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HomeMy WebLinkAboutBLD2008-00068 08- •UILDING PERMIT APPLICA•N MRL Review Ty 068 ype: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00068 Received Date: 2/20/2008 SITE ADDRESS: 1k 31 NO NAME RD PORT LUDLOW, 98365 OWNER: CHRIS B FRANSON PHONE: 360-732-4945 CHRISTY N FRANSON 211 NO NAME RD PORT LUDLOW WA 983658778 SUBDIVISION: Block: Lot: TX15-1 PARCEL NUMBER: 821063016 Section: 6 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW POLE BLDG - UNHTD., NO PLMB TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 85,982.00 ADD'L: HEAT TYPE: UH CODE EDITION: 2006 OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OTHER: CONST TYPE: GARAGE: 5,040 SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop: 0 Total: 0 Total: 0 Rou�'tiing Date: ` 1 --9 Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $895.75 LYK 02/20/08 95923 Plan Check $582.24 LYK 02/20/08 95923 APPROVED State Building Code $4.50 LYK 02/20/08 95923 Total: $1,482.49 MAY 19- 2 iDA Jefferson County Planning &Building Department Jefferson County Building Dision Permit Null: BLD08-00068 Applicant: FRANSON BUILDING PERMIT INSPECTION APPROVALS \pplicable 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 2:110/ tCI, Post Holes /' fci 1 ti , :F777 Footing Drains Q/4 08 / ,awn ER-S = SPOMATS Straps(hold downs) V Nlt, Ext. Shear Wall Nailing IJ/A Framing S ,J iI� Blocking C )° #71/ Drywell/Alt Drainage (i/1//9e G �� �pwNSpG�'S LS Address Posted / / gil- FINAL INSPECTION FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR CONDITIONS for Building Permit# :BLD08-00068 1.) GUTTERS TO DOWNSPOUTS TO SPLASHBLOCK SHOULD BE SUFFICIENT FOR STORMWATER DISPERSION. A MAXIMUM OF 700 SQUARE FEET OF ROOF AREA MY DRAIN TO EACH SPLASHBLOCK.. A VEGETATED FLOWPATH OF AT LEAST 50 FEET SHOULD BE MAINTAINED BETWEEN THE DISCHARGE POINT AND ANY PROPERTY LINE, STRUCTURE, STEEP SLOPE, STREAM, WETLAND, LAKE OR OTHER IMPERVIOUS SURFACE. A SPLASHBLOCK OR A PAD OF CRUSHED ROCK(2 FEET WIDE BY 3 FEET LONG BY 6 INCHES DEEP) SHOULD BE LACED AT EACH DOWNSPOUT DISCHARGE POINT. 2.) 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. 3.) 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. 4.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 5.) 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. 6.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 7.) Minimum setback from No Name Road right-of-way shall be 20 feet. Minimum north and south setbacks shall be 5 feet. Minimum setback from SR 19 right-of-way shall be 35 feet. 8.) 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. 9.) 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. kzi.,LSON ct)6� JEFFERSOfOUNTY ��[{+ � r j ,\ A DEPARTMENT OF COMMUNITY DI IL4 tit1 li. ill 11 ' "\ `''4 621 Sheridan Street • Port Townsend •Washington 98368� 360/379-4450 • 360/379-4451 Fax rt �qs, N0c5 www.cojefferson.wa.us/commdeveloprrkrg6 2 0 lit: Master Permit Application JEFFERSON COUNTY filer-A: -( S Project Description (iltnclude separate sheets as necessary):. 01 t )i(t0.