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HomeMy WebLinkAboutBLD2007-00359 1' A � 1 ? ILDING PERMIT APPLICAT MLA07-00�- , Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00359 Received Date: 6/29/2007 SITE ADDRESS: 2733 TEAL LAKE RD PORT LUDLOW, 98365 OWNER: CHAD L LUND PHONE: (360) 379-2410 JESSICA L LUND 204 GAINES ST PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 821331004 Section: 33 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW SFR W/ATTACHED GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,318 VALUATION 224,120.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: 598 SETBACK: DECK: 96 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 3 Total: 3 Total: 3 Routing Date: lalbl - Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,598.55 KAS 06/29/07 91341 APPROVED Plan Check $1,039.06 KAS 06/29/07 91341 State Building Code $4.50 KAS 06/29/07 91341 AUG 2007 Potable Water Application $58.00 KAS 06/29/07 91341 Total: $2,700.11 Jefferson County Planning & Building Department • CONDITIONS for Building Permit# :BLD07-00359 1.) The application was reviewed by the Jefferson County Department of Community Development staff on August 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 and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: Osprey; landslide hazard area 1; SUSC aquifer recharge area. 2.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 3.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 4.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. 5.) 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. 6.) 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. 7.) 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. 8.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 9.) 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. 10.) The applicant is proposing to create or add 9944 square feet of impervious surface and 30,420 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. 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 proposal is categorically exempt from r under the State Environmental Policy Act (SEPA) pursuant to WAC 197-11-800(1)(b)(i . 13.) The site plan as submitted with the building permit application on June 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 August 3, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 14.) 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. 15.) The parcel has been designated as CF 1:80 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 16.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 17.) Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an autormobile wrecking yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requriements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor vehicles be stored in a critical area. 18.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 19.) The building height is not to exceed 35 feet. 20.) Maximum lot coverage is not to exceed 10%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 21.) 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. 22.) 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. 23.) Minimum setback from Teal Lake 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. 24.) An address of 2733 Teal Lake Road, Port Ludlow has been assigned to the parcel. Teal Lake Road is a county local access (C505309). 25.) A road approach permit (RAP07-0047) was finaled on May 11, 2007. A septic permit (SEP07-0251) was issued on August 7, 2007. A well review (USR07-0039)was finaled on July 17, 2007. 26.) The site is served by an individual on-site well (USR07-0039). 