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HomeMy WebLinkAboutBLD2008-00380 • • 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 PERMI #: BLD08-00380 SITE ADTDRESS: 365 OLD SCHOOLHOUSE RD Issue Date: 10/30/2008 SEQUIM, 98382 Final Date: 3/22/2010 APPLICANT: TIMOTHY P HICKEY PHONE: (702)499-8274 GAIL DENBY HICKEY 1993 PARK CT SEASIDE CA 93955-4139 SUBDIVISION: Block: Lot: TX30 PARCEL NUMBER: 002331025 Section: 33 Township: 30 N Range: 02 W PROJECT DESCRIPTION: REMODEL AND ADDITION TO EXISTING SFR CONVERT 1 BEDROOM TO MEDIA ROOM AND ADD 1 BEDROOM IN NEW ADDITION 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 3/22/2010 I\F_BLD_Occupancy.rpt 10/29/19 PJILDING MLA08-00388 PERMIT APPLICATN Review Type:I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00380 Received Date: 8/19/2008 SITE ADDRESS: 365 OLD SCHOOLHOUSE RD SEQUIM, 98382 OWNER: TIMOTHY P HICKEY PHONE: (702)499-8274 GAIL DENBY HICKEY 204 SOUTH JONES BLVD LAS VEGAS NV 89107 SUBDIVISION: Block: Lot: TX30i PARCEL NUMBER: 002331025 Section: 33 Township: 30 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: MAPLE VIEW ENTERPRISES PHONE: (360)460-9499 BEN SMITH (360)681-2838 193 DAIRY VIEW LN PROJECT DESCRIPTION REMODEL AND ADDITION TO EXISTING SFR CONVERT 1 BEDROOM TO MEDIA ROOM AND ADD 1 BEDROOM IN NEW ADDITION TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD VALUATION 150,000.00 MAIN: 837 CODE EDITION: 2006 ADD'L: HEAT TYPE: EEE OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 160 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 2 Exist: 2 Prop: 0 Prop: 1 Total: 2 Total: 3 Routing Date: S1a\\os '. Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,273.75 KAS 08/19/08 102477 Plan Check $827.94 KAS 08/19/08 102477 APPROVEP State Building Code $4.50 KAS 08/19/08 102477 Total: $2,106.19 OCT 2008 Jefferson County Planning & Building Department e elrson County Building M n Permit Nu LD08-00380 Applicant: HICKEY 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 111.0c1 ?k: • Minimum setback from Old Schoolhouse Road right-of-way shall be 20 •feet. Minimum side and rear yard setbacks shall be 5 feet. Erosion Control SEE CONDITIONS 2& 3 CONSTRUCT ENT STABILIZATION & SILT FENCE Foundation Footing 7 li I©ci Footing Drains Foundation Stem Wall 7'cl q Underground Plumbing / Under Floor Framing Straps(hold downs) ct,Z2,C et ♦i Volt- Ext. Shear Wall Nailing q ,Z2 I, JA Rough-in Plumbing• Framing c ,22 tet UMIk Blocking Airseal q ,2-- `l. IAA.. S Insulation: Walls �. 02 "z`i 0t01- Insulation: Floors G( Z Zi`t VA.A Insulation: Ceiling Int. Shear Wall Nailing Wallboard Nailing 9f/ Gas Line: Interior Gas Line: Exterior Propane Tank Heat/Chimney Clearance 3 .1. i_La Drywell/Alt Drainage ;t t II Li, SEE CONDITION I FOR DRYWELLS Address Posted FINAL INSPECTION \,-2.,-z) ( FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD08-00380 1.) FINAL OF SEPTIC PERMIT SEP08-195 REQUIRED PRIOR TO THIS BLD FINAL 2.) 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. 3.) 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 THEE 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. 