HomeMy WebLinkAboutBLD2009-00093 4113UILDING PERMIT APPLICASN MLA09-00102
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00093 Received Date: 3/31/2009
SITE ADDRESS: 9"D i`k E QUILCENE RD
QUILCENE, 98376
OWNER: JOHN K HANSEN PHONE: 253-517-7135
JOSEPHINE D HANSEN
32725 20TH AVE SW
FEDERAL WAY WA 98023-6437
SUBDIVISION: Block: Lot: TX21i
PARCEL NUMBER: 701304019 Section: 30 Township: 27 N Range: 01 W
CONTRACTOR: REALITY HOMES INC PHONE: (253)926-6330
1308 ALEXANDER AVE E STE B
FIFE WA 98424
Contractor's License REALIH1984CN Expires 2/15/2010
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI' NSFR
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 922
VALUATION 186,252.00 ADD'L: 887 HEAT TYPE: EEE
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE: DECK: 68 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 2 Prop: 3
Total: 2 Total: 3
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,480.95 LYK 03/31/09 105674 APPROVED
��
Plan Check $962.62 LYK 03/31/09 105674 R O V E D
State Building Code $4.50 LYK 03/31/09 105674
Potable Water Application $62.00 LYK 03/31/09 105674 MAY 13 70nq
Total: $2,510.07 Jefferson County Plannin;
&Building Departmen#
Jefferson County Building øsion Permit Nur,: BLD09-00093
Applicant: HANSEN
BUILDING PERMIT INSPECTION APPROVALS Npplicable 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 -Z�}- ` P Minimum setback from East Quilcene Road right-of-way shall be 20
yA feet. Minimum north and south(side)yard setbacks shall be 5 feet.
Minimum setback from OHWM is depicted as 60 feet per the submitted
site plan.
Erosion Control
Erosion Control � SEE CONDITIONS 2& 3.
Foundation Footing 4_Qc-01 C1: ri�,
Footing Drains �1
Foundation Stem Wall q...Wo R �n
.11uckgro and Phimbing 3�
Under Floor Framing 3_^Ur\.
Straps(hold downs)
Ext. Shear Wall Nailing to_ uci
Rough-in Plumbing j f��llR-oct L)
Framing ID—le( `
Blocking
Airseal
Insulation:Walls
Insulation: Floors
Insulation: Ceiling (rti� �,�
Int. Shear Wall Nailing
Wallboard Nailing
Gas Line: Interior
Gas Line: Exterior
Propane Tank
Heat/Chimney Clearance /
Drywell/Alt Drainage SEE CONDITION I FOR SPLASHBLOCKS
Address Posted
�D`ID ..
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
CONDITIONS for Building Permit# :BLD09-00093
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 AT THE EDGE OF THE CLEARING LIMITS
ADJACENT TO THE SHORELINE TOP OF BREAK AREA PRIOR TO ANY LAND
DISTURBING ACTIVITY.
THE MINIMUM HEIGHT OF THE TOP OF SILT FENCE SHALL BE 2 FEET AND THE
MAXIMUM HEIGHT SHALL BE 2 1/2 FEET ABOVE THE ORIGINAL GROUND
SURFACE.
THE SILT FENCE SHALL BE BURIED IN A TRENCH TO A MINIMUM DEPTH OF 5
INCHES BELOW THE GROUND SURFACE. THE TRENCH SHALL BE BACKFILLED
AND THE SOIL TAMPED IN PLACE OVER THE BURIED PORTION OF THE SILT
FENCE, SUCH THAT NO FLOW CAN PASS BENEATH THE FENCE AND SCOURING
CAN NOT OCCUR.
ANY DAMAGE TO THE SILT FENCE SHALL BE REPAIRED IMMEDIATELY.
SEDIMENT DEPOSITS SHALL EITHER BE REMOVED WHEN THE DEPOSIT
REACHES APPROXIMATELY ONE-THIRD THE HEIGHT OF THE SILT FENCE, OR A
SECOND SILT FENCE SHALL BE INSTALLED.
3.) 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.) 10' PUE EEN A WATER LIND PA OF
THESE ONSITE SEWAGEARATIONREQ SYSTE IR D EFFLUENT TRANSPORTNEA LINEALL, TANKS RTI,
TREATMENT AND DISPOSAL COMPONENTS.
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.) A Geotechnical Report dated November 3, 2008 prepared by Stratrum Group was
submitted in conjunction with this application. The report addressed the stability of the
geologic hazard area.
8.) 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.
9.) 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.
10.) A Storwmater 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.
11.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
12.) 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.
13.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
14.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
15.) The building height is not to exceed 35 feet.
