.. / T-0-2 By signing this application fo a owner/ag t 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 false ood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any re uired later inspectio .. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applic ' n that - or she w/nts prior notice. Signature: i I I Date: -C -/ 1-0'1 The action or action pplicant wil/ndertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species nd could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if y u are in complian with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfer le resp risibility f r adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Date: ` Signature: —1.lei L>? 4, G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc BUILDER STATEMENT • The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: sr5Ao%2 /,j rof%' # e.od►s1: (360) 30/-/q 77 ( ) MAILING AD ESS: 3-2/ 8,,,,sAtv., 14 // p) (., ,,,,,a E u,• EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: b 5-6/0 e0 9 3 0 4 NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: , ' New X' Wood Existing: O ewer ❑ Addition ❑ Steel Proposed: Bank ,_ „ommunity System ❑ Alteration/Remodel ❑ Concrete Total: Height:, ❑ Individual System ❑ Repair ❑ Masonry ti/ SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: 0 Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: 3 r X Public Total: 3 /i, 17"em.14 Name of System: If this is a Commercial Protect 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 Under round Tank Qbove ground Tankk Size of Propane Tank: .2 5 0 1:. J Heat Stove Cook Stove I oodW stove 1 Fireplace Insert i of Water Tank 1 Pellet Stove i Other Is this appliance being installed in a Manufactured/Mobile Home? Yes rN'o� 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 , a Amount "f, _...Revision Main Floor Heated )`'1T15(cC EH Bid App Review: 2.laC� Cio:SSzu—€ 2nd Floor Heated Consistency Review: (r'j,2)a Other Heated Base fee: c° 1lt1l3 5 Mezzanine Additional Section: „ • Heated Basement Plan Check fee: 'bt a •Unheated Basement State Surcharge fee: 41 51) Other Unheated Pot Water Review fee: n� ��'1 x Garage/Carport L J�•.- t )2.�,5 SUBTOTAL �y _ fC� Decks / 3 la2cyp`.2(4 911/Rd Approach fee: xt l Other O TOTAL: $3m8 ►t 1 Receipt Number: 1: 104 Cash/Check Number: 9 ESTIMATED COST(REQUIRED) a f 1 L1 ,,,,,Cash/Check ��. •Fair market value of all labor and materials ndation to finish r I 2—Or] 2 / 7 oo. Initials: ___..--- G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc R J • • WCEVEII i (irsON c° , JEFFERSON COUNTY ,± R DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Wash!ngton 9 G6 A4"� ' 02Ov 360/379-4450 • 360/379-4451 Fax � � � N http://www.co.jefferson.wa.us/commdevelopment/ ttiBEli STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# v 1-- 5 7 5 �,7 NROJECT/APPUCANI NAME: 4„.,^ ,y`,25 4 op 1 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.TA S p ) 7 I, � e2 � d 0,/- A : L't/ 1 / fle 4 rJ1 / [ a / ,1 ♦ i i, Existing Conditions Summary 4,;':_+ •-. .. ts_ kr3r `',s 2. Describe the existing topography.o graphy. Indicate contours on the site map. - (7r'eariero 7 S/r," t• CO or.,, Wr'.i 1,, �.3 .. -- Q ei9 4,-3. Describe the existing vegetation. Indicate native vegetation areas on the site map. A. O ,Ity \� /815 6� [' lit.,-)r<c'n.S w% ,4 vt,fi e, .so�.4-e Q c l,J, ` gib • .47 4. Describe the existing soils. Indicate soil type on the site map.• 0 , !'' -° :3 i L) C. •,/ 0 ':'•C N ,.. ,:, Q. ,.,, -, 46-:. 5. Describe the existing site hydrology(i.e., drainage;behavior of water on the site—above,below, a : in thec •und). Indicate existing stormwater drainage to and from the site on the site map. Depict separate drainage base L. • the site map, if applicable,and indicate acreage of each. "" d ..t -"::'. l 1 /,- i eS -Prot " ,S /d P 6. Describe any excess levels of noise generated by the proposed use or activity: R�D ;i =f /u _ stormwater site plan lertplale—rev.10/1/2003 5 • • 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slope etc.)on the site. Indicate location on the site map. /v/4- • 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. Describe the developed.site_h drol 9• DY ogy,as proposed. Indicate whether stormwater will be fully-dispersed(ire.,per -- 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,fro ,existln9 facilities at sue_ •. r !r 10. It he project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed for'!se 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.] 