HomeMy WebLinkAboutBLD2007-00512 11, •
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 #: BLD07-00512
SITE ADDRESS: 25 BLUFF LN Issue Date: 10/29/2007
PORT TOWNSEND, 98368 Final Date: 6/13/2008
APPLICANT: KALA BLUFFS LLC PHONE: (360) 385-7156
260 KALA POINT DR
PORT TOWNSEND WA 98368
SUBDIVISION: THE BLUFFS BLDG 28 Block: Lot: 3055
PARCEL NUMBER: 965300055 Section: 26 Township: 30 N Range: 01 W
PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE AND UNHEATED SHOP
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 ' no )
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 6/13/2008
I:\F_BLD_Occupancy.rpt 10/29/19
IJ N ILDING PERMIT APPLICAT ML 547
Revviewiew T Tyype: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD07-00512 Received Date: 9/19/2007
SITE ADDRESS: BLUFF LN
PORT TOWNSEND, 98368
OWNER: KALA BLUFFS LLC PHONE: (360) 385-7156
260 KALA POINT DR
PORT TOWNSEND WA 98368
THE BLUFFS BLDG 28
SUBDIVISION: Block: Lot: +
PARCEL NUMBER: 965300055 Section: 26 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP NEW SFR W/ATTACHED GARAGE AND UNHEATED SHOP
ALSO A/G 120 GAL PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,862
VALUATION 185,394.00 ADD'L: HEAT TYPE: HTP
CODE EDITION: 2006 HEAT BASE: HEAT TYPE: PRO
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY:
CONST TYPE: 5N OTHER: SHORELINE:
CONST TYPE: GARAGE: 623 SETBACK:
DECK: 162 BANK HEIGHT:
SEWAGE DISPOSAL: CMY
WATER SYSTEM: KALA PT
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 2 Prop: 2
Total: 2 Total: 2
Routing Date: g 1 1 l 101 q--- )
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,475.35 KAS 09/19/07 93148 APPROVE[
Plan Check $958.98 KAS 09/19/07 93148
State Building Code $4.50 KAS 09/19/07 93148 OCT Act 2007
Potable Water Application $58.00 KAS 09/19/07 93148
Total: $2,496.83 Jefferson County Planning
& Building Department
•
Jefferson County Building Division Permit NumblIBLD07-00512
Applicant: KALA BLUFFS LLC
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 Y 1-(o-O7
Erosion Control
Foundation Footing I G7
Footing Drains
Foundation Stem Wall j -
Underground Plumbing
Under Floor Framing
Straps(hold downs)
Ext. Shear Wall Nailing f//17/d7 a/ D4.
Rough-in Plumbing
Framing t". -p€ co,rrtcYion
Blocking
Airseal ' . .° p�'
_,
r
Insulation:Walls , 9.64 Cie f'
Insulation: Floors t 7`�
Insulation: Ceiling t �
Int. Shear Wall Nailing A�
Wallboard Nailing !J—;-t 64
Gas Line: Interior ,
Gas Line: Exterior
Propane Tank
Heat/Chimney Clearance
Drywell/Alt Drainage
Address Posted
FINAL INSPECTION L-\1
k
FINAL INSPECTION MUT BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD07-00512
1.) The application was reviewed by the Jefferson County Department of Community
Development staff on October 29, 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:
Special Aquifer Recharge Protection Area and At Risk Seawater Intrusion Protection Zone
(SIPZ).
2.) A Geotechnical Report dated September 5, 2007 prepared by Stratum Group was
submitted in conjunction with the application.
3.) 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.
4.) 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.
5.) 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.
6.) The parcel is located within an At Risk 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.
An At Risk SIPZ is defined as: areas within 1,000 feet of a groundwater source with a
history of chloride analyses between 100 mg/L and 200 mg/L (milligrams per liter).
7.) A Geotechnical Report was submitted in conjunction with this application. The report
addressed the stability of the geologic hazard area and provide site specific
recommendations. Proponents shall follow the recommendations regarding the
foundation construction practices and the stormwater management practices.
8.) 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.
9.) 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.
10.) VOLUNTARY MEASURES OF COAL&AT RISK SIPZ: •
Water conservation measures:
1. Roof and other intercepted precipitation shall be routed to on-site detention ponds
and/or other approved means and allowed to be released to the soil slowly.
