HomeMy WebLinkAboutBLD2008-00211 MILDING PERMIT APPLICATS Review00244
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00211 Received Date: 5/20/2008
SITE ADDRESS: 86 BAYSIDE CT
PORT LUDLOW, 98365
OWNER: DANIEL M KIMBLE TRUSTEE PHONE: 360-302-0156
DOROTHY C KIMBLE TRUSTEE
86 BAYSIDE CT
PORT LUDLOW WA 983658744 BAYSIDE SHORT PLAT
SUBDIVISION: Block: Lot: 2
PARCEL NUMBER: 821163009 Section: 16 Township: 28 N Range: 01 E
CONTRACTOR: OLYMPIC RIDGE INC PHONE: 360-302-0156
15940 LINDSEY LANE
POULSBO WA 98370
Contractor's License OLYMPRI986NA Expires 8/7/2008
REPRESENTATIVE: E.J. KLINKER PHONE: 360-302-0156
15940 LINDSEY LANE 360-598-3992
POULSBO WA 98370
PROJECT DESCRIPTIOI NEW 555 SF HTD REC ROOM W/ BATHROOM, 397 SF
UNCOVERED PATIO & BREEZEWAY ATT TO EXISTING SFR
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 555
VALUATION 110,000.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: #OF STORIES:
OTHER:
CONST TYPE: GARAGE: 360 SHORELINE:
CONST TYPE: DECK: 397 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: SEW
WATER SYSTEM: LUDLOW
BEDROOMS: BATHROOMS:
Exist: 3 Exist: 4
Prop: 0 Prop: 1
Total: 3 Total: 5
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,049.75 AMS 05/20/08 100211 APPROVED
Plan Check $682.34 AMS 05/20/08 100211
State Building Code $4.50 AMS 05/20/08 100211
Total: $1,736.59 AUG8
Jefferson County Planning.
& Building Department
•
Jefferson County Building Division Permit Num, BLD08-00211
Applicant: KIMBLE TRUSTEE
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
Foundation Footing 9/31.4
Footing Drains
•
Foundation Stem Wall 0,/tos
i
Under
Floor Framing
Straps(hold downs)
Ext. Shear Wall Nailing >a/ii/ae
Rough-in Plumbing M3/oq
Framing /Aye 9 /'r/
Blocking ///3/C O�'�,/
Airseal i/i3fr A �",�/�
•
Insulation: Walls
Insulation: Floors
Insulation: Ceiling _ 15—o(t r},
Wallboard Nailing 040
04,1
Gas Line: Interior ///3/b9
Gas Line: Exterior
Propane Tank 9 I ttl o`t _[(L7C—Heat/Chimney Clearance //13 fr9
Drywell/Alt Drainage il.Z1/DI GUTTERS, DOWNSPOUTS AND SPLASHBLOCKS,
Address Posted i t ( Drt 1 --
FINAL INSPECTION .7I \�tO't t;/
l ,?
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
CONDITIONS for Building Permit# :BLD08-00211
1. ARCHAEOLOGIST MONITOR REPORT WILL BE REQUIRED PRIOR TO FINAL.
2.) A PROFESSIONAL ARCHAEOLOGIST MONITOR AND PORT GAMBLE S'KALLAM
TRIBE REPRESENTATIVE ARE TO BE PRESENT AT ALL GROUND DISTURBANCE
INCLUDING SEWER AND UTILITY LINE.
3.) GUTTERS TO DOWNSPOUTS TO SPLASHBLOCK SHOULD BE SUFFICIENT FOR
STORMWATER DISPERSION.
A MAXIMUM OF 700 SQUARE FEET OF ROOF AREA MY DRAIN TO EACH
SPLASHBLOCK..
A VEGETATED FLOWPATH OF AT LEAST 50 FEET SHOULD BE MAINTAINED
BETWEEN THE DISCHARGE POINT AND ANY PROPERTY LINE, STRUCTURE,
STEEP SLOPE, STREAM, WETLAND, LAKE OR OTHER IMPERVIOUS SURFACE.
A SPLASHBLOCK OR A PAD OF CRUSHED ROCK(2 FEET WIDE BY 3 FEET LONG
BY 6 INCHES DEEP) SHOULD BE PLACED AT EACH DOWNSPOUT DISCHARGE
POINT.
4.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ:
Water conservation measures:
1. Roof and other intercepted precipitation shall be routed to on-site detention ponds
and/or other approved means and allowed to be released to the soil slowly.
2. Water collected from Storm water and roof catchments may be used for watering
lawns and gardens. Unless catchment water has been treated to meet drinking water
standards, there shall be no cross connections allowed between the potable supply and
impounded water.
3. Water withdrawn from wells on each property shall not be used for watering of lawns
and/or gardens.
4. Ground water withdrawn from each property shall be restricted to a rate of three (3)
gallons per minute.
5. Installation of water conserving fixtures such as low flow toilets, faucets and shower
restrictors and other water saving plumbing fixtures.
