HomeMy WebLinkAboutBLD2009-00056 • •
CERTIFICATE OF OCCUPANCY
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
Carl Smith, Director/Building Official
PERMIT #: BLD09-00056
SITE ADDRESS: 61 PORTAGE WAY Issue Date: 04/29/2009
PORT HADLOCK, 98339 Final Date: 10/26/2012
APPLICANT: FRED P NASON PHONE: (360) 385-1116
61 PORTAGE WAY
PORT HADLOCK WA 98339-9735
SUBDIVISION: NASON SHORT PLAT 3.14AC Block: Lot: 1
PARCEL NUMBER: 962700107 Section: 7 Township: 29 N Range: 01 E
PROJECT DESCRIPTION:ADDITION TO LIVING ROOM SPACE OF EXISTING SFR in conjunction with
a shoreline exemption permit (SDP09-00016)
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006
EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes no.
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 10/26/2012
\\tidemark\data\forms\F_BLD_Occupancy.rpt 10/26/2012
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Jefferson County Building D'�fsion Permit Number: BLD09-00056
Applicant: NASON
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 517/Y/ 5 Minimum setbacks from Portage Way right-of-way and Cleveland
Street right of way shall be 20 feet. Minimum north property line
setback shall be 5 feet. Minimum setback from the east(top of bank)
shall be 30 feet.
Erosion Control SEE CONDITION 2 FOR SILT FENCE&CONDITION 3 FOR
CONSTRUCTION ENT.
Foundation Footing 5 /h 109 "-- Jea2 'VI 02)
Footing Drains r 1
Foundation Stem Wall 311 i 0�� Cif
Under Floor Framing 516/0
j
Straps(hold downs) /
Ext. Shear Wall Nailing
Rough-in Plumbing
Framing
rt-10-ac(
Airseal
'7-27 zc(
Insulation:Walls
Insulation: Floors
Insulation: Ceiling )b —12
Int. Shear Wall Nailing
Wallboard Nailing -L'{131(
Drywell/Alt Drainage SEE CONDITION I FOR SPLASHBLOCKS
Address Posted
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FINAL INSPECTION I.L
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD09-00056
1.) DESIGN CRITERIA FOR SPLASHBLOCKS:
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.
SENSITIVE AREA BUFFERS MAY COUNT TOWARD FLOWPATH LENGTHS.
A MAXIMUM OF 700 SQUARE FEET OF ROOF AREA MAY DRAIN TO EACH
SPLASHBLOCK.
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.
NO EROSION OR FLOODING OF DOWNSTREAM PROPERTIES MAY RESULT.
FOR SITES WITH SEPTIC SYSTEMS, THE DISCHARGE POINT MUST BE
DOWNSLOPE OF THE PRIMARY AND RESERVE DRAINFILED AREAS.
2.) A SILT FENCE SHALL BE INSTALLED LANDWARD OF THE TOP OF BANK PRIOR TO
ANY LAND DISTURBING ACTIVITIES.
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.) 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.
4.) PRIOR BUILDING FINAL - FINAL APPROVAL OF SEPTIC SEP08-00016 IS REQUIRED.
MUST MEET ALL CONDITIONS OF SEPTIC PERMIT.
• •
5.) To help prevent seawater from intruding landward into underground aquifers, all new
development activity on Marrowstone Island, Indian Island and within 1/4 mile of any
marine shoreline shall be required to infiltrate all stormwater runoff onsite.
6.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
7.) 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.
8.) 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.
9.) 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.
10.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
11.) 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.
12.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
13.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
14.) The building height is not to exceed 35 feet.
15.) Minimum setbacks from Portage Way right-of-way and Cleveland Street right-of-way shall
be 20 feet. Minimum north property line setback shall be 5 feet. Minimum setback from
the east (top of bank) shall be 30 feet.
16.) 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.
17.) 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.
•
18.) Residential developers and individual builders shall be required to preserve shoreline
vegetation and reduce the associated risk of erosion during construction and any future
activity which may impact the stability of the shoreline.
