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HomeMy WebLinkAboutBLD2007-00527 BUILDING PERMIT APPLICAN MLA07-00561 Review Type:I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00527 Received Date: 9/28/2007 SITE ADDRESS: 201 D ST PORT HADLOCK, 98339 OWNER: ALLAN L RAICHART PHONE: 360-385-5246 BARBARA L RAICHART PO BOX 1631 PORT HADLOCK WA 983391631 SOUTH PORT TOWNSEND SUBDIVISION: Block: 11 Lot: 14+ PARCEL NUMBER: 996401101 Section: 2 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW SFR W/ ATT GAR -A/G 100 GAL PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,220 VALUATION 92,651.00 ADD'L: HEAT TYPE: PRO CODE EDITION: 2006 HEAT BASE: HEAT TYPE: EEE OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 480 SHORELINE: CONST TYPE: DECK: 72 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date: C1 / •g ( 0 f Type Amount Paid By: Date: Receipt: Approved/Date Permit $944.75 CJZ 09/28/07 93241 APPR )\/E1' State Building Code $4.50 CJZ 09/28/07 93241 Potable Water Application $58.00 CJZ 09/28/07 93241 Plan Check $614.09 CJZ 09/28/07 93241 NOV 2607 Total: $1,621.34 Jefferson County Planner & Building Dnnprt', Jefferson County Building Dision Permit Nur.: BLD07-00527 Applicant: RAICHART BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks (0 _cZ- pg Erosion Control Foundation Footing (a—ct-08 }-c.. Footing Drains Foundation Stem Wall 4 iniot /1i" Underground Plumbing 7,-08 )T `717/O.S /#64.7-- JVi L$ d Straps(hold downs) lz,Mlt8At Ext. Shear Wall Nailing a �/ n ii ►'. 2 GL� Rough in Plumbing t/L,,.Z2 4 \OV ; L'i 1 g-o Framing r IMP ir (.. s%i— it.-- -- '- Blocking )2/14/a8 fib Airseal 12 -22'6v Insulation: Walls I ./Z9(of? Insulation: Floors t'oksc SSA B Insulation: Ceiling ' Si ikY?, Fe v+^ / .., lifZe't" -. Rttva-i4-441--'2/31/08 Int. Shear Wall Nailing pc ` _ • -5 i, -r 1& vtA c- nc:A Gam) F7 Wallboard Nailing i .-r`k ,. Gas Line: Interior 12'22 C8 Viet-Alk Gas Line: Exterior Propane Tank Heat/Chimney Clearance Drywell/Alt Drainage Address Posted 12'2274n V14.04f FINAL INSPECTION 4o_ 2c ..0q j FINAL INSPECTION'MUST BE APPROVED PRIOR TO BUILDING BEING OCCU PIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD07-00527 1.) BUILDING FOUNDATION TO BE A MINIMUM OF 61 FEET FROM NORTH PROPERTY LINE. A MINIMUM OF 10' MUST BE MAINTAINED BETWEEN BUILDING FOUNDATION AND EDGE OF DISPOSAL COMPONENT AND RESERVE AREA. 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. 4.) 10' SEPARATION REQUIRED BETWEEN A WATER LINE AND ALL PORTIONS OF THE ONSITE SEWAGE SYSTEM; EFFLUENT TRANSPORT LINE, TANKS, TREATMENT AND DISPOSAL COMPONENTS. 5.) The application was reviewed by the Jefferson County Department of Community Development for the presence of Environmentally Sensitive Areas (ESAs). The Department conducted a review and has concluded that the property DOES NOT contain Environmentally Sensitive Areas. However, future proposals will be subject to a new ESA review and conditions may be added if new ESAs are found on the property. 6.) The applicant is proposing to create or add 3048 square feet of impervious surface and 4013 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. 7.) 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. 8.) 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). 9.) The site plan as submitted with the building permit application on September 28, 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 November 9, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 10.) This approval is for a single family residence with attached garage and 100 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. 11.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 12.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 13.) 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. 14.) A minimum of two (2) on-site pale spaces shall be provided for the single fiy residence. 15.) The building height is not to exceed 35 feet. 16.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 17.) 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. 18.) 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. 19.) Minimum setback from D Street right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. 