(IN — i'l) lAra+) 1'1C� pt ►net ✓10 (['1C: r or - erl C- Tax Parcel c, J p rty Number: Z' L ��1 C`�� oSize: ) (LC1'C.5 (acres/square feet) Site Address and/or Directions to Property: - cac�cit-�S`� a(ro5 S ,Or) t k react - ci yi 3C f&Nam(' � y� r r 1 d l p '{ova_ i1C�"1�1 5pt,�r o N 0 I oine i Ccto+k — o t1 11 r (e'-S—t (0 cP B aver tic:1(e, RA) crtc Property Owner(s)of Record: C V r j S C ;Art "�I"i S-iZ� r f— (^c' r S oh Telephone: •3( C 732 �} > I Fax: Saryi - Calk I1rs I email:G`trnnSull Zl I�'c/n(xpr�rtta'1 lor� Mailing Address: 2-II Nu Nick ry . React Y Applicant/Agent(if different from owner): - S a v- �. Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies XBuilding ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** ❑ Single Family Garage Attache Detached ❑ Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular - _ ❑ Special Use(Essential Public Facilities)** ❑ Commercial* ❑ Boundary Line Adjustment ❑ Change of Use ❑ Short Plat** ❑ Address ❑ Road Approach ❑ Binding Site Plan** ❑ Home Business ❑ Cottagelndustry 0 Long Plat** ❑ Propane 0 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** ❑Site Plan Approval Advance Determination (SPAAD)* ❑Shoreline Management Variance ❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium 0 Tree Vegetaion Request *May require a Pre-Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applicator that-he oyslie wants prior notice. Signature: ( -. Date: — V d� Z The action or actions Applicant wi undertake as a result of the issuance of thi s s 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 respons. ..ty for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: 7 2_0 •-'0,14/ t, 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 assu ing ttt�responsibility of the General Contractor for the proposed project. Signature: J j Z- - Date: z - Z0 -- aif 1 - III GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline:n� Type of Sewage Disposal: '. New X Wood Existing: N r\ ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: 0 Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: fo, Existing: Setback: 1 Private well ❑ Two Party Type of Heat: Proposed: . ❑ Public Total: 1 Name of System: If this is a Commercial Project you must answer the following: jai \ 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 I 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. Square Footage _ Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review:4o 05 ...r.._�.a r 3 .3 --- 2"d Floor Heated Consistency Review: Other Heated Base fee: s`t5 t J Mezzanine Additional Section: Heated Basement Plan Check fee: 5 Q D a4 Unheated Basement State Surcharge fee: 0 4. 5c Other Unheated Pot Water Review fee: • NCB f u-1 P) Garage/ arport n SUBTOTAL Il' �E / T� 85 q%D /0 3 9L g iDecks 911/Rd Approach fee: S Other TOTAL: $ l 'l q 5,c} 1 Receipt Number: 45493 Cash/Check Number: t f`y 1 ESTIMATED COST(REQUIRED) Date: ��//�� c •F it market value of all labor and materials foundation to finish(16 Q,.) U 6 Initials: ,/_._ ::PaCif -`. (._ G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc • • REcEIVED gaoN ° JEFFERSON COUNTY ' FEB 4 . kiro 1 DEPARTMENT OF COMMUNITY DEVELOPMENT 2 2008 . "ti' 621 Sheridan Street • Port Townsend •Washington 98368 JEFfERSON COUn " NC'�O 379-4451 Fax http:///www.co.jeffe s/on wa.s/ommdevelopment/ i, CD STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# C —(Q73 PROJECT/APPLICANT NAME: C ,1 r1 5 F'`I r) Gt If‘so vl 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 114a4.04:-'r h Pa r-.,„ 