HomeMy WebLinkAboutBLD2007-00551 •LDING PERMIT APPLICATIR MR eview
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD07-00551 Received Date: 10/23/2007
SITE ADDRESS: 7270 SR 20
PORT TOWNSEND, 98368
OWNER: GARY N STEPHAN PHONE: (360) 821-1392
BONNIE L STEPHAN
2023 E SIMS WAY#345
PORT TOWNSEND WA 98368-6905
SUBDIVISION: Block: Lot: +
PARCEL NUMBER: 001282011 Section: 28 Township: 30 N Range: 01 W
CONTRACTOR: SOUND BUILDING SYSTEMS PHONE: (360)437-1219
3546 THORNDYKE RD
PORT LUDLOW WA 98365-8229
Contractor's License SOUNDBS027NM Expires 8/19/2008
REPRESENTATIVE: SOUND BUILDING SYSTEMS INC PHONE: (360)437-1219
3546 THORNDYKE RD
PROJECT DESCRIPTIOP NEW POLE BUILDING WITH LEAN TOO
UNHEATED AND NO PLUMBING
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 49,133.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: SHORELINE:
GARAGE: 2,880
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 Total: 0
Routing Date:
10/A /01 `--.7))
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $643.75 KAS 10/23/07 93385 APPROVED
Plan Check $418.44 KAS 10/23/07 93385
State Building Code $4.50 KAS 10/23/07 93385 NOV $ 2007
Total: $1,066.69 Jefferson County Planninc
& Building Department
•
Jefferson County Building Division Permit Numb.BLD07-00551
Applicant: STEPHAN
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
Erosion Control
Post Holes 'IAA
Foundation Footing
Straps(hold downs)
Ext. Shear Wall Nailing
Rough-in Plumbing
Framing .LyII ''� Cori\23-5 7.1/s,k w„sGAsi' 12-13-01
\lik
Drywell/Alt Drainage
Address Posted
FINAL INSPECTION lZ _Z _'�
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD07-00551
1.) 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.
2.) The applicant is proposing to create or add 2,880 square feet of impervious surface and
2,880 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.
3.) A Stormwater 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.
4.) 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).
5.) The site plan as submitted with the building permit application on October 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 October 30, 2007 shall be resubmitted
for review and approval by Jefferson County Department of Community Development.
6.) This approval is for a unheated pole building without plumbing 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.
7.) No plumbing has been reviewed or approved for this project by Jefferson County Public
Health. Additional requirements may apply if plumbing is proposed.
8.) The parcel has been designated as RR 1:5 under the Jefferson County Comprehensive
Land Use Map effective August 28, 1998.
9.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
10.) 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.
11.) The building height is not to exceed 35 feet.
12.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
13.) 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.
14.) Setback from SR 20 right-of-way is no less than 50 ft., setback from private access
easement is no less than 20 ft., side and rear setbacks are no less than 5 ft. If an
environmentally sensitive area (ESA) is present, then the more restrictive setback shall
apply.
15.) There are mapped wetlands on aunt parcels and the applicant showed a "Alma'
water" on his site plan. The staff wetland biologist and the project planner conducted a
site visit on October 29, 2007. No wetlands were found on tie subject property.
16.) No plumbing has been reviewed or approved for this project by Jefferson County Public
Health. Additional requirements may apply if plumbing is proposed.
17.) A MINIMUM OF 10' MUST BE MAINTAINED BETWEEN BUILDING FOUNDATION AND
EDGE OF DISPOSAL COMPONENT AND RESERVE AREA.
18.) ALL COMPONENTS OF THE SEPTIC SYSTEM, INCLUDING RESERVE AREA, ARE TO
BE COMPLETELY PROTECTED FROM VEHICULAR TRAFFIC OR MECHANICAL
DISTURBANCE.
e,LsON
c0�,� JEFFERSO[�UNTY 0
az
` DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax OCT 6 3 '17
www.co.jefferson.wa.us/commdevelopment
.gS, N0�O
Master Permit Application MLA: 69 - J /C'
Project Description(include separate sheets as necessary):
•
C0651rac1i r. of 31e'Xleo'x/le' pole bu,iil,nq garag ' ,a,th. /.15(1,0'x 14' lea„+oo
Tax Parcel J JJ Property
Number: D I z2 g d l I Size: 3.-7-3 acre 5 (acres/square feet)
Site Address and/or Directions to Property: ,,f k c Ir`, ,c d is`► U'e on' I of t "I 1 w I') p� II '4 F_ r.rP'
Ill
n a /Jc, 5.r 0 n<�� s ,G^J J. r'v.