BUILDING PERMIT APPLICADN ML Reviewy 050
T Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00056 Received Date: 2/23/2009
SITE ADDRESS: 61 PORTAGE WAY
PORT HADLOCK, 98339
OWNER: FRED P NASON PHONE: (360) 385-1116
61 PORTAGE WAY
PORT HADLOCK WA 98339-9735
NASON SHORT PLAT 3.14AC
SUBDIVISION: Block: Lot 1
PARCEL NUMBER: 962700107 Section: 7 Township: 29 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE
PROJECT DESCRIPTIOP ADDITION TO LIVING ROOM SPACE OF EXISTING SFR
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADD MAIN: 160
VALUATION 25,000.00
CODE EDITION: 2006 ADD'L: HEAT TYPE: PRO
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: 2 Exist: 1
Prop: 0 Prop: 0
Total: 2 Total: 1
Routing Date:
ala51oC
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $391.25 KAS 02/23/09 105436 APPROVEr
Plan Check $254.31 KAS 02/23/09 105436
State Building Code $4.50 KAS 02/23/09 105436 APR
Total: $650.06
Jefferson County Planninc
& Building Department
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(-;---m, Cat\ JEFFERSOI UNTY •
ti ' DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend • Washington 98368
360/379-4450 •• 360/379-4451 Fax
�q O� www.co.jefferson.wa.us/commdevelopment% ��
SNOBS
Master Permit Application ;1.+-71
,^n,:
.�i, . ; W1,'1 ;, MLA: 0 �t--50
Pro
jl ct Description (include separate sheets as necess ):77011/ 6 P tla 0 5y ff o I: Vr S c.e ^Rel(40Pi( OP it F►Qtt.Alli .�w /
Tax Parcel Number: q6'i -7 d 0 LV 7 Property Size: 3 ,l t j 4 C acres quare feet)
Site Address and/or Directions to Property:
6 ( Po774c Cv4, ?op i 1foi,vc.Jc, 1,4)4. 983) 9
Property Owner(s)of Record: F RE D P. Nil so AJ
Telephone: ,3�j (L� Fax: �" email:Mailing Address: 2[ O RT1l0 P_ UT 1/1-1 ek w q'g'33q
/
Applicant/Agent(if different from owner): (( 5I f f
,),I
Telephone: Fax: email:
Mailing Address:
What kind of Permit? (Check each box that applies
Building ❑ Critical Areas Stewardship Plan
Demolition Permit D Variance(Minor, Major or Reasonable Economic Use)
'g,Single Family AL1Di-rtcr.,❑ Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]**
0 Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)**
❑ Change of Use 0 Boundary Line Adjustment
0 Address 0 Road Approach ❑ Shorl Plat**
❑Home Business 0 Cottage Industry ❑ Binding Site Plan**
0 Propane 0 Long Plat**
0 Sign 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration**
❑Stormwater Management ❑ Shoreline Master Program Exemption/Permit Revisions**
0 Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Substantial Development**
❑Temporary Use 0 Shoreline Management Variance
0 Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment
0 Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment
*May require a Pre—Application Conference ❑Tree Vegetation Request
**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 require later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the appli that or want prior notice.
Signature: • Date: ClfiE) Q 1
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 re in compliance with th Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transfe res sioilit adherin to and complying with the ESA. The Applicant has read this discl ' er signs and dates it below.
Signature: 1
Date: 0� ��
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.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 assu9. g the s�sibility of the General Contractor for the proposed project.� ��2
Signature: 7 4 id` Date: !J
07
GENERAL CONTRACTOR OR MANUFACTURED:HOME INSTALLER: ;` PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
—
CONTRACTOR'S LICENSE WAINS
"NUMBER: NUMBER
ARCHITECT/ENGINEER: �-:,. A
PHONE ( ) FAX:( )
MAILING ADDRESS: 1 . ' " EMAIL
Project Type: Frame Type: Bathrooms: Shoreline 1 Type of Sewage Disposal:
❑ New X,,Wood Existing: 1 ❑ Sewer
x.Addition CISteel Proposed:. --V--- Bank ❑ Co munity System
❑ Alteration/Remodel 0 Concrete Total: I Height: ndividual Sys m
0 MasonrySEP Permit#OY''OOJ G
❑ Repairmo Bedrooms: . Water Supply:
❑ Demolition 0 Other:
Existing: Setback: ❑ Private well 0 Two Party
Proposed: 0.-P'ublic
Type of Heat: Total: 2 Name of System:
eYt.pA N E.
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces:
Number of occupants(includes owners,tenants,employees,etc) Current Proposed .
IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No
If this is a Propane Tank and/or Appliance Installation_permit,mark all items below that apply:
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 Tank 1 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 properly lines,buildings and septic system components,
including the reserve area.