6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation).
Please NOTE that the above listed measures are not intended to be exhaustive, but rather
is intended to be illustrative of the types of water conservation measures.
5.) 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.
6.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through #12 of the Department of Ecology's Stormwater Management
Manual for Western Washington 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.
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 vehiltshall be stored on any lot unless totally seed
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.) This parcel is within a no shooting area per JCC 8.50.
10.) Per MPR Code Section 3.17, accessory dwelling units (ADUs) shall not be allowed in the
MPR-SF zone.
11.) Setback from Bayside Court 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.
12 ) Where lighted signs are permitted, such illuminated devices shall be shaded and directed
so as not to provide glare toward any adjacent properties.
13.) 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.
14.) 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.
15.) The building height is not to exceed 35 feet.
• 0
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Covered breeszeway
_r---j I Existing Home
__ Garage Area
F—__ _ i ' t )Edge of existing pavement I, d e y ��—'
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== 1 I 1 1 II II II I�
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a qa 170 2d/D 1 II 1J IJ Il Il N Garden Hoare angered os not to abstract
.d I appraocb view of rw"I'l home.
v fold Nanoaaa system (ID Schematic Site Plan eMt+a ears i:a Magna
as Finkle. ` Scale:1"o 30 ft
I 1 Down to lawn
1 Open Terrace /
so .,•/Kifch.mitel 15/0 x 15/0• /I
~>a 1 I suld�an a prepared for disais ian9 pg,am
/ t nx rd c: cogof thhe buitT gases
o1-___I— /_t-5tLm�— 1—__ i Stonework As w�i ue brirsgto water/wnste/�oible fartohis w t ar ! \
• -",-./ should a small fo'kt room be considered? 0 ®�
Law plamin Down to lawn •
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Possible Nano windowsE �9e� _ram'
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N 0 5 __Jet' 15 20 25 FT "" ""'
Schematic Plan
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Scale:1/8"=1'-0"
Job.2007-198 12-17-07
RECEIVED
MAY 202008
JEFFERSON COUNTY OCD
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06,¢ o3v 0 jEF ERSON NTY - ,,,``',` ,_ . . ;,62 Ovlt7 V gyp. ,
' �� tia DEPARTMENT OF COMMUNITY DE1/ELO4PMENT 1119-/11__%✓ r..g.k/ S)•e G,)_. g.�
`4 621 Sheridan Street • Port Townsend • Washington 98368 I ,/� n
\ ,, 360/379-4450 • 360/379-4451 Fax 0,1, 1�oY .
\�gS IriNO 0 www.co.jefferson.wa.us/commdevelop 11t 4' t) LLU'a
Master Permit Application CIE fff RSON cr,piry 0 CO ML.A: O --`a,--\ y
Project Description (include separate sheets as necessary)Li r--.ria_. .; t .. __.. 1/, , i ,.,,,,,,(00,e''
Tax Parcel Property v
Number: / — /(�/ Property
(4 (acres/square feet)
Site Address and/or Directions to Property:
Property Owner(s)of Record: tq,v ;';,,, Li -
Telephone:"6Q WC, Fax: r>— email: —0
Mailing Address: 1) / �►y r'�.dl Cam- �(; f,6, (,�, �'3/T
Applicant/Agent(if different from owner): =• J.. �'/, /ram
Telephone: ►" Fax: CY e 7 f fr,t email: 8 j V rf 0 ,-*,,C.
Mailing Address: •
Wuildind of Permit?(Check each box that pplies
ing 0 Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]**
❑ Single Family 0 Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)**
O Commercial* 0 Boundary Line Adjustment
0 Change of Use 0 Short Plat**
O Address 0 Road Approach 0 Binding Site Plan**
❑ Home Business ❑ Cottagelndustry 0 Long Plat**
❑ Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑ Sign 0 Plat Vacation/Alteration**
❑Allowed"Yes" Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management 0 Shoreline Management Substantial Development**
O Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance
❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
O 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).
1
OWNER SIGNATURE • Date: f 2 p/p ,y
By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
his, her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet
may result in this permit being null and void.
I further agree to save, indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and
expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the ap n that he or she wantsu pf i notice,
Signature: c' 4{c,c,c1 6(e i lei/„ . Date: VLOst
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 cDde.The Applicant acknowledges that he,she or it holds individual
and non-transf responsibility for adhe 'n to an complying with the ESA. The Applicant has read this disclaimer andd.sic�yis and dates it below.
Signature: -_•
G�r� Cq �� Date: S/]d/e/V
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
-BUILDER STATEMENT
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be ssu\min�g'the resp`nsibility o the G neral Contractor for the proposed project.
