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HomeMy WebLinkAboutBLD2007-00621 ItILDING PERMIT APPLICA 1 N MLA07-00670 Jefferson County Department of Community Development Review Type:I 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00621 Received Date: 12/31/2007 SITE ADDRESS: 41 HILLER DR PORT HADLOCK, 98339 OWNER: JOHN T GRAHAM 9504 PHINNEY AVE N PHONE: (206) 783 4527 SEATTLE WA 98103-3026 SUBDIVISION: HILLERS WF TR INC TL PARCEL NUMBER: 960300010 Section: 7 Block: Lot: Township: 29 N Range: 01 E CONTRACTOR: -OWNER/Ott-DER lJJCk. 1�k,Y1, i"N Cons-t- Co PHONE: 5- 0� 32.K.c&Lc- v c. p a)V- 1c3 t1-t" 'f 36T REPRESENTATIVE: PHONE: PROJECT DESCRIPTION CONSTRUCT BASEMENT & STAIRS UNDER EXISTING HOUSE ADD 261 SQ FT UNHEATED UTILITY/STORAGE OUTSIDE FOOTPRINT TYPE OF WORK RES SQUARE FOOTAGE TYPE OF IMP ADD VALUATION 95,000.00 MAIN: 6 CODE EDITION: 2006 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: 489 HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: 261 CONST TYPE: GARAGE: SHORELINE: DECK: 219 SETBACK: SEWAGE DISPOSAL: CON BANK HEIGHT: WATER SYSTEM: PUD - BEDROOMS: BATHROOMS: Exist: 0 Exist: 1 Prop: 1 Prop: 1 Total: 1 Total: 2 Routing Date: 1 12 l N ET-A'A) ,Por- C2., Type Amount Paid By: Date: Receipt: Permit Approved/Date $958.75 KAS 12/31/07 95536 Plan Check $623.19 KAS 12/31/07 955.36 APPROVED State Building Code $4.50 KAS 12/31/07 955:36 Potable Water Application $58.00 KAS 12/31/07 95536 JUN 20°8 Total: $1,644.44 Jefferson County Planninc &Building Department f3Z /� o7 - Z2i Jefferson County Building "vision Permit Nurr�'uer: BLD07-00621 Applicant: GRAHAM 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 Foundation Footing Footing Drains Foundation Stem Wall Underground Plumbing Straps(hold downs) Ext. Shear Wall Nailing Rough-in Plumbing Framing Airseal Insulation:Walls Insulation: Floors Insulation: Ceiling Int. Shear Wall Nailing Wallboard Nailing Heat/Chimney Clearance Drywell/Alt Drainage Address Posted FINAL INSPECTION FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD07-00621 1.) Modification of septic system approved/issued 5/30/2008 must be completed and finaled prior to final of the building permit. 2.) 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. 3.) VOLUNTARY MEASURES OF COASTAL &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. 4.) MANDATORY MEASURES FOR COASTAL SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 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 following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 5.) The project shall adhere to the Best Management Practices (BMPs) 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. 6.) 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. 7.) Prior to commencing development activity, proponent is responsible for informing the Washington Department of Fish and Wildlife (WDFW) in order for WDFW to determine whether this action is subject to the Washington State Hydraulic Code (Chapter 220-10 WAC). Hydraulic Project Approval (HPA) is required for all hydraulic projects, which are defined as construction or performance of other work that will use, divert, obstruct, or change the natural flow or bed of any of the salt or fresh waters of the state. 8.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 9.) Not more than 2 unlicensed vehs shall be stored on any lot unless totally Oned 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. 10.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 11.) Pre-existing legal lots of record less than one acre in size in rural residential districts are subject to the stormwater requirements in Chapter 18.30 JCC and must meet the"Area of Impervious Surface Coverage"to the maximum extent practicable as determined by the administrator. Lot coverage is defined as amount of impervious surface, which includes rooftops, driveways, concrete, etc. 12.) Setback from Hiller Dr. right-of-way is no less than 20 ft., side setbacks are no less than 5 ft. Rear setback (shoreline) is no less than 30 ft. from Ordinary High Water Mark (OHWM)for the residence. The deck may encroach the 30 ft. setback. The approved site plan shows a setback of 27 ft. from OHWM. 13.) Stormwater shall be retained and infiltrated on site. The owner shall control all sedimentation and erosion on the property. 