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HomeMy WebLinkAboutBLD2009-00120 22 •BUILDING PERMIT APPLICASON MR evi w Typ e: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00120 Received Date: 4/15/2009 SITE ADDRESS: 3291 PARADISE BAY RD PORT LUDLOW, 98365 OWNER: GARY L OSTERHOUT PHONE: 360-437-9593 BARBARA K OSTERHOUT 1930 8TH AVE W APT 1 SEATTLE WA 98119-5804 PARADISE VIEW ESTATES SUBDIVISION: Block: A Lot: 15 PARCEL NUMBER: 984000114 Section: 22 Township: 28 N Range: 01 E CONTRACTOR: JEREMY VANCE INC PHONE: 360-385-2560 46 VILLAGE WAY PMB 162 PORT LUDLOW WA 98365 Contractor's License JEREMVI001C4 Expires 10/28/2009 REPRESENTATIVE: JEREMY VANCE PHONE: (360) 385-2560 46 VILLAGE WAY/PMB 162 (360) 379-1121 PORT LUDLOW WA 98365 PROJECT DESCRIPTIOP ADDITION TO EXISTING SFR, (2) A/G 120 GAL PROP TANKS & (2) DECK ADDITIONS TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: 120 VALUATION 35,000.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: PRO OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 250 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: OTHER BEDROOMS: BATHROOMS: Exist: 2 Exist: 2 Prop: 0 Prop: 0 Total: 2 To • Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $492.25 LYK 04/15/09 108272 AJDIDIcVEj Plan Check $319.96 LYK 04/15/09 108272 State Building Code $4.50 LYK 04/15/09 108272 MAYS 2009 Potable Water Application $62.00 LYK 04/15/09 108272 Total: $878 71 Jefferson County Planning & Building Department Jefferson County Building DDsion Permit Nur: BLD09-00120 Applicant: OSTERHOUT 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 �/ �5i-lPP--- Minimum setback from Paradise Bay Road right-of-way shall be 20 !'v�Z-U�j ]� Z'11-17-- feet. Minimum side yard setbacks shall be 5 feet. Minimum setback from the top of shoreline bank as shown on the site plan is depicted as 82 feet. Erosion Control SEE CONDITIONS 2& 3 Foundation Footing , Footing Drains Foundation Stem Wall _.4 _� c Underground Plumbing Under Floor Framing ,�Q-0j Straps(hold downs) V Ext. Shear Wall Nailing Rough-in Plumbing uC Framing 1 021—fA Blocking Airseal Insulation:Walls Insulation: Floors Insulation:Ceiling <43 Di Int.Shear Wall Nailing II Wallboard Nailing ` q©A 27\-Gas Line: Interior Gas Line: Exterior (. ( t.1/ Propane Tank _L - -1 Heat/Chimney Clearance Drywell/Alt Drainage SEE CONDITION I FOR EXISITNG TRENCH Address Posted FINAL INSPECTION t (-t7- t FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • CONDITIONS for Building Permit# :BLD09-00120 1.) Stormwater from the proposed addition will flow into the existing dispersion trench that is 2 feet X 10 feet and is adequate to handle 1000 square feet of stormwater. The trench is located on the north side of the existing residence. 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. 3.) A SILT FENCE SHALL BE INSTALLED LANDWARD OF THE TOP OF SHORELINE BANK AND IF NEEDED ADJACENT TO THE SOUTH PROPERTY LINE 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. 4.) ALL COMPONENTS OF THE SEPTIC SYSTEM, INCLUDING THE RESERVE AREA, ARE TO BE COMPLETELY PROTECTED FROM SOIL COMPACTING ACTIVITIES; INCLUDING BUT NOT LIMITED TO VEHICULAR TRAFFIC OR MECHANICAL DISTURBANCE. 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.) The project shall comply with CcOuction Stormwater Pollution Prevention ( P) 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. 8.) 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. 9.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 10.) 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. 11.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 12.) The building height is not to exceed 35 feet. 13.) Minimum setback from Paradise Bay Road right-of-way shall be 20 feet. Minimum side yard setbacks shall be 5 feet. Minimum setback from the top of shoreline bank as shown on the site plan is depicted as 82 feet. Minimum setback from top of shoreline bank is as follows: The standard setback for residential structures, including common appurtenant structures such as garages and workshops, shall be thirty (30) feet or one (1) foot for each foot of bank height, whichever is greater. This setback shall be measured from the bank's edge when the bank's height exceeds 10 feet. When the bank's height is less than 10 feet, the setback shall be measured from the ordinary high water mark. The setback shall not exceed 100 feet. 14.) 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. 15.) 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. 16.) 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. 