Loading...
HomeMy WebLinkAboutBLD2007-00402 DEMOLITION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD07-00402 Received Date 7/23/2007 SITE ADDRESS: 841 S JACOB MILLER RD Issue Date 9/19/2007 PORT TOWNSEND, 98368 APPLICANT: CLEO M AUSTIN PHONE: 360-385-2941 841 S JACOB MILLER RD PORT TOWNSEND WA 983689252 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001081002 Section: 8 Township: 30N Range: 01W CONTRACTOR: OWNER/BUILDER PHONE: OWNER, CLEO M AUSTIN PHONE: 360-385-2941 if different: 841 S JACOB MILLER RD PORT TOWNSEND WA 983689252 PROJECT DESCRIPTION: DEMO EXISTING STORAGE BLDG Directions SEE MAP IN FILE To Site: THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 9/19/2008. REQUIRED INSPECTION: FinalApproval: 542/ ZM BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. SPECIAL CONDITIONS APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY Ilk UILDING PERMIT APPLICA N MRAO-004418 eview Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00402 Received Date: 7/23/2007 SITE ADDRESS: 841 S JACOB MILLER RD PORT TOWNSEND, 98368 OWNER: CLEO M AUSTIN PHONE: 360 385 2941 841 ES JACOB MILLER RD PORT TOWNSEND WA 983689252 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001081002 Section: 8 Township: 30 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: DREW AUSTIN PHONE: 385-6681 251 RIDGE DRIVE PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOr DEMO EXISTING STORAGE BLDG TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP DEM MAIN: 904 VALUATION CODE EDITION: 2006 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop: 0 Total: 0 Total; 0 Routin Date: ( ��_ 23)01 Type Amount Paid By: Date: Receipt: Approved/Date Permit $51.00 LYK 07/23/07 91399 APPROVED State Building Code $4.50 LYK 07/23/07 91399 Total: $55.50 SEP Ic1 2007 Jefferson County Planning &Building Department • SPECIAL CONDITIONS FOR CASE#BLD07-00402: • 1.) The application was reviewed by the Jefferson County Department of Community Development staff on August 30, 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: 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.) 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. 5.) The applicant is proposing to create or add 3660 square feet of impervious surface and 5720 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 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. 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(2)(f). 8.) The site plan as submitted with the building permit application on July 23, 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 30, 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 and demolition of an existing storage building 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 received a re-zone designation from RF to RR 1:5 under the Jefferson County Comprehensive Land Use Map effective October 2006. 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 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. 13.) The building height is not to exceed 35 feet. • • 14.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 15.) 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. 16.) 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. 17.) Minimum setback from South Jacob Miller Road right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. 18.) An address of 841A South Jacob Miller Road, Port Townsend has been assigned to the primary house. South Jacob Miller Road is a county local access (C625319). 19.) A comp plan amendment(ZON06-0010) was approved on October 10, 2006 to change the zoning from RR 1:20 to RR 1:5. A subdivision application (SUB07-025) to divide the parcel into 4 lots is pending. A pre-app (PRE06-0048) to subdivide the parcel was conducted on October 24, 2006. A building permit(BLD07-0402) to demolition an existing storage building will be issued with BLD07-0403 for a new single family residence. A pre-app (PRE94-0046) to subdivide into 2 lots was conducted on March 2, 1995. A septic permit (SEP07-0195)was approved on June 13, 2007. A septic permit(SEP79-0216) was cancelled on January 8, 1980. 