16.) Minimum setback from East Quilcene Road right-of-way shall be 20 feet. Minimum north
and south (side) yard setbacks shall be 5 feet. Minimum setback from OHWM is depicted
as 60 feet per the submitted site plan.
17.) Exterior lighting for residential ueshall not exceed twenty feet(20') in heighlPm the
finished grade, excepting when such lighting is an integral part of a building or structure.
Ground level lighting is encouraged.
18.) Lighting fixtures shall be designed and hooded to prevent the light source from being
directly visible from outside the boundaries of the property. The intensity or brightness of
all lighting, during construction and after project completion shall not adversely affect the
use of surrounding properties or adjoining rights-of-way.
19.) 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.
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JEFFERSON COUNTY
�j DEPARTMENT OF COMMUNITY DEVELOPMENT
•• 04 621 Sheridan Street• Port Townsend •Washington 98368
�� 360/379-4450 • 360/379-4451 Fax
�N��p www.co.jefferson.wa.us/commdevelopment
_14
Master Permit Application MLA: Cl (02
Project Description(include separate sheets as necessary):
Ns r2-
Tax Parcel Number: '7b 13Q 14 U 1 9 Property Size: / • 16 • (acres/square feet)
Site Address and/or Directions to Property:
e cuttc_E Ir =. c-;» 3� , r�. i rcz�
Property Owners of Record: �/JO ?tr ru , . Jl• /iu
Telephone: �:l '5 1 i- l i r Fax: A r )-/1 -it 3 i email:J h rn t'' t L i< / /s
Mailing Address: 31�?Z ij 4 T ftVc .S t.° fA.A.Li-xl toil lUi- pi3L')j
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies 0 Lot or Road Segregation
Building 0 Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use)
Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or Cl**
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
❑ Address 0 Road Approach 0 Short.Plat**
❑ Home Business 0 Cottage Industry 0 Binding Site Plan*"
❑ Propane ❑ Long Plat** •
0 Sign - - 0 Planned Rural Residential Development(PRRD)/Amendmer)ts**
❑Allowed"Yes" Use Consistency Analysis 0 Plat Vacation/Alteration**
O Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions**
❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development**
❑Temporary Use 0 Shoreline Management Variance
❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑ Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment
*May require a Pre—Application Conference 0 Tree Vegetation Request �4�@R 3
**Requires a Pre-Application Confere
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 fad: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 applica• �t n he or she
j wants prior notice.
Signature: � 6 i' ' < /E'" .vi Date: 3 / 2 d c/
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 yo are i mpliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transfer le re nsibility fo adhering to and complying with the ESA. The Applicant has read this disclai /r an signs and dates it below.
Signature: / Date: 3 l R act
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• •
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 wi!I be ming th '-esponsibili of the a eral Contractor for the proposed project.
�Signature: � r _ '� Date: '
GENERAL CON#RACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
MAILING ADDRESS: /, 0 i. / C.Ej EMAIL:
CONTRACTORS LICENSE 11t 1, / 5)P-, 1 WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New ,c Wood Existing: _4_____ ❑ Sewer
1 Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: ? _ Hei ht:, Individual System
U Repair 0 Masonry n SEP Permit#
Bedrooms: Supply:
❑ Demolition LI Other: Water Su I
Existing: 4____ Setback: X Private well U Two Party
Type of Heat: Proposed: ❑ Public
ledli c- Total: 2 c94 Name of System: •
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 Seniice? 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:
Heat Stove I Cook Stove i Woodstove I Fireplace Insert i Hot Water Tank I Pellet Stove 1 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 OOt4 -0 ieViision
Main Floor Heated '1-1 43a ` ci EH Bld App Review: • 13 00
iv
2t'd Floor Heated Y�� 7 qo 'I q. onsistency Review:
al5. 00
Other Heated t Base fee: I SD• q5
Mezzanine •
V ectt•cjr.I r & /j -i 7V On
Heated Basement Plan Check fee: '-T`�
Unheated Basement State Surcharge fee: //''
�T- So
' Other Unheated Pot Water Review fee: \O DO
Garage/Carport SUBTOTAL 5.351. O
Decks "J71/Rd Approach fe a i _oo
Other Cca , �cne (�; - a 1•44 TOTAL $ 35 -.07
Receipt Number: b -1
Y Cash/Check Number: ,^ I
ESTIMATED COST(REQUIRED) Z�� nate: I�' ��[['�
.Fair market value of all labor and materials fou ation to .h - S -31 '09
°D( ``vc) Initials: !--- -
CA PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Annlication 5-29-08.doc
4 • •
SON 00�
,� JEFFERSON COUNTY
1 DEPARTMENT OF COMMUNITY DEVELOPMENT
MAR 3 1 2009
621 Sheridan Street • Port Townsend •Washington 98368
�'.q` _� O� 360/379-4450 • 360/379-4451 Fax
"�xjN http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# Oq- 102, PROJECT/APPLICANT NAME: (r 9'V
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. dicate pasttion and relative size of prpposed improvements on the
site map. -176 ucw.S- r,Ld (i/ I9 C4c;- _ Li.) rt.) aki .
