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Home My WebLink AboutBLD2008-00168 • • 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 Al Scalf, Building Official PERMIT #: BLD08-00168 SITE ADDRESS: 143 TIMBERLINE RD Issue Date: 06/20/2008 PORT TOWNSEND, 98368 Final Date: 8/29/2011 APPLICANT: JOSEPH BASSETT PHONE: 360-301-9335 143 TIMBERLINE RD PORT TOWNSEND WA 98368-9679 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001204011 Section: 20 Township: 30 N Range: 01 W PROJECT DESCRIPTION: REVISED 4/5/10 -INTERIOR REMODEL - COU -CHANGE GARAGE TO SFR W/WOODSTOVE 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 ON8/29/2011 I:\F_BLD_Occu pancy.rpt 10/29/19 BLODING PERMIT APPLICATIOS wiL Revviewiew Type: 205 I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00168 Received Date: 4/28/2008 SITE ADDRESS: 143 TIMBERLINE RD PORT TOWNSEND, 98368 OWNER: JOSEPH BASSETT PHONE: 360-301-9335 143 TIMBERLINE RD PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001204011 Section: 20 Township: 30 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP REVISED 4/5/10 -INTERIOR REMODEL - CHANGE GARAGE TO HTD SPACE COU TO NSFR W/ATT GARAGE W/WOODSTOVE - REVISED 6/24/09 TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,304 VALUATION 97,331.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: WOD OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 0 SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL -- BEDROOMS: BATHROOMS: Exist: 1 Exist; 1 Prop: 3 Prop: 2 Total: 4 Total: 2 Routing Date: 1C _ Type Amount Paid By: Date: Receipt: Approved/Date Plan Check $545.84 CJZ 04/25/08 97226 State Building Code $4.50 CJZ 04/25/08 97226 Potable Water Application $59.00 CJZ 04/25/08 97226 Permit $839.75 KAS 04/25/08 97226 Plan Check $52.00 KAS 06/26/08 100389 Renewal $213.00 KAS 06/17/09 108597 m4109 1PRF�tt /09 108638 '10 117514 HEALTH DEPARTMENT AND FOLIC WORKS APPROVAL REQUIR.RIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. Request must be received by 7 am the day the inspection is needed. Office Hours 9:00 am -4:30 pm MONDAY - THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY -SEE ATTATCHED Jefferson County Building Division Permit Number: BLD08-00168 Applicant: BASSETT BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks 10/13/2008 Erosion Control Foundation Footing 10/13/2008 & slab Footing Drains 3/8/2010 Underground Plumbing 9/8/2Q1 8 1 0 lo Straps(hold downs) v Ext. Shear Wall Nailing %)_q,/v Rough-in Plumbing /� Framing —II—it) St— Blocking Airseal /d--1f_/v k Insulation: Walls 1 i.-,t; (7,-11; Insulation: Floors ! "� R-10 insulation placed vertically around exterior of footing, 10/13/08 FTH. Insulation: Ceiling _0 7C Int. Shear Wall Nailing iv_y Wallboard Nailing /e7:± it? Propane Tank vvvv Heat/Chimney Clearance p 0 Drywell/Alt Drainage 3/8/2010 INFILTRATION TRENCH Address Posted � ,r, �',, FINAL INSPECTION �. I FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR s • CONDITIONS for Building Permit# :BLD08-00168 1.) This 1 bedroom residence uses 240gallons of the 600 gallon septic system capacity 2.) 10' SEPARATION REQUIRED BETWEEN A WATER LINE AND ALL PORTIONS OF THE ONSITE SEWAGE SYSTEM; EFFLUENT TRANSPORT LINE, TANKS, TREATMENT AND DISPOSAL COMPONENTS. 3.) PRIOR TO OCCUPANCY & BUILDING FINAL - FINAL APPROVAL OF SEPTIC SEP07-63 IS REQUIRED. MUST MEET ALL CONDITIONS OF SEPTIC PERMIT. 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 r not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 7.) Setback from Timberline Road right-of-way is no less than 20 ft., side and rear setbacks are no less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 8.) 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. 9.) Exterior lighting for residential uses shall not exceed twenty feet (20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 10.) 