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BLD2008-00200
• 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 #: BLD08-00200 SITE ADDRESS: 113 RADIO LN Issue Date: 07/3/2008 BRINNON, 98320 Final Date: 1/28/2009 APPLICANT: JOHN P MINAHAN PHONE: 503-385-6553 3422 SW SPRING GARDEN ST PORTLAND OR 972193830 SUBDIVISION: Block: Lot: TX63i PARCEL NUMBER: 502103022 Section: 10 Township: 25 N Range: 02 W PROJECT DESCRIPTION: NSFR w/attached deck. 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 1/28/2009 I.\F_BLD_Occupancy.rpt 10/29/19 w Jefferson County Building Division Permit Num.: BLD08-00200 Applicant: MINAHAN 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 47- 1 " , Erosion Control 7/2/08: SEE CONDITION 2 FOR SILT FENCE CRITERIA. Foundation Footing Footing Drains Foundation Stem Wall Under Floor Framing Straps(hold downs) Ext. Shear Wall Nailing i:i /b n✓ o Rough in Plumbing 19/ /913 : (),� d� 1/5/0q ..;N4wrR 94' Framing 10- j-le t-1-40 L 64\119- Wf(-7 - B 1 F IP' cam Blocking Airseal l t9 U, 9it" Insulation: Walls (4 -9-01 9L_ Insulation: Floors Insulation: Ceiling Int. Shear Wall Nailing Wallboard Nailing Heat/Chimney Clearance Drywell/Alt Drainage 7/2/08: SEE CONDITION 1 FOR DRYWELL SPECS. Address Posted PRIOR. - F noa See Conpl+lon 3 FINAL INSPECTION FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR UILDING PERMIT APPLICA N MLLA08-002232 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00200 Received Date: 5/9/2008 SITE ADDRESS: 564 JUPITER LOOP BRINNON, 98320 OWNER: JOHN P MINAHAN PHONE: 503-385-6553 3422 SW SPRING GARDEN ST PORTLAND OR 972193830 MADRONA RIDGE TR 22 SUBDIVISION: Block: Lot: PARCEL NUMBER: 502103022 Section: 10 Township: 25 N Range: 02 W CONTRACTOR: OREGON WILDERNESS HMS CONST INC PHONE: 503-838-2492 8629 HIGHLAND RD INDEPENDENCE OR 97351 Contractor's License OREGOWOWH941OG Expires 9/7/20 REPRESENTATIVE: BRUCE CHAMBERLIN PHONE: 503-871-9779 8629 HIGHLAND RD INDEPENDENCE OR 97351 PROJECT DESCRIPTIOr NSFR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 816 VALUATION 250,000.00 ADD'L: 437 HEAT TYPE: CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: GARA CONST TYPE: DECKLE 504 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: --- Cr '<PS Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,833.75 LYK 05/09/08 100202 APPROVED Plan Check $1,191.94 LYK 05/09/08 100202 State Building Code $4.50 LYK 05/09/08 100202 JUL 3 Potable Water Application $59.00 LYK 05/09/08 100202 Total: $3,089.19 Jefferson County Planning & Building Department • • CONDITIONS for Building Permit# :BLD08-00200 1.) 2005 DOE STORMWATER MANUAL DRYWELL DESIGN CRITERIA ALL INFILTRATION SYSTEMS SHOULD BE AT LEAST 10 FEET FROM ANY STRUCTURE, PROPERTY LINE, OR SENSITIVE AREA. FOR SITE WITH SEPTIC SYSTEMS, INFILTRATION SYSTEMS MUST BE DOWNGRADIENT OF THE DRAINFIELD UNLESS THE SITE TOPOGRAPHY CLEARLY PROHIBITS SUBSURFACE FLOWS FROM INTERSECTING THE DRAINFIELD. DRYWELL BOTTOMS MUST BE A MINIMUM OF 1 FOOT ABOVE SEASONAL HIGH GROUNDWATER LEVEL OR IMPERMEABLE SOIL LAYERS. EACH DRYWELL MAY SERVE UP TO 1000 SQUARE FEET OF IMPERVIOUS SURFACE FOR EITHER MEDIUM SANDS OR COURSE SANDS. TYPICALLY DRYWELLS ARE 48 INCHES IN DIAMETER (MINIMUM)AND HAVE A DEPTH OF 5 FEET (4 FEET OF GRAVEL AND 1 FOOT OF SUITABLE COVER MATERIAL). FILTER FABRIC (GEOTEXTILE) MUST BE PLACED ON TOP OF THE DRAIN ROCK AND ON TRENCH OR DRYWELL SIDES PRIOR TO BACKFILLING. SPACING BETWEEN DRYWELLS MUST BE A MINIMUM OF 4 FEET. 2.) IF NEEDED, A SILT FENCE SHALL BE INSTALLED AT THE: TOP OF THE LANDSLIDE HAZARD AREA 30 FEET BUFFER PRIOR TO ANY LAND DISTURBING ACTIVITY. THE MINIMUM HEIGHT OF THE TOP OF SILT FENCE SHALL BE 2 FEET AND THE MAXIMUM HEIGHT SHALL BE 2 1/2 FEET ABOVE THE ORIGINAL GROUND SURFACE. THE SILT FENCE SHALL BE BURIED IN A TRENCH TO A MINIMUM DEPTH OF 5 INCHES BELOW THE GROUND SURFACE. THE TRENCH SHALL BE BACKFILLED AND THE SOIL TAMPED IN PLACE OVER THE BURIED PORTION OF THE SILT FENCE, SUCH THAT NO FLOW CAN PASS BENEATH THE FENCE AND SCOURING CAN NOT OCCUR. ANY DAMAGE TO THE SILT FENCE SHALL BE REPAIRED IMMEDIATELY. SEDIMENT DEPOSITS SHALL EITHER BE REMOVED WHEN THE DEPOSIT REACHES APPROXIMATELY ONE-THIRD THE HEIGHT OF THE SILT FENCE, OR A SECOND SILT FENCE SHALL BE INSTALLED. 3.) PRIOR TO OCCUPANCY & BUILDING FINAL- FINAL APPROVAL OF SEPTIC SEP07-336 IS REQUIRED. MUST MEET ALL CONDITIONS OF SEPTIC PERMIT. 4.) A MINIMUM OF 5' MUST BE MAINTAINED BETWEEN BUILDING FOUNDATION AND EDGE OF SEPTIC TANKS. 5.) 10' SEPARATION REQUIRED BETWEEN A WATER LINE AND ALL PORTIONS OF THE ONSITE SEWAGE SYSTEM; EFFLUENT TRANSPORT LINE, TANKS, TREATMENT AND DISPOSAL COMPONENTS. 6.) A 10' SETBACK SHALL BE MAINTAINED FROM THE SEPTIC TANKS TO ANY DOWNSLOPE FOOTING, CURTAIN OR INTERCEPTOR DRAIN, DRAINAGE DITCH OR DRY WELL. 7.) A vegetative buffer of 30-feet shale permanently maintained from the top or of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 8.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC)Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 9.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 10.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 11.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 12.) A Stormwater Site Plan has been submitted and approved by the Department of Community Development. Once the subject permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 13.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 14.) Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an autormobile wrecking yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requriements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor vehicles be stored in a critical area. 15.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 16.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 17.) 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. 18.) 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. 19.) The building height is not to exceed 35 feet. 1 iv w4SU cod,. JEFFERSON'UNTY W h ,� DEPARTMENT OF COMMUNITY DEVELOPMENT `3 `� 621 Sheridan Street • Port Townsend • Washington 98368 MAY - 9 2008 360/379-4450 • 360/379-4451 Fax is,.... � 0 www.co.jefferson.wa.us/commdevelopment : nnii. riC HIN fit o . U Master Permit Application MLA: (X3 3 Project Description (include separate sheets as necessary): 4/6;'e ) 1. Ti.s1 ,1 _ Tax Parcel Property _� Number: ,a22A/03a A�. Size: die.,,0t9.5 (acres/square feet) Site Address and/or Directions to Property: / .'�lv`� Tom- Goo, iz./.u,L�.v ,W c `it'32a Property Owner(s)of Record: ri.icAts ? �(ti3 i t*f\-,'I Telephone:SSO3:3S s "(pS 4-3 Fax: email: Mailing Address: .34// t Z(mil} .5/ L/A.) ,+ 6x) «). T oC.Ti-2,Uh �l- ct'l I1 Ci Applicant/Agent(if different from owner):. $ u .6 T1 4.