20.) The parcel is served by 2 wells. I:\F_BLD_Permit_Propane.rpt 10/29/19 o O«�� • • PERMIT#1 b"1 f 7 ci RECEIVED APPROVED CONDITIONALLY APPROVED________ JUL 26 2007 a~,� ��c N4"s NOT COMPLOIANCE WITH AA REGULATION t „--------- ORCAA /. ORCAA UC." �. 0RCAA�F�+` ' -Jam., t� £tEIIiDN•WM•!1- Notification of Demolition Permit It is unlawful for any person to cause or allow the demolition(or major renovation) of any structure unless all asbestos- containing materials have been removed from the area to be demolished. Work shall not commence on an asbestos project or demolition unless the owner or operator has obtained written approval from ORCAA. A written application for a demolition shall include a certification that there is no known asbestos-containing material remaining in the area of the structure. �' h�t ' d* 'J -4.,- ' County: '1'• Project ite Address: __ ��1, Zip: `7LGs ty: ll , 14 „ r State: Ci Starting Date: /� 7 A, .., 203'7 Completion Date: //'J d 7 ` *(There is a 10 working day advance nication period from receipt of permit application) Property Owner: 6.6e //(, 1 1 Telephone: 6O--'tSt5 ' 7,q4) Fax: Mailin Address: g 5, Nita-4 IL '/� Zip: *�'� City: ��'-I l )mod, State: 41 L'` MC-State License#:/- (- Demolition Contractor: l � � �' Mailing ddress 7- ( (7 '? 71/ �`' ' t ' y State:/WI Zip: Contact Person: 77 "' / Telephone: 3!Y)' -s y.'" 3L'U1' Fax:5 J335 - %%i i't YES NO Demolition by Wrecking or Dismantling? ($25.00 fee) check# X Training Fire Demolition? (If yes,attach fire department request for training fire) )( Renovation, Alter atinil,Remodeling,Maintenance,or other Construction? Y Asbestos found or suspected* *An ORCAA"Notice of Intent to Remove or Encapsulate Asbestos"form and appropriate fee must be submitted prior to any asbestos removal work. Asbestos removal projects involving demolition must be preformed by a Certified Asbestos Contractor and all or potentially friable asbestos must be removed before any demolition begins. Refer to ORCAA Regulation requirements that may apply. ��1� )L:luArtip)c�I/t fe Jls1_. .—.. _. Asbestos Survey Completed by AHERA Certified Inspector_ t Certification#_ �` �1--tu �i DPI — (`�,' O This approved permit must Enclose$25 Certification of the Asbestos Survey must be available at the job site Processing Fee accompany this form bi-YI Q TV 2940 B Limited Lane NW,Olympia,Washington 98502 360-586-1044 * 800422-5623 * fax 360491-6308 42'i r� homepage:www.orcaa.org * email: info@orcaa.org Rev.07/11/02 ^Q Elpict �� Drft.A ' DATE , '7 `.1..-0-7 ,�wiSON C�6, JEFFERScOUNTY • rt ��y. DEPARTMENT OF COMMUNI tllygl:3 V l 621 Sheridan Street • Port Townselt.d .Wastingtoftil 6 s 360/379-4450 • 360/379-4451 Fax *qS O� www/.co.jefferson.wa.us/commdevel e�tt G 3 2007 Master Permit Application MLA: ni4 -4 Project Description (include separate sheets as necessary):3 [Milli..: WIN O 4L4bt i 17l/7Cr LKr5'21x jr 50P C�CtOj/v%? Tax Parcel Property Number: (f / C) I 00 2, Size: / 4/465 (acres/square feet) Site Address and/or Directions to Property: haA Property Owner(s)of Record: eel' in, ,414404) Telephone: f' ° e `?=� © // p ^t ,3 e Fax: 21`( f email:ifFf Mailing Address: 1 `). f CO- S' /�1(44l 57Qt / r< -j t-Itt/ 7 i dalApplicant/Agent(if different from owner): ,,))A'-(4 X Telephone: /, 1 ' -- f Fax- Fax: , ]4 email: 4 Mailing Address: S7 /'7 f( iv- :i a/I ?5Y4f Whit kind of Permit?(Check each box that applies tiding 0 Variance(Minor,Major or Reasonable Economic Use) aa Demolition Permit 0 Conditional Use[C(a),C(d),or C]** ❑ Single Family 0 Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular ❑ Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address 0 Road Approach ❑ Binding Site Plan** ❑Home Business 0 Cottagelndustry ❑ Long Plat** ❑ 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 0 Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance ❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium 0 Tree Vegetaion Request *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate p -- 1 4a2f/ _ to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE C____L f;...