4.) A SILT FENCE SHALL BE INS•ED AT THE WETLAND BUFFER PRIOF.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. 5.) 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. 6.) 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. 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 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 automobile 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 requirements 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.) 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.) The building height is not to exceed 35 feet. 11.) Minimum setback from Old Schoolhouse Road right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. 12.) 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. 13.) 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. • • 4 oN Cast JEFFERSON COUNTY JR T''l P", '',•' '4 n r? ��ti :4 DEPARTMENT OF COMMUNITY DEVELOPMENT t' ,..- 621 Sheridan Street • Port Townsend•Washington 98368 '4'" 360/379-4450 • 360/379-4451 Fax AUG 1 9 2008 jiG'9,50� www.co.jefferson.wa.us/commdevelopment o 8 _3 Master Permit Application MLA: JtrrtfisUN COUNTY OCQ Project Description(include separate sheets as necessary): t))71TI0N 1-0 SFR Tax Parcel COa D o2 S- Property Number: Size: t 0/ 4Ci2IS (acres/square feet) Site Address and/or Directions to Property: 36.5- oL0 Sc+/coLHodst. )ZD. C7A-(2,A1NE)2, t.J4. Property Owner(s)of Record: bliCkzY, DEA/DY-,NCkt sr HO FFtr2r 4-S at9/Air T£N4-i-TS Telephone: 1- 83I- 3''v-CliZ Fax: R3/-?VI-orzz email: f►bvtggi Mk/fey,o4-14,rid- Mailing Address: /9,3 ?Act Cov,27-j S=,q-SiUg_, CA 9 39.E Applicant/Agent(if different from owner): igiO S Al 17 F4 Telephone: .760- 4/60-5"1-i99 Fax: 760 68/-283P email: bell s©pkU peN-COWI Mailing Address: /? ' ,41/2y WELL, LA7- Sfauiliq, l.uJi - yS58Z 1 What kind of Permit?(Check each box that applies ❑Building ❑Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit ❑Conditional Use[C(a),C(d), or CI** "Single Family-41:$0iPcmi❑Garage Attached/Detached ❑Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home ❑ Modular ❑Special Use(Essential Public Facilities)** ❑ Commercial* ❑Boundary Line Adjustment ❑ Change of Use ❑Short Plat'" ❑ Address El Road Approach ❑Binding Site Plan'"' ❑Home Business ❑Cottagelndustry ❑Long Plat** ❑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 ❑Shoreline Management Substantial Development** ❑Site Plan Approval Advance Determination(SPAAD)* ❑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 ❑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: • BCC(/ 5 / ti ESIGNATION OF AGENT I hereby de act as y agent in matters relating to this application for permit(s). OWNER„SIGNATURE � • 4/ %lit" Date j//,De By signi' t • pplication form,th owner/agen attests that the• ormation provi ed herein, nd in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omissi n 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 . d right of e 0 to Jefferson County and its employees,representatives or agents for the sole purpose of application rev and any r-• fired later i. .