2. Water collected from Storm water and roof catchments may be used for watering
lawns and gardens. Unless catchment water has been treated to meet drinking water
standards, there shall be no cross connections allowed between the potable supply and
impounded water.
3. Water withdrawn from wells on each property shall not be used for watering of lawns
and/or gardens.
4. Ground water withdrawn from each property shall be restricted to a rate of three (3)
gallons per minute.
5. Installation of water conserving fixtures such as low flow toilets, faucets and shower
restrictors and other water saving plumbing fixtures.
6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation).
Please NOTE that the above listed measures are not intended to be exhaustive, but rather
is intended to be illustrative of the types of water conservation measures.
11.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ:
1. Installation of a flow meter.
2. On-going well monitoring for chloride concentration.
3. Submittal of monitoring data to County.
.4 . MANDATORY MEASURES FOR AN AT RISK SIPZ:
1. For proof of potable water on a building permit application, applicant must utilize
DOH-approved public water system if available.
A 2. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water or an individual well may be used as proof of potable water subject to the
,A��following requirements:
a. Chloride concentration of a laboratory-certified well water sample submitted with
ti" building permit application.
ii. b. Installation of a flow meter.
c. On-going well monitoring for chloride concentration.
d. Submittal of flow and chloride data to the County per monitoring program.
3. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water.
13.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through #12 of the Department of Ecology's Stormwater Management
Manual for Western Washington to control stormwater, erosion and sediment during
construction. BMPs shall address permanent measures to stabilize soil exposed during
construction, and in the design and operation of stormwater and drainage control systems.
14.) The applicant is proposing to create or add 3000 square feet of impervious surface and
3700 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.
15.) A Stormwater Site Plan for a medium project 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.
16.) 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).
17.) The site plan as submitted with the building permit application on September 19, 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 October 29, 2007 shall be resubmitted
for review and approval by Jefferson County Department of Community Development.
18.) This approval is for a single family residence with attached garage and unheatecp
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.
19.) The parcel has been designated as Rural Residential 1:5 under the Jefferson County
Comprehensive Land Use Map effective August 28, 1998.
20.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
21.) 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.
22.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
23.) The building height is not to exceed 35 feet.
24.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
25.) 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.
26.) 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.
27.) Minimum setbacks from the edge of Bluff Ln right-of-way, Kala Point Dr right-of-way and
Sailview Dr right-of-way are 20 ft. Minimum side and rea setbacks are 5 ft.
28.) A septic permit (SEP07-00324)was issued on October 15, 2007 for a tank only permit to
connect to community drainfield.
29.) The parcel was created under The Bluffs at Kala Point Phase 6, filed of record May 8,
1992 under AFN 349659 with Jefferson County Auditor's office.
30.) Bluff Ln (P374) is a private access road. An address of 25 Bluff Ln has been assigned to
the proposal.
31.) This parcel is served by a public water system.
/:,SON C,
. */We Or,. JEFFERSOI&UNTY •
/a DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend •Washington 98368
. 3360/379-4450 • 360/379-4451 Fax
�yS, NO20 www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: CO-54 7
Project Description(include separate sheets as necessary):
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`'\ eS1dedi)c.. f
Tax Parcel Property
Number: q(o c 3 CO 0 S Size: r�
�-•O r`e/O (acres/square feet)
Site Address and/or Directions to Property: P
41.
Property Owner(s)of Record: 14 e ,.>4 isL"id i 5 L G.C...4
Telephone:'' 5 - ""1 15 to Fax: 38 5- 3 \\5 email:
Mailing Address: ZkU le-OKR-. el- 1)r2, . et " 1-®6,)4SYw)» f E,.v Ps ' 6;
Applicant/Agent(if different from owner): t:
Telephone: Fax:
email:
Mailing Address:
What kind of Permit?(Check each box that applies
}Building ❑Variance(Minor, Major or Reasonable Economic Use)
0 Demolition Permit -. ❑ Conditional Use[C(a), C(d),or C]**
I Single Family 16 Garage ,Att�d i Detached ❑ Discretionary"D"or Unnamed Use Classification
b Manufactured Home ❑ Modularn-- ---) ❑ Special Use(Essential Public Facilities)**
0 Commercial* ❑ Boundary Line Adjustment
❑ Change of Use ❑ Short Plat**
❑ Address ❑ Road Approach ❑ Binding Site Plan**
❑Home Business ❑ Cottagelndustry ❑ Long Plat**
..Propane a L q,p-p Planned Rural Residential Development(PRRD)/Amendments**
❑Sign C.E.P 1 J3 '..0 h Plat Vacation/Alteration**
❑Allowed"Yes" Use ConsistencyAnalysis Y ❑ Shoreline Master Program Exemption/Permit Revisions**
❑Stormwater Management ❑Shoreline Management Substantial Development**
❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance
❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment
❑ Forest Practices Act/Release of Six-Year Moratorium ❑ 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 ap lication that he or sh ants rior notice.