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site map. TO Lr) VkSI dr ck. p6(� bv� . ( ►v 0 X t O►� (June y ( s 5 cac res rlea.re �6 ), (At r. a re_ - 0,r►n v- - pa c-f-0ft_ 9 a Existing Conditions Summary 2. Describe the existing topography Indicate contours o t e sit?,map. -for rner ae_ - ± e - bck•i tAik rkrecx rest e f ro, w rf� -5e l0 P e s -}-U -µit_ tn1 e s-f- - Vo-fiv-vn o+ 5 ctx res (kAirsk) it s4-erp pear Ejerivtr Uc1 e rocaA 3. Describe the existing ve etation. Indicate native vegetation areas on the site map. C in I Lit UG Cx.rca - V'c_s+ 0-C rope 43 Wo6Li, br041u , armed IO rd - Oui+1,c -Cecla ry n�U�e r, n e et 'K ItA_S) L` [�c rri� r �- i Clr ri�eCC��S� `s' 4. Describ the axiiting oils lend` ate soil type on the site map Shag — ii 0.m cin lt� CIceoL re ca`P rs6 / a rwa 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 a0.plicable,and indicate acreage of each.i ( (At W I ( l 6 an P e,- -- - pre) p-ed--- 4� �our - r cf o ++ rope e rs to p e.s LA) vl -- ul d o o(.e GI nnY►rya1 C0.f me aOt nh•IIL — proPPrfz +n ' 1� vIvtT►'1 ° r�s — ' s �Iso war b �s -� APPROVED 6. Describe any excess levels of noise generated by the propdsod use or activity: STORM WATER P AN YZO v1 - C4 f.r 'i'1�'t ✓\ 6 GU UI r� Y�O I se, �x►'YVn^Q r s. MAY 1 4 Z00$ Stormwat-r '.. ''s Requires I I,6_4 • •% JEFFE• • e NT stormwater site plan template-rev.1Nll2003 • , DEPT.OF C•, t t / 1'�u1fSIGNATURE: �11 ,�� ka...,01. , 5 lb • • 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. .; .�_ Pfo e'r s o From eas+ 479 -!* - de i ''�� ulna e over 9 qo' (?near 1 ,- it 3 Op er`fi red - 0111 S ► 11‘ 1-i ra►1+ ste ms s 10 i S on UVe.T « rape/ r t C 6e0.ve r Vat /mod A — l0.r-- o on b u t ',' S3k - no tfiJAay.cis .s -) - 8. Describe the general vicinity 51 the site,including adjacent land uses and structures, utilities, roads, and sensitive/critical areas (streams,wetlands,lakes,steep slopes,etc.). '" - f prIV0 re)art t-.0) k 5 &c �ofl\esi-teS - 5 b (p/e+ QrcQs c'v 0 4-h e r p rn pr 4-;c-s ©-�P- `t^-1 S Jo ��1\ p Q vd s T) pet r ti �e� � ( Iow ri 1a. r 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 t e site plan and differentiate proposed facilities from existing facilities. PM 5-}-b r ►�v.w .�t r a w', l 1 be "--('u I a./ s P e►rs- .r�'' "T V1 i s i -• a 0-Q-1rc S;4 A tAck over 4 a-cre.s j 5 r\oa vv-aA \j Q. o Y\ +c, r!.i s e L./Li" Y S 1 1 S S( 1-..ota i r too- -C-o r 3S(o' — V�✓�Zoo' Tnpu GL 1p CtrA 10. If the project requires the use of stormwat reatment 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.] Pro Rose +' no+ Yl e colt -1-7^e ex4-me rvt CXS -F✓I ' cki PPrsed 11. Describe the performance goals and standards applicable to otthe project. Vie 1 r' v�d j f ► pad Ti v ' S ! 'k a S 1/ `f 4 QS te I-0 s : ,6I e CXl'v nn.i v�t yvl t 2-e 41Ao t v.pa ei ,n 414. r r IDPeir F1 (L rt 10 6 I t' 12. Describe the flow control system. � 1 1,J & w 'I (l r1 r+- -r ; 4 /\D C.x L + k N3 -1-10 R.) a�JultNf w ( c-�l 3 ol-s erse. J • y , P � Ait 1.. � ' stormkaler,site plan template-rev.1 W 2003 6 • • • R r� ;~ 13. Describe the water quality system. F.�\J E I V Li it ) b f& n �T,v3 tit �� �._, 2 q 2006 n, 14. D tribe the cono_ay12-1veyance s),stem analysis and design. 5Pn>J� Q ► sP (a. (-�, q Uaro� S E( ` ;i1 ui �� TY � a rai ►-� I k-i-lt°' s Prc-rti avN e_xinsed A 1 f* 6P 9 Ovid b ,)► ( UajA rct Ure 'e L-t1Ct,.