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HomeMy WebLinkAboutBLD2008-00113 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 #: BLD08-00113 SITE ADDRESS: 942 BIG LEAF LN Issue Date: 06/12/2008 QUILCENE, 98376 Final Date: 6/11/2009 APPLICANT: CHARLES D BROWN PHONE: 360-765-0200 SALLY BROWN 40 WASHINGTON ST QUILCENE WA 98376-8588 SUBDIVISION: Block: Lot: TX 45 PARCEL NUMBER: 702113012 Section: 11 Township: 27 N Range: 02 W PROJECT DESCRIPTION: NSFR W/ ATTACHED GARAGE 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 no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 6/11/2009 I:\F_BLD_Occupancy.rpt 10/29/19 OUILDING PERMIT APPLICASN Review 00146 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00113 Received Date: 3/24/2008 SITE ADDRESS: 942 BIG LEAF LN QUILCENE, 98376 OWNER: CHARLES D BROWN PHONE: 360-765-0200 SALLY BROWN 40 WASHINGTON ST QUILCENE WA 983768588 SUBDIVISION: Block: Lot: TX 45 PARCEL NUMBER: 702113012 Section: 11 Township: 27 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NSFR W/ATTACHED GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,938 VALUATION 336,655.00 ADD'L: HEAT TYPE: WOD CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 1,730 SHORELINE: CONST TYPE: DECK: 576 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 2 Prop: 3 Total: 2 Total: /3 Vim-► ► Routing Date: c 1 _) fU y 13c5(0 ) Type Amount Paid By: Date: Receipt: Approved/Date Permit $2,320.95 AMS 03/24/08 97119 APPROVED Plan Check $1,508.62 AMS 03/24/08 97119 State Building Code $4.50 AMS 03/24/08 97119 JUN 2008 Potable Water Application $59.00 AMS 03/24/08 97119 Total: $3,893.07 Jefferson County Planning & Building Department Je7erson County Building Di•ion Permit Num. BLD08-00113 Applicant: BROWN BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 International Building Coc 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 0 Foundation Footing trt - -741AssIt OL q/5/1541/ pok-1, keYcz.,7 hi) Footing Drains a '_- T � fr ),E-10'2Z cts" Foundation Stem Wall fr `�'�' Vim i` O k 1/5/o 9. 1./(AK Op, n umi Under Floor Framing ; stra ewas) E) .-Skis Nailing Rough in Plumbing k"2.b_ Framing 5IL 4 j'OCt Airseal /)-l-'3 v\ Insulation:Walls Insulation: Floors 31-0 1,12. r) Insulation:Ceiling Int.Shear Wall Nailing Wallboard Nailing OA--LS\O!t 94____- Gasjin&In1erior—. k Heat/Chimney Clearance , .-0C1 `yt Drywell/Alt Drainage � �C SEE CONDITION 1 FOR SPLASHBLOCK CRITERIA. Address Posted 'll FINAL INSPECTION to_o ayzikedio FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEINGJOCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD08-00113 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 SPLASH BLOCK.. 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.) PRIOR TO OCCUPANCY & BUILDING FINAL - FINAL APPROVAL OF SEPTIC SEP07-295 IS REQUIRED. 3.) ALL COMPONENTS OF THE SEPTIC SYSTEM ARE TO BE COMPLETELY PROTECTED FROM VEHICULAR TRAFFIC OR MECHANICAL DISTURBANCE. 4.) MUST COLLECT AND DIVERT ALL SOURCES OF DRAINAGE AWAY FROM SEPTIC TANK, RESERVE & DRAINFIELD. MUST COMPLY WITH ALL PERMIT CONDITIONS, STATE AND LOCAL CODE. 5.) The project is located in close proximity to an identified wetland and is subject to the delineation provisions of Section 18.22.330 of the Jefferson County Code. Based upon the proposed location of the project in relation to the identified wetland (proposal is greater than 300 feet from wetland), the applicant has agreed to maintain a 225 foot buffer (setback) plus an additional 50 foot setback because the wetland was not delineated. The applicant acknowledges the additional setback and agrees to maintain the 275 foot setback, therefore, waiving the wetland delineation requirements of the Jefferson County Code. 6.) 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. 7.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 8.) 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. 9.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. • 10.