HomeMy WebLinkAboutBLD2008-00005 •
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 #: BLD08-00005
SITE ADDRESS: 52 PEBBLE LN Issue Date: 03/3/2008
PORT TOWNSEND, 98368 Final Date: 12/30/2008
APPLICANT: LSPI EXCHANGE CORP PHONE: 360-379-5355
20 S SANTA CRUZ AVE#300
LOS GATOS CA 950306827
SUBDIVISION: EISENBEIS BAY VIEW Block: 30 Lot: Al
PARCEL NUMBER: 948603002 Section: 16 Township: 30 N Range: 01 W
PROJECT DESCRIPTION: NEW SFR W/ 250 GAL A/G 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
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON
12/30/2008
I:\F_BLD_Occupancy.rpt 10/29/19
MLA08-00004
UILDING PERMIT APPLICAC1 Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00005 Received Date: 1/7/2008
SITE ADDRESS: PEBBLE LN
OWNER: LSPI EXCHANGE CORP PHONE: 360-379-5355
20 S SANTA CRUZ AVE#300
LOS GATOS CA 950306827
EISENBEIS BAY VIEW
SUBDIVISION: Block: 30 Lot: Al
PARCEL NUMBER: 948603002 Section: 16 Township: 30 N Range: 01 W
CONTRACTOR: STAPF CONSTRUCTION PHONE: (360)385-3199
2727 HASTINGS AVE
PORT TOWNSEND WA 98368
Contractor's License STAPFC*249J8 Expires 4/25/2009
REPRESENTATIVE: RICH STAPF JR PHONE: (360) 301-6184
211 SOUTH JACOB MILLER RD (360) 385-6722
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION NEW SFR W/ 250 GAL A/G PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,716
VALUATION 278,262.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 2006 HEAT BASE: 876 HEAT TYPE: EEE
OCCUPANCY: R-3 UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 840 SHORELINE:
CONST TYPE: SETBACK:
DECK: 444
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: CITY
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 3 Prop: 2
Total: 3 Total: 2
Routing Date:
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $1,996.15 CJZ 01/07/08 95549 APPRcVEEDPlan Check $1,297.50 CJZ 01/07/08 95549
State Building Code $4.50 CJZ 01/07/08 95549
Potable Water Application $59.00 CJZ 01/07/08 95549 1-1Ag 3 200
Total: $3,357.15 Jefferson County Planning
& Building Department
Jefferson County Building Dillon Permit Numb. BLD08-00005
Applicant: LSPI EXCHANGE CORP
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 International Building Codes
To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection.
Requests received after 7:00 AM will not be scheduled for that day's inspections.
ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries.
The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection
Inspection Item Date Approval Signature Notes
Setbacks
Erosion Control '' U$ 7/ SEE CONDITION#2 SILT FENCE REQUIRED
Foundation Footing k%g p/phi * J F,e-� O .t2- 7 f/af
Footing Drains �/.11o.c Ili
Foundation Stem Wall 4/7/q LJiP
Underground Plumbing ` ,,,bn
(� "I ---'p
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Under Floor Framing fie.,,; ,,,461,:zi
Straps(hold downs) `dALL /
zi epl.
Ext. Shear Wall Nailing ot.-)0 --OS rh-
Rough-in Plumbing 1 it OV i r
Framing i
1,07 Uf
Airseal 'k ' i
I (,g
Insulation:Walls i II OS
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Insulation: Floors jd/Z1 a -JC- (;Ak'P.• Lib
Insulation: Ceiling t2 30/p6 fv1 e,Eg-r,r(c fA-
Int. Shear Wall Nailing Ic -31-08 -1 C_
Wallboard Nailing lb ?i_t3r --
Gas Line: Interior 11' -.2-- . ,, 1�
J
Gas Line: Exterior i 1_3_csr \
Propane Tank III l -'3 _v ,.,---.
Heat/Chimney Clearance
Drywell/Alt Drainage Ir,.21,_,Q, 04" 1 b`/p SEE CONDITION# 1. 3 DRYWELLS- ,`) C w
Address Posted i1/3b/o`� h 1, !!!
FINAL INSPECTION 17/31,/f, ()/{ -Car 0) i.7//�'tg✓,
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD08-00005
1.) DRYWELL BOTTOMS MUST BE A MINIMUM OF 1 FOOT ABOVE SEASONAL HIGH
GROUNDWATER LEVEL OR IMPERMEABLE SOIL LAYERS.
EACH DRYWELL MAY SERVE UP TO 1,000 SQUARE FEET OF IMPERVIOUS
SURFACE FOR EITHER MEDIUM SANDS OR COARSE SANDS.
DRYWELLS ARE 48 INCHES IN DIAMETER (MINIMUM) AND HAVE A DEPTH OF 5
FEET (4 FEET OF GRAVEL AND 1 FOOT OF SUITABLE COVER MATERIAL).
