HomeMy WebLinkAboutBLD2008-00159 tIC
ILDING PERMIT APPLICATN MLA08-00197
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00159 Received Date: 4/23/2008
SITE ADDRESS: St t.1 PALMER DR
OWNER: JOHN HANKS PHONE: 425-653-1309
BETTY HANKS
15028 SE 47TH PL
BELLEVUE WA 980063209 CRESTHAVEN SUBDIVISION
SUBDIVISION: Block: Lot: 11
PARCEL NUMBER: 946100011 Section: 12 Township: 30 N Range: 02 W
CONTRACTOR: TERHUNE CUSTOM HOMES INC PHONE: (360) 697-7000
PO BOX 97
POULSBO WA 98370
Contractor's License TERHUCH984MA Expires 7/1/2008
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NSFR W/ATTACHED GARAGE
•
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 2,255
VALUATION 257,190.00 ADD'L: HEAT TYPE: RAD
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY:
CONST TYPE: 5N OTHER: SHORELINE:
CONST TYPE: GARAGE: 751 SETBACK:
DECK: 873 BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: CAPE GEO
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 3
Total: 3 Total: 3
Routing Date: •
0_,,, c L _
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,878.55 AMS 04/23/08 97220 APPROVE
Plan Check $1,221.06 AMS 04/23/08 97220
State Building Code $4.50 AMS 04/23/08 97220 JUN 11 100R
Potable Water Application $59.00 AMS 04/23/08 97220
Total: $3,163.11 Jefferson County Planning
&Building Department
---------------Er- -::- Permit Nu in-1
CountyBuilding Dt, on Applicant: HANKS
Jefferson
BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2006 International Building Codes
To schedule inspections,call (360)379-4455 no later than 7:00 AM the day of the inspection.
Requests received after 7:00 AM will not be scheduled for that day's inspections.
ELECTRICAL PERMITS are issued by the Washington State Departto the ment of
La o's FIndust ilnspection
The electrical permit must be signed off by the State Inspector prior
Date Approval Signature Notes
Inspection Item
SetbacksIIINIMIMNIIII 1lNIIIIIIIIIII
-
I Erosion Control -
i; /i
1
Foundation FootingrSZMMIIIINI
` ' b
IFooting Drains -2 l0 ocr 4MMlimi _ {vl
I Foundation Stem Wall01111111
/
Underground Plumbing d�-e�, IMINIMMin
i i
Under Floor Framing
Straps(hold downs) gln'/O& rallill _
I MIN
I Rough-in Plumbing - —
Ext.Shear Wall Nailing gisp�'j-�$ M111111111
oiliI Framing 6& —
IBlocking
IAirseal MATIRIAimmi} m Go ` (co-)— DoNoTCDVcr- -1re(3"
Insulation:Walls g qI-D4 ! O it ''
I Insulation:Floors IrigaimIIIIII
mum .
—
Insulation:Ceiling
I Int. Shear Wall Nailing log
OEM _. _______
1 Wallboard Nailing • a riglail -.
IGas Line: Interior -iiiktYA MEImom_
IGas Line: Exterior
IPropane Tank MI - --
IHeatUChimney Clearance
IDrywell/Alt Drainage
'
Address PostedMI � -
FINAL INSPECTION tfl Kf 01- NMI
OCCUPIED
HI ERMIT IS FINAL INSPECTION MUST BS APPROVED
VDLIID FOR TNTO
BEARDING BEING
_1:
I 11.
CONDITIONS for Building Permit# :BLD08-00159
1.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater,
erosion and sediment during construction. BMPs shall address permanent measures to
stabilize soil exposed during construction, and in the design and operation of stormwater
and drainage control systems.
2.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
3.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
4.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
5.) Front setback running parallel to N Palmer Dr is 20'/Submitted Site Plan shows 44'2".
Setback to easement- not required.
Side setback running parallel to easement is 0'/Submitted Site Plan shows 5'.
Back setback requirement is 5'/Submitted Site Plan shows :33'4".
6.) The building height is not to exceed 35 feet.
• EC1EP ED
4 O 00- JEFFERSON COUNTY APR 2 3 2008
�': 3j} DEPARTMENT OF COMMUNITY DEVELOPMENT
;` � [ 621 Sheridan Street• Port Townsend•Washington 98368 t[[CE��n� �,���w_���
360/379 4450• 360/379 4451 Fax J L`I O COUNTY 1 www.co.jefferson.wa.us/commdevelopmet
Master Permit Application MLA: 0`6 — i i7
Project Description(include se rate sheets as necessary):C �7 � �ay stru.eA a beat Dorn �� LQ?Ze �C d Lc..a-( 0 CL t--
Tax Parcel Property -1 j
Number: 9� - IOC) 1 HI
, O( I Size: f t 0 0- (acres/sq are fee
Site Address and/or Directions to Property:
-worn Cape e3.eoY9.e, Rdd• t•-i .ov\ •Pca_Lvn.OI 3rd Zak cm lit 4-.
