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Home My WebLink AboutBLD2007-00372 • • CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 PERMIT #: BLD07-00372 SITE ADDRESS: 221 E ISLAND VIEW AVE Issue Date: 08/17/2007 PORT TOWNSEND, 98368 Final Date: 2/18/2009 APPLICANT: MILLENNIUM ONE HOMES INC PHONE: (360) 385-4141 40 VANCOUVER PL PORT TOWNSEND WA 98368 SUBDIVISION: IRONDALE Block: 152 Lot: 20+ PARCEL NUMBER: 962115208 Section: 35 Township: 30 N Range: 01 W PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE ALSO A/G 120 GAL PROPANE TANK THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 2/18/2009 I:\F_BLD_Occupa ncy.rpt 10/29/19 tILDING PERMIT APPLICA4N ML vT Reviewiew Ty 395 ype: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00372 Received Date: 7/12/2007 SITE ADDRESS: aa.1 E ISLAND VIEW AVE PORT TOWNSEND, 98368 OWNER: MILLENNIUM ONE HOMES INC PHONE: (360) 385-4141 40 VANCOUVER PL PORT TOWNSEND WA 98368 IRON DALE SUBDIVISION: Block: 152 Lot: 20-24 PARCEL NUMBER: 962115208 Section: 35 Township: 30 N Range: 01 W CONTRACTOR: MILLENNIUM ONE HOMES INC PHONE: (360)385-4141 40 VANCOUVER AVE PORT TOWNSEND WA 98368 Contractor's License MILLEOHO'OMM Expires 7/13/2007 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NEW SFR W/ATTACHED GARAGE ALSO A/G 120 GAL PROPANE TANK '*-t,U,-0 , SQ,r,\an, aax.1-jC0 Akiki TYPE OF WORK RES SQUARE FOOTAGE: F.,rre9-'A TYPE OF IMP NEW MAIN: 1,568 VALUATION 245,000.00 ADD'L: 676 HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: PRO OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 561 SHORELINE: CONST TYPE: DECK: 54 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 3 Total: 2 Total: 3 Routing Date: / ) J } i� ' 1 . ' / f r Type Amount Paid By: Date: Receipt: Apra d e Permit $1,805.75 KAS 07/12/07 91511 AP � /ED Plan Check $1,173.74 KAS 07/12/07 91511 State Building Code $4.50 KAS 07/12/07 91511 AUG t I 2007 Potable Water Application $58.00 KAS 07/12/07 91511 Jefferson County Planning Total: $3,041.99 &Building Department Jefferson County Building Di"vision Permit Num.. BLD07-00372 Applicant: MILLENNIUM ONE HOMES INC BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2006 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks Erosion Control Foundation Footing Footing Drains Ci`act—t,] 22 Foundation Stem Wall R/11/67 Dv Underground Plumbing ,\ Under Floor Framing 0_/_0 7 ,2,('� Straps(hold downs) !Hob Ext. Shear Wall Nailing 1►' TE2 eoRaBcriaO S Rough in Plumbing ii/i4/ol zrk Framing i/iq B v/�dr/ 7 Al�� iiii - Si48 K rr PFvtscaus 412 RU>lu aViEmJ Airseal ///o/D$ Insulation:Walls ///¢/08 At Insulation: Floors O" Insulation: Ceiling ✓AatrrT t r/zi.6ts Dk /444/aB Int. Shear Wall Nailing Wallboard Nailing ' Gas Line: Interior II—2)0-0 ,."-- Gas Line: Exterior rr Propane Tank 74/7 0-ef - Heat/Chimney Clearance Drywell/Alt Drainage Address Posted `�I1 O? iCL FINAL INSPECTION , (� oU FINAL INSPECTION UST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD07-00372 tit 1)0 1.)yt'(`PRIOR TO OCCUPANCY& BUILDING FINAL INSPECTION FINAL APPROVAL OF SEPTIC SEP07-118 IS REQUIRED. 2.) ALL COMPONENTS OF THE SEPTIC SYSTEM ARE TO BE COMPLETELY PROTECTED FROM VEHICULAR TRAFFIC OR MECHANICAL DISTURBANCE. 3.) MUST COLLECT AND DIVERT ALL SOURCES OF DRAINAGE AWAY FROM SEPTIC TANK, RESERVE & DRAINFIELD. MUST COMPLY WITH ALL PERMIT CONDITIONS, STATE AND LOCAL CODE. 4.) The application was reviewed by the Jefferson County Department of Community Development staff on August 17, 2007 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: SARPA aquifer recharge area; coastal SIPZ. 5.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 6.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 7.) Critical Aquifer Recharge Areas are defined as Seawater Intrusion Areas, and Special Aquifer Recharge Protection Areas and the following land uses located within Susceptible Aquifer Recharge Areas (1)All Industrial Land Uses (2)All Commercial Uses (3)All Rural Residential Land Uses requiring a Discretionary Use or Conditional Use Permit(4)All Rural Residential Land Uses with nonconforming uses that would otherwise require a Discretionary Use or Conditional Use Permit (5) Unsewered Planned Rural Residential Developments (6) Unsewered residential development with gross densities greater than one unit per acre. All of the above listed uses shall be subject to the applicable requirements and standards of the Jefferson County Unified Development Code. 8.) 