HomeMy WebLinkAboutBLD2008-00061 BUILDING PERMIT APPLICAIN MR 08-00 Type:067
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00061 Received Date: 2/19/2008
SITE ADDRESS: J 3TRAFALGAR DR
OWNER: FRANK HANDLER PHONE: 206-282-0223
3755 SW SOUTHERN ST
SEATTLE WA 981263445
KALA POINT#4
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 965000065 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: WALTENBAUGH CONSTRUCTION CO PHONE: (360)385-6105
32 KALA SQUARE PLACE
PORT TOWNSEND WA 98368
Contractor's License WALTECC012BA Expires 1/2/2010
REPRESENTATIVE: STEPHEN LEE PHONE: 206-515-2037
1809 7TH AVE, SUITE 1603
SEATTLE WA 98101
PROJECT DESCRIPTIOP NEW SFR W/ 250 GAL A/G PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,062
VALUATION 300,000.00 ADD'L: 464 HEAT TYPE: PRO
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N SHORELINE:
GARAGE: 410
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: KALA PT
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 2 Prop: 2
Total: 2 Total: 2
Routing Date: 02 I '9 1 O 2 cie
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $2,113.75 CJZ 02/19/08 96953 APPROVED
Plan Check $1,373.94 CJZ 02/19/08 96953
State Building Code $4.50 CJZ 02/19/08 96953 MAY 152008
Potable Water Application $59.00 CJZ 02/19/08 96953
Total: $3,551.19 Jefferson County Planning
&Building Department
Jefferson County Building D..ision Permit Numb r: BLD08-00061
Applicant: HANDLER
BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2006 International Building Codes
To schedule inspections, call (360)379-4455 no later than 7:OD 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 SEE CONDITION 2 FOR CONSTRUCTION ENTRANCE
STABILIZATION.
Foundation Footing l ��, n
Footing Drains 1 l
Foundation Stem Wall /•
'V
•
Underground Plumbing ` ' ` pBJty
Under Floor Framing
Straps(hold downs) /449`De
404
Ext. Shear Wall Nailing �,/�1/mil � /
•
Rough-in Plumbing //lovo8
Framing P/8/6
Airseal Pit166
Insulation:Walls 'D -I N-U
Insulation: Floors
Pre
Insulation: Ceiling /0—l1/ OrK —
Int. Shear Wall Nailing
Wallboard Nailing (
Gas Line: Interior fz /
8/ g
Gas Line. Exterior 0c.
Propane Tank
Heat/Chimney Clearance ,D/B DB
R'PA M
Drywell/Alt Drainage SEE CONDITION I FOR DRY WELL SPECSTKI#1 APPD 8.4'
ff./ad
Address Posted (,_IS—CY)
FINAL INSPECTION
V
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• 111
CONDITIONS for Building Permit# :BLD08-00061
1.) DRYWELL DESIGN CRITERIA
DRYWELL BOTTOMS MUST BE A MINIMUM OF ONE (1) FOOT ABOVE SEASONAL
HIGH GROUNDWATER LEVEL OR IMPERMEABLE SOIL LAYERS.
EACH DRYWELL MAY SERVE UP TO 1000 SQUARE FEET OF IMPERVIOUS
SURFACE FOR EITHER MEDIUM OR COURSE SANDS.
TYPCIALLY DRYWELLS ARE 48 INCHES IN DIAMETER (MINIMUM)AND HAVE A
DEPTH OF 5 FEET (4 FEET OF GRAVAL AND ONE (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.
DRYWELLS SHOULD BE AT LEAST 10 FEET FROM ANY STRUCTURE, PROPERTY
LINE, OR SENSITIVE AREA(EXCEPT STEEP SLOPES).
2.) BMP C105: STABILIZE CONSTRUCTION ENTRANCE
CONSTRUCTION ENTRANCES SHALL BE STABILIZED WHEREVER TRAFFIC WILL
BE LEAVING A CONSTRUCTION SITE WITHIN 1,000 FEET OF THE SITE.