20.) An adddress of 201 D Street, Port Hadlock has been assigned to the parcel. D Street is a county local access (C658909). 21.) The lot was created through the South Port Townsend Subdivision on September 18, 1871. No AFN available. 22.) The parcel is served by the PUD#1 public water supply. 23.) A building permit(BLD03-0786) for a detached garage was finaled on July 5, 2005. A road approach permit(RAP03-0270)was finaled on January 14, 2005. A septic permit (SEP03-0047)was finaled on June 30, 2005. A road approach permit(RAP07-0164)will be issued with BLD07-0527). 24.) A Declaration of Restrictive Covenant has been recorded on March 21, 2003 under AFN 467261 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. 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JEFFERSO w) IEDAi g,4 *� DEPARTMENT OF COMMUNITY DEVELOP�i , •��v 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 . 360/379-4451 Fax SEP 2 8 2007 N�,p www.co.jefferson.wa.us/commdevelopment Master Permit Application JEFFERSON COibta:oCIt Yl -5(I Project Description (include separate sheets as necessary): Tax Parcel Property Number: C,9 ! a/ /Cr,/ Size: .2 e) /c s-, -'f (acres/square feet) Site Address and/or Directions to Property: /7 S7`re'e-' 7 /4y 7' / 7/t:_C// e, !- Property Owner(s)of Record: //e,, /S e ,- Elm: -<<_- j C4�'t ,c ,,-:7 Telephone: 6;4' _-,59 S '2- 5C-4, Fax: email: Mailing Address: /70 Ic>e,),,t /6 s / %',,-'71 e/7t,(-,� Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies uilding 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit --_ ❑Conditional Use[C(a),C(d),or C]** Single Family ,, Gara Attache /Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Module 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use ❑ Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** 0 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)* ❑Shoreline Management Variance ❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium 0 Tree Vegetaion Request *May require a Pre-Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applicationn tI aat"'he or she w pts prior ' . Signature: �',!�`t !-., .r AK->1 Date:' 1 / .-, ,• "' 0 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 relrijcompliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transf le re"ponsibility for adh ring to omplyin itA. The Applicant has read this disclaimer and signs and dates it below. Signature: _- ` Date: ie____Ie 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 assuping je responsibilityp of the Ggneral Contra tor for the proposed project. Signature: I// ,�/_ � � Date: �i;;�;/ 2 ? ei SFP 98 207 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 X Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: ;___- Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: �'.- Height: individual System ❑ Repair ❑ Masonry SEP Permit#C; "% - s-7 ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: /%4. ,1:: e' Proposed: ,ss Public _A-;'),c%'.#0/9 r ei Total: Name of System:/' i p 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 her 'platianse_Installation permit,mark all items below that apply: i Undergroun nk ' e ground T ( _ Size of Propane Tank: .` 7 p e �� I Heat Sto I Cook Stove Woodstove/'' Fireplace Insert 1 Hot Waterr Tan) Pellet Stove I Other Is this appliance emq installed in a Manufactured/Mobile Home/ Yes 7 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 properly lines, buildings and septic system components, including the reserve area. '. Square Footage Current Proposed , ;or.O,f,('ice,Us'e,Op1y, ,';rt,'��_ , ,, Amount Revision Main Floor Heated EH BId App Review: i,i- ?P6 - rjcf Jil fn Cob 2nd Floor Heated �,r Consistency Review: 153 Other Heated Base fee: 61214 IS- Mezzanine ;:,` : Additional Section: �---' Heated Basement Plan Check fee: / .p� Unheated Basement State Surcharge fee: (Q '""/I� Other Unheated Pot Water Review fee: 93 Garage/Carport SUBTOTAL ,W n13\3 I r$-1-1'31 Decks911/Rd Approach fee: Other TOTAL: $ , QagI.39' (I', i''' ,-.--0-ct,. , eceipt Number: (,, q 1 -:' Cash/Check Number: ESTIMATED COST(REQUIRED) Date: C la9 `d-I •Fair market value of all labor and materials foundation to finish Initials: c.g.. .a- ),e0t), G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc • REC1R I•\. ED .gsozv co SEP 2 S 2007 g. JEFFERSON COUNTY JEFEERSON COUNTY DCD t DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Washington 98368 360/"• 'NO�'O http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE O I PROJECT/APPLICANT NAME: 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 ma_p. _/� /�' G20A j/ . w / .