Signature: 4. � 4,0%1 ,f r i4 L mate: q"/2 •�Q�
T 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 lake"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 respo�tsibility f r adhering_ to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature:94#0. .*--a CA, !j�•� h t "'li ft _ I Date: —12—Zepa-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 res onsibility of theh� General Contractor for the proposed project.
Signature:r—4- 4 1�I1 �1,tvr,,,, AAAV ate: a1- 11-— ZOO'
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL: '
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: LiNpr3e .4 _ 9JL, end r4 pi,_,1 47„ PHONE (;�,o )38$_(,73DFAx: (363 )452^'7p(.q.
MAILING ADDRESS: -31 p) S ` /}&j-404. 5(eL.r ii:, dTW 4.444.AIL qe^,3 b 2
Project Type: /Frame Type: 1 Bathrdoms: Shoreline: Type of Sewage Disposal:
`)1-._New .,Wood Existing:
X Sewer
❑ Addition Cl Steel Proposed: 42=..— Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: 'L- Height: ❑ Individual System & 4,-er
❑ Repair ❑ Masonry N A SEP Permit# #E-(t843
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: 91 Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: 2- A /,, `�Public
eiz. ifGA ' lr�ul)t Total: Z p�,1 Name of System:
l 'n Pr, Unu r1
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 above ground Tan Size of Propane Tank: to G -
?i-leat Stove)I Cook Stove I Woodstove 1 Fireplace Insert I Hot Water T. k 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.
1;
Square Footage Current Proposed o�rOfficd,';.0 °e'O i,;"' ���, 464, A �,
Main Floor Heated p�2r- � EH Bld App Review:
2na Floor Heated i �4 ¢�lap
4 , Consistency Review:
t Ufa . lob
Other Heated 4 Base fee: -
Mezzanine „r kY Additional Section:
Heated Basement r A f-: fin97 ;.a 3 Plan Check fee: q58.
Unheated Basement ' State Surcharge fee: 4
Other Unheated ^ , Pot Water Review fee: C
t3.CO
Garage/Carport f' SUBTOTAL '15a,a3
Co2.$ � �-
Decks • `' 911/R Approach fee:
1 '' ' 15 a, CO
Other
TOTAL: $ P r r
• ' Receipt Number: 60 I L'ig
'"4 t�`'" Cash/Check Number:
It r.
1003
ESTIMATED COST(REQUIRED) 1 66 I]'OV �" Date:
•Fair market value of all labor and materials found ' inrsh lv W `` 7
13 15 itials:
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JEFFERSON COUNTY
("3 ,N` ,� DEPARTMENT OF COMMUNITY DEVELOPMENT E
621 Sheridan Street• Port Townsend•Washington 98368
�, �O 360/379-4450 • 360/379-4451 Fax
PIING http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# 61- n 4 I PROJECT/APPUCANT NAME: .:;/ /: .t,•f f ,- G i
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.
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Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
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3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
4. Describe the existing soils. Indicate soil type on the site map.
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5. Describe the existing site hydrology(i.e.,drainage; behavior of water on the site—above, below,and on the ground). Indicate
existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if
applicable,and indicate acreage of each.
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6. Describe any excess levels of noise generated by the proposed use or activity:
t3. APPROVED
STORMWATER PLAN
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7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes,etc.)on the site. Indicate location on the site map.
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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.).
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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.
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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.]
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1. Describe the performance goals and standards applicable to the project.
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12. Describe the flow control system.
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13. Describe the water quality system.
7
14. Describe the conveyance system analysis and design.
15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material.