*%4 6754-4,,4J Telephone:]~b3 "g71 -9 711 Fax: e D3— 1`-2,$ email: Mailing Address: 41 1/61./44,440A , :27,tiAefpIn /berau i 0 4,„ GI?3 s 1 What kind of Permit? (Check each box that applies 14Building ❑Variance (Minor, Major or Reasonable Economic Use) O Demolition Permit ❑ Conditional Use[C(a),C(d),or C]** Single Family El Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification ona Manufactured Home ❑ Modular ❑ Special Use(Essential Public Facilities)** ❑ Commercial* ❑ Boundary Line Adjustment ❑ Change of Use ❑ Short Plat** ❑ Address ❑ Road Approach ❑ Binding Site Plan** ❑ Home Business El Cottagelndustry ❑ Long Plat** El Propane ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination (SPAAD)* ❑ Shoreline Management Variance ❑ Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment 0 Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑ Tree Vegetaion Request *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this pro osal, if known:/ Stirtz It�tS Q;�iPm5 t Pela- k i i 4 ri¢'7.34e a i e a-16 e4 vt)r 7z,r-3-) ,.. DESIGNATION OF AGENT I hereby designate 4/24.1 A `LI to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: /-- /5 ' By signing this applicatio orm,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 i writing at the time of the applicati n t e or s n+ /cA e' Signature: sty Date: ~V•5-- The action or acticins 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 y. are in complia e with the Jefferson County development ccde.The Applicant acknowledges that he,she or it holds individual and non-transfie esponsi.' . Md t mplying with the ESA. The Applicant has read this diss;laim§r ei1¢..signs ates it below. Signature: ` Date: /j /� 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: Date: GENERAL CONTRACTOR OR MANUFACTURED HLl'4L4 STALLER: PHONE: FAX: 10I-.4)) H`0-1 10 c.. I) (CO3) 8 71—ct 7 Z1 (• 03)$3fb-z889 MAILING ADDRESS: &al caaUA EA,ICOFfe60 bkerrOWer EMAIL: CONTRACTORS LICENSE A `1,O Q1• WAINS © NUMBER: 8ir/6 D qT NUMBER ARCHITECT/ENGINEER: i� hL �oeets e� 8'NaQ -'. PHONE (S (3i j\ FAX: ( ) MAILING ADDRESS: "!/� EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: y,.New 'K1 Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Z Bank ❑ Community System O Alteration/Remodel ❑ Concrete Total: Z Height: X Individual System ❑ Repair ❑ Masonry SEP Permit# trfrOf=e331P ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: X Private well 0 Two Party Type of Hea • Proposed: _'a a.... ❑ Public ,Of�i3`T/Jm 0 Total: g Name of System: If this is a Commercial Project you must answer the following: ,UO 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: 16 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 T nk i P let Stove i Other Is this appliance being installed in a Manufactured/Mobile Home? Yes /V /�j4— When applying for a permit to install a propane tank you must also submit a site pl 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 8t / EH BId App Review: 1 J 00 2n0 Floor Heated J/ Consistency Review: cJ`� DO Other Heated Base fee: \ 3.3 --7 5 Mezzanine Additional Section: Heated Basement Plan Check fee: ' 1 pI ( , ci Li Unheated Basement State Surcharge fee: �,,1 — 2408 LA 15 J Other Unheated `► Y Pot Water Review fee: O 3 615 Garage/Carport n , i '7•'11 SUBTOTAL v/-�� C) r ;ttii JUiI J .3// , Decks Q_ ,7/ 911/Rd Approach fee: e X t S{-)r-hi Other � TOTAL: $ 3 35" , , V 1 ---___ Receipt Number: 1 0 Uaoa Cash/Check Number: 5 ESTIMATED COST(REQUIR ) Date: I �D g •Fair market value of all labor and materials foundation to finish Initials: I ._ G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc 0 PERMIT # BLR • 08 - 0200 RECEWEn 44)1'• --"'" ,,. 