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. 11.) A Stormwater 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. 12.) The building height is not to exceed 35 feet. 13.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. • CONDITIONS for Building Permit# :BLD08-00168 1.) This 1 bedroom residence uses 240gallons of the 600 gallon septic system capacity 2.) 10' SEPARATION REQUIRED BETWEEN A WATER LINE AND ALL PORTIONS OF THE ONSITE SEWAGE SYSTEM; EFFLUENT TRANSPORT LINE, TANKS, TREATMENT AND DISPOSAL COMPONENTS. 3.) PRIOR TO OCCUPANCY & BUILDING FINAL- FINAL APPROVAL OF SEPTIC SEP07-63 IS REQUIRED. MUST MEET ALL CONDITIONS OF SEPTIC PERMIT. 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.) Setback from Timberline Road right-of-way is no less than 20 ft., side and rear setbacks are no less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 8.) 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. 9.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 10.) 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. 11.) A Stormwater 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. 12.) The building height is not to exceed 35 feet. • �,cii4SON cvr,� JEFFERSO ' OUNTY -. \� 4 DEPARTMEN1 COMMUNITY DEVELOPMENT '� 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax Ny -trIN0'1*0 www.co.jefferson.wa.us/commdevelopment Master Permit Application APR 2 5 2008 ,, MLA: (�'}� an 5 Project Description(include separate sheets as necessary): j3p 4Ai 1.j . Tax Parcel Property Number: �'0 CIO i f Size: j hiek)(75 (ac s uare feet) Site Address and/or Directions to Property: /g3 /iin 6eacL.JAJE ?t). of-TT jci u,yse/.) c.-A- Property Owner(s)of Record: 5Efl-f 'T7;45,E7T Telephone: (3 4,C) 501 3 3 f Fax: email: 6(-1 S-,7E'?l,TG Se r'tk /1+j It.CC' Mailing Address: /.3..76, 4Ij'P,f T (acre1 ,?4 fok'r %��u,.,wit'.r., /L,'A ci E-41 S> Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies w❑ ilding 0 Variance(Minor, Major or Reasonable Economic Use) Demolition Permit • 0 Conditional Use[C(a), C(d),or C]** ❑ Single Family EX Garage Attache /Detache 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment 0 Change of Use 0 Short Plat** ❑ Address 0 Road Approach ❑ Binding Site Plan** 0 Home Business 0 Cottagelndustry 0 Long Plat** 0 Propane ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign 0 Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance ❑ Temporary Use ❑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 Vegetation 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 its 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 application that he or she wants prior notice. Signature: 7 Date: xi-2.4 _e,&' The actio 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-transferable res sibility for adhering to end complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: : • cos-- '7 C Ls,--> Date: "/ -Zi -L7 Z 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: if L•st-- D%� Date: 'f 2 �� GENERAL NTRACTOR 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: y New pf Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: i Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: / Height: ,X Individual System ❑ Repair 0 Masonry SEP Permit# 3Eti 7.ucCrt5 ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ;kr Private well 0 Two Party Type of Heat: Proposed: ❑ Public G 'rieirf Total: 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: 1 Underground Tank I Above ground Tank Size of Propane Tank: 1 i Heat Stove i Cook Stove r) loodstove 1-Fireplace Insert i Hot Water Tank i Pellet Stove I Other Is this appliance being instilled 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 f Office Us - f-Pjf: ::ig,$ri ,i:'.Ag;a.ri,.4•",-li:. (..1.v lt,te A y.