-ctio -. St. , access and right of en will be assumed unless the applicant informs the County in writing at the of a of thea�pplicatio .-'--1•h. . is p.of notice. yam/ G Signature: �� �, 'L - - / '/1/" Date: e A S p e acti. or actions Appli .- wil und- ake a'a resul 'the issuance of this permit ay negatively impact upon one or more threatened or en.angered species and .uld 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 Cou y makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not late the ESA. A individual,group or agency can file a lawsuit on behalf of an endangered species regarding your actio • ou are i o p ance with t e Je rson County development code.The Applicant acknowledges that he,she or it holds individual an non-kansfef " po fib f er g t nd tom g wi h t e E . T e licant has read this disclai er nd signs and dates it below. Signature: e — Date: g h o 0 i C:\Documents and Settings\caral\Local Setdn emporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc , . • BUILDER STATEMENT TR d CF IRTt D The seer of "s statement d is hereb, i that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assw,mi re - oft e eneral tra for he rroposed project. Signature: yC�7 diDate: 1/,/d AUG 19 200B L CONTRACTOR VR MANUFAC URED HO INSTALLER:// PHONE: FAX: ( ) .IffffHDQN CQUNMY OC[ 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: ❑ New .k Wood Existing: 2 NM ❑ Sewer ,d Addition ❑ Steel Proposed: I Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: 3 Height: X Individual System ❑ Repair ❑ Masonry SEP Permit#50%-Oa 35g ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Z Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: t 1, —1=0 , 1 Public Foi¢cz0 A-t 2 Total: Z Name of System: P.O.D. ri.4Rtou Ea- P-0.P If this is a Commercial Project you must answer the following: Wit 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: ❑Underground Tank 0 Above ground Tank Size of Propane Tank: ❑Heat Stove ❑Cook Stove 0 Woodstove 0 Fireplace Insert 0 Hot Water Tank 0 Pellet Stove 0 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. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated I EH Bld App Review: /295 �37 �ia-7(odo Za Floor Heated Consistency Review O Other Heated Base fee:0 'a1 . .15 Mezzanine Additional Section: 6 Heated Basement Plan Check fee:0 8g1• qT Unheated Basement State Surcharge fee: o — 4.50 Other Unheated Q Pot Water Review fee: Garage/Carport SUBTOTAL 0 a 1 bo. i q Decks 911/Rd Approach fee: /GO 5a.rr. 4 L(o.8C Other TOTAL: $ a 106. iq Receipt Number: l O 1 4-7'"� Cash/Check Number: 3 1 1l 1 ESTIMATED COST(REQUIRED) L .5i3.LriDate: V/pp .Fair market value of all labor and mat , 1,5-0O Da s�`� Initials: ' O C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc ' • S RECEIvF,D ferillikA ON c °�� JEFFERSON COUNTYAUG 1 9 2a08 kil. �C DEPARTMENT OF COMMUNITY DEVELOPMENT 4.� 621 Sheridan Street• Port Townsend •Washington 98368 JEFFERSON CUUN IY BCD 360/379-4450. 