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. 9.) The parcel is located within a coastal SIPZ (seawater intrusion protection zone) according to the County GIS map. There are voluntary and mandatory measures identified in the Jefferson County Seawater Intrusion Policy(Resolution 44-22, effective September 23, 2002) that apply to well drilling proposals and building permit applications on existing lots of record. A Coastal SIPZ is defined as: all islands and area within one-quarter mile of marine shoreline, but no history of chloride concentration above 100 mg/L in groundwater sources within 1000 feet. 10.) 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. 11.) To help prevent seawater from intruding landward into underground aquifers, all new development activity on Marrowstone Island, Indian Island and within 1/4 mile of any marine shoreline shall be required to infiltrate all stormwater runoff onsite. 12.) The applicant is proposing to cre or add 3983 square feet of impervious sulk and 4860 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. 13.) 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. 14.) 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). 15.) The site plan as submitted with the building permit application on July 12, 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 17, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 16.) This approval is for a single family residence with attached garage and 120 gallon above-ground propane tank 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. 17.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 18.) A Declaration of Restrictive Covenant has been recorded on August 8, 2007 under AFN 526187 for the purpose of consolidating the lots to meet minimum land area requirements for on-site septic ad to allow zero lot line setbacks. The Covenant is strictly for building and septic purposes only. 19.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 20.) 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. 21.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 22.) The building height is not to exceed 35 feet. 23.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 24.) 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. 25.) 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. 26.) Minimum setbacks from East Island View Avenue and North Lyter Avenue rights-of-ways shall be 20 feet. Minimum north and west property line setbacks shall be 5 feet. 27.) An address of 221 East Island *Avenue, Port Townsend has been assigr•o the parcel. East Island View Avenue is private (P469). 28.) The lots were created through the Irondale No. #6 Subdivision on June 28, 1910 under AFN 30490. 29.) The parcel is served by PUD #1 water system. -Thr 0o� JEFFERSON UNTY W�,�� lib i(A( FT (4% �g DEPARTMENT COMMUNITY DEVELOPMENT `' •.. 621 Sheridan Street • Port Townsend •Washington 98368 JUL 1 2 2007 360/379-4450 • 360/379-4451 Fax s NG�p� www.co.jefferson.wa.us/commdevelopment EffrHH Master Permit Application MLA: 1 Project Description ('nclude separate sheets as necessary): 6) l Tax Parnr _, Peri/IA-kJ Lk i-k-e-ii,e_ tt,)/117 TO Ched G"-ft 1-LL-ce- Property ,.) � Number: I. H / •9 f c"' (acres/square feet) Site Address and/or Directions to Property: ...Gc ,.,1 .L.o gg.-to... ("614-4 Property Owner(s)of Record: '4'?4. 424, /04, 1 t,,j'S._- Telephone: I tr 3 k ttjl"1 Fax: email: Mailing Address: I J (.0 to c ,.,V 4)0 r "iii., Applicant/Agent(if different from owner): ' 0O..t,I0.,Q„ q9,,.,, 4444 4.6k.....0, S- Telephone: 'a R C - Y/ Li( Fax: -3 J?! r tr'i ./ „. email: Mailing Address: tie,v (IA i C J ti leA•S'.- 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]** a'Single Family E3 Garage / ached/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** ❑Home Business 0 Cottagelndustry 0 Long Plat** Er-Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Sign 0 Plat Vacation/Alteration** ❑Allowed"Yes" Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management ❑ 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: � g DESIGNATION OF AGENT I hereby designate e P`fr( 4.. S k-4 /, I,., to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE rtf..