FILTER FABRIC (GEOTEXTILE) MUST BE PLACED ON TOP OF THE DRAIN ROCK
AND ON TRENCH OR DRYWELL SIDES PRIOR TO BACKFILLING.
SPACING BETWEEN DRYWELLS MUST BE A MINIMUM OF 4 FEET.
2.) A SILT FENCE SHALL BE INSTALLED EAST OF THE PROPOSED DRIVEWAY
STARTING AT THE NORTH BOUNDARY TO SOUTH BOUNDRY AT APPROXIMATELY
THE LOCATION OF STEPIC TANK. (SEE ATTACHED SITE PLAN).
THE MINIMUM HEIGHT OF THE TOP OF SILT FENCE SHALL BE 2 FEET AND THE
MAXIMUM HEIGHT SHALL BE 2 1/2 FEET ABOVE THE ORIGINAL GROUND
SURFACE.
THE SILT FENCE SHALL BE BURIED IN A TRENCH TO A MINIMUM DEPTH OF 5
INCHES BELOW THE GROUND SURFACE. THE TRENCH SHALL BE BACKFILLED
AND THE SOIL TAMPED IN PLACE OVER THE BURIED PORTION OF THE SILT
FENCE, SUCH THAT NO FLOW CAN PASS BENEATH THE FENCE AND SCOURING
CAN NOT OCCUR.
ANY DAMAGE TO THE SILT FENCE SHALL BE REPAIRED IMMEDIATELY.
SEDIMENT DEPOSITS SHALL EITHER BE REMOVED WHEN THE DEPOSIT
REACHES APPROXIMATELY ONE-THIRD THE HEIGHT OF THE SILT FENCE, OR A
SECOND SILT FENCE SHALL BE INSTALLED.
3.) 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.
4.) 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.
5.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
6.) Not more than 2 unlicensed vehiciShall be stored on any lot unless totally scribed
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.
7.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
8.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
9.) 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.
10.) 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.
11.) The building height is not to exceed 35 feet.
12.) Minimum setback from Pebble Lane Right of Way shall be 20 feet. Minimum side and
rear setbacks shall be 5 feet.
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- ; Rich Stapf Jr. - 211 Jacob Miller Rd - PT, WA 98368 - 360-301-6184
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Drawn By: Steve Wilfong - 130 Louisa St - PT, WA 98368 - 360-643-324S
For: Rich Stator Jr. - 211 Jacob Miller Rd - PT, WA 98368 - 360-301-6184
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For: Rich Stapr Jr - 211 Jacob Miller Rd - PT, WA 98368 - 360-301-6184
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06 i�C411
JEFFERSOOUNTY
ti ``�3 DEPARTMENT OF COMMUNITY DEVELOPMENT '
621 Sheridan Street • Port Townsend •Washington 98368
�, 360/379-4450 . 360/379-4451 Fax JA 1 - 7 2043
�p www.co.jefferson.wa.us/commdevelopment
gS, NG
Master Permit Application MLA: $05 �"'"�' r
Project Description(include separate sheets as necessary):
(j) 3 P)EDoOM Z gATH fi1AJ ,-Z..E FAM it-L gE61DF...AJC.E
Tax Parcel Property
Number: q+-(g (Qo3 Dt?Z Size: ` ,1333 (acres uare feet
Site Address and/or Directions to Property:
XXX Pc66LE L-A,J�
Property Owner(s)of Record: LSPI EXC+kAn16E GOR.P, / gicki.ARP BE1E_."+ s-- p ""
Telephone: i_SW- 33Z- 1031 Fax: 408- 35tc- 6BOS email:
Mailing Address: Z.p S. SA.nq CRUZ AVE. *300 LD GAThS c'A. 95030 - 682-7
Applicant/Agent(if different from owner): R IC-k STAPf / -
Telephone:(3(pO) 379- 5355 Fax:
Mailing Address: Z i I 5, 3TAGvb M td-F";__ 1 D, email: ',''a �i Cab I e ge ed.com
To�vn/sF,�p +NA. 983‘„3
What kind of Permit?(Check each box that applies
jlBuilding 0 Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit ❑Conditional Use[C(a),C(d),or C]**
0 Single Family ❑ Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home ❑ Modular ❑Special Use(Essential Public Facilities)**
❑ Commercial* 0 Boundary Line Adjustment
❑ Change of Use ❑Short Plat**
❑ Address 0 Road Approach ❑ Binding Site Plan**
❑Home Business 0 Cottagelndustry 0 Long Plat**
J Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Sign 0 Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions**
❑Stormwater Management 0 Shoreline Management Substantial Development**
❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
❑Forest Practices Act/Release of Six-Year Moratorium 0 Tree Vegetaion Request
*May require a Pre-Application Conference _**Requires a Pre-Application Conference
Please identify any other local, state or federal permits required for this proposal, if known:
DESIGNATION OF AGENT
I hereby designate !IC.44 "STAFF, 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 requir I ter inspection S affs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applica' n t he or she w t nor otice.