360/379-4451 Fax _ `sNO http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# D b- 3 8S PROJECT/APPLICANT NAME: //I(Yet Y rforroe-7— 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. *DD .- R31 S4. rr A-Dtvrtital../ omen, A- rz..&IP So.r E5.r.71-rivk lye wiz, Fond) 4- 7140 s'0.1=T SA-/t-N, -Iwo A /5Z.'x6G ' NoA2-rov,ra-*0 rr.IPM,vt. ,M-tiv4. Exi5 lmtti UQ.Iot,j4.f t.StLt- et 1.. 5£il totru• So►...t A-tOtfoN, 6;OI aCILC LOT /s P. sjvlti 4,s1u Celle-441C.- 104 se.Pt... 4LL «I�Yrtioerovs, is)t1,4, AL ON /34Ck 4 CiLi..7sROP)RoprItr7,6s44nAli, A.ysrei t 1e11.8.FF;tL Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. %tali-1"4' tJA•4. tf 51-oP1- A-JtRd-GithAl,, 7°g P #J+•.A-/tQ Li101+1 /14eA_ a,- tor Tv r./.C.,,51 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. 7H'tt.Ir. A-0.- PR-ux. /D Dov..sf t, F vtv cc- rR�ti to cA.vt ni E i yN S rr A-PI HovS s. t-tr-C. R-c......ti t. O to._ c I_ TIM. Otto s+l_r r 1 D.tsvv2t_ 0.aa-e r. 4. Describe the existing soils. Indicate soil type on the site map. So tOsL. lfff Icst&hir-t£D Solt-S *5 5A1.+04 St LT' L.O -14.4 wwotTQ lam.TH A►.ivt L -o C o I?QLC. 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. - 'T ttR-t. r S A.7 Lt 4-'c rt_ z-.v rt a-4 hr t... oft._ L.f. rt rvt,- rbMf p,fieeL/ Pa Ravi sotLS ,4v0 zxt sr(Ark_ &EU.%riH-icmi C Ai)rvitt. 4.-i.L 124-hvw4-Tr/t caou st7-C. 6. Describe any excess levels of noise generated by the proposed use or activity: 0N1.,9 N D/Zst..q-t... 1. £ 41f LS d F COtv srfLAte r7 CC,l t_t 13 E Pass c„rr D ta�I rvw AfLorc c-r. P R D STORMWATER PLAN tc OCT - 7 2008 stonnwater site plan template.doc—rev.10/12/2003 Storrnwa er Require _ JEFFER •OleDEPT.OF 0, li ME.T SIGNATUR : Ill _ rir IP Nil • • 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. ?tot.siri Sc-oPcs Longr' T'o E44r ter a auAltr`i (.gIL`I(Nh R� Auw-h L 9% S6oPL. 60' ctl/a-,js,t. /,u G4o' w. 3 ,s Po,si cc. L trG,$'1c/A ,4./1[.+- , rift S.W. CoMUCrt A-Collotohc. Tv et",ni 0f2L. 4 ttn4i. S.,'I Cott,CS et AMT44tcO RtO1012-r) NAf DiartiLimi,JtA 7-14-A-- T?t ,d. g12E nJv 1.4171-M40l eff‘' TtirS Plaza. 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.). T Vito VLR-r1 to rir-t_ t,n s T a S ,4- wain') c er, 711-t P Itctu to mit N . s .}�c mop o n,/2- , Ly 1-*# .J- r<sw Sc4,r7-cg t4tzs. 0L12 57-4,t0 110l2.DCS _ prof t'ti-C.- tOfT. Po STRt¢was, WtTLi,uaff, oti C.yhaS . ,.L L0/11,r74t. 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. +'L c ' Tam �t -T-T1L. S ILL C. '� FOL.Ly nis Pc)2S£D." Ted f' /init.rwout 5ur-$4cL ,4.9 FINM► S1cvicD...+T I S 74, F4-1.4./,.,h ✓u,pta rat ro°h r It arQ. Tft t /S APOat—c Soo' or- FLvc., P4111 ,1trs.JEc,., rift. JtL-' Y c°n,r77tt)cry-0 /NiPtnwr+J PRoPtIa,rt 1?,Nn,Y. 10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is normally for"large"projects or projects that involve the potential for dispersion of contaminants.] N c 772 ►rt-,kr - "I-PPE/ter fa at AYECCss,on)r n vt 7-o .4-i c. Cc} n.- Iref ivy. rut_vy A/soerzsc, ,a,v Piz op rc, 11. Describe the performance goals and standards applicable to the project. ov/L C c . /S iu/,ur014*_ Ats ru,. ,7itu c t o t= C->cf sr/nrc.. USCG tr,#1? t vi,ox,o nit iJcr-rrc, c0-/Lu R-uerrcik.) s.7E c..rr-c /cvat.