*110, -" `", Date: h r. 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 o1 r she ways pjior otice. �. Signature: t '(/ Date: 7 - r? —') 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"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 responsibility for herig to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: t- ,i 4,. Date: i ., v " + "7 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 rresp�onns_ibbil ty of th General Contractor for the proposed project. Signature: °.�-°.-L"�T `:L" ..e Date: 1 / - °7 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: '941...?..t.0_ I.",AL %-. ( ) },?.S` 4/4/1 ( 3 is o) 18 5 - V/t110 MAILING ADDRESS: V o (A Jh L v L/ '4.1 EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: IN I L_L. 0 4-I ;) t c) AA IM NUMBER ARCHITECT/ENGINEER: ' *I' C ��1 4 j PHONE (lop) tic 2.ti l l tt,FAX: ( ) MAILING ADDRESS: LC I+ s , {,n,„.tt A , EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: i'New lie Wood Existing: 4-i ❑ Sewer ❑ Addition ❑ Steel Proposed: 1, Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Z►1-a_ Heigh • /Individual System ❑ Repair ❑ Masonry A i4` SEP Permit# cv-i - 1 1 '❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: D Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: 1, Public t,,H _t.; t i-! Total: 4114 Name of System: If this is a Commercial Project you must answer the following: t Number of Parking Spaces: Current: ,IX 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: 1 Underground Tank YT Above ground Tank Size of Propane Tank: 12 0 I Heat Stove I Cook Stove I Woodstove I Fireplace Insert i Hot Water Tank 1 Pellet Stove i Other Is this appliance being installed in a Manufactured/no`7iile'Hom` es / 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. *- ;..K ,. i,1 P..t'. 1 - A \.id-. t ' a1 t L, 1-tt-Ct Square Footage Current Proposed For Office Use.Only Amount Revision >- Main Floor Heated EH Bld App Review: 2"0 Floor Hu( ed ,, consistency Review: l J�.CC E herfit-Med) �A l ��;'_�{ 'v a'.0•ait lase fee: I c5 . 75 \adivvA 0�( "it, ' L additional Section: Mezzanine ______— Heated Basement ^i'‘i,'' Plan Check fee: I g-0 I 1 /i Unheated Basement State Surcharge fee: r Other Unheated R£fFRIr j �_,! IV 11141141111Dof Water Review fee: r Garage/Carport SUBTOTAL �, rLO( ): a.3. ,`7� - _ 3a '1q Decks i 5. t f �Zr 11/Rd Approach fee:' I Co Other TOTAL: $ % Liy C, CCq -�i Receipt Number: `"I 3 I I i� icit Cash/Check Number tcPa 'T ESTIMATED COST(REQUIRED) Date: r7 f -7 . .�15(�� I alcl •Fair market value of all labor and materiels-fo allot;to finisfi -- - -z^. Initials: ') P1 eirtit j✓ Q ui 11-b -1-11-o3 G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc II 0 kl.(4 '114 Al PI ) rik‘C140: JEFFERSON COUNTY �u� 1 2 2007 DEPARTMENT OF COMMUNITY DEVELOPMENT O. 360/379 621 r4450idan S reet • 9 4451 Faxrt nd • Washington 98368 iE�FE�SU�►�UUNIYgCDa` http://www.cojefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# O � PROJECT/APPLICANT NAME: --t 6 IP Q 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. . , 6 yl* -11)(V- k Ph-MA.)1/4A 1 .6-16(q2__, 2-2- _.,i4 ,p:oLi-- ions Summary et:::in d / 5- ›-q---C-÷ Existing Condit 2. Describe the existing topography. Indicate contours on the site map. Pia+ vg o__,--ay - 1 3. Describe the existing vegetation, Indicate native ve etation areas on the site map. 4. Describe the existing soils. Indicate soil type on the site m \ i1 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. YET i'-'>T re5 t `l//.Atli c.Ga- , - to/a- -- ert. - "1/472-0.4, L_Pi)--- Gkj_lcie-12-1.1/4,f-- e,eco--9rA.117 6. Describe any excess levels of noise generated by the proposed use or activit}: APPROVED ne__nb STORMWATER PLAN Sint rnwat AUG 1 7 2007 Required 1EFFERS t NT DerrOF M f Y V. O E stormwater site plan template—rev.lalrztx>3 SIGNATURE: S,,._4111:I 5 • 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes,etc.)on the site. Indicate location on the site map. /A- 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.). esL)e_re.