Signature: Date: „O
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 endang
ered species g 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 ' late 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' com iance with the J fferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable po " ility for adh o and complying with the ESA. The Applicant has read this disclaimer nd gns and dates it below.
Signature: ei R Date: / 3'dJ
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
• BUILDER STATEMENT •
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that,
they will be assuming the responsibility of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: t; $C: _ 7 23507
STAFF - Cows ucrlo hi (36o )38,E-.,5(14 (- 6.0 ) 3e 67zz
MAILING ADDRESS: 17Z-7 -\AST11.165 &tire EMAIL: if.
CONTRACTOR'S LICENSE PREY T4e15r64/:' t iJk i 3w'13 WAINS , i
NUMBER: 6TA PFG* 24 cI s B NUMBER
ARCHITECT/ENGINEER: STE1'E W+L.FOrj Ls- PHONE (360 )3gs--a% FAX: ( )
MAILING ADDRESS: I;p I-o ,4 4 S t% ' 1 PT ,`t"(.`igt.isI=,ti ,AA EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
N New Ni Wood Existing: ❑ Sewer
O Addition 0 Steel Proposed: Z Bank 0 Community System
O Alteration/Remodel ❑ Concrete Total: 2 Height: X Individual Syste
❑ Repair ❑ Masonry SEP Permit# O6
O Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well 0 Two Party
Type of Heat: Proposed: 3 iNf Public
,. — Total: 3 Name of System: CITY of
Pogi --rodsusru O
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 Ap liance Installation permit,mark all items below that apply:
i Underground Tank i bove ground Tati)O Size of Propane Tank: Z50 .'---/-
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.
Square Footage Current Proposed For Office Use Only -•s- .k. , , 5 , L
Main Floor Heated �' I(v =t `:)OS EH Bld App Review: (.:0
2nd Floor Heated Consistency Review:
tJr-1
Other Heated Base fee:
1aCol5
Mezzanine Additional Section: ___ __—,
Heated Basement 7� . 32c2_L Plan Check fee:
Unheated Basement State Surcharge fee:
Other Unheated Pot Water Review fee:
Garage/Carport ��a 2c OD SUBTOTAL 353"i r5
Decks zi 1C1 911/Rd Approach fee: cv
Other (c ),4 .7Z TOTAL: 15
Govr2F n Poactl Zlo� $ 1�'
Receipt Number: 0.95 50
Cash/Check Number: l'a gcNtr
< 6//6410Z.� o aa ?1
ESTIMATED COST(REQUIRED) Date:.Fair m Met value of all labor and materials foundation to finish )^ '1—0 Q d
16Df 000 44 Initials:
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
•
rillik6„4, JEFFERSON COUNTY , _ ;
DEPARTMENT OF COMMUNITY DEVELOPMENT ,•
A� 7 20
` s 621 Sheridan Street • Port Townsend • Washington 98368 di-LT ar
14 �O 360/379-4450 . 360/379-4451 Fax [.; : 1 LOP,AL.NT I
NG http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# I PROJECT/APPLICANT NAME: LS P r -EXci-14.J&-E. / R I U{-A-a Sj7A.Pr,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.
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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: STORM W ATER 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.
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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11. 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. . i ?, , • --— — ! !
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14. Describe the conveyance system analysis and design. J f Lille 3 di 6velS
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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.
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17. Describe the proposed surfacing material.
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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 and include any sp ial 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.
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stormwater site plan template—rev.10/1/2003 7
110 • •
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.
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2. Establish Construction Access.
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3. Control Flow Rates. (`
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4. Install Sediment Controls.
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5. Stabilize Soils.
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6. Protect Slopes.
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7. Protect Drain Inlets.
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stormwater site plan template—rev.10/1/2003 8
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12 Required Elements—Construction SWPPP(continued) A — ��� j
8. Stabilize Channels and Outlets.
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9. Control Pollutants.
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10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
11. Maintain Best Management Practices(BMPs).
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12. Manage the Project.
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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).
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3. Environmentally Sensitive Areas.
a. Description o environmentally sensitive areas that are on or adjacent to the site.
stormwater site plan template—rev.10/1/2003 9
• • •
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).
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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).
I. Provide a proposed construction schedule.
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II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
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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.
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8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable.
a. Sediment Ponds/Traps. /✓//r-
b. Diversions.
c. Waterways.
d. Runoff/Stormwater Detention Calculations
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 I
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 b- •f my knowledge. I also certify that this application is being made with the full knowledge and consent of all
owners of the . - =• property.
(LANDOWNER OR AUTHORIZED REPRES" ATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
1-\\ 3AN -7 2013 \,Y-
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stormwater site plan template—rev.10/1/2003 12