�w , .a- .1cppc/c4p1-f £C�wc.vrS of ar& STrit_ ..t., CA. 'Polk tt� tea.. PA-L vc/►.+'rt.1 N. 12. Describe the flow control system. T7tlt2.L. n o h9 vr^ .+FAQ SM.- To lit 'fro" firs (../n t 7174S Pizaatc i- n-E 14-rto to 'F-LQcv CVLLL uck,Y .0/ �jjZLvr rot Ls- /.t vc L,tj) I 1� � ;il l stormwater site plan template.doc—rev.10/12/2003 r U U cl t_ 11 rJ 6 JEfFEHSDN COUNTY DCD • 13. Describe the water quality system. two Loc.�s M2. .f->vrtc,Ii. -it/. .4 p.q Port vrl�t-c �fRihJ �> A- f2-4-a N SUc$.,fr Unit- �C *414-- wtrK fl r V)/Nye SILT" cf-AJCt.S .1-n• rtt£ .¢4000%. 57,0' d 6- N,1-f-pt...re- UCA,Tier tuc i?u1�r�e1t r7F�f'f >�Yrs fio poi_ Doc.,fut JtL GD-,-jcc-vT 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. /tomb'_ M cit-L/frt. t S 5/plo t&4- •i, i Ce•Riltt I. C yr 4- w t L-L. Izc ra%),t-l.. rtf() Pa-amen 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. G .. C S'fRvrfact) l r1L-L at. Donst Ow t9ND/sl dlU6o ?J*i,L So/c- i3tn. FILL co,.- Swtdw...OovLa. t.+i.,4lc40 4-•••e1..t. Ili t 4( cc. Cv$.Piarcn, 54-rv0 -r00. umeiAA-Ac. It Ce&coLrC 5,4f3S 4r1 f7cL cur%poNerscp jaiIrw- h7G t tot Atfs/Z. 17. Describe the proposed surfacing material. 41%-rq S t.42-.4 Lo .•47& — Svll11va iv/)I..Ak StT't_ L✓l4 c_ Qc 12.tPcoow7't/) ?t1 17A4 it)►2 F 4w Del Ut W'►Y WILL. u!t NoAryv t "Mif t r 10 C' �Z" C P wit{D IM416„.t.I, 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. dU/A 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. EP02T t2otM As vim►c- Elm u►a4m wt cur,4-L sCAtHcc S , s r f-T-I,vc% r>irar-L k,t-c_ Ne4 Wc-Tt41%.10,f c?..i PR.00merV. 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. ,U07— Att4.4442E Of Aril1, R Fr AUG132000 stormwater site plan template.doc—rev.10/12/2003 1rt�L���u ' JE N GOUN1Y(JCR • 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. 71f-t(LS /a-sit NO S£-,%)ScTItTI:- AO-tin oft 'ZTt4i$ Lk)(7'lft ) SW' of CC,fVSrt`R•vcrtvly Al2. ' . CLSaltrl tl. LJv►'►trf 1..,11.1 13£ ryiAckto C 'Ftoaecwr Pairs' Qof r Y i a. 6.'IL. 13L Gotypicrtp us, Frn+.a.. Lo(-gyY.N o2 PrLfo d- rovc2(V FOR F4 ,re.. S4(. 1L.L.. 2. Establish Construction Access. CC)I3St2vcT'rCoh.J UEtitcL£. / c $' L (Lc. L/rtt,12c £',x!rr1,n FsT9-0L/Stic'd j�2r U£w,M49. 4ivy New TOMIt.t. tvtLL 0£. ca'Jsf 40 L..,t r?f C a.uSy-C (Zoc t rhoo /3£. um./ztd Ant- rlf`L )J£w DR1vc..i/1-r .fetit 3. Control Flow Rates. )tl_ L ►t- L.ult..L L 1 F',L,L`-( I)MSPC,WcD.oN S(T£ . S1L_7 Ft IN4 wtLL (3E co Liles. Down) GtiQ.41)tGv7- Jo Sat. y ,}�£�r .1ttr.•+c, SILT' Ft.ar/c t T1Y,i}T IM.Y`r It-fccto Ems i.k .r tv/i-tra NA-rvn.rt- T2-rro nil- A-nf-.0- wru. /LLs c, II-"I . r7-11.4w /34z.cs Pt,fc£b "ic/lors /T. 4. Install Sediment Controls. $rldtt..J Qi/d.SI L.,I4.L I£ (f.r ,!}f �f- J-t Pc,I for WtA M-.rvL Exctcf /te az£c7-co 1t?4_)4.002.0J 1T 5. Stabilize Soils. M4-rol-(.4-t Mt rS PILtD 4ur4L_ BC Covlb2rp o-,u S(T£ nrvi 1,4)05vd S LOPcp A1t41 L..r I L..L. S n2,41,1 S Pit O dx, iL1t . L tW .rc -IQ tic L.,rtL(. r3E L.i'n,i T -L 5cr S SILT F-C-.jC L. 6. Protect Slopes. Thtt2.t IS •NC or{ Serr `R-v-i-t?N .4-t.L SLc/"CJ S#L-..L RE iHtxcttt4L 4- jf) Rr-St1P J Ta Ao-F7VR r Vratic.If 1-(v./ art p,(Le c.k4 c Vstq Frni.?