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
17. Describe the proposed surfacing material.
18. Describe methods for restoration of the site.
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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.
20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
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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.
SEP 1 9 2007
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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 SVVPPP 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.
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2. Establish Construction Access.
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3. Control Flow Rates.
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4. Install Sediment Controls.
5. Stabilize Soils.
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6. Protect Slopes.
7. Protect Drain Inlets.
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SEP 1 9 2097
• •
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
9. Control Pollutants.
10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
11. Maintain Best Management Practices(BMPs).
12. Manage the Project.
2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas, roads).
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b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
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3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
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b. Description 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(e.g.,erodibility,settleability,permeability,depth,texture,soil structure).— rvi N u d 1 S �e.lt 7. t . 1.J r) {' JG. 1J
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5. Construction Phasing.
a. Construction sequence
b. Construction phasing(if proposed)
6. Construction Schedule- Wet season is October 1 through April 30(page 2-21 of the Manual).
Provide a proposed construction schedule.
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II. Wet Season Construction Activities.
a. Proposed wet season construction a 'vibes.
b. Proposed wet season construction activities for environmentally sensitive areas.
7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for the initiation of bonds and/or other financial securities.
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b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable.
a. Sediment Ponds/Traps.
b. Diversions.
c. Waterways.
d. Runoff/Stormwater Detention Calculations
11'77ti:. x = SEP 1 9 2007
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SECTION II—EROSION AND SEDIMENT CONTROL PLAN
Sediment and erosion control measures may be depicted on the master land use application plot plan,a stormwater site plan,and/or a
separate Construction SWPPP site plan. This is a checklist to ensure that the following are depicted on a site plan:
1. General.
a. Vicinity Map
b. Jefferson County Approval Block
c. Erosion and Sediment Control Notes
2. Site Plan.
a. Legal description of subject property.
b. North arrow.
c. Indicate boundaries of existing vegetation(e.g.,tree lines,pasture areas,etc.).
d. Identify and label areas of potential erosion problems.
e. Identify FEMA base flood boundaries and Shoreline Management boundaries(if applicable).
f. Show existing and proposed contours.
g. Indicate drainage basins and direction of flow for individual drainage areas.
h. Label final grade contours and identify developed condition drainage basins.
i. Delineate areas that are to be cleared and graded.
j. Show all cut and fill slopes indicating top and bottom of slope catch lines.
3. Conveyance Systems.
a. Designate locations for swales, interceptor trenches,or ditches.
b. Show all temporary and permanent drainage pipes,ditches,or cut-off trenches required for erosion&sediment control.
c. Provide minimum slope and cover for all temporary pipes or call out pipe inverts.
d. Shows grades,dimensions,and direction of flow in all ditches,swales, culverts and pipes.
e. Provide details for bypassing off-site runoff around disturbed areas.
f. Indicate locations and outlets of any dewatering systems.
4. Location of Detention Best Management Practices(BMPs). Identify location of detention BMPs.
5. Erosion and Sediment Control Facilities.
a. Show the locations of sediment trap(s),pond(s),pipes and structures.
b. Dimension pond berm widths and inside and outside pond slopes.
c. Indicate the trap/pond storage required and the depth, length,and width dimensions.
d. Provide typical section views through pond and outlet structure.
e. Provide typical details of gravel cone and standpipe,and/or other filtering devices.
f. Detail stabilization techniques for outlet/inlet
g. Detail control/restrictor device location and details.
h. Specify mulch and/or recommended cover of berms and slopes.
i. Provide rock specifications and detail for rock check dam(s),if applicable.
j. Specify spacing for rock check dams as required.
k. Provide front and side sections of typical rock check dams.
I. Indicate the locations and provide details and specifications for silt fabric.
m. Locate the construction entrance and provide a detail.
6. Detailed Drawings. Any structural practices used that are not referenced in the Ecology Manual should be explained and
illustrated with detailed drawings.
7. Other Pollutant BMPs. Indicate on the site plan the locations of BMPs to be used for the control of pollutants other than
sediment(e.g.,concrete wash water).
8. Monitoring Locations. Indicate on the site plan the water quality sampling locations to be used for monitoring water quality on
the construction site. Sampling stations should be located upstream and downstream of the project site.
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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. — 141 l _-�i`
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(LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED:
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