17.) This parcel is within the Paradise Bay no shooting area per JCC 8.50. • Ill ON mil, JEFFERSON COUNTY 1/ } DEPARTMENT OF COMMUNITY DEVELOPMENT ` 621 Sheridan Street•Port Townsend Washington 98368 � ,' ww.c9-445r • 36a/3s/ mr Fax \�� www.co.jefferson.wa.uslcommdevelopment APR 1 5 2009 Master Permit Application MLA: CR-- i z Z Project Dnesal lion(include separate sheets as necessary): ( I - /� �`�`1 �'i'd A h k 0 I/$� / P R9 p alb '�t Kh - CJL►�o v-t- �, ro d e,f_ Tax Parcel Number. Cl fi'y C) 11 1 Property Size: I/ q 9 K U (acre y re feet Site Address and/or Directions to Property: 3 `l 1 Pok.r- —cit'S t (30,y0_ Property Owner(s)of Record: Go c-y (9 4-tr �0 Telephone: 360 Lf 3 7 9 S 9 3 r Fax: email: Mailing Address: ( `i 3 0 )s 4-5- A-..re- W .(- 3- -Wk Se G - C i fsr�cc�'lc\ — S if Applicant/Agent Of different from owner): 'SC.r- rh.r \ of e Telephone: 360 301 act 03 Fax Mailing Address: tic v:l ku•. C ttiy email: What_kind of Permit?(Check each box that applies ID urtding 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Valiance(Manor,Major or Reasonable Economic Use) [mngle Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or Cj" ❑ Manufactured Home 0 Modular 0 Discretionary`D"or Unnamed Use Classification ❑ Commercial' ❑Special Use(Essential Public Facilities)'* ❑ Change of Use 0 Boundary Use Adjustment ❑ Address 0 Road Approach ❑Short Plat" ❑Home Business 0 Cottage Industry 0 Binding Site Plan"" 6=Propane 0 Long Plat" ❑Sign ❑Planned Rural Residential Development(PRRD)/Amendmentc"C Allowed`Yes"Use Consistency Analysis - 0 Plat Vacation/Alteration" ❑Stomiwater Management 0 Shoreline Master Program Exemption/Permit Revisions"❑Site Plan Approval Advance Determination(SPUD)* 0 Shoreline Management Substantial Development" ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication" 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices AcJRelease of Six-Year Moratorium 0 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 1 hereby designate Se ' OJ.. _ to act as my agent in matters relatingto this ,/ —�— application forpemnit{s). G+wnt�R SIGNATURE Y' � uat By signing this application form, owneriagent 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 hMd harmless Jefferson County agsins all liabilities,judgments,court c- ors,reasonable attorneys fees and expenses which may In any way accrue against JeffersonY 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 a s and right of entry will be;assumed unless the time of the application that he o wants " applicant U°m's in writing at the Signature: Date: / //V /Q 9 The action or audio pplica 11 undertake as a result of the issuance of this permit may endangered ' and uld lead to a potential"take'of an endangered negatively defined in the one e r l law threatened e 'Endangeredspecies as those terms are in federal law known as the 9 Species Act'or'ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this peperms has even if issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your ( 1you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable res.. • • r1.,--.r adheri o and..... g with the ESA. The_ Applicant has read this disdaiJrt>�and signs and dates it below. Signature: Date: e //y /0 I G:\PemritCenter\• FORMS###\DRD FORMS\Master Permit Application 5-29-O8.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 tbe-IEneral Contractor for the proposed project./ Signature: - /�_ Date: 1S(0 C _ RAL CONT CTO R MANUFACTURED HOME INSTALLER: PHONE: FAX: GENE T.S. Af Um-(-- . J-,.c. C?d ) 30 ( .--°t a 3 ( ) MAILING ADDRESS: I C% . i t /&i .—j fr- . 1 E Z EMAIL: ; v'cr+.ct i‘nC o (Lryt x ,•.- CONTRACTORS LICENSE PIO r j- Ut "-c& tr1- � 4 SS3 6$ WAINS / I NUMBER: •S 0, Nl✓T O(1 C. NUMBER ARCHITECT/ENGINEER: 1)0 r 6`-, PHONE (Z,G b)a.9 �03�( FAX:( ) MAILING ADDRESS: (11 S, 'W 0.1 Ot f'i-)- fie t,'cn OkciR MAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New c Wood Existing: 2 ❑ Sewer Addition ❑ Steel Proposed: Bank Li Community System ri Alteration/Remodel ❑ Concrete Total: Height: Individual System ❑ Repair ❑ Masonry `SCP Permit# O Demolition ❑ Other: Bedrooms: Water Supply: Existing: z Setback: p Private well ❑ Two Party Type of Heat: Proposed: _ ublic t c Total: -Name of System:_A� L _ '"21.3f316-nG APR 1- 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 ,ve ground Tank Size of Propane Tank: 2— I.2.c) I Heat Stove ` oek Stove i Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. > • - tfi h g: ald �i - Square Footage Current Proposed For Office Use Only _ Anmck nt y aan Main Floor Heated �4 1 ZZ' EH Bid App Review: !3 2"6 Floor Heated O yl. Consistency Review: r- Other la4t( L Base fee: Z197.2-5 Mezzanine ona to : 'n- ,- Heated Basement Plan Check fee: -�-j 3lq ,gC Unheated Basement State Surcharge fee: O II 4' Other Unheated Pot Water Review fee: 00 r, Garage/Carport SUBTOTAL lq L.11 Decks LzS 0 ""lt( j d Apo octeh fee. xISn ton . Other TO?AL: $L((pc . Receipt Number: l DF a'1 a ; F ` Cash/Check Number: �! ESTIMATED COST(REQUIRED) Date: d�l5 •Far ma t a labor and ma 'als foundation to finish 35 0o0 — Initials: G:\ParnuCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc ' t . oN o w� °6,,, JEFFERSON COUNTY 41 ,a, Fq DEPARTMENT OF COMMUNITY DEVELOPMENT ,�, 621 Sheridan Street • Port Townsend •Washington 98368 -4451 Fax �`s$7N0�'O http:/3/www.co.jefferrson• 9 a.us/ommdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# OQ I U. PROJECT/APPLICANT NAME: Os-kr kO I- 41‘(/^/ G(',./`/00C(LOtif— 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. 