Square Footage LCurrent Proposed For Office Use Only Amount Revision
Main Floor Heated EH Bld App Review: �� �d
��12 Ilo(� _ 11 ?i.a0
2`d Floor Heated Consistency Review: I tA95.co
Other Heated Base fee: q 1 ' O5 . -
Mezzanine Additional Section:
Heated Basement Plan Check fee: a 4 3 l
Unheated Basement State Surcharge fee: n .50
Other Unheated ' • , - ' S• l0
(Shore,t the ^
Garage/Carport SUBTOTAL I4 �
13. No_ � U'W,
Decks L t5 09 / Lt k 911/Rd Approach fee:
1
Other TOTAL: $ 1a'13, 06 .") I_ -
Receipt Number: I D5�13(, I 0`3"&�
— Cash/Check Number: [o 1 S (CA
ESTIMATED CO3 i (Kt D) Date: ��I�q
mare va ue o labor and terials foundation to finish Initials: 1
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
1
• •
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1"--vsON cow JEFFERSON COUNTY •
►� DEPARTMENT OF COMMUNITY DEVELOPMENT
.. 621 Sheridan Street • Port Townsend • Washington 98368 r n t 19
jti ;� ' ;JvlJ
1(N. AA0 360/379-4450 • 360/379-4451 Fax
http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
IMLA# O `-'C 0 PROJECT/APPLICANT NAME: FiZt 2 i j1"/9/ )(14°14/
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 an relative size of sed improveme is on the
site map. fin � A Lit P ,/ , oD�.S
Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
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3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
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4. Describe the existing soils. Indicate soil type on the site map.
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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 acrea e of each.
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AP?ROVLD
6. Describe any excess levels of noise generated by the proposed use or activity STORMWATER WATER PLAN
P 0 f- MAR 1 6 2009
Stormwe
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Req DEPT.OF C• `nd t �Li FNT
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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.
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.). _[, 141
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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.
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.]
11. Describe the performance goals and standards applicable to the project.
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12. Describe the flow control system.
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stormwater site plan template—rev.10/21/2008
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13. Describe the water quality system.
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14. Describe the conveyance system analysis and design.
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15. Describe the source of fill material, physical characteristics of fill material, and deposition of excess material.
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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. '{y
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18. Describe methods for restoration of the site.
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19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for
"large" projects only and my those for which facilities are required to control flow or treat runoff.] If included, list the Manuals
here. P
20. List here and include any 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 drainage plan or contain more restrictive drainage-related requirements, describe those conditions or
restrictions here.
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stormwater site plan template—rev.10/21/2008
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 Volume II Section 3.2.3 of the Manual (beginning
on page 3-7).
12 Required Elements—Construction SWPPP
1. Mark Clearing Limits.
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2. Establish Construction Access. � L pi. y ( C T
3. Control Flow Rates.
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4. Install Sediment Controls. _/ ft
5. Stabilize Soils. , n ,/I
6. Protect Slopes.
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7. Protect Drain Inlets. /114
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stormwater site plan template—rev 10/21/2008 8
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12 Required Elements-Construction SWPPP(continued)
8. Stabilize Channels and Outlets. n'
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9. Control Pollutants.
10. Control De-Watering (the act f umping groundwater or stormwater away from an active construction site).
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11. Maintain Best Management Practices(BMPs).
12. Manage the Proje t
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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).
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
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3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
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stormwater site plan template—rev.10/21/2008
9
•
b. Description of special requirem n is for working in or near environmentally sensitive areas.
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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).
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5. Construction Phasing.
a. Cons ruction sequence 0 ' N / G1_on I1/h- ' n n� .r�,ivi s ig
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b. ConstructiA
phasing(if proposed), {�p �/�� /
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g. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a proposed construction schedule.
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II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
b. Proposed wet season construction activities for environmentally sensitive areas.
7. Financial/Ownership Responsibilities.
a. Iimpacdentifyts.the property owner responsible for the initiation of bonds and/or other financial securities.
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
PER 400 11-'L. f)--E�fo w1/ B (L--1 Ty
8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable.
a. Sediment Ponds/Traps. �.
-
b. Diversions. i
c. Waterways.
d. Runoff/Stormwater Detention Calculations
10
stormwater site plan template—rev.10/21/2008
• •
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
ownersp'f the affected property.
7gd) ViAr,
(LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
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12
stormwater site plan template—rev.10/21/2008
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(—_ N REVISIONS DATE .361
FRED & JUDY NASON TILLMAN IMI
R ,__R HOME REMODEL BUILDING SITE PLAN ENGINEERING. INC.
4 1 i PARCEL NO. 962-700-107 (P 7 Po\rl2 g-2 1 c v 1� PI