Property Owner(s)of Record:Jo h a I l e- J �--�oJ\k
Telephone: 425-(oSS-t3Oci Fax: email:
Mailing Address: t )O 248 g 4-ri .-P( . B i tit'V tke-, (A.D4 .a7 Ob L, _
Applicant/Agent(if different from owner):T2...1/VUA.3 1, . Cu. (C)► ,A 4130 vv e.S
Telephone:7-f )-(vGt-i ^T 000 Fax: ,610 -10.-r1--1'E O 0 email:
Mailing Address:.Q.ISO?C V 1 "PO li.-t.<>100,, U A 97 3-7 0
What kind of Permit?(Check each box that applies
Building 0 Variance(Minor,Major or Reasonable Economic Use)
❑ Demolition Permit 0 Corditional Use[C(a),C(d),or CI**
fl Single Family pGarage(Attache /Detached 0 D scretionary"D"or Unnamed Use Classification
O Manufactured Home 0 Modular ❑Special Use(Essential Public Facilities)**
❑ Commercial* 0 Boundary Line Adjustment
❑ Change of Use 0 Short Plat**
Address , Road Approach 0 Binding Site Plan**
61 Home Business ❑Cottagelndustry 0 Long Plat**
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
0 Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
❑Forest Practices Act/Release of Six-Year Moratorium 0 Tree Vegetaion Request
*May require a Pre-Application Conference **Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal,if known:
DESIGNATION OF AGENT
i hereby designate to 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 tact 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 a . av e qr she wants prior notice.
Signet re: Ill. Date: 5-Zl '-0
The actio Lions 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-tran t a respon lily for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
SigaiL - Lt�...k._ _ Date: . '"-� 50--O-g
C:\Documents and Settings\carat\Local Settings\Temporary Internet Files\OLK86\Master Perrot Application 12-19-2006.doc
eApr, 7. 20086 4: 02PM3603.TERHUNE CUSTOM HOMES JEFF CO PERMI INTER No, 1017 P, _2_ 02/03
,. '* Au r. I. 2008 2;45PM • HtJUE CUSTOM HOMES : SEQUIM, MA
No. 3940 P. 3
IWILGER al'ATT MEwr
Rio nigneraf th merit abet h [Mt Ihty ore fhb oMmeta iw 1 mfeMAeetl Wein,in 11 am not korona t p th'tyvAA flu;
/ of the eneral Contrado a pnrpasad ?rot, trVeaoln and Dial
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Al cOurRaOioR ,t r r p FAX:
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ARCfirott rot ; rC b,�`_-- _
t Pr�vns( ) `—"• FAY ( ) '
MAJimi wiry: '- sum. .
roiltt Type. FrnmType: Sanhrooms:` Shoreline: Type ofSew:�gehiypoaui:—
NeW Wood fltt)t>ilnp; •—• u Sewer
J Arlrldion U SIMN Proposed:, Sank u Community SyntAra
J AkerltionRemodel u concrete fetal: -9 'l , 144I1h1: ' u Inark/oal A , A
J Repair u Masonry sr;P Permit* OLOA'l
J Dnmoellon 0 Other D ogts: Watof nup
Exlsling: — sec
— back: U Private w d U Two Putty
War: Ptnpoted: ,3— u Public
tat. Totes Name of System;
If Ines is-a Cofnmtzrelekerig you mint eristvgr the 1'epevlingj
Number of ddeg Scpace• nt; 1iro _ Number Pori.*Spaces:
N I r of ccup.1 n s vwne nrmhL plop Dim
9d
Occu 4 Type of co n: - II you have I° Joe?
It Ihla lA.t4 Propene T arttt pneXor Agpfience Instollntign penult.merit o J Rents below there MST
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UnnArgteune Tnnk [Above ground lbnic Size or Pi pane Tonle:
°Heat Stovo 0 Cook Stnvo 0 W odpovo t Fkepbce Ino tt 0 Ho Water Taw CJ Pallel stove 0 Other
le Ihl&Jlpblfdht:R IV)nn tnct ll*d frta Manufactuntd/Mobile Hanoi? Yes °
Whim Applying for ft pool!to!shall n propane tankyort inu 1 also submit a rife plan show/nrj ail of MD bmilelin s,all propel ty
l'dniv4 Vallkloait7on nnddlm,dl&Wi es from the propene tonic to ell properly/net,bulldfngs and. ptfc sysf ern corhp;�e
hlcJufl/np'fhe reserve Brae,
,‘ •r..Tr ow,, ,its,r �YifrF��,tfi Sa., ,,, r . , s
Main ill o mtil•a °mutt Pm.eled a •e' G�� sY 1:1::1S.i,'ti r 1J�S/'A ,lUr it .,, 4,.i .s''`', ts.