14.) The proponent shall notify the Jefferson County Department of Community Development at(360) 379-4450 forty-eight(48) hours prior to commencing construction in order to allow monitoring and ensure compliance with permit conditions. 15.) Work within the jurisdiction of the Shoreline Master Program other than as described above shall receive separate review from this Department. 16.) A"Construction Drawing" Flood Elevation Certificate was prepared by a licensed surveyor and submitted with the application. The Certificate identified the base flood elevation of 11.2 feet. The lowest floor of the structure is required to be elevated at least one (1) foot above base flood elevation or 12.2 feet. PRIOR TO FINAL BUILDING INSPECTION, PROPONENT SHALL PROVIDE THE DEPARTMENT WITH AN ORIGINAL "FINISHED" CONSTRUCTION" FLOOD ELEVATION CERTIFICATE THAT HAS BEEN VERIFIED BY A LAND SURVEYOR, ENGINEER, OR ARCHITECT AUTHORIZED BY LAW TO CERTIFY ELEVATION INFORMATION IN THE STATE OF WASHINGTON. 17.) Flood hazard reduction measures are to be used as required by the Jefferson County Flood Damage Prevention Ordinance 07-0515-06 (Jefferson County Code Chapter 15.15). 18.) Construction Materials and Methods of Construction to Reduce Flood Hazard (i) All new construction and substantial improvements shall be constructed with materials and utility equipment resistant to flood damage. (ii) All new construction and substantial improvements shall be constructed using methods and practices that minimize flood damage. (iii) Electrical, heating, ventilation, plumbing, and air-conditioning equipment and other service facilities shall be designed and/or otherwise elevated or located so as to prevent water from entering or accumulating within the components during conditions of flooding. Locating such equipment below the base flood elevation may cause annual flood insurance premiums to be increased. 19.) New construction and substantinprovement of any residential structure shave the lowest floor, including basement, elevated one foot or more above the base flood elevation (BFE). 20.) Fully enclosed areas below the lowest floor that are subject to flooding are prohibited unless designed to automatically equalize hydrostatic flood forces on exterior walls by allowing for the entry and exit of floodwater. Designs for meeting this requirement must either be certified by a registered professional engineer or architect or must meet or exceed the following criteria: a. A minimum of two openings having a total net area of not less than one square inch for every square foot of enclosed area subject to flooding shall be provided. b. The bottom of all openings shall be no higher than one foot above grade. c. Openings may be equipt with screens, louvers, or other coverings or devices provided that they permit the automatic entry and exit of floodwater. iiREC E IVIE1) ,�w , JEFFERSOIUNTY rzi v.;`� DEPARTMENT OF COMMUNITY DEVELOPMENT ` `41 621 Sheridan Street • Port Townsend •Washington 98368 EC 3 1 2007 360/379-4450 • 360/379-4451 Fax gS N�&pO. www.co.jefferson.wa.us/commdevelopment K rFFE ti COUNTY DEO Master Permit Application MLA: O'1--(e1L Project Description(include separate sheets as necessary): ✓ l J �- ts./CT. A 46 .17/V1.tt7 j f e'` TA!1 1,MinCe E,rc J S I /Ax ' / /r Tax Parcel + Property Number: "! 34)Q r0 Size: 37��Q i , 171'% acres/square feet) Site Address and/or Directions to Property: Property Owner(s)of Record: ..1 Q/4&/ f /4 A M oks. lec0_11 4 Telephone: ?Q(r; 7.8 S -a S 2,7 Fax: email: J ' ' Mailing Address: e`5©41 �//MN, y A\Jg * t' /QT Applicant/Agent(if different from owner): t Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies filiBuilding 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]** li'Single Family ❑Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* ❑ Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ 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 ❑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 ac as my agent in matters relating to this pplicatio for permit(s). OWNER SIGNATURE . r U� Date: ,/ ��3 / 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 oeentry will assumed unless the applicant informs the County in writing at the time of the application that h or s e waptsrpior notice. Signature: __ i 2�'d�4.1.