-'71 (�l 7,4,y Date: 0/1 ,..- ), 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 applicati that he or s ants nor notice. Signature: ,,,, yL c Date: ‘7 2 -4'"61 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-transfer le responsibili or adh ring to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: //V / < Date: ? 1j (,J 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: f G— /mil-J. CLu).h. 1% Date: GENERAL CONTRACTOR OR 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: ❑ New Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: �— Ba ❑ Com unity S tem ❑ Alteration/Remodel 0 Concrete Tota: He' h ❑ Indivi ual S tem O Repair ❑ Masonry SEP Per it X Demolition ❑ Other: Bedrooms: Water Su y: Existing: Se a k: 0 Private I ❑ Two Party Type of Heat: Proposed. ❑ Public 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 i Above ground Tank Size of Propane Tank: i Heat Stove i Cook Stove i Woodstove 1 Fireplace Insert i 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 , ,, ,,ii . ,.: Mount ., Revision:. - Main Floor Heated 9 EH Bld App Review: i 1 3�e 2"tl Floor Heated Consistency Review: (ll3FE Other Heated Base fee: . CO Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: 0k Q Garage/Carport SUBTOTAL I Decks 911/Rd Approach fee: EX`Cri 3 Other TOTAL: $5c3 50 Receipt Number: q(- iq Cash/Check Number: 2053 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 i JI ,EIV(gj1) � ozv c° JEFFERSON COUNTY JUL 2' ;p07 11404 , 1 DEPARTMENT OF COMMUNITY DEVELOPMENT wur 621 Sheridan Street • Port Townsend •Washington 98368rErrtIA� ant 360/379-4450 • 360/379-4451 Fax http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# ©] —s+IC PROJECT/APPLICANT NAME: A /1,57I,t 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 kite map. Ke -1 y is 61sMAccy car— c(/ 4140b1.1 �i�a •.ass t Existing Conditions Summary / _ O ~ 1.) 2. Describe the existing topography. Indicate contours on the site map. JEFFERSON COUNTY OCI no 70 Po4-P. / 5/1keat 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. A4711 56iJ f- - Segi411- DO& Le lie&0 7 l.f?- r ci.< 7-0SE iv rs sr, 410- ork g, sifts .61vaeA0 Lr - 4. Describe the existing soils. Indicate soil type on the site map. 5t' $ 4y P/ApoS 6 t/Y.1J/,9E4 5`r "heal Goc-•i, tO,Lr -d1 J / /fty S'setvzh 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. ie#111 6v'm r,I !irs at/iC/eLy,f A r1►-rR4ruS, APPROVED 6. Describe any excess levels of noise generated by the proposed use or activity: STORMWATER PLAN /6Lu Arxe . ,¢a' &Ri...y ,yes /', rAv.s r=P-ae l� AUG 3 0 2007 Stormwd a JEFF �� �(� Re quire DEPT.OF • l' 11 , • OP F SIGNATUR:: tl��,, stormwater site plan template—rev.10/1/2003 .. '.'A 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. np S1oP1-g n© 'er nos 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.). 5`T� /3 eua4-L, /'�-�En nRz , end /'t L4C / „ 7)O 51-DP Ld144- i- A:441(4 Permanent Stormwater Control Plan This portion of the Stormwater Site Plan consists of the selection and installation.of the appropriate stormwater control BMPs and facilities to remain in place after construction of the project is completed. "Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control facilities are not exceeded. g. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed (i.e., per BMP T5.30 in the Manual) or, if not,what types of stormwater flow control will be utilized for the site or specific threshold discharge areas within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. 5 -D Pin- wfl7z-1Z ,, ite- /xfdb . mpr e6Q. PCs r (11 MAIL o went /31/11.,0 4 PR.o iGD tWA A. CoN1gCL 01 FULL D'5PO=S4L ova LJtyv/J-- (, DOWNSf outs f LI-t ftovF CoATtei.5 Dt SCk04►4r 7t, sr LASH p ocV S, 'SA$P soil, GkaolD si_vm 0 -2.�a/ &stint NO C®VbP of µbW D QRAS5-- vekerikrvb FNXck 5trtif, 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.] ` Ot' firaerze:c- hz �l✓`E 11. Describe the performance goals and standards applicable to the project. - 4- /. /A- JE hPr�f fr.55/./1‘- ""12." lDescribe-the flow control system.: jyc;r stormwater site pan template—rev,:10'1/2003 .. . • • , ,--,s„. , 2 . , 1.4. „ „., ..' , . , \ , ,, Ji.,,..