1•
,s , HB1t1APp •ev• r' 10
22""1;Floor Ild ti:...% �' Con lency Review:
OtherHeared - 3
4. x73; eeae G`:e:
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55'a' ,v.:
t+�tnv � dAdditional section
^ kHedted BayM /„ i .tta Pim Mel fat::
Unheafad Bammnnf y , z e f a ' o '
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t^'-'- u:9,ZIE
aher Unllcel�d -; �7 r
.p,:;4$4 1 �o ter av wfoo: of r:
Mirage/Carport �J. )g,� 1,, SUBTOTAL 3,1 o1/ . I
35.
r� ' -911/Rd Approactl Ma; :—+ t.!
CaViWe�C ?Z•fi o 1OI .''' I' a'� 15i�
cy,hr r•p, 6 Li`l 2, :I I clog` • - TOTAL $3��a 11
T`Y "_ , 4 Receipt Nurhber. ci a
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lir a5 I l U f:htClieuk Number. Z
-11MATED 0*ST(REO t 1REp) � I I L f
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bndm ,l.iIN • fonrotiinisl Data1 f_ : 4- Tlp
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• • APR 232NU -
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S ''O rtcv RMWATEvR PLAN 6
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\ ORT DALVI- R DRVI-
JE ON COUNTY
SIGN R : 3C ' -ASEV \ T
SCALE: 1" = 20'-0" -‘, ��
JOHN & BETTY HANKS D jJV l V QI.I:Q-.,, ±U Si 0 P"� S 150 „
PARCEL # 946-100-011 I
CRESTHAVEN SUBDIVISION lGz1�G� �� � o
LOT #11 14,700 SQ.FT fb r GI a., f1
TERHUNE CUSTOM HOMES g"�101) 12—o" 22'-6"+- ,q
4/14/08 LR 105. 00'
\ —
159V I n I 1 I ELEV.
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ccs
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(1) I posts TBD on site
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RESIDENCE SQUARE FOOTAGES: II
LIVING: 2254.5
oo
GARAGE: 750.5 I I" COVERED PATIO: 401
PATIO 472
ECEIV 1
� iII
1 COVERED PATIO pprox. he Q
4P 2 3 1 . 1
pump loc ion m
2008
Approx. I tion Lv
of 120 . (0
prop e ankd
USUTi COUNTY OCO
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JJ Approx dv ..,tI-
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157V S' REAR Y RD SEIB CK ' Mites • 159V
105. 00' Stormwat P' '_/
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. ,EON .
�. JEFFERSON COUNTY
}4 DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax
http://www.co.jefferson.wa.us/comridevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
i MLA# PROJECT/APPLICANT NAME:
Y.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 stomiwater 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.
6. Describe any excess levels of noise generated by the proposed use or activity:
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stormwater site plan template—rev.10/1/2003
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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.
1\ /
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.).
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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stormwater site plan template—rev.10/12003 6
11111 •
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 of 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 3
p 3 of the
Uniform Building Code. a
17. Describe the proposed surfacing material.
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.
��-... IIMAIRIMMINIMININI1111.11.11
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.
stonmrater site plan terrplate—rev.10/1/2009
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.
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2. Establish Construction Access.
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3. Control Flow Rates. 1 I� �r r ►� t ';1 (ti-�,L-tiue_ — r Y l� -�1 �: �L' 1
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4. Install Sediment Controls.
I A di' uu-euc (4)
5. Stabilize Soils.
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6. Protect Slopes.
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7. Protect Drain Inlets.
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8storm-water site plan template—rev.10l1/2003
• •
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
9. Control Pollutants.
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.
2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas,roads).
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 of environmentally sensitive areas that are on or adjacent to the site.
stormwater site plan template—rev.10/12003
9
• •
b. Description of special requirements for working in or near environmentally sensitive areas.
) C,1
I i
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 asing.
a. Construc n seq nce
,
b. Constructio ph ing(if propose
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a proposed construction schedul
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II. Wet Season Construction Activities.
a. Proposed et season construction activities.
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b. Proposed wet season construction activities for environmentally sensitive areas.
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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 otlitrievidence 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.
b. Diversions. z
c. Waterways. /
d. Runoff/Stormwater Detention Calculations
10
stormwater site plan template—rev.10/12003
• •
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.