�.*le.ie e �, 'rit.it. - Date: //" f F .r, 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 are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable reel sibility for q.4iering to and co2 plying with the ESA. The Applicant has read this disclaimer a signs a dates it below. Signature: �, / .Q� . .a t ' ' L _ Date: /7 7 / 3 /at G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc • BUILDER STATEMENT • The signer of this statement does hereby certify that t y ar the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assumin he res of the G n I C ractor for the proposed project. Signatur - Date: /Z 11/7 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) REV/EiVT-° i ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS DEC 31 2007 NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL t� nnn rt {{� Project Type: Frame Type: Bathrooms: Shorelinel� yfpe 1S tspf�sal: ❑ New t ``Wood Existing: I ❑ Sewer ["Addition ❑ Steel Proposed: I Bank ❑ Community System Wo Alteration/Remodel ❑ Concrete Total: 2 Height: t -Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: D Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: ___/_ urPublic Total: I 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: 1 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 1 Pellet Stove i Other Is this appliance being installed in a Manufactured I 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. ,yy. " Square Footage Current Proposed TorAff eUse.Rrl i z son Main Floor Heated g� � �n EH BId App Review: 2'Floor Heated . ; , . .` Consistency Review: 64 Other Heated " ` -, Base fee: G 52.'1S ' 1°>x f Mezzanine A:n p.r --, 6-1 Heated Basement 1�� , t ` Plan Check fee: a2 •l� Unheated Basement T�`;` �4 � " = State Surcharge fee: 'al5) Other Unheated r' , �ts Pot Water Review fee: , Garage/Carport SUBTOTAL n z\A. Deckstarmo , G 2t`zix �, h fee: l Other tutiat '1-1. WIC, 4 Z 1+ 0 J\q l —� TOTAL: $ ..--"�- [h �-y, Receipt Number: C &p 0 1 Caash/Check NumberI ESTIMATED C Ql1lR � Date:.Fair market v ue of all labor and maten foundation b finish al31 l en Initials: G:\PermitCenter\###VORMS-###\DRD FORMS\Master Permit Application 12-19-2006.doc • • RECEIVED 4(Ilk 0", JEFFERSON COUNTY KI DEPARTMENT OF COMMUNITY DEVELOPMENT D E c 3 1 au �"4" 360/379 4450 621 Sheridan S 360/3 9treet • o4451 Fax rt Townsend •Washington 9836 N��s htt ://www.co.jefferson.wa.us/commdevelo men ` FfC���N COU�1Y no p 1 p t/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# 0 '7- (O 77) PROJECT/APPLIC:ANT NAME: T� /7/1 ( ?.f)-/� jaAr_. 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. ( 1114U C 0� 2( f ' 1 ) 0 4© kci 01 6EA-c44 PA L 1Ntato Ac. s R r t E, w Ex./var. Existing Conditions Summary 2. Describe the� existing topography. contours Indicate j on� {/tthes7ite map. ryssy`l + li\ r.A 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. eCLU cE5 -sc T , � Z t ( `°c p 14 pJ s J1� ID 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. r4G 1 s ice, WA.1( • . ux: .... . t'l i`k . 6. Describe any excess levels of noise generated by the proposed use or activity: ILI 4 STORM WATER PLAN MIN - 3 20f18 siL[16.vh)rLL w:.y.„ rli An: JEFFE DEPT.OF CO. I V. PMEN1 stormwater site plan template—rev.10/1/2003 SIGNATURE: 5 / • • 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes,etc.)on the site. I dicate location on the site map. QMe /b / 1544-004.4 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.). A•4J tiP e r1 `' R F � , � moo, V 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 Jacilities from existing facilities. -4 .. t t A "` " t)L.Ly ( r6 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 conta�nts.]�.