440.4. JEFFERSON OIL VTYOCD HAY - .�1 DEPARTMENT OF COMMUNITY DEVELOPMENT 2008 621 Sheridan Street • Port Townsend • Washington 98368 rr '! 4 360/379-4450 • 360/379-4451 Fax u {Ila � 'i Y D `' N http://www.co.Jefferson.wa.us/commt�(,velopment/ CO STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# l J V 23 1 PROJECT/APPLICANT NAME: 04 'y a h_cur-1 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. %i� v /07-rig- . F-�_ / S -s E Y..- A-e-- r"'r Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the sip map. /7 A2iri 15---.44442.11., r ‘,--"e-li _.5',C7,'#Z 1 ,e—La..) e9/1/ e./W 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. ,/ ' - :a, e , oc,,b. zi pP ce- lz�- 'Q,l r 9/ f �' `� L'S '. c.-2l� 4 ,Cet�E�3•- 4. Describe the existing soils. Indicate soil type on the I map. -n p L.�� ►4-'v'- .-.0 d `�tuba-U- c-K--, &it- -°-; _, 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 creage of each. / 440 hif)Loo iLte b,/ gpia...L., 1.0 1 4*c/' it c. r -9-,? �teL► APPROVED 6. Describe a excess levels of noise generated by the proposed use or activity: STORMWATER PLAN Stormwoter J U L - 2 2008 Required • e - 1EFF,' ., tUN DEPT.OF C' T .vEt� Mgstormwater site plan template—rev.1&1/2003 SIGNATURE: Ill ID � A . 1 5 M1 ti 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep)slopes,etc.) the site/Indicate locat' n on t 'site map. 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,et . Ate4, g,i,./,!'"le.,f GSbc 1 'I •tom / - r- �c i, i 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 dis harge areas within the site. Locate the facilities on the pite plan and differentiate propo ed facilities froril existing facilities. d A e £ / -/ ,i / i.) �c-t �.5. 741"/ ex-de" 60 LOA (1t,/�t) cyl 40 `4.kt',ALI- -f l0 � -f 0 r 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.] // 4 11. Describe the perfrmancee s•als and standard a licabl to the ro t. ,�� /, v it '9iliz 1/films / 7 L) J' E'-ems• /Jp ,12..—Describe the flow control system:' , i+I yE , . ii).. 14-- vAzA 1 its-k -,41-.) I i MAY - 3 2008 I M1 i . .. , . • .. , . ..,.. itl i ,ITy - ---wtftin ro JE FFERSOIi COUNTY DCD stgrmwater sktesplan ter fate rev.10/1/2003 6 • • r � r RF cEi ED 13. Describe the wit quality system. MAY - 9 2008 -NA/ Q LD 14. Describ the conveyance sy em analysis and design. , ,C°L /`�bL� (' '!t. 7 D A 6,5 611C gi 4- i j1 I Aly 15. Describe the source of fill material,physical aracteristics of fill material,and�teposition of eixcess material. pni c,t.L�o .S/lt� .L)/1d 1a AO C.— /t•-1 ►JAI iic4 16. Proposed methods of placement and comp ction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Co . 17c-, ,/ - GO-f a tiell r 0 E-attlktiy4re_l_e_-,-0 17. Descr the proposed surfaq materia_ 1. ii {4/L.L LI 13,C �c.c...1--- 18. Describe methods for restoration of the site. '''' t 1....,... A .i...r 41161 ' Illf i I rii.,!