{- t_bl- 0 I n ia,&)c-ke),6,a ) naonomotIA 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. Loca a these facilities on the site plan and ifferentiate rop sed facilities from exis ing facilitiAs. 's,) akvii 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.] f/`k 11. Describe the performance_goals and standards applicable to the project. • ire pb ►/rS wa4 e( vs nclo0 aA naQ_ .12. ..Describe_.the flow control system.-- (R iEcjj,`�I Ju) 1 Z:27 VIND fFRINIM f.1111N0 tIrfi i i > stormwater site plan template—rev.1 V1/2003 r 1 el 6 V1D 13. Describe the water quality system.1 �` /� Uu \3( . l Q r. t.,A� i. 4+ 44J1-i`I[RH) so/110N hit}co 14. Describe the conveyance system analysis and design. kV—A 15. Describe the ource of fill material,physical characteristics of fill material,and deposition of excess material. n -� 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. N I/A. 17. Describe the proposed surfacing material. 18. Describe me hods r restoration of he site. t5capINY-A. 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. kf , 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 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. N( \A stomwater site plan template—rev.10/1/2003 7 • I 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. p 2. Establish Cons ion A ess. ca c o-eC. 3. Control Flow Rates. ��Vn,� 4. Install Sediment Controls. 5 ,. Est ALP zit..wv_47, Ac 5. Stabilize Soils. c 6A--(211,0) C5a/kyLQ) 1RECEtvm) 6. Protect Slopes. L P ![ 1 2 VT? . iffrnisio H 7. Protect Drain Inlets. 5 4 it„` 4i /11--e- e(A-7- stormwater site plan template—rev.10/1/2003 8 # • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. IR ' A IFT) Ki A 4 �t1 12 2007 9. Control Pollutants. I, s dfffFHllkjmco I 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). a wQ.it l� 11. Maintain Best Management Practices (BMPs). 12. Manage the Project. -to dct _ltr - 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). A1/c b. Description of the down eam drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). 3. Environmentally Sensitive •reas. a. Description of envi onmentally sensitive areas that are on or adjacent to the site. stormwater site plan template—rev.10/12003 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. 1161- 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). M 5. Construction Phasing. a. Construction sequert�e+ l , p '�r`` I)-r-ikt�L UL! Vl.l � 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. II. Wet Season Construction Activities. a. Proposed wet se son construction activities. 6P - (S - p uT pO Af7 57 fivi aS 29e -ems b. Proposed wet season construction activities for environmentally sensitive areas. //72/"9- 7. Financial/Ownership Responsibilities. a. Identify t e propprty owner responsiblefor the initiation of bonds and/or other financial securities. px'I110 O\nem� b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. 0‘^ Q 8. Engineering Calculations. Provide Desig�Calculations on a separate sheet for the f i�i�if�aq lilt.�tll�� a. Sediment Ponds/Tra s. b. Diversions. /fi/�¢ c. Waterways. l� � d. Runoff/Stormwater Detention Calculations /f�/` a rik f 44In�;iIIIN��MIr� stormwater site plan template—rev.10/1/2003 10 • 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 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 certify that this application is being made with the full knowledge and consent of all owners-oft he aff e e -7- 9,-- 67___ (LAN R OR AUTH REPRESENTA SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: RECIEWpy t. ` , 2 243? 1Efftllrl'II�l,1(lijNI)IJr,f, stormwater site plan template—rev.10/1/2003 12 } 0 • I II I 1 tllI 11 o 110 fI O' 1-4' e-0' / e-0' y H ii (ci E I 1 D 1I I I A MT4• A ri• „51/°• cr, I 3aa 0 s r.Ir -I -1 o 0 - I I I I '- m r-s• L.J \ 11 II § / \ 1636 2636 __C.— _ ♦ tYt n 5 m_, - D g$ ° O 266a = 71 \ 3O 6 (1 7669 $ a b o4 ea 0 m a D O ill r JJ O 2666 6 p f� ? 3 A xi �� t �. a-' a-a �r q v0 ale, V I • ° m �� s , U ....\\..\ ••\..� u \ \ r3040 3c40 Q \ atit Mtn ii I> + r-3i. C5M GYir t,.'-/ Oy�L'•� _, 3•-0' ! 3•-0' 61. i o 11 Z a _- c) 13 I J 0 C=,_J !- ,.4 d \'. 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