SEE ATTACHED BMP C105 SHEET FOR CRITERIA DETAILS.
3.) PRIOR TO OCCUPANCY& BUILDING FINAL - MUST MEET THE CONDITIONS OF
AND FINAL APPROVAL OF SEPTIC SEP07-23 IS REQUIRED.
4.) A MINIMUM OF 5' MUST BE MAINTAINED BETWEEN BUILDING FOUNDATION AND
EDGE OF SEPTIC TANK.
5.) ALL COMPONENTS OF THE SEPTIC SYSTEM (TO INCLUDE PRIMARY DRAINFIELD,
RESERVE AND SEPTIC TANK) ARE TO BE COMPLETELY PROTECTED FROM
VEHICULAR TRAFFIC OR MECHANICAL DISTURBANCE.
6.) MUST COLLECT AND DIVERT ALL SOURCES OF DRAINAGE AWAY FROM SEPTIC
TANK, RESERVE & DRAINFIELD. MUST COMPLY WITH ALL PERMIT CONDITIONS,
STATE AND LOCAL CODE.
7.) 10' SEPARATION REQUIRED BETWEEN A WATER LINE AND ALL PORTIONS OF
THE ONSITE SEWAGE SYSTEM; EFFLUENT TRANSPORT LINE, TANKS,
TREATMENT AND DISPOSAL COMPONENTS (PRIMARY AND RESERVE
DRAINFIELD AREAS).
8.) A 30' SETBACK SHALL BE MAINTAINED FROM THE DISPOSAL COMPONENT AND
RESERVE AREA TO ANY DOWNSLOPE FOOTING, CURTAIN OR INTERCEPTOR
DRAIN OR DRAINAGE DITCH.
9.) To help prevent seawater from intruding landward into underground aquifers, all new
development activity on Marrowstone Island, Indian Island and within 1/4 mile of any
marine shoreline shall be required to infiltrate all stormwater runoff onsite.
10.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
11.) Critical Aquifer Recharge Areas require special protection measures to mete 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.
12.) 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.
13.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
14.) 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.
15.) This parcel is within the Kala Point no shooting area per JCC 8.50.
16.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
17.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
18.) Minimum setback from Trafalgar Drive and Blenheim Place rights-of-ways shall be 20
feet. Minimum south and west setbacks shall be 5 feet.
19.) 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.
20.) 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.
21.) The building height is not to exceed 35 feet.
4�.¢SON c06 JEFFERSOIWUNTY •
W � DEPARTMENT OF COMMUNITY DEVELOPMENT
"\ , ` 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
q 0� www.co.jefferson.wa.us/commdevelQ e_t-
SKINO�S _? r 1
Master Permit Application MLA: ( L,.. I,
Project Description (include separate sheets as necessary):
SIN 41.E F-FFM 11.'1 rZ 1 De.00,E
Tax Parcel Property
Number: (165 000065 Size: i6 ,'i16 Yo . FT. (acres/square feet)
Site Address and/or Directions to Property:
Lot' 68 , KfW f01NT DIV1Si0 N y. 1-120 FAL4At /2rtl .