`;. ;.. r<r.r I,t' t r V r° !on'k -0 ,x eVisiOn • `: ' '-` --rG Main Floor Heated 5,4!V v '• ' _ EH Bld App Review: � o l , j 2"tl Floor Heated y;4�' ____ �" Consistency Review: r7��, r Other Heated Base fe : ) lO Mezzanine . Additional Section: t--.7---- Heated Basements ` Plan heck f e ) N, Unheated Basement .^ � _ X��State Surcharge fee: Other Unheated I� _i Pot Water Review fee: — 't S4 ai,4 _ 3' -56k q"3. Garage/Carport },g„I !` _ SUBTOTAL �� s_) , . L i-11 5 a. c0 •13c 1 ,: Decks - 4i��.' , 11/Rd Approach fee: Other r r' "� A TOTAL: $ 5 a.oC� (42_,t c.I ', 2A-{'Cc, CCU .� '5k�H o " �•• Rec•eipt Number: `�Jp 10 daOR 1 115 -1 "Kt. .g Cash/Check Number: t' � �: x k V) 3 1150 19$ ESTIMATED COST(REQUIRED) i.>')I Date: A I a5� aI!lit! t, �� •Fair market value of all labor and materials founda ion to fi tstt- - O Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc • ! ,v,, ON co , % JEFFERSON COUNTY `� 0 DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 60 360/379-4450 • 360/379-4451 Fax , NGS http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE I MLA# PROJECT/APPLICANT NAME: ?N COfl$,-pocrit:P-)/,SOSteii 05StTi--- Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a separate stormwater site plan map. Project Overview 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site map. 7,1 /uiz-biA;('` s:rt / r r /3.4 J /as /-5/(r r'.rnbE2) yA) CG�IPtie rE`b_ coTh7 TFt /9u;') n i7-- Fc+Je e ze" eic',r.( lli V Aee4) '7- e ier,rt2-i3 /9 v, ! ,7/9 Lt -)) Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. , E .9/1L// dim `v yiri/ r/M pee) I3r$/ v I c r 8 c Az r ecd Eb >s 12 A7 30 77) te- r :s 7n'F err rc'/ (17 z Me1- .u.'i/?Ltd At so Fe_,!T N/I'ir/•r Mir nE r,/C Ir€ /5 /ek i->e6-- Sc/t //7t iCt 3. Describe the existing vegetation. Indicate native vegetation areas on the sitmap, Y ��l U��y s 5��y S��s tee.; tckf,i?5 AEF P-T c— PO ,7` e 5/2'r /)0z-5, A if?",;CW.Zie 2ciA/X-4 7-0 TH a-z)vrf/ ICb /95 te- t /r7-,)) y d/R TrE'E- 4. Describe the existing soils. Indicate soil type on the site map. is4E UNDF2 Twc S/TE i5 Ai'zikAtty L'ct-w.!'i,� ( P/r iZFL'A/ (�'/��L 7,0/E 7E57 7-# f'1�9,C'�U� Is 5,i)Aa) AN n C>.-k'd o 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. i f/E 5 Ire` ///)i 6 ccX�'FGG :t3T TJ '1Qi.U/�l� , !J//'7EC C[r 4Gf;y J A--„e6If1 I 2' lr)/cz Rf 4'vL ec• ?j /L) A ? Qi.#J /-fhb J1/1iiL''r'ED — rn - /=145t .c,i elm 77 E- Sim /94,7 FLce.,.i 5607W .064 .t.% T � ��,l�E F 77/I 7,4241,6,2o /tA) .5 Lei P, JI C4. 'MO J✓ek)/YY, 6. Describe any excess levels of noise generated by the proposed use or activity: C.�NTF!' /> /A A s./�c/� 4iT �/�E C'dik/S 'eC iveAJ Jac.)',Se= Lj iL C./Al/0n ad-. stormwater site plan template—rev.10/1/2003 5 • • 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. ,106 1dETc'9i.D5 PE sr-REPOS. j7e A /5 FLA7 3cilgrly 5LoP47-I). 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.). 'H£ 2e;71) /5 3 rnILs'.5 ni Pet r Ta as p71sr6cEiu �h�f Icf. '7iL=5 'VC S ,;CO /30,e s jIFSiDE.0J7/ 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. 'if/E i t)776-e Vt,eu'ijf,Pc>t'r /.JeL4 0i:::; TM t3t i_" 6g/ DC ib ,1 'I P�41METER rPeA:#.J. rHE 2 1I06F i77CS 6F T//i.S 7?RAJA+i ld/c-c- Ct)/fE T17l't r/1t ' 0A.) T' E 5OO7/16/15r 5 i D E O/= j tecr- S 767 1QjJ 0 54vT/f r'lcniULa- 6it.7t= /JF y AIOAy Fie i 1 17/E S/%C AA.7 SCP7ic' 'D pia 1~,czc&a PEAFO12ATEb PIPE �n7 /Al .04iA..`�t�� , y FA 2IC'.. 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.] j}/E,4'E APk-' tir pez,Pest-'1> -s;'•r c.•).4z�2 7.21--7)7r/11-tuT F/Ic'/t-t7// S- 11. Describe the performance goals and standards applicable to the project. 12. Describe the flow control system. •t7F5e,i?. i %Ij -7'ci` 6 stormwater site plan template—rev.10/1/2003 • 13. Describe the water quality system. pUA'D Ft W/7 E (/LL 0- REPL C'i ic-':51,t A y Tyr. USs- 6>= /Lr 14. Describe the conveyance system analysis and design. vt-—.e?1P P /A) gtke�:7 iU►J 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. 50i1.