it t t. I r= .4c. IIL1/�
i '.io H,.vi ao , Port Towasedl IQA 9ti'3108 1
Property Owner(s)ofRecord: C7c.r, 'f Qon„,p Stephan
Telephone: 3 d- y I - 13 9:2 Fax: email:
Mailing Address: 1a?U j-I,,,,• 40 i port To un5and WI' 983108'
Applicant/Agent(if different frdm/ owner): So u„,i /3 tR,Id,�� fi i s Fem 5 I H r
Telephone: 3Ica - 4 3.7- 1. 19 Fax: 3&o-y 3- - i 2.1 b' email:
Mailing Address: 35Thie Thorridy ke. Road , Port Ludlow/ ul/k Re3cos'
What kind of Permit? (Check each box that applies
Building 0 Variance(Minor,Major or Reasonable Economic Use)
❑ Demolition Permit 0 Conditional Use[C(a),C(d),or C]*'
❑ Single Family 12/Garage Attache Detached ❑ Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home ❑ Modular 0 Special Use(Essential Public Facilities)**
0 Commercial* ❑ Boundary Line Adjustment
❑ Change of Use 0 Short Plat**
0 Address 0 Road Approach 0 Binding Site Plan**
❑ Home Business 0 Cottagelndustry 0 Long Plat**
❑Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Sign 0 Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions**
❑Stormwater Management ❑ Shoreline Management Substantial Development**
❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
0 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,-slate orfederaLpermits required far thJsproposaI,if known:
DESIGNATION OF AGENT
I hereby designate o „.d ek,I cl, ; Sys ems ...fin, to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date: / - .-0 7
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 ation that
e or e ants ' r notice.
Signature: Date: /'- ,.,7 '6 7
The action or actions Applicant will un ertake 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-trans9ble resp ibili;, mg to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: t-� ��'W/ Date: A9 3 "7
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Annlication 12-19-2006.doc
0 BUILDER STATEMENT •
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the responsibility of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
5ou„d R Ik,Idlnk Systems Inc ( 3(101137-120 ( 3lc0 ) 437-/2)k
MAILING ADDRESS: J 1 EMAIL:
3SY/o ilurndykr' earl
CONTRACTOR'S LICENSE port Lae(I ow, V)A 4£f 9 6 s WAINS
NUMBER: Se u,v 0 6 S o i N NI NUMBER
ARCHITECT/ENGINEER: l-
' PHONE (s b 3)cg q_1-1.1 FAX: (,se 3)5"l_0 2.5,
A II 1ttnrP Gk9r jnerr de:
MAILING ADDRESS: .1700 Market 54• NE- 5G-ItCm, OR 47 301 EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
V New d Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: -0 - Bank ❑ Community System
O Alteration/Remodel 0 Concrete Total: Height: t2 Individual System
❑ Repair 0 Masonry SEP Permit#
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: 5+ Private well 0 Two Party
Type of Heat: Proposed: ❑ Public
/,2/-fr'' n t- Total: Name of System:
If this is a Commercial Protect 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 i 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.
;nu ,�yy��,�,
Square Footage Current Proposed ,Je,,,da ,y. trig $ * Alai A it;...,j Lto 44,41iik
Main Floor Heated f '' r EH Bld App Review: ,�
$ , 3 -: x tS .Ce.,
2nd Floor Heated Awi
z,' Consistency Review:
i53 Cc
4501,-*' Base fee:
Other Heated 013
r f 15'
Mezzanine 3 WAVE" � Additional Section:
z,,,
Heated Basement Y`1 W;R* Plan Check fee: 8 L7I(,711j
Unheated Basement fad z ki hy1 - State Surcharge fee: .�
!�� .
Other Unheated Pot Water Review fee:
Garage/Carport x'_'m ,, SUBTOTAL a ^( II (1
Decks ' 0.: #'` <". ' 46/Rd Approach fee:
r kttf, 4: ; : f 41 o( t.' --- ---.-
Other `w s r r. TOTAL: $ `, .S j (001
�. �. 4
'�: fir aT " .
``sir 4 r Receipt Number: C; , Y3S CJ
AllI }z'u F Cash/Check Number:
ESTIMATED COST(REQUIRED) Date: r
•Fair market value of all labor and materials foundation to finish ` - I G7
Initials:
i `1S, 000.00 , .
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
.
