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HomeMy WebLinkAboutBLD2008-00284 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 #: BLD08-00284 SITE ADDRESS: 11 CHIMACUM CREEK DR Issue Date: 08/18/2008 PORT HADLOCK, 98339 Final Date: 4/13/2009 APPLICANT: JASON W DINGLE PHONE: (206) 334-7362 LYNNISA M DINGLE PO BOX 607 CHIMACUM WA 98325 SUBDIVISION: CHIMACUM CREEK ESTATES DIV 2 Block: Lot: 14 PARCEL NUMBER: 943700015 Section: 2 Township: 29 N Range: 01 W PROJECT DESCRIPTION: NEW SFR W/ATTACHED GARAGE THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 4/13/2009 I:\F_BLD_Occupancy.rpt 10/29/19 Jefferson County Building Dision Permit Num.: BLD08-00284 Applicant: DINGLE 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 olPE2.. IUrrFs oN l'mtes&nesa Erosion Control idolog SEE CONDITION 2 FOR CONSTRUCTION ENTRANCE S-TA g4LIZATION Foundation Footing /_/ 4,6 1'� tIGLE� I NsTwu.>E0 Footing Drains Foundation Stem Wall Under Floor Framing Straps(hold downs) !nCk?I'5 ii`4. Ext. Shear Wall Nailing Rough-in Plumbing 1 ,.- g Q.t Framing Blocking Airseal /?,�/ c> • Insulation: Walls t �t Insulation: Floors Insulation: Ceiling HIII3 Cq Int. Shear Wall Nailing i > .�-7 r ir%+SI.L �� *�a � n% i '��s� t �. ✓�N���z Wallboard Nailing } . 1-c , Gas Line: Interior / Gas Line: Exterior Propane Tank / Heat/Chimney Clearance Drywell/Alt Drainage c I v SEE CONDITION 1 FOR DRYWELL SPECS. f ✓ Address Posted 1 13 G4/ FINAL INSPECTION �I3I fll; ity FINAL INSPECTIO MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR 4IR UILDING PERMIT APPLICA#)N MRLA08w00pe310 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00284 Received Date: 6/24/2008 SITE ADDRESS: ! CHIMACUM CREEK DR PORT HADLOCK, 98339 OWNER: JASON W DINGLE PHONE: (206) 334-7362 LYNNISA M DINGLE PO BOX 607 CHIMACUM WA 98325 CHIMACUM CREEK ESTATES DIV 2 SUBDIVISION: Block: Lot: 14 PARCEL NUMBER: 943700015 Section: 2 Township: 29 N Range: 01 W CONTRACTOR: HI-LINE HOMES PHONE: (360) 379-8600 11306 62ND AVE E PUYALLUP WA 98373 Contractor's License HILINH*981I3T Expires 2/10/2010 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI` NEW SFR W/ATTACHED GAIRAGE TYPE OF WORK RES SQUARE FOOTAG:=: TYPE OF IMP NEW MAIN: 1,664 VALUATION 128,475.00 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: 484 SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date: la69l0 Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,156.15 KAS 06/24/08 100377 Plan Check $751.50 KAS 06/24/08 100377 APPROVED State Building Code $4.50 KAS 06/24/08 100377 Potable Water Application $59.00 KAS 06/24/08 100377 AUG l4 2008 Total: $1,971.15 Jefferson County Plannino Buildinn Department • • CONDITIONS for Building Permit# :BLD08-00284 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.) CONSTRUCTION ENTRANCES SHALL BE STABILIZED WHEREVER TRAFFIC WILL BE LEAVING A CONSTRUCTION SITE AND TRAVELING ON PAVED ROADS OR OTHER PAVED AREAS WITHIN 1,000 FEET OF THE SITE. THE ENTRANCE SHALL BE CONSTRUCTED ON A FIRM COMPACTED SUBGRADE. QUARRY SPALLS (OR HOG FUEL) SHALL BE ADDED IF THE PAD IS NO LONGER IN ACCORDANCE WITH THE SPECIFICATIONS. (BMP C105, 2005 DOE STORMWATER MANUAL). ANY SEDIMENT THAT IS TRACKED ONTO PAVEMENT SHALL BE REMOVED BY SHOVELING OR STREET SWEEPING. THE SEDIMENT COLLECTED BY SWEEPING SHALL BE REMOVED OR STABILIZED ON STIE. ANY QUARRY SPALLS THAT ARE LOOSENED FROM THE PAD, WHICH END UP ON THE ROADWAY SHALL BE REMOVED IMMEDIATELY. UPON PROJECT COMPLETION AND SITE STABILIZATION, ALL CONSTRUCTION ACCESSES INTENDED AS PERMANENT ACCESS FOR MAINTENANCE SHALL BE PERMANENTLY STABILIZED. ) Critical Aquifer Recharge Areas may require special protection measures to mitigate water quality degradation. The submitted proposal does not require additional aquifer protection measures. However, during construction the project shall follow the Best Management Practices (BMPs) and facility design standards as identified and defined in the Stormwater Management Manual for the Puget Sound Basin. 