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Existing Conditions Summary 2
2. Describe the existing topography. Indicate contours on the site map. A lia�tu�' e)C/d3s:, t ' e
41,
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v fu.h:eW. ,5 l f"Al 37 7 etz n fc..bt %. cw 6 uJcz.„ Lb ,
3. Describe the existing_vegetatfon. Indicate native vegetation areas on the site map.1r `
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4. Describe the existing soils. Indicate soil type on the site map. S tt AL tz- S &-y
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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
pp applicable,and indicate acreage of each.
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6. Describe any excess levels of noise generated by the pros•sed SiFQ'RM AT>ER PLAN
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Stormwa = ' ' S ; MAR 1 2009 —
Require', 1��:4 -fir' JEFF ou
DEPT.OFC YD: L E T
SIGNATU
stormwater site plan template—rev.10/21/2008 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.
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8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads,and sensitive/critical areas
J.streams,wetlands,/I lakes,steep slopes,etc.). �/
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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.
a 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 faci'ties.
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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.]
—AO vk-40A_
4
11. Describe the performance goals and standards applicable to the project.
12. Describe the flow control system. p
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13. Des,n, `be the water quality system.
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14. Describe the conveyance system ansis and desig . K,L) _ Go ei‘
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15. Describe the source of fill material, physical
�hysical characteristics of fill material, and deposition of excess material. /
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i 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform,Building Code.
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17. Describe the pr.gposed surfacing mate ial. / _ii .it,V,.) cd /
18. Describe methods for restoratiop 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.
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20. List here and inclyde 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.
MAR 3 1 2009
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.
2. Establish Constru
ction Access.
3. Control Flow Rates. 'f.
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4. Install Sediment Controls.
5. Stabilize Soils.
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6. Protect Slopes. �/ •
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g S -Q-I L ('Lrtti las c qr.� - .��t G-r L�LsI�C� (AfT-12, L .(4 �I�J b�C, (1, .- .'ezek)
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7. Protect Drain Inlets. . _ / c_
n vS y t ( >C vrt�t ow.) � C�-ex�c� r l�G�C�/ eat.N- d�-& 1--,561,-)
1v
stormwater site plan template—rev.10/21/2008
8
• •
12 Required Elements-Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
9. Control Pollutants. f' ,, WaSk �(
WJ1 fie, atJ� c� u��� -� `weth
10. Control De-Watering (the act of pumping groundwater or stormwater away from an active construction site).
c.:45) cca. iti*etail 663,
11. Maintain Best Management Practices(BMPs).
u
'UCt-rik, S ii n, the WL-4/ r ajt ti w�-���v v o £ ` 7to �tinv
A¢ury cat r-.e€.,4iinti -k s . I ar 6-e rc ei.ad e..)eiyar, etia b /'-6144
tbf a
12. Manage the Project.
trr• y C�°�-0/-e y/,,e)uld a iI
e>01 ,5 :13=-
r er r .�-��wt.- .�t is -elea/ a-
2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams,,lakees wetlands, residential
areas, roads). II "
flya-a-71
w r,1.,,41,41.6 e&, -
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
4 i / ) • I
, .
i
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
Ni
MAR 3 1 2009
9
stormwater site plantemplate—rev.10/21/2008
410 •
b. Description of special requirements for working in or near environmentally sensitive areas.
iv/6
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).
•
5. Construction Phasing.
a. Construction sequence . /
rAr 1/21. ),;(ja.,/-t:0,%J , 114..4,"-j rit,xj (./aRAA--("f' frIA-6-4)-
b. Construction phasing (if proposed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
Providiffe proposed construction schedule. �` p
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II. Wet Season Construction-Activities. it J
a. Proposed wet season construction activities.
b. Proposed wet season construction activities for environmentally sensitive areas.
r1 (AD&
7. Financial/Ownership Responsibilities.
a. Ide tify the prope y owner responsible for the initiation of bonus and/or other financial securities.
V 4—yc /6`>' dos:-p h,4c .
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
fel)>5 rcloy CIAX(..,6(4,3j
8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable.
a. Sediment Ponds/Traps.
b. Diversions. fit�
c. Waterways. N/1)
d. Runoff/Stormwater Detention Calculations A/tit
stom,water site plan template—rev.10/21/2008
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.
1.12C"--
3 431- G
61
(LANDOW.E OR A THORIZED REPRESENTATIVE SIGNATURE) (DATE)
t
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
stormwater site plan template—rev.10/21/2008
12
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