Signature: !"' d�f:Crf/ G� Date: 1fjo/r 1'
l /
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
D/ ' 9,,. �U4 � Vie ) 1-70 0/T ' ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: /c PHONE ( ) FAX:( )
43,. ry�-•_h
MAILING ADDRESS: ._ F�/r t f f( -- EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
C"New E3"Wood Existing: 0 Aewer
❑ Addition 0 Steel Proposed: t Bank ❑ Community System
O Alteration/Remodel 0 Concrete Total: i Height: ❑ Individual System
❑ Repair 0 Masonry SEP Permit#
O Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑dPrivate well ❑ Two Party
Type of Heat: Proposed: 1 Public �f
.-0 Total: —0— �c�0 Narpe of�System:� 1 ���y„
If this is a Commercial Project You must answer the following: l �
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 l Hot Water Tank I Pellet Stove i Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No
When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property
lines, tank location and size,distances from the propane tank to all property lines,buildings and septic system components,
including the reserve area. 55� a
WS� -yi [� '� j F2V n n�' ( '.i^+�}t'` *"' -cT. .A .`4'Y' 'C' O4' v
Square Footage Current Proposed ri4`- rir e)i.1O' t r A x
Main Floor Heated ! ,y,,�l 4 EH Bld App Review: _
3X;ie .;T:qoili
2n°Floor Heated „fit Consistency Review:
Other JHeated ' Base fee:
": l04". -75
Mezzanine . �}k Additional Section: _
Heated Basement .: Plan Check fee:
Unheated Basement State Surcharge fee:
- ,3 4 .5D
Other Unheated, " Pot Water Review fee:
Garage/Carport " SUBTOTAL NCO.
5q
Y {Ti{ 3 /�
Decks 1 «' r: Shc,re I YtG lL�r ' �� vn i
Other � :I-tl✓UVlvl "2 (Oa r.*f39�1= TOTAL: $ a�� �
''T "� -- -, Receipt Number: _dv `1 i ,
—
O'
‘r '•.,, Cash/Check Number: -�,14,..1
�,�������l it Q".t
ESTIMATED COST(REQUIRED) __-2J1 r TJ Date: (�,
•Fair market value of all labor and materials foundation to'i7nrTi- 5 10 D
—'- , Initials:
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
• •
JEFFERSON COUNTY
(Pk
Kt DEPARTMENT OF COMMUNITY DEVELOPMENT
0,,, , 621 Sheridan Street • Port Townsend •Washington 98368
1gSi//I/� 360/379-4450 . 360/379-4451 Fax
'`'�t7rN0 http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# O D.,qLk PROJECT/APPLICANT NAME: t ik° 4/4
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. • hqm . S co c44,,L - saii_
vi,ups - -t- 100 Cp 411,c4,1,,44..
Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
(--(94/t/l -L Fib 9 .
4. Describe the existing soils. Indicate s it type on the site
V-*�� g map
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.
ell ll.J{i WI CA;V ity.
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stomlwSYaissite1040141Plateitt RP/Ors 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.
ivies
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.). (2 {/
L- 1 V
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.
9. 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.
o
(3/0 _ T?or C_cmk csho 040,
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10. If 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.]te
11. Describe the performance goals and standards applicable to the project.
12. Describe the flow control system.
stormwater site plan template—rev.10/1/2003 6
• •
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.
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
17. Describe the proposed surfacing material.
18. Describe methods for restoration of the site.
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.
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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.
7-'
�EEFEHSUN LlijN[y oCC
stormwater site plan template—rev.10/1/2003 7
• •
CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP)
The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the
template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for
preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater
Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential
development.
SECTION I—CONSTRUCTION SWPPP NARRATIVE
1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or
will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable
to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual (beginning on page
2-15).
12 Required Elements—Construction SWPPP
1. Mark Clearing Limits.
2. Establish Construction Access.
pus
3. Control Flow Rates.
N►�
4. Install Sediment Controls.
5. Stabilize Soils. ,C A
6. Protect Slopes.
AJ?
7. Protect Drain Inlets.
stormwater site plan template—rev.10/1/2003 8
• •
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
Ala
9. Control Pollutants.
)Llid
10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
11. Maintain Best Management Practices(BMPs).
t°S
12. Manage the Project. 1/IC
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2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas, roads).
/<Lf2_
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
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stormwater site 9n,lernplflte-rev.10/1 003 9
i M
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).
N0
5. Construction Phasing.
a. Construction sequence
b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a proposed construction schedule.
cU- CJ
II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
b. Proposed wet season construction activities for environmentally sensitive areas.
7. FinanciaVOwnershi esponsibilities.
a. Identify th property owner responsible for the initiatio o onds and/or other financial securities.
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
"ice
8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable.
a. Sediment Ponds/Traps Ale
b. Diversions. /GA
c. Waterways. /if
d. Runoff/Stormwater Detention Calculations �f�g
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 wo I. •--t, I as the applicant/owner attest that the information provided herein is true and
correct to the best of my kno. •.•e. I also ce ' that this application is being made with the full knowledge and consent of all
owners of the affecte• • .•erty.
/1111111.11P" dAkVair
(LANDOWN.-ORAUTH• GNATURE) (DATE
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
•
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stormwater site plan template—rev.10/1/2003 12
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