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 11.) Minimum setback from Big Leaf Lane and Wildwood Road rights-of-ways shall be 20 feet. Minimum setback from the north propety line shall be 170 feet(commercial forest land reduction). Minimum east setback shall be 5 feet. Minimum west setback shall be 250 feet to commercial forest land. Minimum south shall be 5 feet. If an ESA is present, then the more stricter setback(s) shall apply. 12.) 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. 13.) 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. 14.) The building height is not to exceed 35 feet. All k,�4--- cO JEFFERSON NTY III ti i�y DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port�Rse •T1Nr it atli .368 360/379-4450 • 360/379-4451 Fax ,1-�.I V AIL) .1,:e �O www.co.jefferson.wa.us/commdevelopment Master Permit Application AR 2 4 2Un8 pp MLA: -- I Project Description (include separate sheets as :necessary} t�5 F wr to A aeNc.� ,L phut Y 1r Tax Parcel 4 // Property Number: �� _ 3 �. Size: ,,C.j.) ./C_:_g s (acres/square feet) Site Address and/or Directions to Property: l Q1,(/L CG kI t R/G NT oN Cb /n Brn 3r, G o 7o N w y/a/ 41KiN. k 01\1 l0 / G o (\1o72T-N ra (,,1c r7w00) r?ml_ Tu(2N /GHT-. Go %y 1`4/1-E To ?J "LL-�F"tviN�- Go RIGHT, Ga Fa 7bP 0r. f /LL 7c, 9y� Property Owner(s)of Record: (7,.(fNgL/L )`-- S/i'-L i 3R0c,,_.,l . Telephone: j io(-- 7i._ 5- 02,0C) Fax: email: Mailing Address: >'2 G(_)/45(-// !\'Gi7�l' S7 C1f,l , jG L--''4. `l '37G Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Building 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]** D Single Family ❑ Garage Attached Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modulal 0 Special Use(Essential Public Facilities)** 0 Commercial* 0 Boundary Line Adjustment ❑ Change of Use ❑Short Plat** 0 Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** 0 Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign 0 Plat Vacation/Alteration** 0 Allowed "Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance 0 Temporary Use ❑ 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 -In R -JG 'p' � to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE 1 . ,5 .)y __. -.- Date: .3-d4.'7 - C-" 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 fac: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 application that(te or she watits prior notice. Signature: )( '°f v \' -"i ,Cy i -- _ Date: ,e5 —2-9-_`L%6' 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-trans erable responsibility for adhering to and complying with the ESA. The;Applicant has read this disclaimerd signs and dates it below. Signature: ii (,lyv_- Date: 3 - 2- ' -014 G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc 0 BUILDER STATEMENT • The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: �f'il �. ,`rv— Date: — 2- `{— 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: Type of Sewage Disposal: New ❑ Wood Existing: ❑ Sewer 1 ❑ Addition ❑ Steel Proposed: 2•% Bank ❑ Community System ❑ Alteration/Remodel E Concrete Total: 2.5 Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: LI Private well ❑ Two Party Type of Heat: Proposed: ❑ Public LcSD0; 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: 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 1 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 10-51 EH Bid App Review: tf; 2nd Floor Heated Consistency Review: i. a Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: f 672 Unheated Basement i State Surcharge fee: ` Other Unheated Pot Water Review fee: /,j u Garage/Carport 15215L(-U SUBTOTAL `� 173e A I o Decks 1� ��tj-`3 911/Rd Approach fee: 5 7c, eu 1sn>JC-5) Other TOTAL: $1 ) Q1 Receipt Number: C1l j jR1 gash/Check Number: 6---- 1 CX0O ESTIMATED COST(REQUIRED) Date: �2 ` •Fair market value of all labor and materials foundation to finish „ ` 05 Initials: _ G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc • RECEIVED ozv ° JEFFERSON COUNTY MAR 2 4 `8`3 F DEPARTMENT OF COMMUNITY DEVELOPMENT JEFFERSON COUNTY DCD 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax NO' http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# 0 g` I y c PROJECT/APPLICANT NAME: f Aire 7_L/ r/ (A) 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. s/1\lCLL F'HM/Ly 2E-s /bgA/Cc LL.)1--rH sj1A)LL Y' -‘L .)21 IJEwrky Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. Housr