•-,... ' .L. A itik. , . #'d 1 So . y 1.. _ / 1Uli )P idc^J 1 . 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. ) /4 20. List here a d include any special reports or studies conducted to prepare the Stormwater Site Plan. V it — 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 drairtkge-related requirements,describe those conditions or restrictions here. t/ .5,/-A/f •.�1 // r e iki-%-a C Ht 6L-W 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 Clear g Limits. 2. Establish Construction Access. 3. Control flow Rate 4. Install Sedim n ont I lg � �oJ4._ 5. Stabilize SS ils. ° /4—ate P I 6. Protect Sloe . itt- 7. Protect Drain Inlets. MAY — 9 2Ot8 ,(1/f"/, �„ an ,tr - n , t,t,11y1 W stormwater site plan template—rev.10/1/2003 8 • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize C nels and Outlets. ,f/i4- F C Ell 4,I) MAY - 9 2ufl8 9. Control Pollutants. �y/— pn 6"_ tr�Gar : A :i+1 lidri L314 i 10. Co .De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 12 lit- 11. Maintain Best Management Practi s(BMPs). il> leite: znep ..„6,,&A...-„„e-, - e../,,,fie oto ..-Fx.c.. 12. Manage the Project. y. ____________411,—,410 .. . Per-/-e.. .4 ,f,..et',2e-Z'j(er41 CI--(.-6) f19-77,400-- ) 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). ,lam A w rr e9,e- 4-t-2. " b. Description of t downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards) /'T- 3. Environmentally Sensitive Areas. a. Descri tion of environmentally sensitive areas that are on or a jacent to h site. ,C�ride- L 4� 1 b? hf( �.1. stormwater site plan template—rev.10/1/2003 9 • 0 b.`` /�D scription of special requirements for working in or near environmentally sensitive areas. 2)/A- 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility,settleability,permeability,depth,texture,soil structure). Al 5. Construction Phasing. a. Construction sequajuca-, ) - b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Ma al). I. Provide a proposed construction schedule. hi 5 c T '' /czel kl'<� II. Wet Season Construction Activities. a. Proposed vet season construction activities. 0 b. Proposed wet season construction activities for environmentally sensitive areas.ts 7. Financial/Ownership Responsibilities. a. (dent' th ,property ow er responsible for he initiation of bonds and/or other financial securities. RECEivE ID b. Describe bo and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. MAY - 9 2008 I I.. L cj,JCUUfll BCD 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations 4`d. RS„,Is. ,.+..t.Rs JCL 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 y nowledge. I also certify that this application is being made with the full kno ledge and consent of all owners of the aff ed p perty. O-- 08 (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DAT THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: RECEIVED MAY - 9 2008 COPIt:lt DCD ?EMI # BID _ O8 - O2O ( JEFFERSON COUNTY DCD stormwater site plan template—rev.10/1/2003 12 1 • 0 z y Zuw: -Y,- S., N l��y-y— Tj Z wCn ci /- - wry UN Jerry _ ________.- --- „„ i ma rilitr.i. ,,"'"'U/CC Lip V'✓ cw7 t,J Q.) z J h 0 I. ,i 9 _i_.,- zi2 (V Qg L1� .ne t=.7 ti W �� V r�/� J :14A W.0 rli a VL.. d' V �� t 4 LI ancemnif ( / -41 o -� d�� r�°3 ._i :' ff _ o rd �, ` O O z S _ . 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