4.) 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 cortact the Jefferson County Department of Community Development to arrange a schecule 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. • • 5.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 6.) 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. 7.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 8.) The road approach permit (RAP08-0061) must be inspected and finaled by the Jefferson County Department of Public Works prior to the final inspection/certificate of occupancy of this residence. Contact Terry Duff, Department of Public Works at 360-385-9159 for the final road approach inspection. 9.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 10.) Minimum setback from Chimacum Creek Drive right-of-way shall be 20 feet. Minimum setback from SR 116 (Ness' Corner Road) right-of-way shall be 30 feet. Minimum side and rear yard setbacks shall be 5 feet. 11.) 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. 12.) 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. 13.) The building height is not to exceed 35 feet. 14.) PRIOR TO OCCUPANCY& BUILDING FINAL - FINAL APPROVAL OF SEPTIC SEP08-00132 IS REQUIRED. MUST MEET ALL CONDITIONS OF SEPTIC PERMIT. 15.) MUST COLLECT AND DIVERT ALL SOURCES OF DRAINAGE AWAY FROM SEPTIC TANK, RESERVE & DRAINFIELD. '' qrz —,,*r fiiii, CE V3 i fl JEFFERSOi )UNTY k‘4,,..„' DEPARTMENT OF COMMUNITY DEVELOPMENT "' 621 Sheridan Street • Port Townsend •Washington 98368 JUN 2 4 200$ 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment iEffE` ?j rf�fll�l HD :tine( �9L COUNTY U Master Permit Application MLA: 08-31D Project Description(include separate sheets as ne sa .1�u.) c�c s t .ioti - (� /2) S fa ��s, � � w fftlfdda/ 6e Tax Parcel c� Ploperty / Number: /4/,3 6 ,C)/ �- l Size: y tU (acr s/square feet) I Site Address and/or Directions to Property: Cv11mGtGc�^ C-J t-1 D( ()off I_ 18G1< C�;,,(,�.�c.._Cr S R�I 9, S`' � i5R I I t) NtsS (0,-,,' Rjzc;(&),r1yti t & <<.1$: c CNA_D _ , Property Owner(s)of Record: , r Telephone: %- 331/- 9-36'2 Fax: S60-'732 YO92 email: strt i'srx9 cb,coin Mailing Address: P-G, 8O,K €09- e/i1/✓t..acct., c-c44 5> o5— V Applicant/Agent(if different from owner): Sze Telephone: Fax: email: Mailing Address: What sj d of Permit?(Check each box that applies 'Aiding 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]** Single Family j2f•Garage(A:ftache)/Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* ❑Boundary Line Adjustment ❑ Change of Use 0 Short Plat** .Address "// .Road Approach ❑Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** ❑ 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 ❑Wireless Telecommunication* 0 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 t t k Signature: Date: 6-/9-©d The actiorl or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this • permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable i forcadFe ing td apd cgmplying with the ESA. The Applicant has read this disclai er and signs and dates it below. Signature: .. r Date: '/ a "-O g 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 assuming the responsibility of the General Contractor for the proposed project.) �1 n Signature: _) Date: % v d GENE //ONTRACTOR//lOR MANUFACTURED HOME INSTALLER: PHONE: FAX: r 1L f ,ftQ nitilAkeS X6) 37 -(Fee,e, ( ) MAILING ADDRESS: //33 (<2 r^ ."