- li c► ZEE Si TE X)i'� /�,9r:1'/1. L J f iT 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 461 —/5 Cc'rnort-i-e-> (17--ief/r'E- 1' /.tl ` /7 I<t)Ze..i06!-- ComPher A y THE Fyeldeibitle' el►.vs 'llfCjir►� 17. Describe the proposed surfacing material. (.luy:,e�7e .5Li9B 6iv 7ziP c c !�'il l'i�e� ('r- Accl_., 18. Describe methods for restoration of the site. C:/9S 77) %etc" ail /.tom I L 4_ ,fj�= ,5)17C 11`%r-ie e r Ar��c. _ 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. 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 7-Al 1i2 E .VO P�PfCr:�L .pc-129.02 r 57-0 <=5 (1L d 'a?1.)C ye- . 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 i • 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. 1,F /1M FFi.) C'lE9.eE7) L(J ilH i7 /UFFfr�' 06)1,d xi 7/7 2. Establish Construction Access. l'k,/✓1 PfC'rt-L> - ,q - .e rib-) S Tel 711E f >>i I it // i-O i>/T 3. Control Flow Rates. L b _ Ks t/A-Rx- et) J Z;> :i7e7 /tJf) Ili aZji?L c�1/FiU /9F r A Nil ev Tem./.:1 4. Install Sediment Controls. .5J /5 1 J,rf/ 1/,C 'y /Cr/j .54 e"cc- •nnY�N /,c) Pep A-7"T f}FA,+.. -5 j- Ar,) (A 9 R t 14117 vi. 5. Stabilize Soils. fJR/--L9s /V0 3 J>/) ; o f iW s/YF !4fr-- /7/(51> /J Q/lr E€/)1) i/�E .5I D- 1 ZccJ 4,Ch 1-4/x 6. Protect Slopes. .fTL' i& C4A) .g(' Per iX) 4,0 y - i,PF5 7. Protect Drain Inlets. Poe, F j9>4_1 rti L T i_f s J f-L /E Or9Ppr fD ,'.A)7"/L- 7-fie �-u Tree -pry_,)A i Pry,js ,4?e .,9 i tC'//f%) 8 stormwater site plan template—rev.10/1/2003 • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. 77i'/ 1,5 NO uJ 47 ) i'-Ler o`cirPoi..C-f/ , i:T r � i�/1i/ >slt, t 9. Control Pollutants. j1/A /iiJ/L ijr- AI") 174/_c.t' ici25 C`-E-/LIL 'A/'1) /c zil me:- eU/G/P/ua-"- ia,,F'p re7,27- 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). .77/ JS AID LCJ A k' .47ez(J "WPC)&0xi 7 YF 'TeJI_pi.Ava- $1T: 11. Maintain Best Management Practices(BMPs). /071/OLVY,4 /00 'Pe iJ,)f= - "bif,eJA a 77ie (1,9.4)5i-'LC°t4.1.1:9 ��--F-_'/C1 i S AU)tic'/1-'/11 5.-e114.3 4.l i 4 4 f e',.l S ITS 177 • E57e/C'r e-'/P/.t S'ier A I:. 12. Manage the Project. . .- Pft/Lc �'L ep/v S.//`e- _ 2/44 Tim T� 1,11,9AJ 4��i 77-1.c -pP,c?..7 zi 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). 'TNF j3c,/Lj?i,c./C? 5iT i.3 ir..) i7tcc: /l1'bht C f)t,:--. ` 5- "ley?i pieelep,y. 7i'/.FJe,- h"1'E ,A.)r., 7j/J�- 'S '/Z L./Ix t&''S /AJ t,te= Vic,iI fry d i%007 Paw[.../A'ee TR,/A2s i j i'c.e,e% iC r. JX'Gni T E S/Jic7/.0 ° `i/,r/_ , b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). -r/ir- '� /s Zc-k-QrrV 7- Fe-n 7 AA)i? /9,uy co ' is 4O,-,,e by" e4:" AIFGz, 77iei9i.0 iit J(i Se,//. 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. Al i E /ii,F'F AJO AiV,://k'esj?Fiti77i7 y _iF,,ri /i7 'sL /94,Fi'9 o- J r' stormwater site plan template—rev.10/1/2003 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. �/, 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility,settleability,permeability,depth,texture,soil structure). 7//F Dell/its' L1/i?y /� t , �-.C'eS/? J /5 /LS07" l3 5. Construction Phasing. a. Construction sequence rt) 4 hIrc/iT or i9 /3c/L1'/,t.)6/ P' °" - ze);vsrei/rlry''-' b. Construction phasing(if proposed) et/057-ppe -iel,L) kw./ e/'a.J 7/A.J E�°� a T/L (2c).n,F'LC Yf 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction schedule. /IIIy- Joy y `oc II. Wet Season Construction Activities. a. Proposed wet season construction activities. b. Proposed wet season construction activities for environmentally sensitive areas. fty4 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. 7 /2rn j/cc /4i ii,2ry b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. A Platte 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. 4/4 b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations 7 j/nicir-g jJ. 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. 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