` Y 15. Descr a the source of fill material,physical characteristics of fill material,and deposition of excess material. r\cv -H 11 — I p \re 16. Proposed methods of placement and compaction consistent with the aptlicable standards on Appendix Chapter 33 of the Uniform Building Code. ,, f 0. S�-k�j�r i .r��a 3�� en ; In0 s0 li p to cc 0( 6, tic,{c �o -k�o v v\-ck.0244-e ✓t - On t c b tz; l i k o++ 17. Descri a the proposed surfacing material. J i m , kw s 4 ra v`e I Tyo rn�f�' (S kd;m �` v a.rr r��� s e cs�. ISY\ r1 vac_ C`� T '`-'�r 5 Vr Cc 14?-44- 18. Desc •' e methods for restoration of the site.IrN I a r`► V-efkAl CLL./y i s-k.1^5 ---o m ✓\lc e ;f+ r o c 3raiA s , A. g r ems.3 s-e _ck o-n AtUa I-k_ c: p o s o re p (� vd4,r s 5 - vr s.ve qe el c-c.-"H >� 19. An Operation and Maintenance Manual is required for each flow conol 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. NJP 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. No re f'p -t - k"oked opsn.iI ` pcs or' websih 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. - J0s+ bvAlki ► p_i,r ;I- pAsid- 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. \Jc are. Yd+ (eari — Apr jec� is n vvi C lPQ r specie P — tJa s p ca S4-Vre. 2. Est blish Construction Acce s. �re tc't s - 0•rt vP(A.nu -Prom p 9 -too, r i parr. ra vt. o o, J 3. Control Flow Rates. re iv- c rYa c �avr, eas� -4za �es� w ► 11 rt v�o s't-k irkd c4,r=, ve (.✓ ay b./U ra S S cot Q vex- a* dirt Install Sediment Controls. rave( Over (Ire '► ► . ) s e ItlaY >' 9 ra_s s s-e-e 4 o f Ir 5. Stabilize Soils. 1-a vte. O V'e r 0.✓ro. v-. , S kuj/g fTLSS Sc-col\ pvcr 6. Protect Slopes. s(opes (Ai ; LA VNo± 6e Q411-r cc - r -Pam s - 7. Protect Drain Inlets. I irV �s0.i I h(� c o` stormwater site plan template—rev.10/1/2003 8 • • ° ECE vTED 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets.graJel CLS rye tc -cA FEB 2 020en 3Eff 1 t CB 1 BCD 9. Control Pollutants. R ra ve - ct yA ra.ss S e-c+� `dole- 6_uiAi�•� cons-lira sly ivif genc✓ram Pa u'fak\-(s 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). N —f -- _ 11. Maint in Best Management Practices(BMPs). w i IL be a►n s, rna In '� p 12. Manage the Pr ject. 7 T (AD.)l� b e o �c ,�r,u naLLy I V4rA p r'a j cg7- 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). II AND o r roper �� o u be a `�'f�c c- c� b o cl ►\ e_ to C. vacs ct ' o�c -�td- t 4-r �--t' c �,o u�-`I' \ b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). � *00 c r s U sT 9 b ey ov�� y o r prepe.(� �e a vs r V-�I l r K r) — 1—F-I to c l 5 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. ovY\ p Gt. r'Se1s 5 - 15 c -c►res Cc. c� Ina VP_ Pa,�.c s — `J'V�c c .re up k J I -hr-am I p al'c +1 5A.e. ep s pe is -7O0 ' au�a�J stormwater site plan template—rev.10/12003 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, ettleability, permeability,depth,texture,soil structure). r0 h e_ --OYSG e yl 5. Construction Phasing. a. Construction sequence Permit) ph lc se+i-Li , -era nets , .51��►� b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. ec6_i A:.� Cons 1c ; Y, ASAP . ckeee►'`j s ova 7 e r in it - ko ,) I( b o rr M d rch/I rr II. Wet Season Construction Activities. a. Proposed wet season construction activities. (i n l c S � 1'✓j ) �Yn yin r � i ✓Lc� b. Proposed wet season construction activities for environmentally sensitive areas. J hO Yl. 