`-' gr„.aeriL",9 q 7 CONTRACTOR'S LICENSE �AINS NUMBER: /-1-1)H *C 95:2Y 1.S f NUMBER ARCHITECT/ENGINEER: n ,4 O� A� 4 6,„ 5 PHONE ( / ..z yFAX:( ) MAILING ADDRESS: 7 EMAIL e;c-Vi-74/32_ 0-4.2- jie s `'ii l''Z Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: v-New Wood Existing: ❑ Sewer ❑ Addition 0 Steel Proposed: Z— Bank 0 Community System 0 Alteration/Remodel 0 Concrete Total: 2 Hei9hy Individual Syst ❑ Repair 0 Masonry /I�// SEP Permit# nci:c. ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: _ Setback: ❑ Private well ❑ Two Party T e f Heat: Proposed: 3— ublic f,a � Total: r3 ,� Name of System: Pa, ,y. .74� Uloz7 rz If this is a Commercial Protect you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants, employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: i Underground Tank i Above grow d Size of Propane Tank: i Heat Stove i Cook Stove t oodstove i Fireplace Insert I Hot Water Tank i Pellet Stove i Other Is this appliance being installed in a Manufactured/Mobile Home? Yes When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size, distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only Amount Revision ,. Main Floor Heated I 66 q I. (9103Ic tH Bld App Review: 70 Ot/ v 2"d Floor Heated A 1jA Consistency Review: 115 Ob /� Other Heated , r/ pr Base fee: i 1 lCJ�' i Mezzanine ^r/A Additional Section: Heated Basement r N Plan Check fee: , , / 151.50 Unheated Basement Ni/�- State Surcharge fee: 4 .50 Other Unheated N/4 Pot Water Review fee: q5.CD Garage/Carport L/ SUBTOTAL �/� �C� De -Li t HIV Exit �a�al�� p aa-1.t V 911/Rd Approach fee: 1 f� La •W Other J U ft 2 4 2928 TOTAL: $25a . 15 Receipt Number: I 1 0b5"7-7 JEFF.E�?a.' 1 COUNTY Cash/Check Number: WO ESTIMATED COST(REQUIRED) Date: / a 1 i I � _ .Fair market value of all labor and m vials foundation to finish q2) DDD, Op I agrt:15-� itials: G:\PermitCenter\###FORMS###\DRD FORMVMS\Master Permit Application 12-19-200o.doc i • . oN �---,„\ °� JEFFERSON1lll���� 1 ,, A... . 'In COUNTY JUN 2 4 2000 g Aso 1 DEPARTMENT OF COMMUNITY DEVELOPMENT j ,. 621 Sheridan Street • Port Townsend • Washington 98368 J L f f f D M COUNTY D D D 360/379-4450 • 360/379-4451 Fax Na' http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# 0 g — 2 3 t PROJECT/APPLICANT NAME: )a. M �G(j 1 it!`SC. / 754 Please answer all of the following questions to the best of your ability. Where the questions 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. CGU-S.- -C�`c `a— sTe :?Q rzi,.. Existing Conditions Summary 2. Describe a existing topograph . Indicate contours on the site map. 3. Describe the existing vegetation. Indicate native vegetation areis on the site ma . /VarL.cep fur.}-.n�cQr-s c /c L c�mac . ,.erS 0-14 4. Describethe existing soils. Indicate soil type on the site map. Co e. . ..F AI---- ---.4--4e.t,:z d 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 applicaable,and indicate acreage of a ch. bl ' e�tiet . 7,./.1-Lia-441- 1T �l trrl�p2 z APPRON 6. Describe any levels of noisea e nerated by the proposed use or activity: STORM WATER PLAN iliol JUL 2 9 2008 StormWa3 $IGNAT Requir d JEFFERSO {;�►UNl DEPT.OF C', ,j l •F stormwater site plan template—rev.10✓1/2003 UR y01.10 �t i' `i`il� A 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. flials D o� 8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads, and sensitive/critical areas (streams etlands,lakes,steep slopes etc.). `' VV 4 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 an differentiate proposed facilities from existing facilities. r`/, 13 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.] /114 . R17 C 'Wy V E ) 11. Describe the performance goals and standards applicable to the project. rb,�>� /� ,, s .SUN S ..,.