-tL C.i2 r, .44v1 ct-c.t1.49-7-c1) mBs't/zgrh s k.( ( L placer.) o.. ueL.11 srcG. o-P- sLayt 7. Protect Drain Inlets. /4fte ,r0 /jz,f-(A) t IVLLT7 ►&VOLoco Lv(Ttt- 711-II t'RctTsc7'- R E,CF1rvl stormwater site plan template.doc—rev.10/12/2003 JEE1ERSUN C111iNTY ern • R 1 ,C \r D AUG 1 21O8 12 Required Elements-Construction SWPPP(continued) 8. Stabilize Channels and Outlets. JEFFERSON COUNTY OCO merit. A-12- » C4- - .tmcLS Cat o1Jrt_£.n oNI nits l72 cT /d Lid U-vl 4't,t. I S F 'LL- n(S 3 uttS'cD CAN - 9. Control Pollutants. /4-rt,-t cc rvt?()-ttcr(chs-2 D£R/1-1 S Lew_ /3 V 1j4-vt.[p earc- 5(TT_ To A- t.,thr r_ fc�tt.tN, No o,.! 5tTC ruLL ri)-+..rA1 aft- H,tt'2,OtL/ltroi cHiLw•te4-t..f t.,tt_� at. /i tau t l.tO Fu- 764t3 P20T t c7 C anK2zTt. TYLu A. ('i.4tfr 'vr 5 tt tt t_ i(w.0 L DYS/A NArri, 4I'ac/3- wlfle SrR.icv IZ .0 PCa.' sitrt/t. Eska/ftnei Fc4vOiltcvT" Rc0,442 twr7! t)It c,rtretri P/1N S 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).' ntv�� s foots rabble So,L-s w,rrr•- y-(4t-i PTA tn1A-R/LIPi wttt_.. 4t,r /Z£Qvt/L L. OCc,,,A-7-t/tt njlt 11. Maintain Best Management Practices(BMPs). 11-LL_ 13rii) Srvfit&t LAA4- -q /'Pm -(c j r3C 1 4-1A.rr/rium -n,n 1 frn pa..0-0-to 4--e dJt% j .Tbhto%IttEt-- e-c,r- TItt. tA-7r1 C'v•�rl1Mcrtcn- Pltrf r. 12. Manage the Project. 02 rr,Y rTr2-Ucrjon,) Forksh'.f-r.J w►L.L_ ac P£Rrotvmyt,Y 2£rPot113LF T7n/Z 77-£ !A5s-rK.L.$-rt/iv/ 1444-iNTC-NA-,dCL ®F A-tL 57r✓/i4tt t4-44-rcIL- °MAP'S. 2. Adjacent Areas. a Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). T7:f-r-st A /vo wL?l.twOrt STOCAvv S, o(L Lt,A'TcIlw1r.1S tto Thft ()them_ /9-l-L Ltm-TG1_ 411 L L D£ F-ut..t..Y D t S P£tz-S cA clv S I'rt. b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). T t2&. ► S A D 2 -tN4..Ot L C S tT'C 4ro0 NG f2 CC(t.ut JJ--- f1ot-t O t, cj2. 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. 1?tc,2.0 A 2c Ne. ENV/ariM4,1ttvTet t..L.."( 5 E-ft?S£T-t Jc ,qj O NJ 7`11-1 J a A+Cf£L A-c Hf-a-O TO NGr cnrct R`I /2-k L NE! 44/I urc. TO lit-C EAT- % t A 4 t+n„£ e t.,4-4 S m oc wsT-L 01-n,p a L'r r1fL D c -F{!L tt.p uoT i44-rc4- /}GRc/f 51o4-/L stormwater site plan template_doc-rev.10/12/2003 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. 71f€ F 412.E N o N UrQo11 114t v/-4-r„`-r S r.7 t Try C .412-c4-r ait /3.,FFZ[2Lr Oiu 1"1+1 4/14C1-. 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). No PRoacc4,,,t. f. �2rS � .4-1-L S.g-Fr-/ I iis.„4j vR,fraL S o StMP S F rtli wt. co rvJ1 f trc r-r a►.) P i- L 61 /Va t'1-T-C 5. Construction Phasing. a. Construction sequence 5 rm. Pacp, FGND•-TIcn F wt./ /2corrivti /ti-rritio2 / b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. S£P I.. /54 Serf, 57041+4w4-1-trL 4 inns ra-zr 5 r r Pi p S TM;.tt.t 24-r-1 gad. /s r (PEW_ Pc/tot tr Appfr v,.