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. C I�,r; �, tea( CIA ru(-r j o ►n b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. p ersork_Qt I I aU► �� y 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. J A a. Sediment Ponds/Traps. 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 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 owneC-6 s of the affected property. 2 - Za -aS (LANDOWNER OR AUTHO IZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: stormwater site plan template—rev.10/1/2003 12 © / 60.-0" / Qom Z III8" 12'-0�. 12.-0" 'I I / I O Z A • �� , 4068 DR 6 0 C vi cC1 II 71 0 C] >a I (—�1 (—� —r-�-� °° 0 4 l_Pa ( C [ I I 1 1 �4 1 1 1 l 1 1 �L_',�I 1 1vyO 'Omrn o) _Ixo x x D x x Cmo prn C) In 0 co xmZo'P1 muco p Z O A J 0m Dm m CA a r 0 rl r r m(AZ �NCM ZOZ IACm--r----r-- IC -- I ' I I' II I' I1 ( l0�l li IQ='+mil SI Img,1 t1Odi 1 11j l 1 I O A O -D 13 Oco C D C Z O x r N r x A a A ° 01U I I I ro Dm OZ 0 O Ay w® I v Z0 VI C 0 A 0 DD Np A mX JA IC)" U1 f1 O I ( p n at _ , 00 Op /• 8'—O•• 8'—Or, A 00 Z" 0 H rI n --=I0•11I1•IVim 1 Inn'' I'mmI)1111=I'1•I1•IIIMMII r _(1 L -JL [1- [1 f, �11 r1 rl rI r1 ti 1l I 1 1 I ►. m fo), • o 0 _ I I OI O A C A C m ( �.�( I k 1 Z m ���'���JI �1���' UI df I� d (j V :U I N - 1IsI�ISIO.Im_Ilim A r C c C A N r • x r m WA _ I ©© co N V1D 0 o 0 ' - 0 P N. 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H . 99E w c, 0.•�COUNTY: JEFFERSON CANBY, OREGON 97013 c ROOF LOAD: LIVE 25 PSF ENGINEERS DESIGN RESPONSIBILITIES ARE LIMITED EXCLUSIVELY TO 503 263-6953 r a d DEAD LOAD, 4 PSF THOSE DOCUMENTS BEARING HIS SEAL AND SIGNATURE, ANY ALTER- ',' r j AT IONS TO THESE DOCUMENTS OR THE PHYSICAL STRUCTURE BY ANY 503; 266-7102 (FAX) V. J� //,,, WIND LOAD, 85 MPH EXP, B PERSONS OR AGENCY SHALL VOID SAID DOCUMENTS AND RELIEVE ENGR OF SCALE NONE DESIGN RESPONSIBILITY, AND MAY CREATE LIABILITY ISSUE FOR THEMSELVES SEISMIC ZONE, D DRAWINGS ARE FOR STRUCTURAL COMPLIANCE ONLY, THEY ARE NOT TO .0 FOUNDATION PRESSURE, 1500 PSF BE CONSTRUED AS HAVING BEEN PREPARED FOR BUILDING USE, OCCUPANCY GLC/JG 2/14/08 'Q 39188 C{�. AND/OR FIRE & LIFE-SAFETY REQUIREMENTS OF LOCAL CODES OR C'. G`ISI'ER�V LAT. S❑I L BEARING: 150 PSF AGENCIES. SLAB P. HAIRPINS SHOWN FOR CONSTRAINMENT ONLY. DESIGN ,NO>,� BUILDING DESIGN; 2006 I.B.C. MIX, THICKNESS, CJ' s, P. REINFORCEMENT BY OTHERS. THIS �5OIONALSr. STRUCTURE HAS NOT BEEN DESIGNED FOR USE WITH INTERIOR FINISH CLOSED BUILDING MATERIALS SUBJECT TO DAMAGE OR FAILURE DUE TO LATERAL MOVEMENT KIT MW07485 EXPIRES: 12/04/ 4q----1 O m ,..{ J Cl - ,i D a Vu 1 k'i Ana L7 - '-'. -i 4 --r O m ,5L -----7------1----------__H .___ --- i i 6/ _ as c o 1 I A v - , 73 tv RI $ 7 i -i N GA , z, O r J ; 1 d"10N-No Iarli , i los --1 \ -- 1 r }}m -,70 VC) 1 AC!N-H S i .-1 "E g }-71-1 rt\V 211-7 -2J t-v 1 ,ry 15 m m 3 O N S - k Q S r- W ' 1 T r i kW E y (NAa-1-6 --1-0-1-ut-N1- ti Q -5 I. m 0 o r-- —; b >y • srvaLl�a'f(7 77t/ T v O �n Z 1 yid ' a..[M 4 ! 'z/S n/oZJ/ 6'L�-- _ �r O -P t; O �l o,� ; J\ N ;1 m I o O i - m -y m o S ()WV n 1-7 —1 m n > �-� d � n�as 1 t �1 a �,-to-�► n �l 1 +c z mei ct, ; , , ' _- I zs APP 0 r► C1 1c2s, ,7 7 T ccg w rem- tv Act, 0 0 0.4 ----- ---... Gam- 1 ..