- _...C I'L 14... 9 i t!3 E 3r:i ,IE U'tl U 1-2. Describe the,flow control system. 1 CV/ I , 1 stormwater Site.Qlah terrplate-rev.10/1/2003 6 • • 13. Describe the water quality system. /g4 /14 ,-ex.eL .)5 RECEWED - JUN24 ?NB 14. Describe the conveyance system analysis and design. [IC 15. Describe the source of fill material,physical characteristics of fi!I material,and deposition of excess material. /`J- 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building t 17. Describe the pro osed surfacing material. 18. Describe methods r restoration of the site.e ( ( ,,--zw""' ej 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. /LI) • 20. List here and inclu ;�y 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 d ainage plan or contain more restrictive drainage-related requirements,describe those conditions or restrictions here. /t 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. 5 /170 2. Establish Construction Access. ta / A ALA O -Qa .'ram 3. Control Flow Rates. aitipS 4. Install Sediment Controls. 5. Stabilize Soils. 4519, 6. Protect Slopes. /1)/d 7. Protect Drain Inlets. ij ( 1[' 1[�5Tri D A9//4 JUN 2 4 2003 storrnwater site plan template-rev.10/1/2003 8 • ! 12 Required Elements—Construction SWPPP(continued) ( I�1I�C j 8. Stabilize Channels and Outlets. ; ' 1 1 \J LL� JUN242G8 9. Control Pollutants. E C J'1 `' I p tti E !f i Iruui'i! I �LD 0 - 10. Control De-Watering,(the act of pumping groundwater or stormwater away from an active construction site). 44- _. 11. Maintain Best Management Practices (BMPs). a- )11 -`6'› 12. Manage the Project. 6/116 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). ,v/i 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 sensitiveQ areas that are on or adjacent to the site. /Yr'�ecA, stormwater site plan template—rev.10/1/2003 9 • 111 b. DescripAAtioolnnnof 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). /L 4 SU L& --eL4—e_ ——1,4-e-t 5. Construction Phasing. a. Cons ction sequence earl'ii., , 71/r..A-ce4^-.5 i 4--zezJc(c"---) deacet,Z) ,- -C-Zir-ge-,/frar12/a52'. ....e. ....0 -40-ver-4,--teciA-4/4._a-P-e 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 construct' n sc dul a� p A_ _,2_ -fit dd20 -- II. Wet Season Construction Activities. a. P oposed wet seas n construction activities.,. b. Proposed1wet season construction activities for environmentally sensitive areas. 7. FinancialOwnership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. ��t _ a 4v b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. Ai 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. �{� )- -�` b. Diversions. /n-- p E�EI \ T)1�.> ll c. Waterways. d. Runoff/Stormwater Detention Calculations J U N 2 4 0nt r C1 ugiJi.'4iuuu �I 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. ( WNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: RECELl�!�J1_4> _)) JUN 242fg3 Irr rr' n. stormwater site plan terrplate—rev.10/1/2003 12 c / 54'-ml / c_ -7-4 / 22'-0" / 32'-0" . 2'-0" , / 6'-0" i �' mll.1 t_ 1 G z tN \ \ \ \ 40 50 HS 6050H5 _, oN 0®yrT- IGI C ' ► 0 II II X0 �f. (p r -- CJD Ul S I ID 5- N - O omD A B H <C7 0 = T m 7a N Tc o < 'm .A c Z o • N 0 N o rc-{ -1 om� u' \ r \ cn - D = m z a>a N(jt H A N41 1�� 5i 5211 �. 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