(LANDOptsIER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED:
12
stormwater site plan template—rev.10/12003
• 11111
Ci‘N
JEFFERSON COUNTY �;t
1, DEPARTMENT OF COMMUNITY DEVELOPMENT APR 2 3
., 621 Sheridan Street - Port Townsend • Washington 98368 r
,c0 360/379-4450. 360/379-4451 Fax '.— r ,tiff S74 ill-, i
http://www.co.jefferson.wa.us/commdevelopment/
Stormwater Calculation Worksheet
MLA# PROJECT/APPLICANT NAME: ��In Irv_* '�� �
k._►�G4 S
DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater calculation worksheet should be completed first
to classify the proposal as"small,""medium,"or"large." The size determines whether a Stormwater Site Plan is required in conjunction
with a stand-alone stormwater management permit application, building permit appiication, or other land use approval application that
involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan,if required.
PARCEL SIZE_(I.E.,SITE)
Size of parcel •'4 acres An acre contains 43,560 square feet. Multiply the acreage by this figure.
Size of parcel in square feet I 9,—]00 sq/ft
Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover(both vegetative and
non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling,
excavation,and compaction associated with stabilization of structures and road construction.
Native vegetation is vegetation comprised on plant species,other than noxious weeds,that are indigenous to the coastal region of the
Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as
Douglas fir,western hemlock,western red cedar,alder,big-leaf maple,and vine maple;shrubs such as willow,elderberry,salmonberry,
and salal;herbaceous plants such as sword fern,foam flower,and fireweed.
s
LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL
Calculate the total area to be cleared,graded,filled, Answer the following two questions related to
excavated,and/or compacted for proposed development conversion of native vegetation:
project. Include in this calculation the area to be cleared for.
Does the project convert 3A acres or more of
Construction site for structures T bU0 + sq/ft native vegetation to lawn or landscaped areas?
Drainfield,septic tank,etc. N/A sq/ft Circle: Yes • No
Well,utilities,etc. t d0 f sq/ft Does the project convert 2 1/2 acres or more of
native vegetation to pasture?
Driveway,parking,etc. 600 — sq/ft
z�Q Circle: Yes No
Lawn,landscaping,etc. sq/ft
Other compacted surface,etc. N 1 A sq/ft Indicate Total Volumes of Proposed: •
Total Land Disturbance —1 DC.) 4- sq/ft Cut �+ Fill 2+- (cu/yd)
[over]
stormwater talc worksheet—REV.10/1/2003 1
III 1111 .
impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions
prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow
from the flow present under natural conditions prior to development. Common impervious surfaces include,
,but are
not limited
ed materials,
tops,walkways, patios, driveways,parking lots or storage areas,concrete or asphalt
and oiled,macadam or other surfaces which similarly impede the natural Infiltration of stormwater.
STORMWATER CALULATIONS-I1111kRVICSU3•SURFACE •' :.-1. a . A
NEW MISTiNG
Structures(all roof area) 39 (1 sclift Structures : I roof area) sq/ft
Sidewalks IOO stlift Sidewalks
clift
Patios
32-O sq/ft Patios —L s
Solid Decks sq/ft Solid Decks NM
(without infiltration below) (without infiltra'• below
Driveway
foC) Driveway
O so/ft sqtft
Other
sq/ft Other sclift
Total New s l ft Total Existing ecteft
TOTAL NEW+TOTAL EXISTING* 9 q sqift
This amount mil be used to chedc total lot coverage.
The following questions will help determine whether the proposed project is considered development or redevelopment
0EV * • =, v.REDEVELOP ••
Divide I• total exi-in. imps ••• •� surface abo ,• by ••nvertto aet %by the:'- = of the parcel • p
..: the site hay: .-•• or more of existing impervious surface?
r ,. :, Yes No
proposalis considered redevelopment and the attached Figure 2 should be
FURTHER INSTRUCTIONS: If the answer is yes,the �����new development and the
used to determine the applicable Minimum Requirements. If the answer is no,the proposal Flownsi Chad a determine the Minimum
attached Figure 1 should be used. At this juncture,the applicant should refer to the applicablethe todtrapplication requirements.
Minimum
Requirements for stormwater management. DCD staff will help verity the classification of the project
and For proponents of 'small" projects who must comply only with Minimum Requirement 12—Construction Stormwater Pollution
o
Prevention—an additional submittal Is not required. The proponent is respons Pick��for employing the 12 Elements to control erosion and
the Construction
prevent sediment and other pollutants from leaving the site during the construction phase of the project.
Stormwater Pollution Prevention(SWPP) Best A anage:ne Practices(BMPs) Packet Proponents of"medium"projects—those
that must meet all 10 Minimum
that must meet only Miriimum Requirements #1 through 15--and for large' projects—those th ofs a Stormwatereet10 Site Plan.
Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal templefate r
principally for rural residential projects. Complete the temppla in Stormwater Marragar Site n In ��s and Submittal Temp
prepare a Stormwater Site Plan using step-by-step guidance
APPLICANT SIGNATURE
By signing the Stormwater Calculation 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.
illP
, LAN.• ER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
2
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