Property Owner(s)of Record: SANK I+ANDL 1
Telephone:(DA'4) 206 2$7- 0123 • Fax: email:fatMkhc)s401+Wetfom.�+
Mailing Address: 3'155 90 Spuivrett, Sir. 5Epfi1LE , wit 921 ze
Applicant/Agent(if different from owner): 5hft4EN LE-4 / S EPi4E+J L EF_ P ZLC l4 I TAT 5
Telephone: 206 5I5 - 203l Fax: 206 6/4. 051$ email: 5 lee .3GcLiAcktS •G,,,w
Mailing Address: 180 q 1-111 Ave , 5V I T} 160 3,_ S6P TTVV, tMA - ci g(o I
What kind of Permit?(Check each box that applies
.I Building ❑Variance(Minor, Major or Reasonable Economic Use)
El Demolition Permit ❑ Conditional Use[C(a), C(d),or C]**
„jli'Single Family ❑ Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home ❑ Modular El Special Use(Essential Public Facilities)**
❑ Commercial* ❑ Boundary Line Adjustment
❑ Change of Use ❑ Short Plat**
❑ Address ❑ Road Approach 0 Binding Site Plan**
❑ Home Business ❑ Cottagelndustry 0 Long Plat**
❑ Propane ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑ Sign ❑ Plat Vacation/Alteration**
❑Allowed "Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management ❑ Shoreline Management Substantial Development**
El 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
El Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetaion Request
*May require a Pre-Application Conference _ **Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal, if known:
DESIGNATION OF AGENT 55. ArrAGii-C-gyp LET-K-(t,
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 gwt'I Vagent 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 a ig it will be assumed unless the applicant informs the County in writing at the
time of the application that he or she wants prior notice.
Signature: -
Date: �� eP- 20b3 •
\
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 E A Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you are in comply nce it/ A efferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable responsibili f %f r . . art complying with the ESA. The Applicant has read this disclpaimerC signs and date it below.
Signature: Date: 1 F i %-
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
• BUILDER STATEMENT li
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:
WflLLENMVO CO Tt'GTtoN (36o) 329 6toy (31 o ) 311 Z737
MAILING ADDRESS: 32 ICALA 5Q, 9l., rotx Taabera 13662 EMAIL: scot}..) 45 olImpw► •A t
CONTRACTOR'S LICENSE WAINS
NUMBER: w`a) Ler E r`G Q I 1 13A NUMBER Q
ARCHITECT/ENGINEER: 5 use PHONE ( ) 515 j037 Fax: (Lob )6U4. 05(B
MAILING ADDRESS:(2O '1I pnE• 4(403, o1/4-mC, wpi,11(9 I, EMAIL s f,per p7411 014 t$e1,(AMA
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
,le New ,'Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: 'L Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Z. Height: K Individual System
❑ Repair ; ❑ Masonry SEP Permit#O1-00923
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: 't ❑ Public
rail, - Total: 'Z Name of System:
I t-A DINT vt iu 01
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces:
Number of occupants(includes owners,tenants,employees,etc) Current Proposed
IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply:
i Underground Tank ove ground Tank _ Size of Propane Tank: 2,2o
i Heat Stove i 6ok Sto i Woodstove i irepiace I ert i Hot Water Tank i Pellet Stove I Other V'( rZ
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 Amount Revision
Main Floor Heated I,0 62 I 100 o, 53' (o EH Bld App Review:
i •
2"°Floor Heated 4.6 4 414 0�"')fJ Consistency Review: ` 5
Other Heated Base fee: c , `G ,r-j
Mezzanine . Additional Section:
Heated Basement Plan Check fee: ' L 3- J q-
Unheated Basement State Surcharge fee: d
Other Unheated Pot Water Review fee: 3 G 115
Garage/Carport `,r 0 ,I,a-i I go
I,r_ice SUBTOTAL �' 'C\
Decks 7 911/Rd Approach fee: L (_
Other tSCJ At`gt TOTAL: $ 3Ci -70,19
l Receipt Number: C'(9 p, 3
Cash/Check Number: LOB
ESTIMATED C T"(RtQUIREM, 1?rt: 1 g 2008 a' l . toy
•Fair marke ue of all labor and material foundation to finish
Initials:
• J
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
1
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.4r Illi% JEFFERSON COUNTY 'I L 1 r �___., . :
1 DEPARTMENT OF COMMUNITY DEVELOPMENT ; FEB 1 9 2008
621 Sheridan Street • Port Townsend •Washington 91368
�g� O 360/379-4450 . 360/379-4451 Fax __
"ESN 2x http://www.co.Jefferson.wa.us/commdevelopment! nrr ''
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# 0 (Q1 PROJECT/APPLICANT NAME: NANQL4 Z. / $1E1j LEE•
Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the
applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a
separate stomiwater site plan map.