27.) The proposed location of the single family residence is located approximately 102 feet to the east of the mapped 370 foot contoured landslide hazard area, which is where the steep slopes are located. Therefore, the landslide hazard area conditions are not required and a geotechnical report was not required for this proposal. Jefferson County Building Dilion Permit Num BLD07-00359 t Applicant: LUND BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2003 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks jy r a- Erosion Control 3/5/OB GRADED i READY FGtt 5g/ D11,)G 2/I1/GS V Foundation Footing 10. -1.1 it4 UPi G Footing Drains `6.6 -J1 AVVI at- - Foundation Stem Wall 10 �1 d L �' MY+/)U II Underground Plumbing N A DL Under Floor Framing lb/ZZ t,7 ll1 I aoR floe/MErEZ ICI A/t/ usP l LLl EO Straps(hold downs) �//c G/l , r Ext. Shear Wall Nailing 1//5/G7 70y ok IZInF PCRIM "�L /VF7ERiL1MG dk ll/Ihi Rough in Plumbing /l/Z.b u7 6k Framing l 9 dg oy Blocking /// Or #' d Airseal ///Pr gii- . 4 Insulation:Walls //I`/O$ Ai- Insulation: Floors 3/5/08 # eb-enGi fE Insulation: Ceiling p3 Diol IX. ett71.. bk lit G/oe gi e.EieT/`164re- Int. Shear Wall Nailing N/A Wallboard Nailing //SAS Al' Gas Line: Interior N/A Gas Line: Exterior N/A Propane Tank N/A Heat/Chimney Clearance N A Drywell/Alt Drainage 21/4 Dg 1D2/uN5 -ro 1PA YL/6 NY Address Posted 3/5 OB FINAL INSPECTION 3/5/� , °K -Pa- 0 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR c,SON C • IRE IIV PT)odJEFFERSO OUNTY t ,iW \ DEPARTMENT OF COMMUNITY DEVELOPMENT 13 ,- 1-4 621 Sheridan Street • Port Townsend • Washington 98368 JUN 2 9 7007 360/379-4450 • 360/379-4451 Fax �x/S NGp5 www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: JEffp,,IJIHRilico .9 Project Description(include separate sheets as necessary): fJt, 5,�yi,_k - �\AA. ],- ;CI 5',Ckt VI C CI '. y ', C,tVcV::(- c` (�cG ( - . Tax Parcel Property' II Number: 'Z t 3 3) (j 0 c'� Size: I I, (1 7 acre quare feet) Site Address and/or Directions to Property: �.7 3 3 �P (,(.L.A. k r , 17c3 1' 1� (..(A 01 1 c'-,v , t•�.%' c F8-3(c5 Property Owner(s)of Record: r)AC -.) )C cz I (q 0 th Telephone: )Lf'( 37)- ?`1/C' Fax: 3(n6-3c0-- (n Li d(/' email: -,-t- 0,1 & (,�h oc,<cA1 Mailing Address: Z `i (7Qc ni5 S( ,I C.'A+ "- r,'. :'�S.: C.'lci L l.0 `i -- /-k Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) i Building I Variance(Minor, Major or Reasonable Economic Use) I Dernolition Permit l Conditional Use[C(a),C(d),or C]** Single_F�milvi_ i Discretionary"D"or Unnamed Use Classification varage Attached Detached i Special Use(Essential Public Facilities)** I anufactured Home I Boundary Line Adjustment Modular i Short Plat** Commercial* i Binding Site Plan** I Change of Use I Long Plat** I Address i Road Approach i Planned Rural Residential Development(PRRD)/Amendments** I Propane I Plat Vacation/Alteration** I Allowed"Yes"Use Consistency Analysis I Shoreline Master Program Exemption/Permit Revisions** (ir Stormwater Management) i Shoreline Management Substantial Development** Site Plan Approval Advance Determination(SPAAD)* I Shoreline Management Variance l Temporary Use i Comprehensive Plan/UDC/Land Use District Map Amendment i Wireless Telecommunication* i Jefferson County Shoreline Master Program Amendment I Forest Practices Act/Release of Six-Year Moratorium *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 to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: 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 agains:all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assu d unless the applicant informs the County in writing at the time of the application that he or sh wants ri r notice. t Signature: I .f a� (cP -4) Date: (c?I i 6/C f The action or actions Applicant w'I ndertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable responiibi for adher' to and c mplying with th ESA. The Applicant has read this disclaims and igns and dates it below. Signature: p-e (rt 1 t"(l 01 Q-9 Date: 62/ '0/07 G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.doc BUILDER STATEMENT • Il 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 he responsibility�f�,the General Contractor for the proposed project. Signature: �_�-'� --___ Date: /I 0 b GENERAL CONTRALTO R MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: 71, New 124, Wood Existing: 0 L Sewer ❑ Addition 0 Steel Proposed: &,7..7 Bank 0 Community System ❑ Alteration/Remodel 0 Concrete Total: Z,-Z.'? Height:, '$ Individual System ❑ Repair ❑ Masonry SEP Permit# Au1�d irx" ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: — A Private well CI Two Party Type of Heat: Proposed: }` _ ❑ Public I,i�J o.11 jl'1 c;,,.1�" Total: Name of System: If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: I Underground Tank 1 Above ground Tank Size of Propane Tank: I Heat Stove 1 Cook Stove I Woodstove 1 Fireplace Insert 1 Hot Water Tank I Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines,tank location and size,distances from the propane tank to all property lines, buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: y r f vt� (;e1I r)zi ,8 .0C, 2 °Floor Heated Consistency Review: Other Heated Base fee: • Mezzanine 1 lR J1 A 'J f r f `'� ,l� Additional Section: I' )� r J * Heated Basement Plan Check fee: :IUN 2 9 2007 1 ) 39 0 In Unheated Basement State Surcharge fee: C Other Unheated ��� I Eff ��� �j)iNI ���� Pot Water Review fee: ilf" C\� �Garage/Carport () SUBTOTAL Decks 911/Rd Ap roach fee: Other 4 54 „c 1c`^mot', �(.,,' i Red$.1. TOTAL: $ C-1 I l Receipt Number: CI( .� �� ( / Cash/Check Number: _l( t ESTIMATED COST(REQUIRED) LI //"I Hof Date/ ` •Fair market value of all labor and materials fours tion to finish f 2 1 1 vas,,5 7 r 1nitials: G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.doc 4SON c, •• IN1)1�`\ !I i��I i 6,. JEFFERSON NTY , / `" `:3 DEPARTMENT OF COMMUNITY DEVELOPMENT W + 621 Sheridan Street • Port Townsend • Washington 98368 "I!�( 2 007 360/379-4450 • 360/379-4451 Fax qs, p� www.co.jefferson.wa.us/commdevelopment -IFFRONIIP.1:1111N1 iirp Master Permit Application MLA: 0 .1 �(c61 Project Description(include separate sheets as necessary): Tax Parcel Property Number: Size: (acres/square feet) Site Address and/or Directions to Property: Property Owner(s)of Record: Telephone: Fax: email: Mailing Address: Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Building 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]** ❑ Single Family 0 Garage Attached/Detached 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** O Home Business 0 Cottagelndustry 0 Long Plat** O Propane 0 Planned Rural Residential Development(PRRD)/Amendments** 0 Sign 0 Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** O 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 to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his, her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or she wants,:prior notice. 7 Signature: `N ) .�'�ll�—' - Date: /(7C'�/° / The action or actions Applicant,will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable respon9biliy for adhering 'to and complying with the ESA. The Applicant has read this discla a sig and dates it below. hd Signature: l J ^. ` Date: .t ? 