�d .� • ,,� S r / 7Gr i7. , /y "d,,;t e r' L✓, Y c2 2- c_rl Existing Conditions Summary 2. Describe the existing topography. Ind' ate contour on the site map. 3. Describe the exi ting vegetatpn. Indicative vege ation areas on the site map. '. .Sa„'L�' ' ' "� �' � ��► ,ter 4. Describe the existing soils. Indicate soil type on the site m h�< r? a.�l 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. APPROVED 6. Describe any excess levels of noise generated by the proposed use or activity: STORM WATER PLAN �► ` NOV - 9 2007 Stormwa ' �,�1�� Ulre$ u�Afll"� ,EF R ,UN Re4 . DEPT.OF O, t L' E SIGNAIUR : �I i�r,„) stormwater site plan template—rev.10/1/2003 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. Ns pr 8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads, and sensitive/critical areas (streams,wetlands,lakes,steep slopes,etc.). �! Permanent Stormwater Control Plan This portion of the Stormwater Site Plan consists of the selection and installation.of the appropriate stormwater control BMPs and facilities to remain in place after construction of the project is completed. "Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control facilities are not exceeded. 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. 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.] MA . 11. Describe the performance goals and standards applicable to the project. ,7 /7" r s y,- .�, I-., �, /c- • 12. Describe the flow control system. • NI ' f44 Y S l Y � 4 4 r �. 7 E• jr . storrmatte}d a Pi ci tex:01at rev. C2O0.3.... 6 • • R ti C J \1' �7 •4 .I - 11 �L.�� SEP282DP 13. Describe the water quality system. NM- ff-_ftSO) Catititiv DPP 14. Describe the conveyance system analysis and sign. / 1—j`,f' .- s • 91 /-- 1 SA ,� /49 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 surf cing material. 18. Describe methods for restoration of the site. Vim' . c• y- 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. NA- 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. 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. 2. Establish Construction Access. J c��^�'✓ L✓�: / 1'` "r"s�/� 3. Control Flow Rates.` 4. Install Sediment Controls. %f� .7�. c f T %fie=PFli 5. Stabilize Soils. 71/Cif y r 6. Protect Slopes. 7. Protect Drain Inlets. stormwater site plan template—rev.10/1/2003 8 • • �� RED VED 12 Required Elements—Construction SWPPP(continued) SEP 2 8 2007 8. Stabilize Channels and Outlets. J-EfFEDSO CBIJNT? DCD /47A 9. Control Pollutants. 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). /VA 11. Maintain Best Management Practices(BMPs). 12. Manage the Project. cat1 1 1C 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). 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. sten/water site plan template—rev.10/1/2003 9 I • • 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.,ero ability,settl9bility,permeability,depth,texture,soil structure). _ �S'fY6`'Lt, /t e /7 4' Cif",J . c` ri /(:) 4,-.4' 6/�•a^'tf i / -C'- a e--,-� c6 Try e-'rr.---7 -7' / > ,fir �� !-7/�/ 7 r--- ..•-- c--., /� �` 5. Construction Phasing. a. Construction _seequence /1 -5-j %rr ,x-, e''' ' 1-15' . l'''' e'i7 ..7) 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. � � `"fr112f• /-� / ,Z4/27 *` Z / "4 4 / c"/ -.<< "-A-7 f z l7 „09;ea r^ r / II. Wet Season Construction Activities. a. Proposed wet season construction activities. 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. 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 stormwater site plan template—rev.10/12003 10 • • Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan,the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems,treatment facilities,flow control facilities, or structural source control BMPs (not standard on-site stormwater management BMPs),the applicant shall submit a final corrected plan ("as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DAt E) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: stormwater site plan template—rev.10/1/2003 12