Project Overview
1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the
site map.
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Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
ge,a--r I V"I POT./ RA49 - Am KJ 112 So ui+ EMT.
3. Describe the existing vegetation.� Indicate nat.ve vegeet��.atioppn$reas on the site
ccmap. ,�j
(SsitW tisc. OF
4. Describe the existing soils. Indicate soil type on the site map.
S 71 —
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.
— NvM ' ' - _
APPROVED
6. Describe any excess levels of noise generated by the proposed use or activity: STORM WATER PLAN
rNro •
MAY 1 4 20u8
Stormwater A) JEFFERS O Y
'�`,-4t, ,di r_ DEPT.OF IT E PME
Require 1 iv - SIGNATUR .
stormwater site plan template—rev.10/1/2003
5
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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.
Non) .
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.).
r2 N ) iT• (47E0GE - S T•
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.
ekfo5iN< 3 Q Vti L,JEtL5
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.]
N /A
11. Describe the performance goals and standards applicable to the project.
IN I(.A- MAC MYL/A w tI -a- 61\J $(1_ •
12. 'Describe the flow control system.
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stormwater site plan template—rev.10/12003 6
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13. Describe the water quality system.
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14. Describe the conveyance system analysis and design.
15. Describe the source of fill material,physical characteristics Df 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.
61. c a -.o Po*, aw P ,c- ais wkrati C3/4 -0
17. Describe the proposed surfacing material.9- �,� 1�,F,
"4 JEL +t r 117- (A'US�7ZJC T /S-N .
coo N T IPPV(Cdelti .
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.
N/A
20. List here and 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. SE
stormwater site plan template—rev.10/1/2003
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CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN (SWPPP)
The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the
template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for
preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater
Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential
development.
SECTION I—CONSTRUCTION SWPPP NARRATIVE
1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction 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.
yam, )% (It, MPAG OLFAIZI(34 L(MtT,r.
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.
6. Protect Slopes.
N//4
7. Protect Drain Inlets.
11/A-
stormwater site plan template—rev.10/1/2003
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1. 1 '
12 Required Elements—Construction SWPPP(continued) '/ ( —�
is
8. Stabilize Channels and Outlets. F E B 1 9 2008
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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).
IN/21_
11. Maintain Best Management Practices(BMPs).
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).
ltki?� e(thoptic ktio r Alva A iSl AGE .
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
N/Ph
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
stormwater site plan template—rev.10/1/2003
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b. Description of special requirements for working in or near environmentally sensitive areas.
IJ/A.
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. ConstructionA�j sequence p� �.1 �/}_. , �/
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b. Construction phasing(if proposed) 't 7
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
Provide a proposed construction schedule.
ir T Li to Atv f6041.1 Af 'L .
II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
1,10 5 V , rl (( S 1TE - W I(A. TA 4 M I' T1(NJ
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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.
N/A
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 separateeet for the following,if applicable.
a. Sediment Ponds/Traps. N
b. Diversions.
c. Waterways.
d. Runoff/Stormwater Detention Calculations
stormwater site plan template—rev.10/1/2003 10
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Stormwater Site Plan Changes
If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be
submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised
drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change.
Final Corrected Plan Submittal
If the project included construction of conveyance systems,treatment facilities,flow control facilities, or structural source control BMPs
(not standard on-site stormwater management BMPs), the applicant shall submit a final corrected plan ("as-builts")when the project is
completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as
constructed.
APPLICANT SIGNATURE
By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and
correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all
owners of the to r erty.
•
19 2662-
(LANDOWNER OR AUTHORIZ _PR_ESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
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stormwater site plan template—rev.10/1/2003 12
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