11(J l 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: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: \s. PHONE ( ) FAX: ( ) MAILING ADDRESS: ` EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood \ Existing: ❑ Sewer 0 Addition 0 Steel Proposed: Bank Cl Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: [_1 Individual System 0 Repair 0 Masonry `;, - SEP Permit# ❑ Demolition ❑ Other: ' Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: ❑ Public Total: - Name of System: If this is a Commercial Project you must answei the followinq: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,em lo ees,etc) Current Proposed IBC Occupancy: IBC Type of constru Ion: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Instal on permit,mark all items below that apply: I Underground Tank i Above ground Tank 1 Size of Propane Tank: I Heat Stove I Cook Stove 1 Woodstove I irepla e Insert i Hot Water Tank I Pellet Stove I Other Is this appliance being installed in a Manuf ctured/Mobile Home? Yes / No When applying for a permit to install a pr pane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size, distances om the propane tank to all property lines, buildings and septic system components, including the reserve area. r Square Footage Current P posed For Offie Use Only Amount Revision Main Floor Heated \ EH Bld App Review: 2nd Floor Heated ; Consistency Review: Other Heated / ' Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ Receipt Number: Cash/Check Number: ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc �., oisr co R -cute'' D JEFFERSON COUNTY 440- '31-4 DEPARTMENT OF COMMUNITY DEVELOPMENT 9 �? . ., 621 Sheridan Street • Port Townsend •Washington 98368 l `Al �' N5' http:/3/www.co.jeffe• s/on 379-4451 wa.s/ommdevelopment/ JFax FFFEHsJt 1,�IiINI1 «I STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# 0*1 - 5(c."1 PROJECT/APPLICANT NAME: nAc 1 4 J e;5,cc 1,L1 v1 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 s�o map ( c at a_ j Js) 5-m Lt. ` Q vv,,, �, ,A , S_DTC Ot(a•,, n i o�C✓l 1J � to k ok cv-> w am- o, ,a- Q • A 4`64 of LOo f `�-� QortaL C -le WR--kro 0.&3 vS`I�Q4 , -2-C ,S'`;-t-- ( A• Existing Conditions Summary eIce.0 dF. 2. Describe the existing topography. Indicate ntours on the site map. titer 3 0 ,, P o Lc Q oo c: i of cl l c � w�.a..l>_R U l ok 1 h\ S'i T1c ,i ONQt _1. .-1,/, (` e...n,' I S I o O .k cry) A 3. Describe the existingvegetation. Indicate native v getation areas on the site map. 9\1 �4;tie i.i-e<SS �.. -6 `tomDo.r*ok -Y v,c(oc 70 e., a(� �„,<,1 P.�, , Ivkoo(�0Aa `1-it st��ok. rrS I blaTG. 1,05►A G „� I 511r, s,.4e Q( . 4. Describe t=istingsoils. Indicate sail type on the site map. -S0,1 i� P l 11'Ci-n ,r2 f s 4 4 cQ okoX R o /3-15 fi at tat . s_orc-N ,tS- Pr iv._Q . 0 5. Describe the existing site hydrology(i.e., drainage; behavior of water on the ite—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. F,, 34,E S e olcG(d I oa r� d 3 �-s`,, Nc hJ � u,.( . Th cLP Qt rP IND 5$4--rv.w A rca'm 1Z , NO 0ol,, � to f- (n)0 -A l C �--Q.(5 i 7l`L9emn S OC' e..�r6±l a,Aa-A (/a t v t�/l pc -C,. �2 Ft-e e,r-.L2 ✓-r, okra,V�A 1}. � ,s v\,s • APPROV Lt d 6. Describe any excess levels of noise generated by the proposed use or activity: LD Na- v.e(.s �,_,Q_ ,ef,a_p,,,•0,k H0 la_Q___ L ,--,\„ , !ATERQPLA - ,,,,,m,,,,4 in/N._ • Stormwa 's . Atli 3 2007 Re uired q JEFFER . &OONTY stormwater site plan template- ate DEPT.OF Co, Y ,%VE I P NT 1 5 SIGNATURE: it I41I lir 1f 1 7 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. S�cp� c e�k c,(o✓� T Pop L zke �� C�`'tv� 90> i3 "s!i " f c v1d5fdt, a rc9 . (S6c mt)040 I C)), Ther-e ctra •10 .zQ;s :� t�ar��C -f1004 1'IG c� I c&3Sci cQ t (4 $ke ca AA) o r ()ad ccf � j cA-kr ` pc , A c�,-I��c- �, ceo e,rsQ -15 `i4Qvik 4,c c -10,. !�7�Po- cQ . 8. Describe the general vicinity of the site, including �rfs adjacent land uses and structures, utilities, roads,anditivegial "s rn(streams,wetlands,lakes,steep slopes,etc.). Sr 'cQ c '�( i�c "I fv ` Q��� o�S'�CU� ft�1�h c� 5ao1` C w-f t ofCOS cir-t �tQ eel O�n 1 Qe.