47/4 11. Describe the performance goals and standards applicable to the project. 1 �f 12. Describe the flow control system. i , , stormwater site plan template—rev.10/1/2003 6 • • RIq{tea LI, 13. Describe the water quality system. -a m. 'i iit A -L' JUL e €? 'A, �+`� , 3 `�14. Describe the conveyance system analysis and design. i M,C�7 ii,„4 7 ,i 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. —/ J //'"'\� // +- ` . /AP Aar) :5-0 If 'f -i7/Tti .7/ .>te -+�a /- •4?C+L r A� 1t l, %,4'," 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. r+i 4,11..r .0 4 _ .. v"+ J to;/',ed (011,5%r•`i�l C1''`r.{a st 17. Describe the proposed surfacing material. CrGc at / U i1 O'rl t!-4rr-"7 18. Describe methodsI for restoration of the site. f/)O J elA/0 / ,-� v) tit/ r 1 Ait a7'r t, 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 induded,,,Jjst the Manuals here. . / ii. 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. / .-r 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. t stormwater site plan template—rev.10/1/2003 7 � � 1 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 sedirribnt and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential development. SECTION I—CONSTRUCTION SWPPP NARRATIVE 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or will,be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual(beginning on page 2-15). 12 Required Elements—Construction SWPPP 1. Mark Clearing Limits. • • 2. Establish Construction Access. 3. Control Flow Rates. -70 /i"Ot U C V c'3e T'P T d A tA e-'J k n r� at /I' . /v, l S p .. / 4. Install Sediment Controls. /t • 5. Stabilize Soils. , e, pug; n e k'c'a vu /•,fin �r� ; ,s=:o �, _. ' ,n,., / ,s�; 6. Protect Slopes. // 7. Protect Drain Inlets. C it) 71- • stormwater site pan template—rev.10/1/2003 B S )� 7 1 J 'a `ti! 12 Required Elements—Construction SWPPP(continued) ._8. Stabilize Channels and Outlets. F 17i 1!'1 f fee / 4f11 c / S' ff /�I':::,.'�'�-,'7 r L!`"' i 0 ✓"/%f,,/'r� f0/) r O/2 , �f , 9. Control Pollutants. r �1 �r��. s /.5 Je.'"S LL pSr-�0/l t ✓t,-e�. /Y tt�el ots -i r C O, r t C° �/ e C/Yz.1� tr� Du7"/ j1, d, f-u9 t Ci • •<,s . 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 1 4z 4 //� „fee 1 7 �' f5 a 1 fu ,r-.�-. S �cr ., S cla� 11. Maintain Best Management Practices(BMPs). } Once —CU 4,, c c �! S n 6ac .�-{; //� n S 'J a/► t. i t a rrL / 12. Manages the Project. /1 if ✓a ray - A, he 77•r Kr A ea-14" i e / c i>JnS 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). /v2it/C b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). //7Ne 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. stomnvater site plan template—rev.10/12003 9 410 • • b. Description of special requirements for working in or near environmentally sensitive areas. ,4/4 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). /VO/V 5. Construction Phasing. a. Construction sequence b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. - ~-III-------Wet Season Construction-Activities. -- a. �Proposed wet season construction activities. • /v �f b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. IdentifyifJ"NA tthee property owner responsible for the initiation of bonds and/or-other financial securities. f V b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. /V / 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. /I b. 'Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations stormwater site plan template—rev.10/12003 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. `;1 APPLICANT SIGNATURE By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. (LANDOWNER OR AUTHORIZED REPRES ATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: • • • ,•er.. stormwater site plan template—rev.10/12003 12 Si'-0' 4 row 6'-0" vw.3'-0" 4'-0".1'I' 3'-0".I'i' 6GL NNG.1. 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