0 0 p po 5e -\-z con S4-,v,- 6 - X -c' vSJ- kv 4-1, `-4,- �-0 0 &e _ Cu Existing Conditions Summary APR 1 5 2009 2. Describe the existing topography. Indicate contours on the site map. { t Ge r\4-I t. S t�t r.�tj wr\ V r� ro u-1 -to Liam /�(n O c/ S t el.. 12 V'�-1, 4 tia t cic `� 1 0 r o b +V--- 1 S S 6 ' 0 t-- Qcc9 r'0,y J�,4,C. W 0__A-c - M G,rk, T t 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. g_R'J.S S y w,-1-(L Tw D - --,' +-c—e--.' 4. Describe the existing soils. Indicate soil type on the site map. Vas-i< S r.-, 4-1'3.C,i-- c w‘r t► Ica" 4-0 s�•,J7 I o e-Al 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. S—V r ,'l C-kJ ri--\-ww ^ro kd US C.. S-rrn L.)S r`c 4 e-�'54- ,�_ s-r to-5 L lo(0 C.- S ` ^ G ''" I r ./ F G r 0 t '� CyU _.ro_e -CAo t r`TJ rfis.: S p{r c i a,\ f 4- S,n �rO O r`t� Li o-�e.1- ck -n S e (" 4a C Ck^ t o 0..."N ') n d clew P o_'�1-\ 1'5 e.v-i:d,i" ". 6. Describe any excess levels of noise generated by the proposed use or activity: APPROVED y,� tr-wV COrN S. .,-N,0-�'I n A0I' S� STORMWATER PLAN Stormwat 1 MAY 1 2 2009 Requi l JEFF i� ,` O \ stormwater site plan template—rev.10/21/2008 DE PT.OF C 4 ill ���I �, 'M T 5 SIGNATl ' .: /�� i�!\ • • 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. S ,0 r 6-4 S 6 t-q-t}r-N. 1.\1 H - 4 la t c.k 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.). pp Un e , r vru` is a07 0 '_t) (-^ 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 Qdifferentiate proposed facilities frog existing facilities. r e• CA,o` -c r'N cU P Q S-e �/`- 0-- �l r" 170 - -\\0 L.-) r•N - q vte-k-e r l0O 0 P P o S ° t>0 ix .4-t' \. 9 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.] No 11. Describe the performance goals land standards applicable to the project. j - S 4'0 f M W(n_A,f 12. Describe the flow control system. (�I 1.4 5- n-e r5i ��. ..-�-en �/ i'l�L.) C.�I /��-�' r—� stormwater!Ate plaq template-c v.'10/21/2008 6 e • • 13. Describe the water quality system. 14. Describe the conveyance system analysis and less gn. 15. Describe the source of fill material, physi I characteristics of fill material, and deposition of excess material. n 0-4 A-e- 1� r h o ex- c 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. Iv A-- 17. Describe the proposed surfacing materiel/ 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 normallyrequired for "large"projects only and only those for which facilities are required to control flow or treat runoff.] If included, list the Manuals here. APR 1 5 2009 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. 1 7 4- stormwater site plan template—rev.10/21/2008 7 • i 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. r' j 2. Establish Construction Access. l (� s - t vv \ v--(-- 3. Control Flow Rates. /170 4. Install Sediment Controls. S \ r-c 2, 5. Stabilize Soils. 6. Protect Slopes. Ar 7. Protect Drain Inlets. IV A- stormwater site plan template—rev.10/21/2008 8 • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. 9. Control Pollutants. 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best M nagement Practices(BMPs). 12. Manage the Project. 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). g-ro v,-,K 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site.APR 1 5 2009 stormwater site plan template—rev.10/21/2008 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. ✓✓ 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils (e.g.,erodibility, settleability, permeability, depth,textu e, soil structure). 5. Construction Phasing. a. Construction sequence b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. 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. Identify the propertx 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 impacts. 8. Engineering Calculations. Provide Design C u ations on a separate sheet for the following, if applicable. a. Sediment Ponds/Traps. •b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations stormwater 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 h (LANDOWNER OR HOR REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: stormwater site plan template—rev.10/21/2008 12 111 „ , . ,i, ,,,,....,,, ,....0 _ )„ , „ ,„....„.,,,,,)(,,,, __,.., _,—. ,, N. 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