Lt, okLfl s/T oN 7 /-Try3 of 5( 1 L / /Vc 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. /Aifi PL E /9 L b £ '. ? :e 3 4. Describe the existing soils. Indicate soil type on the site map. S-4C11U Thy Gc)E LL QHI ac,) 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. No 57A1J b/NG Cc)flTF, APPROVED 6. Describe any excess levels of noise generated by the proposed use or activity STORM WATER PLAN /Vol\c JUN 1 1 2008 StOrmlv�fet r �tS , JEFFERSO OUN Required 1 41.w • , DEPT.OF C V. ME. le • SIGNATURE: stormwater site plan template—rev.10/1/2003 5 41) • 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. L L) rL �l D Enl o r PkoPE ,�° SI Ej 5Loy�/ 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.). (c)El-L1 Al)5- sLofD 56N )F/C.AN1 " biS /VCc Ffzo M How S/7Z 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. c $ "D c.(.) s? (-c.TS o N i,{/DGf 5 )/S�E.e��,d N /V)qTz-(/ L l/EGE 77977 o/,j 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.] 7\1/1;17i 11. Describe the performance goals and standards applicable to the project. /14i N/MEL P4c7_ 12. Describe the flow control system. /7\1141 ti stormwater site plan template—rev.10/1/2003 6 • • ECEWED 13. Describe the water quality system. a,rr 0 A I,J6LL LEMON COUNTY 2 O 14. Describe the conveyance system analysis and design. aU 1-I Stec C Ts 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. i2E cifP'i-,1) DK sire 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 65b- cacK 17. Describe the proposed surfacing material. 6; N 1(L- [3 N5,9L7- 18. Describe methods for restoration of the site. r2CPL 1q NT l 1 7-" }Ai I0(1_5 rke S - S NI(43S 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. /V/X 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. A7/4 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. 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 wiil 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. 2. Establish Construction Access. 3. Control Flow Rates. 5 / L /5 l-( u C/!q N Ej) 4. Install Sediment Controls. CHIP Blc''S 5. Stabilize Soils. O1 N E I)e-b 6. Protect Slopes. 7. Protect Drain Inlets. stormwater site plan template—rev.10/1/2003 8 • • 12 Required Elements—Construction SWPPP(continued) ,.} n`� T ,- ,_i; ,n\, 8. Stabilize Channels and Outlets. "1\\Vnji t► r► ��� {t. 1 ,,. 9. Control Pollutants. tjtgtt ; (\( /9 10. Control De-Watering(the ct of pumping groundwater or stormwater away from an active construction site). /\\\(/7/ 11. Maintain Best Management Practices(BMPs). o Lc) N E L( 1 be Lc)/ L ri\1 C N c7A15 12. Manage the Project. CO N_E 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). N0N6 b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). k DJ fl/ t G E 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. t E -LAND 5li p SLo stormwater site plan template—rev.10/1/2003 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. // )(///Ifi 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\10 /V 5. Construction Phasing. a. Construction sequence FottN-D14TtoN. / (�igLLS FLoo{Z f T f J 5(D/N-�` 4TC? 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. 57-7? r 1 » T'1Ay c tN15N II. Wet Season Construction Activities. a. Proposed wet season construction activities. /'SON /To 0N1IToN NIITI ' 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. b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. c A ) NG K 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. b. Diversions. c. Waterways. 1 A d. Runoff/Stormwater Detention Calculations V 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 owners of the affected property. ( C„,( 0 a(2 3-20-O8 OW R OR AUTHORIZE PRES NTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: stormwater site plan template—rev.10/1/2003 12 111 {'•m' D'-m' b'-3' 1'-b' 3'-b IR' 3'-m' b'-B I!!' m o - TT �ID� � � 1 i I 0 /J J -r-e • O II ..- I 3�91{ 3050 Bul - ----- ��I -- --------.. 13 �� �I � _ ,i, r P z 4 , Do G, a rrl m s 1 � or /v m P 11110\ ;'I i 44110 � I - D — @� — tA I—Q 5 O J3010 O 3m WB L \eti: —, 0I rieK--.= • I Y 1' \ f=-fi--f-_— __-__D 6•.__..-._-_.f. 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