�RECEIVED DEC 3 1 2007 11. Describe the performance goals and standards applicable to the project. JAC f C�� COUNTY DCD 1 rt.) 12. Describe the flow control system. 1- Cert-0 `Ft DO.A. eon f� 4 - .44 tormXteei itte"rtbr,410Iit'el tiAr 1a1/003 ' 6 .r • • DEC 3 1 2007 ARM COUNTY DCD 13. Descr a the water quality system. w A, Trk, . --1-eio UK( 4 ui 41erk. coo 4.ey., 14. Describe the conveyance system analysis � U ,*.t sign� � A� , A heft t ` 6 L kJ 15. Describe the source of fill material,physical characteristics of fill ma rial,and deposition of excess m terial " e-.t ( C. t„..q v� reef , 1. a, ' i [ 1 "E/00 �/�y 4 1 ' b& �L 3 f 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. w ,." 1 17. Describe the proposedd•surfacing material. ,,+ O , 18. Describe methods for restoration of the site.i / a 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for "large"projects only and only those for which facilities are required to control flow or treat runoff.] If included,list the Manuals here i1/4J Abe 20. List ere and include any special reports or studies conducted to prepare the Stormwater Site Plan. IsECE!VED 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 regjEeile3tsidre those conditions or restrictions here. N JEFFERSON COUNTY HD 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. otra4Vir4ctiPw.1 v_ki rtn )10 „Ttor.44,_ ita 5 2. Establish Construction Access. IL* *4114Vis ` e. ``°r k,VE40A'Y mccgi 3. Control Flow Rates. Arrez TO Ter- dor§477-ou.p.74. , 4. Install Sediment Controls. T' C 5. Stabilixq Soils. 6. Protect Slopes. IVIA-17,\V$ irdp 1-AL-C-Vb 7. rotect Drain Inlets. RECEIVED �o >C— e_A--t P L -i S DEC 3 2007 . A cum Da stormwater site plan template—rev.10/1/2003 8 • • 12 Required Elements—Construction SWPPP(continued) 8. St bilize Channels and Outlets. 1 a - C - [fit coe u7. 9. ontrol Pollutants. C°}j R-er- r'_.( CS C 1_) T6_kt Q P F z ', -��-,E�1 N R ICE 10. ontrol De-Watering(the act of pumping roundwater or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). ECEIVE [) 12. Manage the Project. DEC 31 2007 t.L"EISIli E_.kll la 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). LC.--Q t L/� \Jr b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). ,t -j12 A i41 i ' 7 44 : 7=; "AC -4 3. Environmentally Sensitive Areas. a. D escrittion of environmentally sensitive areas that are on or adjacent to the site . 1 stormwater site plan template—rev.10V1/2003 9 • b. Description of special requirements for working in or near environmentally sensitive areas. .-� ( T" - .. I M 40\,(' " Tr`_l A P A Mf l Ql 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). 1 A. l G--'(L 1 - PT/ c fl f gLYSt_ 1 5. Construction Phasing. a. Construction sequence k OV C ' -U S fa .41 , JFOO L4710A b. Construction phasing(if prbposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. lYr'�!F,-r '� Pr e. ,A m t U E t! A U A l L-AZ L.-E II. Wet Season Construction Activities. R -_1 CE A VJ a., Proposed wet eason construction activities. 11 ` C;UJ DEC 31ZOOt b. Proposed' et e,ason construction activities for environmentally sensitive areas. A Vim JC11E1 EN COUNTY BCD 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. fl-f o yvi {--4 A,Ylr1 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. A c. Waterways. /Nl, A 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. 2 /1-0/67 (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: RECEIVED DEC 31 2007 JEFFERSON CDUNP1 DCD stormwater site plan template—rev.10/1/2003 12 rn � oo � °°.00 -0-OM -va� 3 -o ff; - - a cmo3 co CO _ .<CD -0 x 4. m n `� � omen s 00. co CSI D m N �� 0.0.0- Iv c c oD3 .•ohs CT °CT � cn o < o . oW� anc svo c CD _ 3 •. °' x co m o r CD a IP Z m w o A000 -w_..lcn C • N o iiicor,) ca IVcpo" Q. ,cv •�2N -�-n-noo) rCn(n _-___ . ._._._._._._._._- Centerline of Hiller Dr. 0 ROW&location of Water Main o N N Q. �r-�,� fir- • • _ -- NA) x� Ica •• ___ --- _ T1 n� O-•N (y `°�° , `� w HillerDnv wa _� a �� x m V�cn �m-a' co �0 = !y • o cn�= ou, cno ��• �cDcnO • OccDCD m •r'oc> > o acn a TI rzo cnwo �" w n.0) p Ivy mooQv o 0. — m �� osvo ? • - - / o m � ar — • co su o III CD m co A- CD g. I 400\ N,..' 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