„........, „. ---- .,., ., 13. Describe the water quality system. _ F vez,e- Fan* stiLy s la whet-amigo T 2tW? >rr- /3 p ,moo i is d E `,r n q101'i ,fit �L6id tejUil ► 14. Describe the conveyance system analysis and design. 4kTIV-6 tb rooms p r5 It. .14'5 p exstot4 s pia sH e,t-oul--s Tb sou- Siat - 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. AD F1 L-L- dt %i9T,ADtt!65---i2 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. �` 0/ / hi)/e6 P l�Zt'O D `,,)i V' a_c Z-,f01( f.S . 41" 17. Describe the proposed surfacing material. COVVE[, Sk2FA-CE a+J 1.36t4 DR-LV5-WA/ 18. Describe methods for restoration of the site. /11'ii,Iarrt cAiv, 5&d-fa-it(7- At'/f/-f..ift5 $ II i9r1 1 51#2416S. 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. - IF K 1)ED, s%-E SarL €vkLutro+v Pe21-0-1Lnec> Fat. SEpnc sysfe PL i'tI 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. /1G/b 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. /T /S 4'L/'4r4Dq (t L�-fc/E'1 y /tt M-V W I M 5TAica 2. Establish Construction Access. i�-y'e- - r Sot/0 10.1.412hylif(t es -5 3. Control Flow Rates. 5 !�� 12A4//t5 /7frizairaii 4. Install Sediment Controls. 5. Stabilize Soils. LCVEI_ 5 i TE 6. Protect Slopes. p70 vE0p 7. Protect Drain Inlets. stormwater site plan template—rev.10/1/2003 8 i 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. y= r3o.j , 1/r 74 ,eorlj1 1//frf fit j 9. ('nntrol Pollutants. 51-fgee Ae 6-f-4e 6‘/(1).-s ,- ,eem-xtle- /bzi-i-fr-Air3r - /f ,Z27—er- 6.52ify 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). t' /-3 09,ec/ ifii?? . 11 /IS fir¢ `f 11. Maintain Best Management Practices(BMPs). i a//11 iw 'z to 8ni/� .r 12. Manage the Project. r 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). /70 4nay ,o4 'ilh) r1' (egg_ 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. i-- ,e,12T , 5 9/T/ ,y-,, < stormwater site plan template—rev.10/1/2003 9 • • b. pie yription of special requirements for working in or near environmentally sensitive areas. 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils/P_n Prodibility,settleability permeability,depth,texture,soil structure). oxei 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). I. Provide a proposed construction schedule. ?Oil& P ��/� i �'D'V5T,_eue"1 II. Wet Season Construction Activities. a. Proposed wet season construction activities. Wow b. Proposed wet season construction activities for environmentally sensitive areas. dUJL 7. Financial/Ownershlp Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. Lido 5Y7A/ b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. 0 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. /1O1W b. Diversions. c. Waterways. 4014 d. Runoff/Stormwater Detention Calculations //DYLL stormwater site plan template—rev.10/1/2003 10 • S 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. JJ2z ' (LANDOWNER OR AUT ORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED: stormwater site plan template—rev.10/1/2003 12 8CC-Z9t' (090 :Xb'A '0058-ZSt7 (090 89C86 `YM `ON3SNM01 Z9S96 VM 'STI30NV 180d ad021 N311IW ecovr H1nos Lts o 0 t'ii X08 '0'd NI1Sfld 03'lO aN31°l0 0 0 0 6 �J Z C Vj �.1 1/� O Z00-180—� #00 �30�!` d' r co 6 7---1 'ONI '0N12133NION3 ONIW31d 110OS NHOtt NV1d all t0/1112 311u �.�• `-Z C=a,4,vz 1£1 n 7-eD j-=--1 GAS O 7,• > U1 ;y 7/: I kstf*.;it‘49; n N NV/f� ...IZr2. it3 r N C'=7 -- I I' L i l CV g N 4 S� L1► wk ' off ► "� t, [trr4..r.cr; I--- vi s o I a (V / n a_ 0 � y laii111 80-2-V1 'S 4. �9 ~. 411P�i/ .I 3 N - f9 p.4 H = co�� 3 a' vt .a� v VS t11 t!1 4 k' E *ammo 6 ow �® S'WooYaa e z ®� CA v J ai J� y•d 4.(311'I `9mi35. v O'131.+NWYC 't la h 0iZr7 Y � y 1-1\ — \01 42 'VI ca. \ z ' 7. AL A i sPf 5.x Z y ss 4G " L�8 9\ of V r J 07 / i o� y3 21 � 17�t1Lt?ca ) b���d • � �{ �Z •//•yyam� v/ , > 411•0 ]/� y�1\ ��5, J arm // ,„ //I:) Z s Uj 4.1 ,4-4 /// 211 taw ),n�j+I `{tr` \jl] + v r �+ ( \\ II- on ca ,gh 't7% _ Y o W (-F)i o9Z , W