• •
RECEIVED
°, , JEFFERSON COUNTY
iirlik
47 DEPARTMENT OF COMMUNITY DEVELOPMENT OCT 2 v 20
07
j �l ► ,,A, 621 Sheridan Street • Port Townsend •Washington 98368
379-4451
` O http:360/3//7www.co.9-4450jeffe s/on wa.us/ommdevelopment/ F��6k COUNTY BC
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# 011 - 5 To PROJECT/APPLICANT NAME: Tr= 2 k y•-.)
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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cY' proVc.r 1 . ( k�. At--iJe__IAJALI fr Ani e--Xi1sit," (Ira, ,>r1 r:,) t✓„/,,1 .
Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map. r
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f �� '—'►'fL ce,osraA.,AI rVN., e i b, 1., r /1,c Frri, e g A r-A,p,
3. escribe the existing vegetation. Indicate native veg tation areasg on the site map.
,��f"(`N,q c. Ar pore. i_r ti,.v�E. oe_)of Jt W;t1-. �r of- 1 h. ,.4/J x>f a CO.A _ /, eiP .
f'✓PC9ree-r., free- . 1
4. Describe the existing soils. Indicate soil type on the site map..
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.
cam_f'Svn,." / iv A..0 1 V IN ;1,1 (, r x [ r- c.i1,2 v
6. Describe any excess levels of noise generated by the proposed use or activity: APPROVED
�/�4�e..--- STORMWATER PLAN
OCT 3 0 2007_
itffEISON !UYt I Y lCD DE!*T.OF COE 0 O N F
stormwater site plan template—rev.10/1/2003 5
SIGNATURE:
• •
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.).
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 o contaminants.]
11. Describe the performance goals and standards applicable to the project. 1
7h C" /vU ✓�l C' I �' R r �.via i' 1 )\ /�. t� /7I t�vt A,,rh .� ' V ✓ fF' ir,�C� v
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12. Describe the flow control system.r✓t L1/4
b �, .-zf��o ), w gar r o.�. >` x► s *k f ,T �try./
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atifEit<�Alft. f 1?Si. 1,/1 1{�Y { ..�irg yyl fRry
stormwstersitAifaA ` icite�ir��i 1ivi)7bb& t`41 i 1t1 T'f�tt1 i s��60���a.9 COUNTY �1 11 6
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13. Describe the water quality system. RE
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14. Describe the conveyance system analysis and design. SFr, ' e a��/ ��
15. Describe the source of fill Imaterial,physical characteristics of fill material,and deposition of excess material.
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16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
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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. /
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20. List here an 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
0 /
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 t
Limits. ` \1 I
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2. Establish Co trycticin Access.
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3. Control)Flow ates. I-
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4. Install Sediment C ntrols.
7117 )
5. Stabilize Soils. /1/4/
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6. Protect Slopes. �f C
7. Protect Drain Inlets. / / 1 -Lt'd� 1L R v tin
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Are:
stormwater site plan template—rev.10/1/2003 8
• •
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channel Outlets. _All,CEI VF D
2 2OU7
OCT
9. Control Pollutants. ergs/SON COUNTY
7
10. Control De-Wat (the act of pumping groundwater or stormwater away from an active construction site).
11. Maintain Best Managementn — iv )Practices(BMPs).
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12. Manage the Project. 1
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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). 1
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3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
A
JLF tI iON C04111tY OCD
stormwater site plan template—rev.10/1/2003 9
• •
b. Description of special requirements for working in or near environmentally sensitive areas.
4 2
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).
71f1
5. Construction Phasing.
a. Construction sequence
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b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
P vide a proposed construction schedule.
II. Wet eason Construction Activities.
a. Proposed wet season construction activities.
b. Proposed wet season construction activities for environmentally sensitive areas.
/2)
7. FinanciaVOwnership 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 or}a separate sheet for the following,i appli'[�ble.
�.(ff�(;
a. Sediment Ponds/Traps. �� '�f,° '� flirt
b. Diversions.
c. Waterways.
d. Runoff/Stormwater Detention Calculations U CT 2 c 4 1
Yh4 C \TY BCD
JEFFE S N
stormwater site plan template-rev.10/1/2003 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 t • ..,lfic t a the information provided herein is true and
correct to the best of my knowledge. I also certify that 1 .• 9 ioti4s bei de with the full knowledge and consent of all
owners of the affected property.
OCT 2 3 2007 o
DOW R OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
JEFFERSCIN COUNTY DCD
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
EIT # JJ
07 0 5 5 I
JE1FE` SON gCD
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