� Le Q� ' TPcQ 1.4L+c i� CirtnCGC.W,a'��1 1 M,RA 4 tU E • o ae l"4 n nt Q �j c,d c� vN Q�h (� , \y 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. 9. 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 sit plan and differentiate proposed facilities from existing facilities. Al u-e(o p Anc.0c4kr ocke a 5 G ru) w ' 1 1we rta1 Lo e oQ -Col\ cksb ueNspcs iCA 4,cpt(z,-^- -�- 13mP 15.30 c-DSKr• 30ir Itw-A, 5cw. t.,_)aA-kr Pe nne•nDFt o� clQoa-cofGVP o. ('�t_ a,Av•r‘ apocr ,,v"n4- I50 X I00-4 WI'o� o 11 h c `{�11�1l d�csodz 11.re)"bk c 1.e4st icon- o� nQf + v p�2'fc 6". A Tf;•3? )d I �Sa .�Se� �S -t 5, 0 1��a 's atT3 ,,� M G re3koloQ i�efnorcR aSLQR 1►� 10. If the project requires`the'use of stormwater treatment facilities, escnbe the types of stormwater treatment facilitiesli7 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.] �e.r-e,t c t g c. 5 5c c`Ce 0 . \5 (� co d p tre(o .w.�,�� s;{e. 1L,a� `ce 6,,,, G�1 Fo ��F f(NP (( L r-e°I0.;,n Q cJt ,2 c.. c3.r ect lcnc2• v n off �, .II lye ICIf o� t3 QJtrso c� , ?)0A Ts,�o �)00 I 1 So cepa - 11. Describe the performance goals and standards_ applicable to the project. w Q�t kr C.v(�c� -F w,1\ ( � p„.ArS�oQ - 12. Describe the flow control system. REVEVE1) 0 � 3 2047 stormwater site plan template-rev.10/1/2003 6 ti } III . 13. Describe the water quality system. /vi, - See . 0 REE1Ifl 14. Describe the conveyance system analysis and design. JUN 7 JEffEitto +;IIimo gr1P 15. Describe the source of fill material,physical characteristics cf fill material,and deposition of excess material. UO -11 uVkQ {`, C,-k_ "I Le 01'1 =0--ece - 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Unifor Building Code. s� 17. Describe the proposed surfacing material. N jA — v.& - MrA\ cr 18. Describe methods for restoration of the site. NIP\ - &c, i;% 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. N [t s M 10 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. (\on e. 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. rcce . 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. \'e 1.\-14 n u e c cik +P-eel wen-e IA eceon ` elo o f ,\n )o,Ic 'i- S A �c� 1 Sn`�-e cR ` re o.S C Go re 4 �,of ow ry SS yr ���Q �0 P�P .,A oLo -1 a f.(0.� Oct e) o` -/--P (�m use (CO I- `6,n \ P cbk-E ,); �.• crp,.r- , 0,®os LA Occ adu o c (‘Q caul o4 'b LI) es . 2. Establish Construction Acces . Co-f‘Sii c,c McC .11.> 3 1,n\--, a cb ` fi- d c,,-e �a c o a733 Try.-E' L L& 00 r Q. `. ,o>r -6 'h.�a 34-0- % cif t tt cv c*(N/N- -i.), O(A-Wm r,C-e 4 d c u�P tx P f tJt V1 Cb.-.\004 0-1-1-4 `-10 C1\ s,c,,te G ' ,r✓tn Sub^}Q fQ�.� • C s L.`.a d [oec, „`� DDQ5- G.-r' 1 t c G. (,,, U k �-t Q( —cQ oky-L I YJtU Sriv fooCe . fn73. Control fFAow Rates. �\ U ( v,nn�k n r^^� t_ Co✓ASVvci e.,-. .S, u i (\ Ise A3 c -P4 11,4ea 1 t, A rnmNn MA.,,.vk d- 1 on 44 ( $ sR 6.,„/ .egfea_ lc.n c ( ('CA [/J-\ ‘,1 a It)��4ec, s, r ,N r4�e . 4. Install Sediment Controls., M.R.n Co-it ,`�v`n oQ tv\ lam" AAA-0 c�io* o l 15c�r,l o n o{ ttI!C A'Vc,\ 9 r9- I a an '` cc�,, 1, 7( ©© -r �3-- U-P (3 o" J-{�t f 5+ t A 8 G�n�;'{nAc Q (\c1`Ccd\ ,/j pO3 ` Cds, 11 l u CLR�1,.ycol , 5. Stabilize Soils. c'6)1 dab; 1 i�-a* r>; A\ 1..e c.eli..o�-ate w;rM M4_,1rk 0, (54ca w c,r c� Q., cQ 5 -1-c- ve v-A--•4=--, n>, ,.,---t cc i Q t,. ,t1 " c-01A D iv--oo�ii.1 7\� fvt1,1 c1nM t1'n •5$ S�c? too 04-)1 qaa, c o i �n . �a '�...e a4.r;v-e jc . �Cve5 �c 3 l\ s.ec.-t ,.z>e t Ask Q- wAck bt-' . 6. Protect Slopes. .Sto�?s 4 Q t._-e..cx (i e . d�(.v-e v.�c t l I �- eh-o� uJ ,"(� a of 1 cb,.)i Qa e cu. f �i 0, ��tPca V L,A o ,��( t [,-t `� L-y S 1 (;4, 0)4s, qQ,„,„ o�,NN“ wa ^(\ c,/\(`ro�naf ,.