(J rn./ cc.r.s rn-vnti) o F II. Wet Season Construction Activities. S.Nzuc-TV/u• a. Proposed wet season construction activities. F6i'' .9 LL. C, ccP i c r r-t. Pp cp. b. Proposed wet season construction activities for environmentally sensitive areas. IVlls 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. U-L Hcf-t2- / Ti mod- Q.A-i L t--fc%c�r b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. Gt rrtNJt/2. t CCsr'TR.4-c-rt.RJ Re-NO t/J r .7--titsu,2rn . 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable. a. Sediment Ponds/Traps. Nth¢ b. Diversions. Xa4 c. Waterways. ?/ d. Runoff/Stormwater Detention Calculations 1U(r�}� 1H H (E V� AUG 1 9 2ca5 stormwater site plan template.doc—rev.10/12/2003 10 JEEttHSUt COON YDCD • 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. (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE)1.4-.011,"7:-/9E) / �� (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: AUG 1 9 2UU8 JEFFERSON COUNTY DCD stormwater site plan template.doc—rev.10/12/2003 12 . 1 , 0 0 i t I .mon _ .. _ 1 I III III I r77-16' ' - - 1 gm 11 1 INNI11111 ' I K .: IMO I IMME 1 r- - p----------- Ca CD 11101 a. 1III101111111 z it) :VI ' 00' 0. --I '''' ..L m I s ' , - - \P1:4)) 'i---- -- . 11111 x En' NN . e / , 1 1 ' - iiii 41) Ramo cp co 101110111 11011101111 IME XL: ____i co M 0. N) lig t2 4 II. : hum il o ---- - - - o 1111111110 ' --- I I ri: c'")00 , 0 111 -0-' 111 1 1. CI) I mm m 1 1 in 0 g in .g. 1 ., (12 - II I D -' II I m 7' 1, Z - Miming n111111 1_-_-., .' I -111111 ,llimmik...,..:: :..._.,._.; ;;-;„_. ._: _ ___ . .. .:__ ..,.„..,.._ ,;,,.,..„, pli..; 1, - 1 1 . „ I ( 28' , 7 7i 1 ›- ,- j b, = cc, , N..) ,... El 1, E oOoA1NnolNOSO3e Bi.ify F , 9 v rb ' (4,4:\\''..,, . i CA ..) 1 _ .o ,-0' '-1Th d -------,I 3 _i �J 4cn fJ r ti l— -' 1)\-, -;-- CD 0 ‘-- 1 / •S' _____. C) • • om 0 to vif,w . --- ai-3 c — 1L Q r 1 _, xa �� ❑ ❑ 1 1 J 11r _ 4-7 d r— r - - T" V ff-` r �7 Z o .N G 7-4 CD -1. I E al. D 13) ...x = ( Cii NJr 1 k R. y • .., . , r...j us .. . 8 fl r+ CO - "`L Fri . 11,- r , , _ 5. 12. _ (b 4# rf d r t o -"' - f t r ter_ 1 r,. • 0 0 419'- fs' — — ._ 13 n IIin a 8 -33 tC , O I v.) > m m New CD xiP+ n 71 Driveway c� w i 0 55' Parking I D a" --i 'EXisting Propane Existing 1 15' \-- o Qr m 125 gal A/Gi Home / — I S v 1 / - -- �.. New W 'mron m 37 15 1288 sq.ft. xisting Water Hookup it,l Barn 36' I g i ro a---= o Q z 38' 12�Proposed New water suppl li - ,��2160 sq.ft. — — I' �^'„ = O !1 \ tion Cane mnp I 2 z0 i r�g yJ Exis'ny �e�`�a __ rn m Proposed - `Septic \ ;2' I: Z v = Drywell En V O 4'X 4' I,n \ Prop drywalls 4'X 4' I --n m II XI Proposed Septic IMP"ti I I PowerCA \\ f II II 1 \\\\\ II 11J inPropo ed \(-)1m CO Silt \' O\i I I h'd N Fence \ N n , Co I o r�� I- \ &J1 la it A \ .• 0 418 \ I''. Zil--- \ ::"."4 5' _ N i g t�eserve Area Leach Field I I - 1 Existing-- ---.1 Horse Ai 1 Hut (portable) Probe,ty Boundry ! 192 sq.ft. Slope Slope I Ir 9% aye xl 9% aie I 12 om W,-m a "0' QI D "'oz — KKmCD o Setback i C• 3 I tg < �= mD * � Dm<Omm (''p Q I o r-azm • _ N ? � mxN T .,f ®p (o r se. NI mI I r- rn i z° 1tt 1 I Y,bj 1 O ate �-,• � 30"County R.O.W easment -� ono LIZS_.o. 1 1 _CIL — _ �$9 51Y81W- c-• 1 4 ti c co .1-44 z� Old Schoolhouse Rd. I r'0 d Pe