-..Ls ►,�' A-- v-12 if ets'k-o" # 7. rotect Drain Inlets. xim f iv f A - nQ e�i b �5+:,� 0-.t. gQcC e A al ca -,n1� E�A \ ,, 3UN 2 9 zairt stomrvrater site plan template-rev.1 N12003 8 . • • IRE EW11 T JUN 2 9 200 ` 12 Required Elements-Construction SWPPP(continued) 8. Stabilize Channels and Outlets. 1l,, AJ IA - f\o \ uGc c�,-3) 44- cIAa0 (5 0.c- FFFfHjjg ��A C9. Control Pollutants. (� 11� 1 n j 1 e.. S'KU c% &N O 5 i) I -e C c 2 c cQ M�'o ov�.P G oc I5�t c i, i l ce�Vt(7�a. o.n ot 1zfi U(cr ‘3,s ~�vn'3-e D oU,>\ - . (�rf cn e'& .124Q c L Tho',\)AKs) L i?ti� Li,i,cV 0 1 o,',,9 el cj r c c o( ,,, I� "� � 15 1 , J 10. Control De-Watering(the act of p mping groundwater or stormwater away from an active �construction site). 1�c, Gi3�,�(1 , `� cs o r t�✓!1\- f/ t.,3` R ek ok(Ac can >! Cbc�r S� o{ ^cik� , `o.", ) ' I( '-) 13(yt f ry2 o L./1v, a� ck r-PS f- V 11. Maintain Best Mana ement Practices(BM s). S c.,.1,\\ 1Ds_ I -Po a.l v c\A-e ot 4 o o(;'tee.oe 0. - cedo,,,o , ✓t..12e(104 • „c�`) (Ne“),-C2- Qfa� cr ,•ut.l eC\-- r�>' C UOI)c l-2 c4L— c, ,&.A-oeC i ce - ev 4 o 'k ,,c 1 LA of o -Q_ vtAAA d.(A C't• A,S141_,c`��,/\. . - ,nn Qct c., Cb� A.S c—N\ (1 \a-e- )2�Mow(bx-- L. j n 30 o)Q 1\ i 12. Manage e Project.1 n �b"A- 1 r q41a ,z, c, I ,I'1.2h c11 cA c r2 vJo , \,I I Le ('�M ,Q. 'C`c5+ Sc ai t �c� $ 6 Q v-eR n n ‘ro'I:•,-^- otV (b,h, J 6 ') 5 a Cb/�S-Vsti c( �;0�. P v r -, , I Ntl b� Tee' o5+ `1u� r CaA�r-• tNtv 1(AA c'v. co,,1 ,� .1 I GHQ ��.,pS(}Q 4..Q yl�n k.y c7c a See X V1iv1 c n a�p `CN�; 0 O h Soon N poyr 1. - 2. Adj . a. acent DescriptionAreas of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). Ill _ c'Qft2 e. /\o 34it.o,,vws 11eA`lk,it wPi1Q+.naQ.1J c,clt c /t-l� oc °rotv:,e :n�`-t Ack is Q Ai. '14-4 4lo•nc1Z (y\11 r\ai G r4 2. b J ?fin crg �-k r. s,\11 \oo --�1I�Jo1 3x�� � . 7P � �a1 .4Z.. '- �dIJU6,A7, `- ) ` e . d c�c.a w c b. Description"f the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards).-11...P cQ '5 INo CP C P 1 �!, boot 11 c-0$ r r. `M , t �n‘R ,0-f cbri), • - .�� 1A-.11\ 1� I ad\5 t�rAc4 ' nQ� '14Y( .` 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. ,S1 OCP l\ .i P0--12,- .LL •1 i 4I stormwater site plan template-rev.10/1/2003 9 • • • b. Description of special requirements for working in or near environmentally sensitive areas. of c sic u i 11 ?)coc k_o Cc n o 4 ck 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, er eability,depth,texture,soil structure). 56)`S arc c Sc>t rQ 0A i le 4 ,(3\ t(Ak.9 Q -�..t. �5 kA i L, L C't?() e I U �o-Q- 1� a`}e JI 1�J `CCs 2C o c.^ C-C S,�r0p� c�Lec�� R ,� ;,�, 1� V� ��c 1 �a o2 �.i, . o t e <h Qt� �MP's o 1(4 4 A r Q\n c,-Q • 5. Construction Phasing. a. Construction sequence tA_NO. t\.S' cA et7klx,. Nasga S Qx cV c c , 1 (`�. !fin-. al� vL'J P� eNkSlstt--)C- 0-A, �sl r- (A.bUIJk..Q b. Construction phasing(if proposal) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. (A-.1-)4-e,› rye o..)Q aM -i-e 6 _Sv1._6_ 07 tr) (>- c i,- ea"f� II. Wet Season Construction Activities. a. Proposed wet season construction activities. `b. Proposed wet season construction activities for environmentally sensitive areas. f1t7-IVY • 7. Financial/OwnershIp Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. Cin a a& P SS i e c\ cA vn ck- b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. i'rS o C a.n c1t. 9,w,of. 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the fo i(�ap l ' I1 a. Sediment Ponds/Traps. /v r tl b. Diversions. /U fsr c. Waterways. N JUN 2 tat? d. Runoff/Stormwater Detention Calculations N JEFF ll ' flN tt$ 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. 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. 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